Diana's Blog

It's weird to me, how it's alternately hard/easy to talk about it this time. We've lost another baby, which happens...but while it's happening, boy does it hurt. It was somewhat like last time, no heartbeat at the 9-10 week ultrasound. It apparently had happened recently, a loss of blood flow to the fetus.

The first thing we want to ask is, Why?? Why no miscarriage, again? No warning signs even, this time. It seems my body will do anything to hold on to the idea of a baby! We're having some tests done, but I don't necessarily expect answers. At least, it could out-rule some causes; though we may be left assuming that it was just a case of odds, and muster the guts to try again anyway. ...Which I would do, because humans are that way - remarkably resilient, and having strong drives.

It just hurts. --And anyone who has been through it knows it adds stress to a relationship and to a bank account. --And I really feel the modern lack of community - i.e., no-one just to talk or cry to for an hour, live, at short notice. My family does their best via phone, and friends are sympathetic. Everyone' just busy, including us! It's strange though, when you have a couple of forced rest days and need to grieve, and the immediate world's schedule has no space for that.

I know I'm lucky to have Greg, and even have this opportunity to try for kids. But right now, I'm sad, and I miss that little nugget.

The other day I had a cold, and was feeling like I couldn't keep up/catch up with things...and being frustrated at little things that seemed to impede progress. Suddenly I stopped and realized where I was...in the world and in life, and I felt incredibly lucky.

Regardless of your lot, the little things can make a huge difference. I wanted to take a moment to thank people who in some small (but at the same time, huge) way are making my life easier or more pleasant, right now:

...Dr. Eastlack, my dermatologist, who has supported my acquisition of a home phototherapy unit (saves me several hours per week in trips to the dr's office for treatments, as well as major co-pay $$); the guy from the pathologist's office who returned my call *twice*, to explain a mysterious bill I'd received; my amazing, wonderful clients, who always show up when planned, and make my job a pleasure with their enthusiasm (and sometime sarcasm); my husband Greg, who supports me through everything; my sister Lori, who listens to my phone-babbling (and shares hers :>); REI, for offering to exchange the used hiking boots that I outgrew during pregnancy for a new pair (no extra cost in the end!); AMVETS and UCP, for picking up donations right from your house; the FedEx guy, who always waves and asks me how my training is going when he sees me on my bike; my parents, for having the good hearts they do; Greg's warm and caring (and extensive) family; my cats, who make me laugh and feel warm all the time...I hardly know where to stop this list!

Thanks. Not a day goes by that I don't feel grateful for a million things.

I know this is a very personal topic, but I feel like writing about it, and sharing it is helpful to me and possibly to others!

Greg and I were ecstatic to find out several weeks ago that I was pregnant. We were cautiously excited, knowing it was early... But by nine weeks, we started to get more excited. It's impossible not to talk about names, start some mental planning at least, and see if you can sense what gender it might be.

Being pregnant, I was tired, bloated, and hormonally charged, but I had relatively smooth sailing - only occasional nausea (no appetite problems!), no pain, ability to exercise regularly, etc. The pregnancy happened early and with ease - this was fantastic news! And, I felt so happy and excited; it's hard to express to what magnitude. The last thing I expected last week was to find out (via ultrasound) that the fetus hadn't made it.

Because my body seemed to want to hold on tight, I had to have a D&C yesterday. Everything went smoothly, and I'm recovering well - I just have to wait a bit to return to my "normal" activity level, which involves 3-hour bike rides and trail runs in the heat of the day. The best word to describe it is "empty."

Greg is so sad. It seems like he hasn't had the proper time to grieve, being the sole developer at a startup software company. It seems like a surf vacation would be the ideal thing of the moment, except that I can't be in the water for a little while. This will pass and we'll move on, but we'll also never forget this experience. I was thinking of planting a flower or fruit tree in the yard, as an honorary gesture of life, which really is a miracle. 

