Monday, August 27, 2007

August flies by!

My husband and I often play "Guess where I am/we are?" with our boys via cell phone, and I guess I could do the same with my blog readers for the past several weeks. I am not quite sure how August "just flew by", but it did.

My husband and I celebrated our 35th (!!) anniversary, not by having a lovely intimate meal somewhere special (like we have done other years at the restaurant Bella Ciao in Ann Arbor) but by helping both of our grown up boys pack all (at least most) of their "stuff" that has still been in closets, the basement, or the garage at our Michigan home into vehicles on their way to new locations on each coast. Our older son has moved east to Virginia and our younger son went west to Washington. The following morning my husband and I started the cross country road trip in the packed and loaded family mini-van, helping our younger son with his move to the Seattle area (I knew we still needed that van!).

Many people have asked me if I was sad when both of my boys moved away from their home on the same day. (Neither of my boys were born in Michigan but both have lived here for most of the past 20 years.) Truthfully, yes, there has been some sadness, but mostly there are overwhelming feelings of joy as I have allowed years of memories to flood over me this month while thinking about and ackowledging all of the accomplishments that led to that day. I will start by saying that nothing has been easy, but I am way beyond grateful for my multiple blessings. To help you glimpse just the tip of the iceburg, I have been very fortunate able to: (1) have a supportive husband and marriage for 35 years, (2) have 2 children plus been able to experience all the trials, tribulations, and joys of parenthood that have led to ultimately seeing my boys grow to become highly capable, hard-working, compassionate, and thoughtful young men who no longer really need their parents but seem to still like being with us, (3) survive every cancer diagnosis and complication or late effect from cancer therapy thrown at me thus far, and still have my overall health and family intact (although sometimes I do joke that I think I am held together with duct tape!) so that I am incredibly fortunate to be still experiencing the joys and challenges of life at age 57 with hopes for a reasonably healthy future.

I remind myself of my good fortune that my husband and I can still play the "guess where I am" game with our boys (cell phones are wonderful for this!), both Virginia and Washington are wonderful places to visit (!!), there are non-stop flights to both cities, my boys are truly ready, willing, and able to "fledge", and we have transitioned from custodial "doggie grandparents" to full time dog owners of my older son's dog, so we still do have someone at home who "needs us". :-)

Just a quick food comment: for supper tonight, I cut one of our home-grown heritage tomatoes into 4 thick slices, layered several fresh basil leaves on top of each slice along with a pinch of freshly grated parmesan cheese. I then put these slices under the broiler of our little toaster oven for just a few minutes and ate them all myself. If my husband had been home, I would have needed to cut two tomatoes; no sharing - they were that good!!! I highly recommend that you visit your local Farmers' Markets during the next several months to truly experience your locally produced mouth-watering produce. Don't let a week go by without seeking out a Farmers' Market, talking to your local farmers, buying both an old favorite and trying something new.

Have an enjoyable end of August and start of September, which I always think of as the real beginning of the new year.

Diana Dyer, MS, RD

Friday, August 10, 2007

LIVESTRONG Presidential Cancer Forum

Here is new information from the Lance Armstrong Foundation regarding the first ever Presidential Cancer Forum in Cedar Rapids, IA for both Democratic and Republican presidential candidates on August 27 and 28, 2007. If you cannot go, please submit your questions. I am working on how to word mine, but it will definitely be focused on what they will do to incorporate Medical Nutrition Therapy by Registered Dietitians as a component of true comprehensive cancer care for all cancer patients from the day of diagnosis forward through recovery or hospice care.

This is your chance. Make your questions tough! Most of these candidates will not know that nutrition is not routinely part of comprehensive cancer care. Click on the title of this post to go to the web site that has more information! Please let your voice be heard loud and clear and strong - yes live strong!

The forums will be broadcast live by MSNBC from 10-12 noon Central Time.

(Here is the link to submit a question - you will need to cut and paste it into a separate browser.

How is the next commander-in-chief going to fight the
#1 killer of Americans under 85?

