Cilantro Chicken and Gratitude

Hello everyone!

So I have been bad about the Monday recipe plan, but I have also been a bit nuts with school. I have also not made many new and exciting recipes that were worth sharing. This recipe is certainly worth sharing! Technically, since I found it on Pinterest, it's already been shared. But here goes. (Credit http://www.pipandebby.com)

Slow Cooker Cilantro Lime Chicken

24 oz jar medium salsa (Pace Chunky Medium)
Juice from one lime
1/4 cup fresh cilantro, chopped
1.25 oz package taco seasoning ( low sodium)
2 jalapeno peppers, finely chopped
6 boneless skinless chicken breast halves

Mix together first 5 ingredients in crock pot. Add chicken and coat with mixture. Cook, covered, on low for 6 hours. Serve chicken with salsa mixture spooned over the top or shred and use as a taco filling.


***Changes***
I omitted the jalapenos and used chicken tenders instead of breast halves. I made some brown rice, and spooned the shredded chicken over the rice into flour tortillas. I shredded colby jack cheese on top.

Gratitude

I decided that for Lent, I would take on writing down something I'm grateful for every day. I'll try to blog them or Facebook them or something.
Today, I am grateful to my principal for letting me share what I learned at the Rice Ally training this weekend. It's a touchy subject but I hope I was able to help the way we teach tolerance for all kids, including GLBT youngin's (whether they know it yet or not).
I am also grateful for this weather, which has not been so terribly cold this winter. We have not had a hard freeze, and today I took a walk in the park and it was 86 degrees. I might be a little sunburned.

Since the above was written (Wednesday), I have the following things I've been grateful for:
Thursday-  The weather was gorgeous, so SexyLawyerMan and I went to the park again. I am slow but I am able to jog/walk two miles.
Friday- My transplant coordinator called to catch up on my case, and I was able to tell her that I'm still doing really well and that's why they have not heard from me in months.

Saturday-I have the luxury of staying in bed all day to read. I finished "The Hunger Games"in two sittings, one last night and one for about 7 hours today.

In Which I Knock on Wood...

Oh, right, the kidneys. I wanted to catch up on all departments so I should probably update this one as well. Um, no news is good news?
This time last year I wasn't eating, I had visited the ER on the 2nd day of school, and I was going to the dialysis education class and making decisions. BIG decisions. My kidney function was hovering between 16 and 20%. We had followed the pattern and that pattern said in 6-9 months something would flare up again and my function would drop another 10%, putting me in the danger zone. That was 12 months ago.

Despite weird symptoms from time to time, like that lingering back pain that makes me nervous, and a new intolerance for large quantities of greasy foods, I'm actually doing really well on the kidney front.
My last lab results (September 14) showed creatinine at 2.1. This is the same number I had several months ago that was so low we thought it was a fluke. So if this is another mistake, it's a mistake on the right side of the curve. My current kidney function is at about 33%. Woo hoo! (Ok, that's crap, but to a much lesser extent than before.)
I feel good and I have had my blood pressure medicine dosage reduced twice this summer since I'm just doing so awesome. I intend to finish out this school year and then head to Houston as planned. I'll become the Mama Bear for Sexy Lawyer Man's firm, and we'll deal with transplants and such when I'm eligible, which right now I'm not.
It's really weird to be this sick on paper and feel so good. But I'll take it as a blessing and enjoy the healthy time I have while I have it. Whee!

Bittersweet

So this week has been strange. 

It's the last week of school, so I have had to take down all the decorations in my classroom and say goodbye to my kids and my coworkers. Only not really goodbye, because I'm teaching summer school, so I'll see a lot of my coworkers for another month (and two of my kids.) Also only sorta goodbye because I don't have a job yet for next year. I was the only probational teacher at my school who was cut due to budget issues, but one of 181 district wide. They have now hired back 87 of us, according to the TV, but no word yet on me. So as I stood up in front of my peers at out luncheon, I wasn't ready to say goodbye because I really firmly believe I'm coming back. But I don't know for sure. Regardless, I have cleaned out my desk in the meantime. 

