What's up, doc?

It’s somewhat customary, when one has been absent a long time from one’s corner of T’Internet, to apologise and offer an explanation.  So, lovely readers, the primary reason that I have not been posting recently is because it is hard to work up any enthusiasm for writing about food when you seem to spend half your life dealing with it at the other end.  I am sorry to be coarse, unladylike and to be offering what is undoubtedly I of the TM sort.  But there you have it. 

Finally, at the end of last week the problem was diagnosed as Bile Acid Malabsorption (BAM) or, as it is sometimes called, Bile Acid Diarrhoea (BAD), almost certainly caused by the removal of my gallbladder around eighteen months ago (I wrote a post about my experience with that so will link the two together in case it should prove useful to anyone).

I won’t pretend to understand the ins and outs of it, but basically BAM means that your guts are not absorbing as much bile acid as they should be so you end up with bile swilling around that your body tries to flush out by releasing more water – the result being that you end up with pretty much permanent tummy trouble.  A normal reasbsorption rate is about 20%.  Anything under 15% and you get your BAM diagnosis.  Anything under 5% is considered severe.  My rate was 1.8% so –well.  Winning. 

I have now started taking medication which should mean that the problem is sorted out and very shortly I will be looking back and laughing at all this.  Because, believe me.  I am not labouring under any sort of delusion that this is a Big Problem in the grand scheme of things.  I am perfectly well aware that there are many people out there who are dealing with far worse and I am a little ashamed that even at my ripe old age I have not got any better at pulling on Big Girl Pants and being stoic in the face of such annoyances. 

2018 - the year in review

As with most years, 2018 was like the curate’s egg – good in places.  For the most part, it involved a lot of keeping on keeping on.  Work ramped up and became considerably more stressful in the latter few months for various reasons beyond my control – bad.  I struggled a bit with my continuing digestive issues which began to have an impact on my mental health – tedious beyond belief for all concerned.  But there were no big upsets, or dramas or traumas – good.  We had a couple of lovely trips away, including a few days in a little shepherd’s hut in York which I never got around to detailing on here – excellent.  Yet again, I have managed to end the year lighter than when I started it, mainly thanks to a successful re-acquaintance with WW back in the summer.  That may have trailed off a bit of late but I am keen to get stuck back into it now we are emerging from the month of December, when somehow it becomes normal to eat mince pies for breakfast.

Dishes of the year is a tough one to call.  We went back to Raby Hunt and loved it every bit as much the second time around but given that many of the dishes were almost exactly the same as the ones that we had eaten previously, I don’t feel quite right to hand over another coveted trophy to them. 

An early contender was most definitely the stunning duck dish that we had at Joro in Sheffield.  We liked it so much that we recreated it at home for our Easter Sunday lunch, and I am not convinced that our version wasn’t even better!


The duck at Joro

The duck chez nous

But, to be honest, the thing that still stands out for me is this little fellow.

Pizza, Jim, but not as we know it

This was the scallop sashimi, spring truffle and togarashi spice “pizza” that we ate in Skosh back in June.  As mentioned above, I never really got around to talking about our York trip in much detail but we were lucky enough to eat some wonderful food and this dish was just head, shoulders and upper chest above pretty much everything else we’ve eaten this year.  Put it this way: we liked it so much that we immediately ordered a second one.  It sounds weird, it sounds like everyone’s idea of badly done “fusion” but the combination of flavours, the delicately balanced marriage of the sea and the forest floor, was absolutely sublime.  Skosh changes the menu pretty regularly, so I doubt I’ll ever get to have it again.

Dessert of the year came in the closing moments, and it may sound ridiculous when we’ve eaten at some truly wonderful venues, including Il Ridotto in Venice where we were served the most glorious, challenging pudding combination of truffle, ginger and pumpkin which was as strange and wonderful as it sounds.  Yet nothing can compare to the dessert that D made me for my birthday this year – the sticky toffee parkin.  A mash-up of the traditional sticky toffee pudding and the Yorkshire parkin.  I have the recipe and I will be blogging it shortly.  If you like sweetness and spice then you will adore this, I promise.