Wanted to share a couple of lighter, nutrient-packed meals for gourmet dinners at home! (Even the kids will probably love these.)

I've entered both of these in recipe contests too - we'll see how they stack up against competition...

Vietnamese Clay Pot Fish with Bok Choy and Chopped Salad
(Makes 4 servings of a whole meal - and the whole meal costs only $15!)

INGREDIENTS

Main dish:

1 lb. fresh tilapia, cut into 2-inch chunks
2 heads fresh baby bok choy, sliced on diagonal
4 Tbsp. Vietnamese fish sauce
3 Tbsp. white or raw granulated sugar
1 tsp. freshly ground black pepper
2 tsp. canola oil
6-8 cloves of garlic, thinly sliced
1 Tbsp. fresh ginger, sliced into thin strips
4 small shallots, thinly sliced
3-4 scallions, cut into 1/2-inch segments, plus 1 Tbsp. oil (for garnish)
5 Tbsp. caramel sauce
2 cups cooked brown rice (optional)

Caramel sauce for fish:

1 cup granulated sugar
2/3 cup + 1/2 cup water
1 Tbsp. fresh lime juice, plus more to taste

Salad:

1 head green leaf lettuce, chopped into thin strips
1 cucumber, chopped into thin matchsticks
10 cherry tomatoes, halved
1 small bunch cilantro, chopped (about 1 cup chopped)
1/4 cup roasted and salted peanuts, finely chopped
Fresh-ground black pepper, to taste
NOTE: You can use a mini blender or food processor to chop the peanuts, or crush the peanuts with a large, flat-bladed knife or cleaver.

Salad Dressing:

1/4 cup Vietnamese fish sauce
1/4 cup rice vinegar
1 Tbsp. soy sauce
2/3 cup cold water
5 Tbsp. granulated sugar
1 tsp. roasted and salted peanuts, finely chopped
NOTE: If short on time, you can simply dress the salad with rice vinegar.

PROCEDURE

Marinate the fish:

In a medium-sized bowl, gently toss the fish with black pepper, shallots, fish sauce and sugar. Marinate in refrigerator for 15-30 minutes.

Make the caramel sauce:
(Makes approx. 1 cup)

1. In a small, dry saucepan set to medium heat, combine sugar and 2/3 cup water.

2. Stir with a wooden spoon until the mixture turns darker, about 8 minutes.

3. Remove the pan from the heat and add another 1/2 cup water. The sauce will thicken slightly, but will liquefy again in the next step.

4. Stir well, and then cook for 7-10 minutes over high heat until the sauce is smooth and integrated. If the sauce starts to boil over, lower the heat.

5. Add the lime juice and remove sauce from heat. Stir well.

NOTE: Caramel sauce will keep in a glass container for a couple of months in your refrigerator.

Cook the fish and prepare the salad:

1. Heat a medium-sized saucepan over medium heat. Add the oil, garlic and ginger, and stir-fry for about 1 minute.

2. Add the marinated fish. Add the caramel sauce, and mix gently with the fish.

3. As soon as the pot begins to bubble, turn the heat to low, cover and gently simmer for about 5 minutes.

4. Add the bok choy on top of the fish, re-cover, and simmer for another 5 minutes, or until fish is just cooked through and the bok choy is dark green and softened. (If the pot looks dry at this point, add 1-2 Tbsp. of water and cover again.) The fish should be tender but still hold its shape.

5. Meanwhile, make the salad: In a large bowl, combine all salad ingredients, and toss gently. In a small bowl, combine all dressing ingredients and stir well, until sugar is dissolved.

6. Taste the sauce and add fish sauce, sugar, black pepper, or lime juice if needed.

7. Quickly sauté the scallions with oil and add them to the serving dish as garnish. If desired, serve fish, bok choy and salad with brown rice. (Dress each salad plate with a few teaspoons-full of the dressing.)