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Now, I'm sure you are all eagerly awaiting my lab results. Right? (Thanks, Mrs. A, for the concern.) Well, I don't have the full print out but I know two key numbers. First the good news is my bloodcount is 12, so I'm not all that anemic. Not great, but not dangerous, either. But then there's the creatinine, which was 2.44. That's up from last month. 2nd "up" number in a row, after about 6 months of consistently "down" numbers. (Cheat sheet: creatinine is a byproduct of muscle tissue breakdown, it's filtered out by kidneys, normally you have less of it in your blood, but if your filter doesn't work, you have more of it. It is a pretty standard measure of kidney function.  Healthy = under 1.2 mg/dl. )  I was at 1.8 (36%) when this all was discovered Dec of 2009, 3.5 (17%) at my worst in August 2010, and was at 2.1 (32%) two months ago. So now I'm back under 30% and I am seeing my trend of "better better better" turn around. Not that I should complain about 26% function when I have felt 17% but I am worried that this trend is going to continue and I am going to get very very sick in then next three to six months. I base this prediction on what patterns I have seen before, though, really I have no clue since we still have no idea what is going on. In the meantime, I have to get a little more strict on my diet. I'm not sure that my diet will really help anything,since an autoimmune disorder will not be slowed down by lack of sodium, but it's my way of doing penance in hopes that I will tip the scales toward "she deserves to get better." So I'm drinking a lot of water and trying not to fret when I feel strange pokey pains in my lower back. Only time will tell. If you're the praying type, I could use it. 

Onto other things. We almost got a dog this week. Or, rather, she almost got us. On Monday evening a precious yellow lab puppy (less than 6 months) showed up in our backyard.  She dug under the fence to get in. We drove around and posted signs, hoping that her family was looking for her. Nope. So, being the saps we are, we bought some food, patched the fence, and let her stay over night in the yard. By morning she was gone. Not the end of the story. She came back in the afternoon. Sexy Lawyer Man fixed the fence again and we fed her and let her stay another night. We had a long tearful (just me, really) discussion about whether or not we could really afford and care for a dog right now, and decided that this was not a good time with me being out of a job (maybe) and him still in school, and a good chance of big ugly medical bills looming. Wednesday we called all over town looking for a no-kill shelter that would take her, but no one would. Eventually he had to take her to the Waco Humane Society. They seemed confident that a cute, healthy, sweet puppy like her would be adopted really soon. I hope so. She deserves a good home. Preferably one without potted plants. I didn't really want okra after all. 

Distraction

So I have not been feeling that well lately. I have been insanely tired, and I'm starting to have an aversion to meat again (which showed up during my July 2009 flare up, and for about 3 months leading up to my August 2010 flare up. ) Some nausea and loss of appetite and lower back pain. Mild enough that it could totally be hysteria, but enough to give me some concern.

 Last labs, done about a month ago, had some iffy numbers. The important stuff was awesome. Protein leakage, blood pressure, creatinine... all down. (Good news.) But then there were some numbers that were not so good. Like how my CO2 levels are down, so I have to drink this nasty sour salty medicine every night. Now I'm not sure what CO2 level being low means exactly. My doctor explained it in a lot of terms I distinctly remember learning and forgetting in Mrs. Porter's high school biology class. But it's a side effect of low renal function. So is the anemia, which has shown up again. (Explains the tired.)

Now, I'm used to the side effects of medicines. The puffy feet, the shortness of breath, the crappy cardiovascular abilities. These are from medicines, not disease. Healthy people can have medicine side effects. (Healthy people aren't usually on the BP meds that cause these... but that's not the point.) My dismay about these particular numbers being off is that these are a direct result of renal insufficiency. These are disease side effects. I was perfectly happy going along as if nothing was really wrong with me, for the most part. I watch the diet, I take my pills (down to only 7 a day now, which seems quite light.) But I'm seeing real chemical changes in my body other than the obvious creatinine levels being elevated. My labs are starting to show more "off" parts, which mean that my sick little kidneys are in fact puttering out. 

