Nourishing Me

Twelve Weeks In

2012-06-24T18:29:00.000-08:00

I don't know where the last few months have gone. Living with an infant is like being in a time warp. Minutes, hours and days are slow; weeks and months (I suspect years too) pass in a blink. I have a feeling this sensation will last forever, the passage of time redefined. Let this post serve as a whirlwind tour of our last three months.

Not interested in reading (It's okay, I understand), new pictures can be found here.

Arrival:

We were ecstatic to meet ZEB at 12:34 am on Saturday, March 24. She arrived after a long, hard labor. By long I mean 40-hours long. Basically we experienced 24-hours of "natural" childbirth, laboring mostly at home without medical interventions, followed by 24-hours of almost every medical intervention up to and including a midnight c-section. By hard I mean mostly "back" labor, which my mother experienced with me (Sorry about that mom!). Back labor is more awful then was previously described to me. It hurts all the time and just becomes even more intense during contractions. Thankfully, ZEB never showed any signs of distress. In the end we got exactly what we wanted: a healthy, happy baby. She was 8lbs 5oz and 22" long.

Weeks 1-3: Mastering the Basics
Eat - All the f-time. Although we took the Breastfeeding class and I had done a significant amount of reading on the subject I was totally unprepared for how often ZEB would be eating or how long each session would last. Just like her mama and papa, the girl knows how to chow down. She's a champ at it (and has been from the get go). At her 2-month well baby check she clocked in at 14 pounds, 2 oz, that is a 70% increase. She's growing like a weed.

Sleep - Once again just like her mama and papa ZEB's a good sleeper. During the day we attempt to put her down in her crib conveniently set-up in our living room. This proves successful less then 50% of the time, well worth the effort when you get an hour or more of time unconnected to her. At night she sleeps in 2-3 hour chunks, sometimes more and can be lulled back to sleep fairly easily. She starts the night in a bassinet in our bedroom and ends up in our bed after her 2am feeding.

Poop - Having never changed a diaper until the arrival of ZEB, it was a bit hard to be introduced to the skill in the hospital post c-section with an awkward IV in my hand. AKB was a natural at it from the get go. Is there anything the man can't do one handed? I have quickly gotten up to speed. We are cloth diapering most of the time. We invested in the fancy-pants one size, all-in-one pocket diapers: Fuzzi Bunz and haven't been disappointed. For ZEB's behind, for our wallets, for the environment we felt like it was the right thing to do. Seriously, its not that much extra work.

Shades of Colic
In the first few weeks I was constantly asked if ZEB "Was a good baby?" My basic reply, "Yes of course she is, aren't all babies?"

It is true though girlfriend has big lungs and can be very expressive. While loathe to label ZEB it is the easiest term to describe her demeanor at times. Technically colic is defined as crying for an unknown reason that lasts more then 3-hours a day, 3 or more days a week for 3-weeks in a row. I have never used a stopwatch to see if ZEB fits the exact criteria, I am too busy consoling her. What I have discovered is "colic" is a catch-all term for crying for an unknown reason. There are only about as many theories about colic as there are are parents, grandparents and pediatricians and shockingly little actual research or "fact". For the most part its generally regarded as a benign right of passage for some families.

"Colic" however you define it is just rough. I would liken it to labor. Its impossible to really describe how painful it is to hear your baby cry for hours and have very little to do about it. After the pediatrician's office basically said "Live with it - She'll likely outgrow it by 3-4 months", I did a bit of my own research and found lots of anecdotal and some actual research that some colicky babies respond well to changes in the mother's diet. Particularly to the elimination of cow's milk protein and other commonly allergenic foods and the introduction of probiotics. I started by eliminating dairy, and we saw some improvement in ZEB's disposition. However, after eliminating wheat we saw fairly dramatic improvement within 24-hours. While its impossible to know if the elimination of these foods and the improvement are coincidental without adding them back into my diet (which you couldn't pay me to do) we feel pretty confident that there is an association I share this for anyone who may find themselves knowing a "colicky" babe. It may be worth it to your own sanity to do some independent research and find a good lactation consultant. If nothing else it feels good knowing you've tried everything.

Repeat cycle: Eat, sleep, cry, poop

Weeks 4-5: Great Grandparent Adventure

While many people host lots of visitors (i.e. grandparents) in the early days with a baby we opted for an alternative approach. At just 4 weeks ZAT went to the great grand-parent meet-up in the Bay Area. Ironically the visit would not have been possible without the help of many of our friends in particular Maryann (who hosted ZAT), the Moss-Chaw's and Elizabeth all of whom we spent very little time with sadly. To say that ZEB's grandparents and great grandma are as smitten with her as we are would be a significant understatement. They could not get enough. We spent the vast majority of our visit on Maryann's couch with a parade of grandparents (All five were able to be with us in the Bay Area) arm wrestling over whom would hold her next. It turns out ZEB's great grandma is hands down the "baby whisperer." All in all it was pretty sweet trip.

