@Michel inquired about the treatment for Lyme that I am pursuing. So I'll say a little here today.

   I have been undergoing treatment for Lyme for almost a year now. Treatment commenced with weaning yeast friendly foods out of my diet and adopting The Lyme Whisperer's Diet to Minimize Yeast.  I was also started on a medication called Nystatin four times a day, to kill off yeast. Yeast is considered to be a co-infection of Lyme. The immune system weakened by Lyme, cannot combat the opportunistic and rapidly growing yeast.  The yeast feed on the sugars in the bloodstream of the host (in this case, me!) and the brain does not receive the energy it needs for functioning. Blood sugar drops and the call goes out for more sugar to fuel the brain. The host eats, the yeast get the bulk of the energizing sugar and the cycle continues. 

The Diet to minimize yeast states:

What is most important is that you read all of the "ingredients" labels of everything that you eat and drink, and avoid the following ingredients: Sugar, Splenda,Sucralose, Cane, Sucrose, Maple Syrup,Honey, Molasses, Alcohol and Corn Syrup.

I had no idea how truly pervasive sugar in foods are. So the less processing, the better. Sugar is added to seemingly everything in the grocery store that doesn't look as if it came from a garden or farm field or has been recently slaughtered.

Avoid other foods high in carbohydrates, such as: Breads, Pastas,Cakes, Cookies,Nuts,Almond milk, coconuts and coconut milk,Fruits,Crackers and Cereals.

It all has sugar. 

It is best to avoid....Rice,potatoes,paricularly sweet potatoes,corn,peas,red or yellow peppers,succotash,turnips,carrots,tomatoes,squash,artichokes,avocados,beets,brussels sprouts, Eggplant, kale,onion,parsnips,beans other than green beans or wax beans, mussels,oysters lunch meats and other processed meats.

That pretty much takes care of most of the grains and favorite winter vegetables.

Foods that are better to eat in order to reduce yeast and are low in carbohydrates include: Unprocessed meats:Beef, Turkey,Uncured Pork,Chicken,fish,) Tofu, Soybean products, Eggs, Celery, Broccoli,Iceberg and Romaine lettuce, Spinach, Green beans and wax beans, cucumbers, White Mushrooms, Radishes,Asparagus,Green Pepper, Food for Life Ezekiel 4:9 tortilla bread.

Not a lot of variety there. 

Suffice it to say, my diet has radically changed over the last year. I stick to it because it works. When I "cheat" it is usually with tomatoes, colored peppers and onion.  Rarely carrots and kale. If I eat any of those foods for more than one day my pain increases and my mind becomes less organized, more fuzzy. What a lot of Lymies refer to as " brain fog."

I am not a creature that likes the habit of rising early to greet the day. When I was healthier I primarily worked evenings and then did on-call for a Home Health Agency that often took me out late at night or in the wee hours of the morning. When I started working days several years back, a lot changed. I relied on cereal and bagels for work-a-day breakfasts.  All that had to change as I further adapted my diet to meet my doctor's requirements. Now I usually have a soy custard that I created in response to the need for a quick morning food. I also make ahead several sausage patties using my neighbor's fresh ground pork and spices from my cabinet. I cook these ahead of time on the weekend and use them during the week.

For quick snacks I like to take an Ezekiel tortilla and spread I.M. Healthy unsweetened soy nut butter on the tortilla.  It's quick and while it doesn't taste like peanut butter, I have grown to enjoy it. Especially with a little dairy butter mixed in to make the texture more spreadable. 

For a while I was drinking a lot of milk and eating cheese. Evidently, I was eating too much of it and problems with my digestive tract arose. So for now the only dairy I have is some half and half in my coffee. If it comes to me having to release that, I will stop drinking coffee. I have been unable to find or create a satisfactory soy "creamer." So I'll release coffee if it comes to that.

About a month ago, I found myself missing muffins. Being a veteran of Weight Watcer's from the eighties and nineties, I thought I'd try the dieter's trick of grinding bread into crumbs and then using it in a recipe the same as I would flour. I used no sweetener. The dry crumbs were added to milk, canola oil, eggs, baking powder, minced onion and minced green pepper. I baked them in the oven in Pyrex custard cups and they were WONDERFUL! With three tortillas I was able to make seven muffins. I thought I was onto something great! If I only ate one muffin, that was a little under half a tortilla and fit within the parameters of the diet. With visions of garlic bread dancing in my head, I told my doc. 