Sticky toffee parkin

And an honourable mention to the Guinness cake that I ate during my first visit to the Rusty Shears.  The thought of this still makes me smile.

More icing than cake

At home, we’ve been dousing everything with sriracha and coriander and green chilli chutney – sometimes both at the same time.  My palate is becoming better and better at tolerating heat and I’m really beginning to learn how, like a pinch of salt or a drop of acidity, it can really bring cooking to life.  If I was going to commend one recipe to your attention this year it would be the chutney / sauce / salsa / whatever because it is such a good fridge staple.  I can think of few savoury dishes that would not be enhanced with a hefty splodge of this stuff.

As ever, I’d like to thank everyone who pops by and reads my little blog.  I still enjoy writing it after all these years, as a chronicle of adventures both at home in the kitchen and further afield.  And while it may not be a diet blog per se, it still stands as testament to the fact that I will never quite give up on trying to nudge the scales down to unremarkable levels. 

To all of you I wish a very happy New Year and here is to great things for all of us in 2019.

Post Christmas blue(berry scone)s

Seasons greetings to all! We are now in the period of the year where, if your household is anything like ours, you will be barely moving apart from the well trodden path between the sofa and the kitchen. Secretly, you will already be planning the health kick to end all health kicks on which you plan to embark at one minute past midnight on January 1st. And then you remember that you’ll have a fridge full of NYE leftovers at that point so best hold off until you return to work.

Today is my birthday. Most of the year, I dislike having a birthday so close to Christmas but, I must admit, there is something nice about having an event to look forward to post Boxing Day if only to punctuate the naps. I woke to the smell of blueberry scones in the oven - there are few better smells than home baking and, I might almost suggest that it beats the more commonly evoked scent of bacon frying into second place. But I digress. Behold these beauties which were sweet and buttery and perfect with a cup of tea. They were an almost exact replica of the old Starbucks berry scones that I used to adore back in the day and which the bastards saw fit to stop producing (in the U.K. at least).

Hopefully everyone had a wonderful Christmas dinner? Our duck legs were as delicious as ever (I don’t really understand why we only tend to cook them once a year). And D’s last minute brainwave of making shredded duck and black pudding bonbons, very lightly flavoured with Chinese five spice, was a genius addition.

We were due to spend Boxing Day eating a Christmas dinner proper with my parents. And, indeed, D managed it. But I took to bed mid afternoon with a stomach like a washing machine - a potent combo of my gnarly digestive system in uproar about the surfeit of rich food and drink that I had dared to subject it to, and that wonderful monthly visitor that makes it such a pleasure to be female. I am rather sad about this, although 24 hours of barely eating seems to have calmed things down slightly and my Mum did package up some turkey and sausage-meat for me to enjoy a traditional post-Christmas sandwich. Hopefully, it will be sorted out early in the New Year (the gnarly digestive system rather than the being female bit) at which point I might buy a turkey breast and offer to cook them a not-Christmas dinner in recompense.

That aside, it has been a lovely festive season and I have once again been reminded of how lucky and blessed I am. A blog is a funny thing - even one which is ostensibly about dieting and food will often come to be treated as a sort of confessional and that means the focus here might be skewed towards the less positive aspects of my life. This year, like all years, has brought its issues and struggles but also its gifts and it will be the memory of these latter that will endure.

A pre weigh-in post

So, first week nearly over and in a few hours it will be time to hop up on the scales.  Whether they are the Scales of Doom or the Scales of Joy remains to be seen. 

I wanted to make sure that this post was written and up before the weigh in, so that I can look back on it regardless of the result.  Because, whatever the scores on the doors, this has been a successful week.

As I hoped, operating within a structure has been really good for me.  I have been eating properly for the first time in a while and my fruit and veg consumption has rocketed as I embrace zero point snacks.  This has had a knock on effect on my mental health – I feel much calmer and more in control.  And physically, my stomach has been OK.  Not perfect, but OK. 