Fajita-style Shrimp Tacos with Vidalia-Mango Salsa

Serves: 4-6

These tacos are colorful and super-healthy, featuring a delicious blend of sweet onion and mango, savory shrimp, subtle lime, and gentle spiciness. Kids don't even mind the cleverly integrated vegetables! The mango salsa can be served on the side, for more sensitive palates.

INGREDIENTS

Tacos:

12 small four tortillas (for a hearty flavor and extra nutrients, try whole wheat)
2 Tbsp. olive oil
3 cloves fresh garlic, peeled and minced
2 large Vidalia onions, cut into thick strips
1 red and 1 green bell pepper, seeded and sliced into thin strips
1 lb. large or jumbo shrimp, peeled, deveined, and tails removed
NOTE: Optionally, use pre-cooked, Individually Quick Frozen shrimp, defrosted on low power in the microwave to remove extra water. (This will shorten cooking time in the pan.)
1 Tbsp. white cooking wine
1 Tbsp. ground cumin
1/2 tsp. ground white pepper
Sea salt and ground black pepper, to taste
1 large, ripe avocado, sliced and drizzled with lime juice, for serving
1 c. shredded romaine or green leaf lettuce, for serving
3-4 limes, quartered, for serving
1 c. lowfat sour cream, for serving

Vidalia-Mango Salsa 

1 large, slightly underripe mango, peeled, pitted, and finely chopped
1 large Vidalia onion, finely chopped
1 white nectarine, just ripened
1 clove fresh garlic, peeled and minced
4 whole jalapeños, finely chopped (for a milder salsa, remove some of the seeds)
1/4 cup fresh cilantro, chopped
1 1/2 tsp. olive oil
1 Tbsp. fresh lime juice, or to taste
Sea salt and black pepper, to taste

PROCEDURE

1. In a medium bowl, combine all ingredients for salsa. Refrigerate to let the flavors blend while you make the tacos.

2. Heat the olive oil in a large wok or non-stick skillet, over medium heat. Add the garlic, and stir-fry for 15 seconds.

3. Add the onions, and stir occasionally for 3-4 minutes, or until they just start to look translucent.

4. Turn the heat to high, and add the shrimp. Stir occasionally for about 3 minutes. Add the cooking wine, ground cumin, white pepper, sea salt, and black pepper, and stir-fry for another 2-3 minutes, or until shrimp are cooked through.

5. Add the bell peppers, and stir-fry for about 1 minute. Taste and adjust with more cumin, sea salt, or white pepper. Remove from heat.

6. Stack the tortillas on a plate, and cover with a damp paper towel. Heat in the microwave for about 1 minute, or just until warmed.

7. Place 2-3 tortillas flat on each dinner plate, spoon shrimp and onion filling onto each, and top with mango salsa. Serve with the sliced avocados and limes, shredded lettuce, and sour cream.
SERVING IDEA: Set the tortillas, filling, salsa and condiments out on a table or buffet, and let guests serve themselves. 

My favorite pie has made it to the semi-finals in a recipe contest! (...My own favorite creation, being heavy on peanut butter and chocolate and high in great flavor, but not so heavy it weighs you down.) It's also high in protein, making it nutritionally valuable - love that.

If you'd like to vote for the recipe (and see other tasty, healthy recipes), go to: http://www.mambosprouts.com/events/recipecontest09/vote.html

Category winners get a bunch of healthy cooking products! (--Which I will certainly use and share).

You can make a non-dairy version with silken tofu or Tofutti Better 'N' Cream Cheese instead of cream cheese. The crust is changeable too - works well with peanut butter cookie dough baked into the pie pan first, or finely crushed chocolate sandwich cookies with a bit of water to hold them together.

Over the last few days, I've been feeling more like myself, energetically - i.e., coming out of a slump where my body couldn't recover properly from the flu b/c I was on Humira, an immunosuppressant drug for psoriasis.