After he looked mad, heard me out and then started laughing, he told me that while I was working within the parameters of the diet, I was making the carbohydrate in the compressed sprouted grain tortillas more accessible to my body and was feeding the yeast. He laughingly told me he had never had anyone do this with the diet. And then we discussed removing cheese and milk from my diet. I started to tear up a little and needed a Kleenex. I was totally deflated. 

I've gotten over that, and am now doing my best to eat the way the diet prescribes and make the best of it. I find playing with spices helps relieve the boredom of the food I'm eating. I am grateful for the food I can eat.  I am mindful that this is helping me heal and focus on the good that is coming out of following this diet. The Nystatin helps to calm the cravings by killing the yeast. I do not crave things the way I used to. Sometimes I think about something I'd like to eat, or feel resentful when I am at work and the sweets are being passed around. For the most part the people who know me well respect what I am doing and no longer offer me tidbits I once found pleasing.

Another time I will write about the antibiotics and yeast medications with which I am being treated.

Blessings abound

  One of the lessons for me in this life has been to take care of myself before taking care of others. When I was younger, I had the energy to expend so I skipped sleep, ate irregularly and " did too much' in the opinion of others.   I would be able to go for a while at full tilt and then would crash from sickness, like a cold and then later pneumonia, or need to sleep for a day or two uninterrupted in order to gain my equilibrium.  After a decade or so, I gradually became better at pacing myself, at saying no to extra shifts and eating better. Sure, I had times when I would fight the siren call of sleep, and I would need to stop and rest and eat well. My body forced me to do so by working less efficiently.  And then one day I was sicker longer and didn't recover my joie de vivre. My life was difficult and painful and tiring. And my body kept crying out for my attention, pains here, fatigue  there. Tight muscles. 

   As time went on, I learned to do for myself what I did for others: took my own advice. Slept better. Pushed through the symptoms of what was then diagnosed as fibromyalgia. I would still ignore symptoms and try to push through because I thought that was the best way in which to deal with something that has no cure. 

And then I was diagnosed with Lyme.   

  Now I'm more consistent with resting. I still have pain, but if I work too many hours, the pain and fatigue worsen. Fortunately, my obtuse ignorance of my body's cues in not as acute as it once was. I've asked for another day off next week since I had to work yesterday. I self-massaged the knots in my thigh and lower back on the right to help rid myself of the three a.m. Charley Horse in between the top of my foot and medial shin. 

Even as I try to type this, my brain is foggy and I realize I need to sleep. I'll try to write something more coherent and comprehensive later. 

  This morning the outside temperature was -31F. 

  Michel had asked about the ponds and rivers here in winter. On my drive into town to have the new battery installed, I paid attention to the North Branch of the Middlebury River and the changes the temperature's plummeting had wrought on the river. In mornings past, I had noticed currents of steam rising skyward. The river water was warmer than the air and it looked as if it were steaming. The colors of the water and rocks were tan and white. The rocks and boulder, grays and whites, visible as the water wended it's way around and over their presence. Gradually the water cooled over the days and weeks and no more steam rose. 

   When temperatures plunge into the sub-zero range, the river starts to freeze at the bottom. The freezing ice expands and pushes the fluid water upward and outward, making the stream broaden and the ripples in the water flatten. The ice starts to change the colors of the river to green blues and muted whites.  Boulders and rocks are covered with the rising river and no longer appear as hummocks in the early fields of spring. The edges of the river start to freeze first, there shallower depths in proximity to the frigid banks more susceptible to the chilling of the earth's surface. The surface becomes smoother. Sometimes with the smooth reflective quality of a highly polished mirror, sometimes with waves frozen gently into the surface. Towards the center of the river a thin stream of water rushes over the growing ice and finds it's way in and out of holes not solidly frozen around the rocks, still moving, resisting the encroaching change from liquid to solid. Right now, the banks of the river are snow covered. In some areas damaged by the floods of Irene's onslaught last year, the trees were ripped up by there roots, the strata  of sand, soil and deeper bedrock revealed and resistant to the blanket of snow attempting to accumulate. 