Traveling you ask with an infant? A breeze. Truly, I think flying is an infant's dream: You're worried about their ears so you're encouraging them to breastfeed, the engine noise lulls them to sleep, and there is no where to go so you don't try to move them. Dream - right? Honestly, its easier and quieter to travel with ZEB in an airplane then in a car seat.

Weeks 5-8: Finding a New Groove

The predominant routine: Eat, sleep, cry, poop remains the same. However the interval between the four has lengthened. We are slowly getting better at squeezing things in between.

I am able to prepare simple meals, shower or make a brief telephone call. All things I took for granted prior to sharing a home with an infant.

ZEB and I venture out a few times a week to a new parent's support group, a weekly play group at the park, and we can almost do our weekly grocery shopping on our own. It can take us all day to complete an errand, but we can get it done.

Weeks 8-12: A New Normal
It's actually starting to consist of more then eating, sleeping, pooping and crying. After breastfeeding almost continually in those first few weeks every three hours now feels like nothing. We are much better about picking up on ZEB's sleepy cues: After the third yawn she's a mess. We have wizened up and start our nap/bed-time routine much earlier: At the first yawn. While she still can get her wail on, it's much less frequent and has a different tenor to it. I am still avoiding dairy and wheat and will likely continue to as long as I am breast-feeding. I can't say that we have mastered the basics but we are no longer novices either.

I feel like the "fun" part is just beginning. Honestly, I wouldn't trade those first few weeks for anything but they weren't very much fun.

Now, its fun.

2012-04-08T19:49:00.000-08:00

Another set of photos.

Introducing ZEB

2012-03-26T21:32:00.000-08:00

A few more pictures to satisfy the grandparents!

Winter in the interior - Highlights

2012-03-02T15:27:00.000-09:00

Even with 6-weeks of winter weather left to endure Spring is at least is starting to feel like a possibility: The light has returned and the temperatures are bearable with multiple layers and the promise of a hot beverage. With the turn, I have started to realize why people choose to live here. Honestly, in December and January I wondered. The dark and the cold scream almost complete inhospitably.

As unwelcoming as the weather is there is still plenty of activity throughout the winter. If your jacket and boots are thick enough. Given my growing girth we have been very conservative in our participation. We passed on skijoring, downhill skiing and even cross-country skiing this year. Opting for the indoor activities or those that allow for a surer-footing and a quicker return to the car.

Some highlights from our first winter in Alaska include:

More photos winter photos here

Early in the winter we were able to see the Northern Lights through our living room window. While not as spectacular as the viewing away from the city lights still pretty mesmerizing. The color moves.

While brunching with friends we were able to watch a moose through their picture window. Prior to moving I had no comprehension that moose are very large and can be quite dangerous. I live in some fear of a moose encounter. This was the perfect viewing.

More photos winter photos here

The Yukon Quest started this year in Fairbanks. A 1,000 mile dog sled race between Fairbanks and Whitehorse (in the Yukon) its considered by many to be more difficult then the Iditarod. Both the start and the finish are very well attended even when the temperatures are well bellow zero. "Mild" this year it was -5' F at the start. The excitement is absolutely palatable as the dogs go by.

Unfortunately we also endured one of the coldest January's in 100 years (According the Fairbanks Daily News Minor). It was f-cold. Personally, once its below -20'F its all about the same to me. With the exception being your car is noticeably more and more unhappy the colder it is.

People really, really like their toys here: Monster trucks, jeeps, ATV's and snowmobiles abound. I don't get it but in an effort to try to catch the enthusiasm we went to the finish of the Iron Dog Race the "world's longest and toughest snowmobile race". Given the "hot" finish line was a few miles up river it was bit anti-climatic.

Held in conjunction with the Tired Iron, a vintage snowmobile show there was something for everyone. Including "Moose turd" bowling for kids. I never cease to be amazed at how happy the kids are to be outside here even when its below 0 they seem genuinely thrilled to play in the snow.

As always all photos by Andy Bliss

Getting "Outside"

2012-02-03T16:01:00.000-09:00

Its widely accepted in Alaska that you have to go "outside" at some point during the winter to keep your sanity. Prior to living here, I never would have described myself as a sun person. Now I know I like the sun, I like it a lot. Its not the cold that has bothered me as much as the monotony of grey days this winter. In late December after returning from the "outside" we went weeks without really seeing the sun. It was hidden behind over-cast skies. Let me tell you it starts to affect your sanity. The days blend together and your PJ's call your name all the time. Its true what they say, you are wise to get out at some point during the winter. I am so glad we did.

In conjunction with the annual AGU conference in San Francisco we planned a whirlwind trip through the Bay Area seeing friends and family along the way before continuing on to Maui for "Babymoon". Stopping along the way in Seattle for a long lay-over and "date" with my Dad and his partner Renee to the Museum of Glass.