Anyway, long story short, I had labs done yesterday morning and while the results should be back by now, my doctor's office is closed until Tuesday, in observance of Memorial Day. So I'll know them if I have anything to legitimately be alarmed about, or if I should just quit whining about my labs not looking like a healthy 27 year old because I'm not one. So in the form of distraction until Tuesday, I give you some garden pictures.

1. Look how green my grass is! (And by grass I mean stubby, sad grass that can't hold a candle to lush, Sugar Land St. Augustine... and clover.) We had some good soaking rains. Of course, we also have mosquitos now, which I don't actually remember ever seeing in Waco before now.

2. My green bell peppers are producing again. For a while I was worried that I got the only two I was going to get.

3. Okra! Did I tell you I had okra? These two were purchased for $0.50 at HEB. They seemed promising in a Charlie Brown Tree way. So I stuck them in a pot. Also note the little basil seedlings coming up. Whee!

4. WTF?

5. Also WTF? My parsley was doing great and suddenly it's all, "Meh. I don't wanna."

6. My cilantro, too. Meh. Maybe that's what started the parsley in getting all lame. I blame the 100 degree weather and my sun-baked little patio. Potato is doing well, I think.

In other news, I made breakfast tacos! Not super low in protein, sodium, or cholesterol, but they were really good. (Actually, they were mostly made from whites, so kinda low cholesterol... until the bacon.) The secret is taking some chopped onion and bell pepper and jarred salsa and heating it in a skillet for a little bit while I cook the eggs. Nice and roasty.  Also, HEB whole wheat tortillas from the bakery are super tasty. Also featured: red bell peppers, strawberries, eggs, one crumbled piece of bacon, and colby jack cheese. And "Simply Apple" fresh apple juice.

Other, other news: Went to my husband's 10 year high school reunion. It was a lot of fun. And on the way back we stopped in College Station to meet some more friends at Blue Baker, which is a magical place. We picked up some garlic herb bread and some focaccia. Om nom nom. Now if you'll excuse me, I have to go inside. I had been sitting outside in my skychair for about 2 hours, but it's quite dark now and I am afraid of the dark. 

State of the Kidneys

Originally Posted October 16, 2010

So, to clarify and answer questions, here’s a long, wordy explanation of where I am in the Kidney Adventure.

After the big scariness of August, things have returned to “normal” for the most part. My creatinine came back down some from the big spike that we were seeing (creatinine = bad) but has not gone down to what it was before. So this leaves my function around 34%. But this is good news, considering that for a while it looked to be under 20%.   

It now looks like we have a sort of pattern. Six to nine months of nothing exciting, then about 2 weeks of some strange kidney-related illness and the function drops.  We’re pretty much giving up the search for a reason and we’re sticking to damage control now. No explanation for these little flare-ups.  We’re in uncharted territory now, since I don’t fit any of the usual reasons for kidney failure and there’s not a lot of research on people like me.

The plan from here is to change my diet to a “renal diet” to try to preserve function. It restricts sodium, cholesterol, protein, phosphorous (dairy, cokes), and potassium (potatoes, bananas…).  I don’t have to restrict fluids yet, but I am going to be a real pain to feed at family functions. However, I have not had much appetite lately anyway, especially for meats. (My body’s way to help me with the diet, apparently.) At least I have lost some weight! (Bright side, right?) I’ll be meeting with a nutritionist soon to make sure I can still get all I need to get from what I do eat.

As for other treatment, right now we’re looking at trying an ACE inhibitor again (different BP drug). Studies show that sometimes it can slow the damage that the rogue protein levels cause, which could lead to more years of stability. (Though almost all the studies are on diabetes-related kidney failure.) The catch is that it will make my creatinine go up a little, and I’m in the Danger Zone already. Then there’s a bit of a chance it could make things MUCH worse. So, I’m supposed to sleep on it and decide whether or not to give it a try. (HOW AM I QUALIFIED TO MAKE THIS DECISION?!?)