I have had a lovely weekend with friends and managed to enjoy myself without going ridiculously overboard, without adopting a “Screw it, I can’t point so I’m going to eat and drink everything in sight,” attitude and, hugely, without having a drink.  I am a girl who loves her alcoholic beverages: to get through an entire sociable weekend watching other people tuck into large glasses of Pimms while sticking to water is a pretty big deal.  But I made the decision that it wasn’t worth the points and it wasn’t worth the potentially catastrophic effects on my beleaguered digestive system and I stuck to it.

So whatever the scales have to throw at me today (and I’m genuinely in the dark) I’m going to try and remember that, by any other measure, this has been a GOOD WEEK.

Sunshine, lollipops and a new blog post

Long-time no blog!  It is probably a little self-indulgent to say that I hope that I haven’t been missed – but I feel it is slightly justified given that lovely Hazel left a comment on my last post saying she missed my Meal Planning Mondays!  I promise to reintroduce them forthwith.  With regards the radio silence:

 

Reason the first – my digestive discomfort issues have been continuing.  I have always prided myself on the robustness of my digestive system and this has been unpleasant and disconcerting.  I finally plucked up the courage to go the GP and it is probably something very simple related to stomach bile (sorry if TMI) post gallbladder surgery.  It is not uncommon and can be controlled with medication.  So once anything more sinister is ruled out (and giving that all of this has only kicked off post surgery it seems highly unlikely) I will be rendered as right as rain by the wonder of our NHS.  Happy days.

 

Reason the second – which is related to reason the first.  Long term readers will know that, from time to time, I have a bit of an issue with anxiety.  Or rather, Anxiety, because anxiety is when you’re a little bit worried about a presentation that you have to do at work the following day and Anxiety is when you are frightened to leave your bedroom for reasons that are obscure even to you.  It’s frightfully common nowadays – the go-to mental health issue de nos jours, so I feel like something of a cliché but there you have it.  Fretting about my health and always trying to ensure the nearest toilet was within easy access in case of emergencies combined with my existing predisposition and made me…well, a bit shaky.  I don’t want to dwell on this too much – if it’s boring and tedious to me then it is undoubtedly boring and tedious to you.  Needless to say, fasting went by the wayside (low blood sugar is the last thing you need when you’re wobbling anyway) as did much cooking or, indeed, taking much pleasure in food.  (Sorry for the melodrama – can you understand why I didn’t post now?)

 

I haven’t weighed myself in a while but from the feel of clothes and suchlike I think it is all relatively stable but I’ve not been eating particularly well and that is stupid, because one of the best things to do for your mental health is to ensure that your diet and fitness are on point.  So that leads me to reason the third why I’ve been a bit reluctant to blog.  I’ve decided to go back to WW for a bit.

 

I know that I swore off it and I truly believe that, in the longer term, intermittent fasting will enable me to maintain my weight without being a slave to the pointing and weighing and measuring.  But I also believe that just for now, a bit of structure, something to focus on, would be a Good Thing.  And if I can ditch a few pounds in the process it will be an Even Better Thing.  I don’t intend to be evangelical about it.  I will eat out and have nights off – life is too short to never eat another takeaway.  And I will continue to monitor the situation.  If the return doesn’t justify the effort well, then, I’ll stop.

 

I’ve already signed up for the app and will be going to my first meeting tonight.  I’m intrigued about the new plan – it seems to be edging ever closer to Slimming World with more zero point foods – including lean poultry, fish, eggs and pulses.  I struggled initially when WW switched from Pro Points to Smart Points so it remains to be seen if the further changes make it more or less doable.  Regardless, a healthy project is just what I need at the moment to take my mind off my own navel. 

Head - meet sand

I'm avoiding the scales for a few weeks.  Possibly because I've not been feeling 100% lately (I remain in terrible thrall to a delicate digestion and it is becoming rather wearing), the fact that the scales have remained stubbornly static is making me disproportionately annoyed and upset.  So I am giving myself permission to back off for a while.

In times like these, my mind turns to alternative methods of dieting which would get me to where I want to be a little quicker than this circuitous journey on 5:2.  I starting Googling the Keto Diet* the other day (high fat, low carb), flicked back through our Dukkan book and wondered whether I could combine 5:2 with 16:8 (which would mean on non-fast days only eating within an 8 hour window).  But I think, actually that I just need to give my head a wobble, to stick to what I'm doing, to up the exercise and to concentrate on the fact that I've found something that works (albeit slowly) and has improved my relationship with food a hundredfold.