Practicing what you intend to preach

2011-11-28T11:00:00.000-09:00

For many years I have been the recipient of handmade birthday cards from two extra-ordinary now young adults. With rare exception these two were highly encouraged, read required by their mother to make cards for close family and friends. On the verge of becoming a parent myself, I am keenly aware of how these seemingly small traditions shape young people. I am even more conscious of the necessity to model the characteristics we hope to hope to instill in our children ourselves. How could I ever "require" handmade cards, if I do not make them myself?

Original:

My very first hand-made card inspiration found via Pinterest search "Birthday cards", originally from Oh Party.
My interpretation:

It seems only fitting that the first one would one be for one of

those young people who inspired the tradition.

Eve of New Year's Eve

2009-12-30T17:00:00.000-09:00

How will you celebrate the arrival of not only a New Year but also a new decade?
I am still working out my exact plans but I found lots of helpful suggestion on the internet!

At

I found a great collection of recipes "Eat Yourself Lucky: Good Luck Foods for New Year's Day"

As a child I was forced to eat "Hoppin' John", I turned up my nose and squinted my face at every bite. Last year I realized it isn't actually that bad. I cannot say that it is that good either but definitely not worth any amount of fuss for just a bite or two to secure good luck in the New Year.

This article also include a paragraph at end about foods to avoid. Lobster, chicken - Who knew?

Snopes can be counted on for other New Year's Day traditions to uphold.

and
is also full of simple instructions on how to ring in the New Year with gusto.

Personally,
I think you should spend the first day of the New Year in the fashion you would like to spend the upcoming year. For me that means:
- In a clean house, everything picked up and put away. If you're really on track, all the laundry done
- With the person I love the most (and others too)
- Starting on the perpetual New Year's Resolutions to eat better and exercise my body and brain more

Oh, and I also like this article about how to make your New Year's Resolutions Stick

In an effort to...

2009-10-28T13:49:00.001-08:00

to spend less time at the grocery store (and cooking in general), I have started planning out our meals for the week on Sunday night.

I know I am not inventing the wheel here but I am pleasantly surprised that everything that has been said/written about this habit is true. It has saved me a lot of time. Not only at that grocery store but also in meal preparation throughout the week and space inside my head. Also, I have spent less.

Now, you may say (like I did) that I don't have time to plan. That, that step will take too much time in and of itself. Seriously, I sat down on Sunday night with last month's Bon Appetit, my computer and a pad of paper. Even with distractions on the Internet it took me less than an hour to do the planning.

Now, you may say (like I did) that it is not as fun as going to the grocery store and just making it up on the fly. I don't think that has been true. It is just as fun. I feel charged that I know what I am doing instead of searching for what to do. And the things that inspire me, I file them away for next week or if reasonable incorporate them now. I don't think its drained my kitchen creativity. I think its made room for more.

All in all,
We have eaten just as well but its taken me half as much time and less money. AND it has been just as much fun.

It is not because...

2009-10-28T13:33:00.000-08:00

It has been a long time since I posted anything here. A long time - months and months.

It is not because I haven't been cooking, I have been.
It is not because there haven't been other sources of sustenance in my life, there have been.
It is not because I haven't thought about it, I do.

Like everyone else my life is crowded.
Crowded with commitments to make a living, to take care of myself and others and the space that we live in, to keep in touch with my friends.
Just crowded... even if in a fun, joyful way.

I don't know if I'll post more.
I don't know if it matters.
I do know: I'll keep cooking, my life and the people and things in it will sustain me and I will keep thinking about it even if I don't write about it.

What's for Dinner? Week of June 15

2009-06-17T16:38:00.000-08:00

Monday (6/15): Ginger and Honey Baby Back Ribs; Spinach, tomato, olive and feta bread salad
Why I thought these two dishes would be complimentary is beyond me? Both were tasty but not together.

From the cover of Bon Appetit. I doubled the amount of marinate and added more honey to the recipe. I also reduced the sauce after marinating and basted towards the end of BB-Qing. I did not make the dipping sauce, it seemed unnecessary and a little strange? In the future I would reduce the amount of salt. Very, very tasty but a bit salty.

Tuesday: Left-over Vegetable Chow Fun from Huong-Tra; Cherry cobbler

Wednesday: Gingery Pork Belly, rice and stir-fried veggies

Thursday: Something inspired by Emeril's Tangerine-glazed pork belly recipe. Given that tangerines are out of season, I suspect I will substitute oranges (or maybe even grapefruit) which are slightly more in season.
What's the story with all the pork-belly? I defrosted a large pieced of bone-in pork belly from the Mangalitsa cache, the piece was larger and more unyieldy than I suspected. So, I separated it from the bone (this piece will be used for Emeril's recipe tomorrow) and I used the boneless piece tonight.

Friday: "Everything dinner" heavy on produce. Produce, I suspect will be in the house come Friday - Potatoes, kale, left-overs from the pork belly extravaganza, avocados, cherries, peaches, and produce from this week's CSA box.