   What of ponds, he asked. Here my experience is more limited. The yard behind our home slopes gently and a small,oval frog pond has pooled in the depression in the lowest point of the land before it rises again into a forest of tall pines and smaller hardwoods that haven't developed as much as they might due to the pines over shadowing them. This pond has been frozen for a couple of weeks now. As with the rivers, the freezing starts from the edges and works it's way inward. Mica thin sheets of ice,like patches of glass to cover microscope slides, start small and gradually join with each other to make a thin blanket of ice. Patterns emerge as the air is trapped in the transitioning element. Then the snows came and covered the ice. I imagine it thickening all the time the temperatures are plummeted, the ice at the bottom of the pond rising up to meet the surface. Soon the ice is thick enough for our Labrador to trod upon safely, wondering where her swimming hole has gone. With the next thaw she will find a hole and try to enlarge it, wanting to swim again. For now the pond is quietly waiting, the frogs and newts burrowed beneath the mud. 

   It is -19 F here- or as we fondly like to say, 19 below zero. The winter sun has topped the ridge and is slanting into the living room touching the green couch, kissing the loveseat. The woodstove crackles in the corner, turning the sunshine trapped in the logs into winter warmth.  The Holstein cats languidly drape themselves on their furniture, a piece for each. Nearby, LoraBoraLabraDora has snuggled in for her morning nap, made more necessary from the energy expended when she has gone out in the freezing cold. 

   I am glad I don't have to go outside to do my business. Thankful for indoor plumbing.

  I am going to have a quiet day today. I stayed at work until a quarter to seven last night, taking care of  a denial of an MRI from an insurance company that came late in the day. The doctor will have to call the reviewing company's doctor for a Peer to Peer Review. The review that I did didn't fit cozily into the prescribed form for an MRI of the knee, and so the test was denied. I knew while I was giving the information that the reviewer could not abandon the script written for her by the insurance company, but nothing I said could shake her from the script, or cause her to consider why this aberration from what the insurance company usually expected needed to be considered. So now my doc needs to take time out of seeing patients-about twenty-four scheduled today-to speak with the insurance company about the mass that is living in the patient's knee. What a waste.

No more thoughts of that now. Perhaps I'll go out in the winter sunshine when it is a little warmer-say, zero! But for today I am snuggled in and enjoying the peace in my household.

Blessings abound

   Sometimes I forget to trust that what my body is showing me is accurate. Several years ago, I had an incident after eating a lot of shellfish, when my tongue was so swollen it was sticking out of my mouth and I started to wheeze. Epinephrine from my nurse's bag took care of the symptoms and the presumption was made that I had a shellfish allergy. I only tried clams once after that. My tongue started to itch, I started to wheeze, and once again epinephrine was employed. I did not knowingly eat shellfish again. 

Until yesterday.

   My doctor had suspected I had an allergy to cats, as my new cat ,Jack, tends to inspire wheezing and itching when I pet him too close to my face. My doctor  decided to check my IgE level for an allergy to cat epithelium. At the time, I asked him if we could also test varieties of shellfish to see if I could eat any of them. The orders were entered for ten different types of shellfish. All results came back as negative. My doctor gave me the go-ahead to eat shellfish. I was puzzled but excited at the possibility of once again eating the seafood I had enjoyed when I was younger. 

   Vermont is not especially well known for his superior seafood, having land to the North, East and South. Most of the Western boundary is adjacent to Lake Champlain. No seafood to be had there. So off to the local supermarket we went. 

  For my first foray into shellfish consumption, I chose a can of crab meat and two bags of frozen Maine shrimp. I knew it would be less satisfactory than the fresh shrimp and crab meat I had enjoyed living in Maine, but with my diet being so restricted due to the Lyme, I decided it was worth exploring. I mixed the canned crab meat with a little mayonnaise and placed it on mesclun with one of the Ezekiel tortillas. The texture was what I expected from a canned product. It was ok. I was most interested to see what, if any reactions I would have to my little experiment. 

  After a little while, my tongue started to itch. In the mirror, it looked slightly swollen, but not as grossly swollen as it had been years ago. Two hours later, my face was flushed with redness. My tongue itched for a few hours, then it went away. I was perplexed.  No wheezing occurred.

   For dinner last night, I thawed the Maine shrimp and composed a salad with mesclun, arugula,cucumber, garlic olives and hard boiled egg.  At the last, I placed about four ounces of shrimp in the center.   It was delicious! The shrimp were not as sweet and flavorful as the one's I used to buy during shrimping season on the side of the road in Maine and New Hampshire, but tasty nonetheless. About one half hour later, my tongue was itchy. It stayed that way through the night.

   A little later in the evening, I was speaking with my sister. I was perplexed. Why was I having this reaction when my IgE levels indicated there were no antibodies in my blood indicating allergy to seafood? Sandy, my sister, observed that my antibody levels may have been too low too detect as I had not consumed shell fish in almost twenty years. She also pointed out that her middle daughter, my niece, Kate, is allergic to shellfish containing iodine-that is, shellfish that turn pink-but not to mollusks such as scallops, clams and mussels. My next experiment will be with one of those bi-valves. Perhaps I am destined to have a life where shellfish is ok once in a while, or only of certain types. 