I am no longer content to let the cancer question go

That is why the Lance Armstrong Foundation is hosting
the first-ever LIVESTRONG Presidential Cancer Forum to
make sure our next President knows that Americans
across the country expect cancer to be a national

In Cedar Rapids, Iowa, on August 27 & 28, we will ask
Democratic & Republican presidential candidates to go
on the record with their plans to fight cancer.

As a member of the LIVESTRONG Army & a leader in the
fight against cancer, I need you to be part of the
LIVESTRONG Presidential Cancer Forum, demanding
answers to the cancer question. Here's how you can get

1.Get your tickets. The LIVESTRONG Presidential Cancer
Forum is open to the public & tickets are FREE.
Quantities are limited & will be distributed on a
Cut and paste this ink into a separate browser:

2.Submit your questions. Lance Armstrong & MSNBC
Hardball host Chris Matthews will ask candidates
questions from the public.
Cut and paste this link into a separate browser:

3.Spread the word. Ask friends & colleagues to sign
the LIVESTRONG Army petition to make it clear that our
next President must be prepared to answer the cancer
Cut and paste this link into a separate browser:

As of this week, Democratic candidates Senator Hillary
Clinton, Senator John Edwards & Governor Bill
Richardson have confirmed their participation for the
Democratic LIVESTRONG Presidential Candidate Forum on
August 27. Republican candidates Senator Sam
Brownback, Governor Mike Huckabee & Governor Tommy
Thompson have confirmed their participation in the
Republican LIVESTRONG Presidential Candidate Forum on
August 28.

The goal is to get rid of this disease forever.

The LIVESTRONG Presidential Cancer Forum gives all
Americans the opportunity to ask the candidates,
"What's your plan? And where does cancer fit into your

Together, as the LIVESTRONG Army, we can put an end to


Lance Armstrong, LIVESTRONG Army

Diana Dyer, MS, RD

Thursday, August 2, 2007

Are bitter melons really bitter? Oh, yeah!

I have seen bitter melons in the grocery store but never bought one because (1) I didn't really know what to do with it and (2) I had my doubts about how fresh they really could be since it considered a tropical vegetable.

Well to my suprise I saw some at my Farmers' Market yesterday. There are several types; I purchased 2 that looked like they could have been a warty zucchini or cucumber. This farmer grew them like summer squash except that he trained the vines to grow up strings so that the melons would not lay on the ground and get eaten by insects living in the dirt. They actually were beautiful to look at on his table. He chuckled when I told him that I never bought one before and wondered what suggestions he had for how to best prepare them. Before he really got around to responding, several people standing by jumped right in to the conversation to offer their experiences.

I'll share what I did. First I looked in all my vegetarian cookbooks for some general information and recipes for bitter melon and found nothing. (I have given my one Indian cookbook to my older son's girlfriend for her to enjoy; I'm sure there would have been many recipes in there.) So then I looked on the web and found this fascinating notation on the web site for the National Bitter Melon Council: "A long, warty, and very bitter fruit used in global cuisine, healing practice, and art. A member of the gourd family, it possesses qualities that can be used as food, medicine, and as instigators of situations that promote conversation and community." Wow - instigators of situations that promote conversation and community! Well, I already discovered that at the Farmers' Market. :-) Tomorrow I am going to serve the following recipe at a small gathering of neighborhood moms at my home, and I'll just bet that it starts conversations there, too!

Basic Bitter Melon Stir-Fry (modified from a couple of recipes seen on various web sites)

1 pound bitter melon (about 2-8" long melons)
1-2 tablespoons minced garlic (I used our home-grown garlic)
1/2 teaspoon chili pepper flakes
1 tablespoon oil for stir-frying
1 tablespoons soy sauce
1 tablespoon red wine, balsamic, or rice wine vinegar
1/2 teaspoon sugar
a few drops sesame oil

To prepare the bitter melon, cut in half lengthwise, remove the seeds and pith (I used the jagged front of a grapefruit spoon to scrape all this out) and cut on the diagonal into thin slices. Sprinkle salt over the slices and place them in a colander to drain for 15 minutes. The slices were still incredibly bitter (!) so I followed the additional suggestion of one of the women talking to me at the Farmers Market by next rinsing them in the colander and then blanching the slices in boiling water for 3-4 minutes before draining again.