The What's for Dinner? post inspired by Chaos in the Kitchen. It seems to be a good way to both plan and re-cap the week's eating.

Sausage, Fontina, Bell pepper and Greens Strata

2009-06-03T11:14:00.000-08:00

Traditionally thought of as a breakfast casserole, Strata is really appropriate morning, noon or night. It can be adapted to utilize what's available in your vegetable crisper, makes use of left-over (or over purchased) bread and reheats well. Inspired once again by this month's bon appetite.

I made it for dinner Sunday night.

Sausage, Fontina, Bell pepper and Greens Strata
In a large frying pan over medium-high heat saute until brown:
~1 pound of roughly chopped chicken sausage (I used pre-cooked Trader Joe's Chicken, spinach fontina sausage), about 7 minutes.
Remove from pan, place in large bowl and set to the side.

In pan drippings saute until translucent and starting to brown:
1 onion roughly chopped about 5-6 minutes
1-3 (based on personal preference) cloves of smashed garlic

Add:
2 thinly sliced red bell peppers
Saute until limp 5-7 minutes. Remove from pan and place in bowl with sausage.

Lightly coat skillet (the same one) with olive oil, wilt over medium heat:
1-2 pounds of greens roughly chopped
Remove from pan and place in bowl with sausage, onions and peppers. Stir well to combine.

In a medium size bowl combine:
3 eggs
3 egg whites
1/3 cup of grated Parmesan cheese
2 tablespoons of oregano
2 cups of low-fat milk
1/3 cup of whipping cream
Stir well to combine.

For the next step you'll need:
~1 pound baguette roughly cubed
1/4 pound shredded Fontina cheese

Spray a large square casserole with
Pam (0r other non-stick spray).
Place one thick layer of bread cubes in bottom of casserole. Pour ~1/2 of egg mixture over bread cubes. Mix to coat bread cubes entirely. There will be excess egg mixture in the bottom of the casserole. Layer 1/2 of your shredded cheese, and 1/2 sausage, onions and bell peppers. Cover with remaining bread cubes. Pour remaining egg mixture over top. Spread remaining cheese on top.

Bake at 350 F for 45 minutes. Allow to set for 5-10 minutes before cutting into squares.

Time: 1.5 - 1.75 hours (1 hour unattended)
Servings: 6 - 8 large squares

Huevos Rancheros

2009-05-12T05:00:00.000-08:00

I love to go out for breakfast and when I do it is next to impossible for me to order anything other than Huevos Rancheros. In honor of two of our favorite events at Kent Court, Cinco de Mayo and breakfast for dinner night I prepared my all time favorite breakfast.

It is a hybrid of these two recipes. No picture it was fiddly and gone too quick.

Ranchero sauce

In a medium sauce pan, over medium heat, saute
1 onion roughly chopped in 2 tablespoons of olive oil.
When softened and starting to caramelize, approximately 8 minutes, add
1/2 - 1 chopped jalapeno pepper (with or without the seeds, your preference), allow to soften a few minutes, add
1 tablespoon of cumin, stir to enliven the spices

Add:
1-15 oz can chopped fire roasted tomatoes
1 can of chopped green chilies
Stir to combine, reduce heat to simmer and allow to flavors to meld approximately 1/2 hour.

Lightly grease a large frying pan, heat over medium. Barely heat/fry a corn tortilla, do not allow to brown, flip once or twice. Sprinkle a few tablespoons of cheese (cheddar, jack or queso fresco are all appropriate choices) in the center of the tortilla. Crack an egg in the middle of the tortilla. It may run off the edges, its fine. Cover with a lid and allow egg to set-up. When mostly firm flip as carefully as you can, and finish cooking to your preferred doneness.

Serve smothered with ranchero sauce, side of black bean, more cheese, and/or sour cream.

Joined

2009-05-10T18:51:00.001-08:00

We will pick-up our first box on Friday, can't wait

Slow return to normal

2009-05-05T19:00:00.000-08:00

Prior to the wedding we had a great last dinner upstairs, it seemed only fitting to return to normal with an exceptional meal. Inspired by a several recipes in last month's Bon Appetite, last night we had:

Shitake mushroom, asparagus, and leek tartlets
Saute in 2 tablespoons of butter and 1 tablespoon of olive oil,
2 thinly sliced leeks, white and pale green parts only (rinse very thoroughly to remove any sand and grit)
10 - 12 ounces of shitake mushrooms thinly sliced until wilted and lightly browned

Remove from heat and place in a medium sized bowl with,
1 pound of asparagus, bottoms snapped and diagonally cut into 1-2 inch pieces
1/2 cup of creme fraiche
2 oz of grated gruyere cheese
Zest and juice of lemon
1 tablespoon of thyme
Stir to combine.

Preheat oven to 400 F

Cut 2 sheets (1 package) frozen puff pastry into 8 squares, place on 2 ungreased cookie sheets. Distribute mushroom, asparagus and leek mixture evenly, mounding slightly to leave 1/2 inch border on tartlet.