Anyway, when function gets 10-15% worse (and all the doctors believe it will), I will be getting a preemptive transplant, which means I have to line up a donor to avoid going on The List.  This probably won’t be for a few years (fingers crossed.) If this plan works, I won’t have to do dialysis at all. This is best-case scenario. I’m really trying not to think about alternate scenarios right now because I don’t like them.

Ok, so this has been really serious.  There’s not a really fun way to say all this stuff. (Maybe I could sing it?). It all sounds a little negative, so I should assure you I’m fine. It’s a little bit of a relief to quit searching for a cause with no success. Meanwhile, I’ve been camping and partying and traveling and teaching and life is good.  I do think this has given me a reason to be more optimistic about things. There are scarier things than finances, or dirty laundry, or 5^th graders, or any of the other things that had been stressing me out. And honestly, I feel like I have dodged the scarier things, too. I have a lot to be thankful for, and while I am disappointed that I’m not getting a handicap parking tag out of this, I am doing pretty damn good. 

I went to the doctor, I went to the mountains,

I looked to the children, I drank from the fountains

There's more than one answer to these questions pointing me in a crooked line

And the less I seek my source for some definitive

The closer I am to fine

The closer I am to fine

-Indigo Girls

(Song I like. Not related to the situation exactly, but made sense to me.)

Kidney Adventure 2010, Round II

Originally posted August 21, 2010

So, people have asked and I figured I should put some actual facts up here instead of a series of vague, whiney status updates. (Or, in addition to whiney status updates... can't promise to quit those. )

When last we left off, around May-ish, all was well as far as I could tell. Blood pressure stable, kidney function 50% (not great, but holding.) I was staying to a low sodium/ low cholesterol diet and things were beginning to look pretty normal. 

August: Last week I was not feelin' so good, so I decided to go to my Dr just to make sure everything was cool. Lab tests were NOT COOL.  So more lab tests. And more lab tests. A week later I feel a bit like a pincushion, and it appears that my kidney function somehow slipped from 50% to 16 %. 16% is not good. We are not sure if this was slowly creeping down all summer or if it suddenly went down in response to this latest flare-up (although it's probably the latter.) 

So, options:

1) This dip in kidney function is in response to an acute attack of Kidney Gremlins and function will return to normal (50%) in a few weeks. This is the happiest option, so I vote for this one. (Like I have a say?)

2) Kidney function stays here and I use immunosuppressant drugs to keep this from happening again. (And maybe increase function?) These drugs have crappy side effects, which is why we didn't try them before now. 

3) Kidney function continues on downward turn and reaches 10%, at which point I will be declared to have End Stage Renal Disease (which really sounds like a scarier condition than it is) and I go on dialysis and start looking for someone's kidney to steal. Good news here is that I'll qualify for Medicare and Uncle Sam will start paying my medical bills. 

Now, in order to figure out which option this is, and HOPEFULLY get a real diagnosis (surprisingly, Kidney Gremlins is not a medical term), I will probably need to get another biopsy while things are (apparently) active. I do not look forward to this, since the last one hurt like a bitch. However, the complication I had then is not a common one, and they don't seem to think I'll spring a leak this time, so we're not looking at a two week recovery again. (Although that was a great excuse to sit in bed for two weeks and watch the Olympics on TV...) I really don't want to tell my new boss at my new job that I'm taking a week off...

In conclusion, I want to thank everyone for their prayers and concern. Your support has really been awesome. Also, I want to point out that this is going to be damned inconvenient but not life threatening. If Osama Bin Laden could be that busy while on dialysis, so can I. Maybe that's a bad example. My point is, I will figure a way to keep on keeping on, so don't worry. I've got a great support system here and I've got Jesus and I'll be fine. 

I leave you with the chorus from my new favorite song:

Ain't no rhyme or reason, 

no complicated meaning

Ain't no need to over think it...