In a small bowl, mash the chili pepper flakes and the minced garlic together with the back of a small spoon or a flexible flat knife.

Heat wok over medium high heat and add 1 tablespoon oil. When the oil is hot, add the minced garlic and chili mixture. Stir-fry briefly until aromatic (about 30 seconds).

Add the bitter melon. Stir-fry for about 2 minutes, then splash with the vinegar and soy sauce. Stir in the sugar. Cook for another 1 to 2 minutes, until the bitter melon is browning and beginning to soften. Stir in a few drops sesame oil if desired. Serve hot or even chilled.

This recipe says it serves 4. I don't think so, maybe ~14 people taking a small taste as an experiment the first time or as a small taste at the beginning of an Indian meal. I learned in my reading that traditionally in India a small amount of a bitter food like this dish would be eaten as the first course of a meal, served with a small amount of something like plain cooked rice, to both stimulate the appetite and wake up the taste buds. I can vouch that this dish will do just that, along with being an instigator of situations that promote conversation and community.

Enjoy something new this week from your Farmers Market!

Diana Dyer, MS, RD

The Maze of Cancer Care (including follow-up care)

How hard it is to be a patient these days.......Reading the New York Times articles published this week (one is linked to the title of this post) that highlighted several real-life examples of the difficulty getting a timely diagnosis, finding the best care for your diagnosis, and then actually getting that best care surely showed the challenges that each patient faces in order to advocate their own way through the maze of our current uneven (i.e., broken) health care and insurance system.

I have had to do this time and time and time again. Just a few days ago I had one of my doctors tell me that what I have done right is to never give up and question, question, question. The previous time I was in his office, he had a 3rd year medical student observing the visit. On the way home, my husband asked me if I was paying attention to the med student during the visit. No, I really wasn't, why? My husband said that he watched her eyes get larger and larger and larger as I dug deeper and deeper and deeper with my questions for this doctor.

This particular doctor actually told me during this week's appointment that he hopes that I will talk about the importance of this self-advocacy process when I am talking to groups. I had so many thoughts as he said this.........He hardly knows me and I hardly know him to gauge if he has a clue in terms of realizing how much energy, time, and work such a process is for each and every patient (when they are often not feeling well at all to boot!).

In any case, the two of us decided that at the current time I can relegate him out to my "back 40". I often joke that I have a stable of docs to keep me (and all the late effects that continue to show up from my childhood cancer therapy) patched together. However, the fact that patients need to be their own best advocate is no joking matter. Unfortunately, it is the only way to navigate the health care system these days.

I remember the moment when it occurred to me that my oncologist was not thinking about me and the particular nuances of my case for 24 hours/day (oh, duh! how naive was I?) Another way that I have looked at this sudden recognition (the proverbial light bulb moment) is to link that sudden awareness as the real beginnings of my self-advocacy efforts that ultimately led to a more global effort on behalf of cancer patients everywhere.

Don't think that because I have been at this for a long time that it becomes easy or fun. In fact, it is neither, and I find that I grumble a lot about the challenges for me plus all of you out there who do not have the medical background that I have. I am just going to pick up a new book from the library called How Doctors Think by Jerome Groopman, MD. I'll report back my further thoughts on this issue when I am done with that book.

Meanwhile, I'm off to make Caponeta using all local vegetables, including our home-grown garlic which we just harvested. I still need to purchase olives and olive oil that are imported from Italy, as even with global warming they don't grow yet in Michigan! The best recipe I have found is on my web site (link on the side of the screen under my favorite web sites). On my homepage, click on Recipes, then scroll down to Fruits/Vegetables to find the link to Caponeta. I always make a big pot of this and often just spoon out a bowl of it to eat as it is that good. Bon appetit!

Diana Dyer, MS, RD