*Anyway, if I started on an eating plan that allowed me to eat unlimited cheese I would literally end up TURNING INTO CHEESE. 

MPM: 19th February 2018

Amazing meal at Joro last week (write-up to follow shortly). Less than amazing was my digestive system's reaction to it. Yes, I am having (ahem) ishoos at the moment with what feels like food in general (and, in particular, food) which I'm fairly convinced are linked to the fact that I had a bit of said digestive system lopped out last summer. It appears to be rather pissed off with me and is exacting revenge. I'm fighting back by keeping a detailed food diary complete with colour coded (ahem squared) movement monitoring which, at some point, I may need to go and wave at the doctor. Although I'm terrified that they'll make me FODMAP, or some such thing. Which would not be in keeping with my (shamelessly nicked) life philosophy of everything in moderation, including moderation.

Anyway, the point is that the meal plan unravelled slightly towards the end of last week to accommodate my delicate little self. Although we were back on track by Sunday for a fiendishly good fish finger sarnie. I reckon that I've nearly nailed ciabatta rolls which are the perfect vehicle for any sort of sandwich that has the potential to be messy: robust yet airy with an excellent flavour.

New week, new start and I've stuck to a fast day today (I suppose it's only half six, there's time for it all to go wrong) will hopefully be able to stick, more or less, to the planned meals for the week without needing to resort to gruel.

Monday: fast day - soup

Tuesday: freezer dived turkey curry with rice and cucumber raita. And maybe a flatbread if I can be roused to such dizzy heights.

Wednesday: fast day - soup (and a trip to the cinema to see The Black Panther in an attempt to distract from the hunger pangs)

Thursday: prosciutto capalleti, garlic bread, some sort of salad

Friday: as part of our ongoing quest to cook our books, I'm doing a couple of dishes from Tim Anderson's "Nanban". I think that I've selected Tonkatsu, which is the Japanese equivalent of schnitzel, with sushi rice and mushrooms with spicy miso butter. I'm not entirely sure that it would be considered at all authentic to both things together, but the idea worked in my head, so we'll give it a go.

Saturday: D has requested burgers, so I'll be doing ciabatta rolls take 3 and will leave the filling of them to him.

Sunday: we had a pot of cream in the fridge that needed using up, so I threw together a pommes dauphinois last week and whacked it in the freezer ready for next Sunday lunch. Such a rich dish needs very little else, so probably a small amount of roast meat and something no-nonsenseley green.

Notes on gallbladder surgery

A slight departure from the usual Foodie Fare and probably not of interest to many.  But, you are more likely to have a dicky gallbladder if you are overweight, and if you starting reading this blog because it was supposed to be about dieting (hollow laugh) then this is something that may one day apply to you.  If not, no sweat, I'll be back with a cute cat picture shortly.

I really wanted to write this because I was so scared before having my gallbladder removed that I can't even begin to tell you.  I have issues with anxiety generally, particularly when it comes to matters of health, and the prospect of surgery terrified me.  So if this helps anyone else out there who is even half as frightened, then it will have done its job.

I first went to see the doctor in December over persistent, nagging abdominal pain - some generalised but some concentrated in the upper right quadrant.  It was never agonising, which is how gallstones can and often do present, but it was annoying. An abdominal CT scan showed some stones and that the organ itself was inflamed.  At this point, when surgery was mentioned, I must admit I didn't particularly feel that the severity of the symptoms warranted it; the advice of the experts, though, was that once you start having gallbladder problems they are likely to get worse and can end up very nasty indeed so, really, you're best off getting rid.

The process, in retrospect, all happened very quickly.  I saw the consultant within about a month of referral and then another month or so later was given an appointment for a pre-op assessment and then was put on the waiting list.  In my area, the average wait time from going on the list to procedure is 20 weeks, but I was given a date after around three months.  I should add, though, that I was offered a cancellation spot that I was able to take up which brought the operation forward.  It certainly seems to help if you can be flexible in these circumstances.