   This reminds me of something I learned early in nursing, especially when I worked in the Special Care Unit:

"Treat the patient, not the numbers.'

  In other words, no matter what their numbers look like, observe the person for whom you are providing care and see how they are tolerating the state the numbers indicate. I am reminded that medicine is not a set of absolutes, as one sees in algorithms for conditions. It is also an art of observation and balance.  Another of my teacher's had taught me,"whatever the body shows you is accurate.'  It occurs to me that I have to trust what my body is showing me and avoid foods that make my tongue itch and my face flush.  Even after all this time, I am still learning to trust my body an what it reveals to me.

Blessings abound

   I am feeling a bit less discouraged tonight, a tad more optimistic. The achiness of the previous forty-eight hours has somewhat improved. I started work today in a truly horrid mood, but by the end of the day, it was better. It is so hard this time of year to do all the triage and scheduling and be able to make time to do all the Prior Authorizations needed to appease the Insurance Gods so patients can get their medications or procedures. It is a sucky system and there is no equality to it at all. 

   I have given up dairy for the time being with the exception of the half and half for my coffee. I cannot bear the thought of black coffee right now. I'll research soy creamers over the weekend to see if I can come up with something. If not, well, we'll see. 

Wish me luck.

Blessings abound

  Today was a follow-up appointment with The Lyme Whisperer.  Without disclosing all the details, I reached a point in treatment where the co-infection of yeast overgrew from having to add an antibiotic to protect my knees while I had dental work. The antibiotic left me with a nasty vaginal yeast infection.   So yeast medication was added and a compounded Nystatin was started to replace the suspect Nystatin manufactured by Teva.   The upshot was that the vaginal candidiasis resolved from these changes and from using miconazole vaginally and I became burdened by the worst constipation I have ever experienced in my life. Constipation so bad I had to give myself an enema on the bathroom floor and hope my husband didn't hear.  He didn't .  So bad that even with the addition of Senna, I had to manually disimpact myself in the bathroom at work because I was sitting on a giant ball of-well, you get the idea.   I have delivered children only slightly larger than these MegaPoops in a shorter amount of time. 

The introduction of constipation into the picture means that I am continuing to have a problem with yeast and the culprit found and eliminated. So for now, in addition to the usual dietary restrictions, I am not allowed cheese and milk. I am to increase my vegetable intake which has slackened due to the season and the lack of appealing fresh salad greens.  I also found out that by grinding the Ezekiel tortillas in the food processor and making them into muffins I am making carbohydrate more available to the yeast. So even though I was working within the constraints of the diet to reduce problems with yeast, I was creating an additional source of nourishment for the dratted yeast. 

   To add insult to injury, the kelp noodles I discovered that seem to fit in the diet are on hold for consumption until the constipation and herxe are resolved.   To say the least I am extremely disappointed.   At least I have the distinction of being the only patient the Lyme Whisperer has treated who has ever pulverized the tortillas in order to make muffins. It made him laugh and made me smile to think I was clever in my innovations.

Blessings abound

   I first met Ray through one of my clients in my massage and meningeal care practice. He was big and muscular.  He had heard from his friend that I was very good at deep tissue work.  He was about six feet tall.  Brawny would describe his build most accurately. He became a regular in my practice and I looked forward to the hours when we would work together, talk and laugh. 

   After I closed my massage practice and returned to full-time nursing, I still saw him occasionally at the clinic where I worked. A year or so ago, maybe a little more, I learned he had Carcinoid Syndrome. I didn't reach out to him because I wasn't sure of the appropriateness of it due to HIPPA regulations. About six weeks ago I decided to hell with it and approached him in the exam room and said hello. We hugged. Ray had changed. He had lost a lot of weight.   His face looked different, but his eyes still danced and he smiled when he saw me. We hugged. His hug was still the same, warm and enveloping.  After his appointment he came to my office and we chatted about our kids. He said the cancer had taken away the two favorite things in life: Enjoying a good meal and a good shit. We hugged. I did not see him again. I learned today that he has died. I am glad for him, that he has passed into a place where I imagine he no longer feels pain and may once again enjoy those pleasures belonging to the body. I am so grateful I was able to hug him one more time and see his smiling face.

Blessings abound