OK, I work pretty hard at perpetuating a positive attitude. But right now, I'm using this space to vent briefly on the confounding paradox that is my immune system.

The Humira partially cleared my skin, but not enough to make it woth feeling frequently sick and immunosuppressed. Today as I was out riding my bike and feeling so grateful to be able to be active again (even if I'm not 100%), I noticed some red spots on leg areas that had been temporarily clear. It's truly amazing, perplexing, etc... Feeling good overal = bad skin, and vice-versa. Do I succumb to chronic fatigue, and get a partial relief from the itching and depression and extremely high maintenance of applying topical steroids to a thousand spots with a Q-tip, or have energy, but accept the burden of maintenance? -- And be more unhappy/frustrated about the painful and ugly psoriasis symptoms?

For right now I've chosen having energy (not to mention avoiding the risks associated with Humira - cancer, lymphona, questionable safety during pregnancy, etc.). This means I still go to the dermatologist's office three times a week - yes, three times - for UV light treatment. I don't know yet whether this will be enough to maintain my sanity, but I'm hopeful! Now if I could fenagle a way through our beastly healthcare system, to get a light box for home - and save hours every week!

...Speaking of healthcare, Cigna is currently giving me flak about the UV light treatment, using whatever language they can imagine to make it so I have to pay a co-pay. Three treatments = $60 per week! This is not realistic, or justifiable. You go to the doctor's office, stand in a tight UV chamber for a couple minutes, and leave (without seeing a doctor). For whatever reason, the derm's billing service has a weird policy of billing UV treatment under a doctor's name - but it's a doctor I've never even heard of, who works in an entirely different office. Cigna has twisted this around to mean that it's still an "office visit" of some kind.

According to the National Psoriasis Foundation, UV treatment is to be billed as a "non-elective maintenane therapy" and covered 100% by insurance companies.

And so I embark on my 10th or so phone call about this issue....

A couple of weeks ago, Greg acquired an iPhone. I say "acquired" in the sense that it is like another limb or integral body part. It might more aptly be named "CrackPod" or the equivalent. Needless to say, he has a hopeless crush on his new gadget. What's more, I want one too! (I really was looking for a phone that would also let me check email, but found the Blackberry's keyboard too tiny. I mean, not all fingers are that dainty!)

Meanwhile, I won not one, but two shiny new gadgets - and they both arrived today! Funny thing, the FedEx truck just arrived as I was writing the previous sentence (literally) and in came the HTC Fuze phone I've won. First thing this morning, there was an iPod Nano on our doorstep. ...Hmm, maybe this Fuze will fit the bill!

How did I win these things? The Nano was the drawing prize for having done a brief email survey for Getty Images, from whom I've purchased marketing stock material in the past. The survey took me about 90 seconds of "zone-out" time, between other work. The Fuze was an instant win from a sweepstakes put on by the sponsor. I haven't been random-draw contesting much lately, but I do continue to enter creative copywriting/advertising/recipe/etc. contests once in awhile. It doesn't feel like work; the ideas strike me while I'm drifting off to sleep or on my bike - and I've been lucky enough to cover my a** with the cash winnings.

(Did you know that last year, the winner of the Pillsbury Bake-off got $1M for wrapping Pillsbury P.B. cookie dough around a creamy peanut butter filling? Tens of thousands enter each year, so the odds are low...but the prize $ they give away is mind-boggling! There are always several $5K category prizes, too.)

Alright, back to the "real work..."

So Greg and I were cooking last night, and between the oven, toaster oven, and microwave, there was a lot of beeping. The toaster oven, in its eagerness to give feedback, not only beeps when the set temperature is reached or the food is done, but at every touch of a button. With so much beeping, it became hard to distinguish meaningful beeps from superfluous ones. And then it's like online ads...you start tuning them out!