Unless they have a particular reason not to, gallbladders are removed using keyhole surgery which means that you can be in and out of hospital in a single day.  Apparently, the average procedure takes 45 minutes, although they can take anything from 20 minutes to 3 hours.  I had four little incisions, one of which was inside my belly button.  They inflate your abdomen to make it easier to manoeuvre, which means that you might (I did!) feel a bit bloated and gassy afterwards.  However, it is not an invasive procedure - I can't believe how small the marks are.

The thing that scared the bejeesus out of me was the anaesthetic.  Up until this point, I had never had a general anaesthetic.  I hope that I never have to have another one (the stress!) but it was fine.  And if you are reading this and are worried because, like me, you have a too high BMI and know that this makes you higher risk all I can say is I had no problems whatsoever.  There were two doctors taking care of the anaesthetic side of things and, I am told, they are present the entire time to make sure that you are OK.  If you are slightly overweight, they will raise your head slightly to make it easier for you to breathe.  If you are so overweight that it is going to cause a serious problem then you are unlikely to get through the pre-op assessment - i.e. if you're there and they're happy to go ahead then someone more qualified than you has decided it's not too much of a risk.

It sounds a cliche, but one moment I was in the operating theatre feeling a bit tingly, wondering if it was actually going to work, and the next minute I was coming round in the recovery room and the nurses were reading out horoscopes.  I expected nausea and disorientation but, for me, it wasn't much worse than waking up from a really heavy sleep.  I was slightly woozy and slightly dizzy, but within minutes was able to sit up and sip water and, as soon as they got me to the ward I was ready for a cup of tea.

In terms of general recovery: I was told differing things about the amount of time required off work.  At my first appointment, the consultant said 2-3 weeks.  The doctor that I spoke to on the morning of the operation said 3, the nurse in the recovery ward said 4.  My GP gave me a Fit Note for 4 weeks in the end but, to be honest, I probably could have gone back a bit sooner.  I am still ever so slightly sore, but not so much that it distracts from day to day life.  Immediately afterwards, other than the slight wind issue, the best way to describe the sensation is that it felt as though all my innards were bruised.  I was uncomfortable and a bit battered, but it was nothing that normal, over the counter, painkillers couldn't deal with and certainly nothing to be concerned about.  I had very little appetite for the first week or so.  I have also noticed that my digestive system seems slightly more...delicate subsequently.  I don't know if this is a long-term thing or just a question of things settling down over a period of time.  I am trying to listen to what my body is telling me in terms of quantity of food (I generally seem to want less) and not going overboard on anything with a particularly high fat content.

One thing that might well be TMI but no one mentioned to me beforehand.  One morning, I woke up to find that the largest incision site, in my belly button, had...well, ejected a rather large amount of blood-tinged, clear fluid.  I, of course, panicked, ringing NHS Direct at 5am and turning up at my GP's surgery first thing for an emergency appointment.  But apparently it is quite common to get a build up that all comes out at once, and it is nothing to get too concerned about, especially if the wound is not showing any other signs of infection.

The main thing that I have really taken away from this is how wonderful is our poor, beleaguered NHS.  I know you hear some horror stories but I can't praise the staff with whom I came into contact highly enough, from my GP right through to the nurse who gave me a hug before I got taken down to the theatre, to the lovely anaesthetist's assistant who chatted to me about his Mum as he was wheeling me in.  They do a bloody hard job day in and day out and I am very grateful to all of them.  They all said that it is natural and normal to feel nervous.  I mean, they probably could have done without me weeping on them at every opportunity but they were very patient and kind.

If anyone is about to go through this and has happened across this blog post and wants to get in touch then please do in the comments or to the blog's email address.  As I said above, I am more than happy to answer any questions about my own experience especially if it could help to alleviate someone's fears.

Normal service - i.e. food related witterings - will resume tomorrow.


Edited 25/02/2019 - following this surgery, I ended up with something called Bile Acid Malabsorption which is not uncommon and easily treatable but if you HAVE had your gallbladder removed and you are experiencing persistant stomach issues several weeks or months down the line, then I would strongly urge you get this checked out with a medical professional.