Bake for 10 - 11 minutes, turn and flip sheet position in oven. Bake an additional 8 - 10 minutes, remove from oven. Run edge of spatula under each tartlet to loosen, allow to sit for 5 - 10 minutes before serving.

Lightly minted, fresh and bright pea soup
Over medium heat, saute in 2 tablespoons of olive oil 6 shallots - roughly chopped

Add 1 1/2 lbs of frozen petite peas, stir to combine with shallots.

Add 4 cups (1 box) of low sodium vegetable stock, stir to combine. Raise heat, and allow to come to a boil. Reduce heat and allow to simmer for 8 - 10 minutes. Add:
2 tablespoons of chopped fresh mint
Juice of 2 lemons

In batches puree peas and broth until silky smooth. Return to stove heat over low. Salt and pepper to taste

Accompanied by
Pan fried Mangalista chops, from our swine supply in the freezer

Commission on Dietetic Registration

2009-04-14T18:55:00.000-08:00

Congratulations! You have passed the Registration Examination for Registered Dietitians.

Of a possible 50, ... .
A total scaled score of 25 is required to pass the examination by completing a minimum of 125 questions.

While it is easy to be critical of both the DI internship requirement and the examination itself. At this moment, I am just simply thrilled to join the profession of dietetics.

Thank you to Sharon Bode and all my preceptors at The Methodist Hospital (especially Christi, Hailey Whitehead, and Anne); Texas Children's Hospital Claudia, Dawn, and Terri; Becky at DaVita and Karen at Employee Wellness at The Methodist Hospital.

Butternut Squash and Pork Tagine

2009-02-09T22:20:00.000-09:00

In some countries this dish is made in a fancy dish with the same name, tagine. I use a skillet with high sides, with excellent results.

Start with:
Olive oil, enough to lightly coat pan (not more than a tablespoon or so)
2 pork ribs (the big ones), ~3/4#
Using a large skillet with tall sides, coat with olive oil, heat over medium high. Brown the pork ribs on both sides, 4-5 minutes per side. Remove pork ribs from pan, let stand. Cube pork, the pork will be pink inside and not safe to eat yet.

Turn heat to medium, add to pan:
1 large onion - thinly sliced
4 - 5 garlic cloves - smashed
1 - 2 inch chunk of ginger - peeled,minced
Stir to coat with oil and drippings, allow to cook until starting to brown and onion turns translucent, 5 - 7 minutes.

Add:
1/2 large butternut squash - peeled and diced into small cubes
apple - peeled diced
Stir to evenly distribute onions and aromatics throughout.

Add:
cumin - 1 tablespoon
coriander - 1 - 2 tablespoons
turmeric - 1 tablespoon
Stir and allow heat to enliven spices, cook ~2 minutes
Add:
1 1/2 cups cup of weak chicken broth
Add cubed pork and any drippings back into pan. Cover, adjust heat to simmer. allow to cook 15 - 20 minutes until squash is tender and pork is no longer tender.

Remove lid, add:
raisins - 1/4 cup - 1/3 cup
almonds - 1/4 cup
cilantro - 1/4 big bunch roughly chopped
Allow sauce to reduce ~5 minutes over heat high enough steady bubble. Using wooden spoon, smash butternut squash to aide in thickening. Tagine should be thick, more like stew than anything else.

Serve with couscous, quinoa, or naan to soak up the yummy goodness.

Serving: 4
Time: ~45 minutes

Houston Grub

2008-11-30T06:25:00.002-09:00

Whilst in Houston I was more disciplined than ever about eating humbly. More than any other time in my life I ate at home and brought my lunch to work. I also threw away practically no food, I ate almost everything I bought. Surprisingly, I did not miss eating out. It was not for lack of options. There are more places to eat-out in Houston than any other place I have ever lived or visited. Seriously, there are ten restaurants on every corner.

However, I did eat a few times and can whole-heatedly recommend these fine Houston eateries:

- Zabak's Meditrerranean Cafe
Hands down best, cheapest falfafel sandwich($5) I have ever had. Genuine, friendly service. I went twice in 6-months and would have gone every week if my budget would have allowed it.

- Brasil Cafe
One of my few complaints about cafe's and bars in the SF Bay Area is the lack of not only outdoor seating but also the size and stability of tables. This Houston cafe far surpasses any local cafe or bar. Tons of outdoor seating and small but very stable tables. Perfect for sitting and studying. Plus, the food is great and reasonably priced AND you can can get coffee/tea or wine/beer. Favorite place to linger in the afternoon with a study material.

- Boudreaux's Cajun Kitchen
I was first introduced to Boudreaux's by way of fried dill pickle chips. Not something that prior to living in Houston I would have considered tasty or delicious. But fried dill pickle chips = tasty and delicious. You do however need to split an order with at least three people because you're satiated early with the salty and yummy treat. Boudreaux's has an extensive menu with almost any fried item you could possible want (and many items prepared in other ways too but really why bother). Casual and fun. A little expensive but ample portion size. Great drink specials before 7 pm.