I wonder how many beeps we hear in one day? From an alarm clock (if you use one), to a cell phone waking up, to the blips of logging on, to some microwave action, to the car door or the iPhone/Blackberry to the elevator to the car door again to a truck backing up to the phone again to some more digital toaster action, to the beeping of any number of digital devices in the workplace, to the grocery store checkstand, and sometimes a simulateneous chorus of two or three of these. I'm sure I"m not the first one writing about this, but we live with a LOT of beeping. I'm either becoming assimilated or desensitized...

So the posts get fewer and farther between; but it's only because I'm putting more into fitness work and a related blog. (Feel free to check it out at http://lovejoyfitness.com/ or http://lovejoyfitness.blogspot.com/.)

While I still don't have a regular rhythm to every day, I feel momentum building. It has been tough, in these economic times, to be on my own trying to start up a business. But with that quality my husband not-always-affectionately describes as "a dog who won't let go of the leg," I persist. I have some new clients, and as a bonus I'm covering the local Training Transition tri group while the main coach is on vacation. This latter part is hardly like "work" - yes, I'm leading workouts, giving tips left and right, watching each individual in the group...but it's such a great group of people that it feels like recreation. :>

One thing I especially like about this work is that it's inherently social. Being slightly shy and susceptible to environmental stress-energy made a bad recipe for working in a cubicle. You're in a cube-farm, yet essentially isolated...and you learn that coming out of your cube or making yourself visible often results in more work being dumped on your head.

I really think social isolation is a big part of our modern dilemma. I believe far fewer people would feel anxious, overly stressed, inadequate, lonely or obsessive if we just got off the treadmill and sat - or danced - around a campfire more often! I'm not talking about Facebook, MySpace or LinkedIn; these do not count in my mind as antidotes to isolation. --So how to break the inertia? One little person at a time, I guess. --And by being a bearer of *positive* energy, so that energy benefits others instead of bringing them down.

Well, the only way to find out if some treatment or other helps with psoriasis is to try it...so on I go. I have a few insights, which are clearer now looking back at the last few years. Having no control group of myself, I don't know if I'm right, but here's what I suspect:

Sleeping in a hypobaric tent may have slowed down the progression of my psoriasis. During that time, my stress level increased (re: my job), and the spots on my lower legs seemed to intensify. But, it was as if something was held in check. (To complicate things, the slowed immune response meant I got sick more easily, which stimulated the immune response, and caused skin outbreaks.) The rapid worsening and creeping-all-over only began after I got out of the tent in 2007. So, tent = good for suppressing auto-immune disorders; but ultimately bad for overall energy and immune-system strength. Lovely paradox.

The psoriasis response in 2007-2008 seemed like a rebound effect; not only did the skin get worse, but it seemed to be moving very quickly, as if to make up for lost time.

When I tried hyperbaric oxygen therapy recently (after researching how it speeds up repair of body tissues), I felt healthier and more energetic, but my skin, which had begun improving in response to Humira (biologic immunosuppressant), suddenly stagnated and even made a turn for the worse again. Two days after my last hyperbaric session, the skin began to calm down again. In the meantime I'd also added PUVA (narrow-band UV light), thinking the Humira wasn't working for me. I know, seems chaotic and unscientific, but...the need for relief from psoriasis and its multitide of related frustrations is powerful.

And, with this stuff, you only have answers in hindsight! Currently, I believe Humira + UV light is helping the skin. How to boost or stabilize my energy levels remains mysterious, as effective solutions only seem to make my skin explode. Right now I'm hoping my attempt at tapering off topical steroids is successful. Maybe, in a year or two, my skin will rebuild the outer layer that has been dissolved by steroids, and tears in response to the tiniest of twigs!

Given how long it can take for the immune system to adjust to change, I still believe that in time, my skin will become calmer on its own - time being the key word.

I'm wondering if I should start carrying around little cheat-sheets with a bulleted summary of this problem, for the people who ask, "What happened to your skin? Psoriasis? Have you tried xx?"...