Let go laughing! 

Life don't go quite like you planned it,

we try so hard to understand it.

 Irrefutable, indisputable

The fact is it happens. 

(Sugarland, "It Happens")

Low Sodium Cooking Continued...

(Continued from February 17, 2010 post)

Dinner #2:

I made this dinner for my parents when they came to visit me. I have an ongoing mission to convert my father to a heart-friendly diet, since he has some cardiac and kidney risk factors. He's a good man and I want him to live forever.   

"Fake Southern Comfort Food Dinner"

Oven Fried Chicken:

Mix plain yogurt and minced garlic in one bowl. Mix plain bread crumbs, parmesan cheese, pepper, dried basil, and dried oregano. Dip a boneless skinless chicken breast in the yogurt mix, then the dry mix. Spray top of chicken with Pam. Bake at 400 for 55-60 min. 

**Notes: 1)This was awesome. Really really good. 2) I have absolutely no idea how long it actually cooked. I forgot to set a timer. I know it went more than 30 minutes. My super-scientific way to tell: wonder what smells like burning... look in the oven... see that it's the breadcrumbs that fell off the chicken onto the baking pan... use a meat thermometer to verify that chicken's above 180 degrees. Done. 240 mg sodium.

Green Beans: Simmer a bunch of fresh green beans, half a red onion (chopped) and a bunch of garlic in enough water to cover. Keep it covered and bubbling lightly for about 20 minutes. Then simmer uncovered until the water evaporates (according to Mom's recipe) or until you are impatient and you dump out the rest of the water (what I actually did.) 

***Notes:These would be a more generally appealing with some salt, but if you appreciate the taste of fresh green beans on their own merit (I do) then they are good. Just don't compare them to Gran's "cooked on the stove for hours with butter and tons of salt" Green Beans, which are infinitely superior.

Cheddar Biscuits: Mix 1 c. flour with 1/2 T baking powder. Cut in 2 T unsalted butter. Mix in 1/3 c. milk and 1/4 c. grated lo-fat cheddar. Roll into a ball and flatten onto greased baking pan. Bake at 400 for 10 minutes. Melt 2 T unsalted butter in a tiny pan (or bowl) and mix with garlic powder and parsley flakes. Pour over the top of biscuits when they come out of the oven. 

***Notes: These are modeled after the Red Lobster biscuits. Those are better. In fact, they are in a class of their own, called "Best Tasting Stuff On Earth That Will Probably Kill You." However, these are very very tasty, and not in the "will kill you" group. Technically, these have 14 mg sodium if you eat 1/5 of the recipe. I dare you to only eat 1/5 of that recipe. Also, the recipe calls for "Sodium Free Baking Powder" and "Low Sodium Cheddar," neither of which are available in Waco. So take the sodium count up a bit. But still probably won't kill you.  

(Note about these low sodium ingredients: Many companies are jumping on the low sodium bandwagon. I applaud them in this! We should all go out and buy unsalted tortilla chips to celebrate. However, watch these products carefully. Many, including the two ingredients named above, use the salt-substitute potassium chloride instead of sodium chloride. This means that while the sodium content is lower, the potassium content is higher. This is a BAD idea if you are a renal patient, since potassium will kill you dead. If you struggle with high potassium levels, as does my very own Granby who has been hospitalized on several occasions with "medically unlikely" levels of potassium, steer clear of any and all salt substitutes.)

Ok, that's what I have today. I'll keep trying recipes and tell you when I find the good stuff. So far we are 5 and 1 with the Heart Assoc. book( lentil soup was not a winner), and 1 and 0 in the 500 Recipes book, so not bad.

Low Sodium Cooking Adventures!

Originally Posted February 17, 2010

So, after being gently but firmly admonished by my nephrologist, as only a nice old man can do, I have decided that this time I might actually try to eat a low sodium diet for reals. (My early phase of "reduced- sodium" was promising not to eat rock salt out of the box anymore.)