- Big Woodrow's
A fellow intern intern worked at Big Woodrow's throughout the internship and loved it. She insisted that we introduce the incoming class to traditional Cajun food here, specifically boiled crawfish. Crawfish are widely distributed in the southeast and considered a delicacy, rightfully so. I thought it was so great we took my dad when he came two weeks later for crawfish. When ordering crawfish for the first time make sure you find out how spicy they are. I loved it but my dad was a little overwhelmed by the spice.

And who could go to the almost South and not partake of BB-Q:
- Goode Company
Everything they say about Texas BB-Q is true. It is soo good. It also widely available but believe it or not, I only went for BB-Q three times while I was in Houston - twice at Goode Company. Just go, don't think about splitting a plate, get a combo and try as much as you can. They say the pie is also good at Goode Company but I ate so much BB-Q I never had room.

Mangalista Mania

2008-11-30T06:24:00.000-09:00

Several months ago I agreed to purchase a pig (I don't think it was the pig pictured above) from a high school friend, Kylan Hoover. Six months before Kylan and I had gone for lunch together, while catching up, Kylan casually mentioned that he was interested in returning to pig farming (He had raised pigs for the fair in high school). I had just been reading on Michael Ruhlman's blog about a pig-purveyor in Washington who was looking for a northern California outlet for his prized Mangalista. One thing lead to another and Kylan was the proud daddy of more than 50 pigs in less than a month. Given the introduction I feel a connection to his "herd" of piggies.

When given the opportunity I had to have one. Some girls have to call their fiances and say "I went a little crazy and bought another pair of shoes", I had to say "I kinda just bought a pig... with your checkbook." Lucky for me Andy (and my mom) really like bacon. Even a small pig yields far more pork than two can reasonably eat so I solicited friends to purchases "shares" of our new friend.

I have never bought a whole animal for consumption before (chicken's don't count). I didn't know the pertinent questions to ask:
Q: How will the Mangalista go from living to dining?
A: The swine along with nine other friends were transported in a horse trailer from their home in the Livermore Valley to a small family owned slaughterhouse in Modesto on a Monday. Where they met their end quickly and humanely. The whole hogs were transferred in a refrigerated truck to Star Meats in Berkeley where my pig "hung" for several days. Hanging is necessary to allow natural chemical reactions to occur taking the meat from icky to amazing. Kylan left directions for the cutting and on Friday morning the pork was cut. Friday afternoon we picked up many neat brown packages.

The other pigs went on to the French Laundry where they were processed for curing and aging. They will make a prominent appearance early next year on the menu.

Q: How many pounds of meat will the piggy yield?
A: When all is said and done I still don't know. By conventional standards my pig was small weighing just shy of 200 pounds at the end. I weighed most of the individual cuts in order to fairly divide among shareholders. However, I did not weigh the head, heart, kidney's, liver, lard or intestinal bits. Some of the poundage is lost during butchering I think its safe to safe in the end I had over 150 pounds of pork.

Q: What happens to the head, heart, kidney's, liver, lard and intestinal bits?
A: I kept and rendered the lard myself.
I met my limit at "processing" the other offal so I arranged a trade with Hank Shaw. Who made excellent use of the other nasty bits and publicized Kylan's business a bit on his blog Hunter Angler Gardener Cook.

Q: How do you fairly divide the pork among shareholder's?
A: We laid all the neat brown packages out on a table in the garage. We took out several "odd" pieces including the pork shoulder that I roasted for the party. We weighed the pieces and with Kylan's help we just started making "equal" piles. On the day of distribution I used my own share to swap with people who wanted different cuts. It just worked itself out.

The list of questions goes on and on.
Needless to say most of us (including me) don't really know how our dinner starts.

Let me tell you this dinner was damn good even knowing a little bit more about where it came from.

Photos courtesy of Andy Bliss - More photos of the pig party.

Daily Grind - Food Service Managment

2008-10-25T08:51:00.000-08:00

Compared to my almost grueling 10-week clinical rotation, my 4-weeks of Food Service has gone by lightning fast. I barely have blinked an eye and I am done.

Once again I was assigned to a hospital within the Texas Medical Center, that's where the similarities between the experiences stop. Unlike my clinical rotation: I arrived at 7:30 am and was almost always gone eight hours later at 4:30 pm; I saw patients only in the halls of the hospital, I don't think I uttered more than ten words to one; I spent a lot of time in the basement (where most hospital kitchen's are located); I had more than enough time to complete the tasks assigned to me; Everyone was really, really nice, all the time.

I wish I had a quarter for every time I have heard: "I didn't get a degree (or two or three) to work tray line", "I hate to cook", "I don't do food service". Seriously, the way many dietitians talk you would think nutrition and food were completely unrelated. Most dietitian despise the words "food service". So, I hate to admit it... I kinda of like it. Although industrious employees who take great pride in their attention to detail, food service doesn't take its self quite so seriously. Your fellow employees come from a greater slice of life. Not everyone has a college diploma (or even a high school diploma); its a little less idealistic, a little more r-e-a-l.

Typical tasks performed during this rotation:
- A lengthy "Patient Services" check-list to get familiarized with all the jobs and tasks required to get meals to patients.
- Audits of: Patient identification and proper hand washing among food service employees (No need to worry: Everyone appropriately identifies patients, everyone washes their hands), the proper use of formula order form among physicians, and kitchen inspections of the hospital and food court kitchens
- Documentation of food service related charges in a doctor's lounges of a newly opened unit of the hospital
- Development of independent learning activities for food service employees who missed customer service training
- Development of a bulletin board marketing a customer service program to employee's
- Data collection and presentation of clinical dietitian monthly productivity
- Analysis and recommendation of provision for emergency food supplies (MRE's v. recognizable, microwavable product).
- Development of tool to track quarterly changes in food cost

Yes, some of this work was tedious. However, I was exposed to the breadth of tasks required in food service management. My days also could not have contrasted the relative sameness of the days of a clinical dietitian more.

Twilight

2008-10-05T07:40:00.000-08:00

There is something completely absorbing about these books.

They are the absolute epitome of a fairy tale and the
sickening reality of adolescence woven together.
Highly recommended

Hurricane Ike

2008-09-13T18:52:00.000-08:00

Hi all!
Thanks so much to all of you who e-mailed, called, texted or just thought about my safety over the past 24 hours.

I am happy to report that I have survived my first (and hopefully my last) hurricane unscathed. Many others in the gulf cannot say the same, I feel very lucky. Hurricane Ike came through over night, the real action lasted about 5 hours. Jenny (my roommate) and I dragged a mattress and pillows into the hallway and slept there. It was loud and a little scary but all-in-all okay. Our power was out for about 6-hours but came back on this morning (Most people in the area are not expected to regain power for a few days.) We are LUCKY.

I have posted a few photos at http://picasaweb.google.com/tjgirl/HURRICANEIKE#. My entire neighborhood has debris and trees down all over. Most of the street lights are out. Many of the street signs have been toppled. It just generally looks tattered. People are out and about cleaning up. Most in good spirits. You can hear generators buzzing, people are BBQ-ing. While it NO way feels like a block party, people openly express their gratitude for their personal safety and property. I think everyone's just glad its over.

I expect to go back to work at the medical center Monday or Tuesday.

Hope each of you are safe , warm and dry.

Be in touch.

Always,
~Taryn

Daily Grind - Clinical

2008-09-08T15:36:00.000-08:00

In some ways I can hardly believe that I am already 1/2 way through my Clinical rotation. In other ways if feels like it should be long over. The Clinical aspect of the internship is the longest and most intense of the 5-rotations. It is a 10-week crash course in not only the various disease states and how they relate to nutritional status but also the mechanics of working within a hospital.

It is the practical application of everything you have learned in school
AND everything they don't teach you.

I am at a large, prestigious teaching hospital. It is ranked as one of the best hospitals in the country. Inarguably, it would be next to impossible to get a better experience somewhere else. However, it does have a reputation for being tough on interns. Within a matter of weeks we are expected to learn the lay-out of the hospital (a sprawling 5-building complex with up-teen elevators), a computer charting system, a food service set-up, the subtitles of relating to Dr's, nurses, and other essential personnel, AND see and document on 8-10 patients a day. We work under a different dietitian each week, whom each cover very different floors. Every day, every week is different than the one before. With the level of expectation building the longer we are there.

I have had the opportunity to work the following floors/specialties: Cancer, General Medicine, Cystic Fibrosis, Neuro-ICU, Neuro-stepdown (strokes and other brain injuries), Post-Gastrointestinal Surgery, Bariatrics and next week I'll follow the renal dietitian. After that I'll spend a week with an ICU dietitian before 2-weeks of practicum (working floors independently as an RD would).

So, what does a clinical dietitian do?? It is helpful to think of almost every health care provider (pharmacists, dietitians, physical therapy, speech, occupational therapy, etc..) in a hospital as acting as consultant to the MD. With nurses both playing the role of consultant and actually getting everything done.

Dietitians keep track of the nutritional component of patient care. When patients are able to safely eat, we stop by their rooms and encourage them, make sure they are getting their meals and "between meal nourishment's" (AKA snacks) and try to subtly slip in some healthy eating cues without being labeled as the "diet police". When dramatic changes are needed in a patient's diets (ex. new diagnosis of diabetes or kidney failure) we are sent with a packet of instructions and go line-by-line through a complete dietary change. When patients are unable to eat we act as a consultants, providing MD's with suggestions for alternative support. This may mean a enteral/tube feeding or parenteral nutrition/directly into the blood stream.

Every dietitian has the same mantra when working with alternative nutrition support: "If the gut works use it". Enteral nutrtion, the digestion of food through all or some part of the digestive tract is always the preferred mechanism of nourishment. If a patient is unable to chew or swallow a tube can be used. A nasogastric or nasoenteric a tube is placed through the nose and down the throat to the gut. While a PEG or J-tube is "surgically" placed directly through the abdominal wall to the stomach or intestine. Formula is than dripped or gently pumped into the body, and the gut completes the digestion and absorption of nutrients into the body. Enteral nutrition is used a wide variety of clinical conditions: It is used when a patient simply doesn't have the energy or ability to eat enough, when they are unable to swallow correctly (after a stroke for example), or when the stomach is unhappy but the gut is working properly. Enteral nutrition is almost always the preferred route for a myriad of reasons: It is more biologic, less invasive, less expensive and just less complicated than its cousin parenteral nutrition.

Parenteral nutrition takes alternative nutrition support to a whole new level. The smallest elements of food: sugar/dextrose, protein/amino acids and fats/lipids are directly infused into the blood stream no digestion required. Generally a central line directly into a major artery is used and the nutrition is continuously pumped in. Parenteral nutrition is only appropriate in a select number of patients, those whose digestive tract are unable or unwilling to digest food. This may happen when there is hole somewhere in the gut, after a surgery when the gut doesn't wake-up, with severe inflammation of the digestive tract or just complete upset of the entire system/major trauma. Parenteral nutrition may seem more straightforward than enteral but it is anything but. Our bodies are incredibly efficient at digesting and using food, so parenteral nutrition skips millions of years of evolution. It is anything but biologic, very invasive, incredibly expensive (more than $1,000 per day) and prone to complications. That said in select patients it is a lifesaving therapy.

MD's are only required to take one nutrition class during their training. Dietitians fill in the gaps. Providing consultation about the appropriateness of their selected nutrition regiments and offering alternatives. For our suggestions to be relevant they must be holistic, taking into consideration the other related aspects, of patient care. Since the human body is the ultimate integrated system as a clinical dietitians we review and consider A LOT of things:

Why is the patient here now? What is their progress?
What is their past medical history and how does it relate to their current condition?
Daily labs
Medications
Output of fluid from the body (urine, waste, drains, etc..)
Medical therapies being used (ventilator status, hemodialysis etc..)
What are our goals? (E.g. increase PO intake, minimize loss of lean body mass, etc..)

Unfortunately, a medical record is not a clearly delineated dossier of patient history and treatment, and everything they say about doctor's handwriting is true. So, often it feels like you are detective trying to figure out what the heck is going on with this patient AND what the heck you going to suggest for them. This process repeats itself as you work through your patient list. It can be both ridiculously frustrating and incredibly rewarding contributing to the care of very sick, very sick individuals.

Clinical nutrition is simultaneously everything I expected and an entirely different ballgame.

Ps. The opening image is of the Texas Medical Center, where I am completing my clinical rotation. Check out this link for more information about the medical center and the organization's within it.

Houston Theater District Open House

2008-08-30T09:37:00.001-08:00

Last weekend I checked out the Houston Theater District 15th Annual Open House.
It was quite a nice event. Even though I was not inspired to become an opera singer!

Soup on Sunday's

2008-08-24T16:20:00.000-08:00

I have been horribly uninspired to cook since I started "working".

Perhaps its because I spend at least 8 - 10 hours everyday talking and thinking about what other people eat and seeing first hand the consequences of poor dietary/lifestyle choices. Perhaps its because its not as convenient to get great ingredients (No Monterrey Market, no Berkeley Bowl, no Trader Joe's). Perhaps its because I am only cooking for me. Who knows?? Anyway I've got to get back cooking... Starting with a little soup on Sunday's.

Spicy Southwestern Soup

Soak 1.3 cups of mixed dried beans in water for a few hours.
(I used beans from North Day Trading Co, found in the bulk bins at Whole Foods)
Use a colander, drain and rinse beans.

In a large stock pot over medium-high heat saute 1/2 chopped onion, 2 -3 cloves of garlic in ~1 tablespoon of olive oil. Allow to become fragrant and translucent ~7 minutes.

Add beans back in and cover with about 1.5 inches (~6 cups) of water. Add 2 tablespoons of Better than Bouillon or 2-3 cubes of bouillon. I like chicken or veggie flavor. Add 1/2 cup of prepared salsa. Cover the pot bring to boil and than turn down allow to simmer for 60 - 90 minutes. You want the beans to be tender but not falling apart.

At the end a 5 - 10 minutes before serving (depending on how cooked you like your veggies) Add:
Handful of chopped cilantro
1/2 chopped red bell pepper
1 cup of of chopped carrots
1 chopped squash (zucchini or yellow or whatever you have and like)
Whatever else you think would be good.

Garnish:
Cheese, avocado, lime wedges

Time: 2.5 hours, mostly unattended
Serves: 4 easily - 6

EL SALVADOR

2008-08-24T07:28:00.000-08:00