My awesome husband, who will from here be referred to as Sexy Lawyer Man, bought me two cookbooks for my birthday. (The American Heart Association's Low Salt Cookbook, and a book called 500 Low Sodium Recipes.) I highly recommend them both, especially the Heart Association one. I knew I was going to be ok when I opened to the first recipe: Potato Skin Nachos complete with cheese, olives (drained and rinsed), sour cream and homemade salsa. Those were cooked by SLM while I was still in my useless, post-biopsy bed rest phase, and they were REALLY tasty.

After doing the (real) low-salt thing for a week, I can say that this is probably the most effective diet I have ever tried. If you really look at diet food, it's all low cal, low fat, low carb... and then 864 mg of sodium per serving. You are never going to lose water weight eating like that. I have lost my semi-recently acquired "puffy" look (thanks, Mom, for that description) from all the water retention from stupid kidney stuff. It's only a few pounds, but that makes a difference when it's all water. Also, if you don't eat salty snacks like Doritos and stuff, it will reduce your calories, too. So I say to you, oh healthy type people: don't wait until your doctor tells you to quit salt. Do it now. It's fun. I promise.

Here, I'll show you. 

Dinner #1:

Mediterranean Fish Fillets:

Take a fish. Drip lemon juice all over it. Then cover it in tomato slices, pepper, green bell pepper pieces, plain bread crumbs, olive oil, and dried basil. Bake 25 minutes at 350. So freakin' easy.

**Notes: My only complaint was that the fish tasted a little like ground. I am a recovering non-fish eater, so I understand that this may have been more my fish prejudice than the tilapia. Still, it was pretty tasty. 176 mg sodium, if you add capers (packed in balsamic vinegar, not salt water) which they do not sell in Waco. Those of you in closer proximity to a Whole Foods might fare better. It was fine without the capers.

Side dishes were Steamed Broccoli with homemade dressing (dijon mustard, lemon juice, sugar, pepper, olive oil) and Wild Rice. This was the boxed wild rice and long grain rice mix. A normal 1/3 cup serving has 1000mg sodium (literally) so when I made this, I fished the solidified chunk of seasonings out of the packet before cooking. This is not a perfect method, so I bet the end result was still pretty salty (tasted good...so yeah...) and next time I will buy the kind of rice that has a separate seasoning packet (Uncle Ben's) and discard almost all of it. Or buy the wild rice separately... but that was actually more expensive.

Kidney Adventure 2010!

(This is the beginning of my kidney adventure. I got high blood pressure in May of 2009, and it continued to rise after the school year ended. We moved and I started seeing a new physician in December of 2009. On Christmas Eve, I got a call from my doctor with lab results. This was how I found out that my kidneys would take me on a lifelong adventure. The following post was written for Facebook after my first biopsy in February 2009. It contains some information that I now know to be incorrect (I'll include edits in purple), but I left it in to show the progress of my understanding of Chronic Kidney Disease.)

Long and technical description, if you are interested:

Here’s what I know, based on the preliminary results. We’ll have more information later this week.

The biopsy was successful, which is good. Sometimes they hit healthy tissue that doesn’t tell them anything, and you have to do the whole thing over. I have had some bleeding around the kidneys so I’m dizzy and I’m going to have to stay off my feet most of the time for a few more days until it absorbs back in. This may have caused some anemia (it actually didn't...just insanely painful muscle spasms), so we’re keeping an eye on that. My school has been really understanding and they say I can take off as much time as I need to, and make up the days later. That’s a blessing right there.

Results of the biopsy show that I have a kidney disease called mesangial hyperplasia, or mesangial proliferative glomerulonephritis. (That's more a description of what they saw, it's not really the name of any specific disease. So Glomerulonephritis is what we're calling this for lack of better term.) This is a less common form of kidney disease. (Dad was even stumped as to what it was…mark your calendars!) Fewer than 10% of kidney patients have this type, so it is not as well researched as some of the others. It is aggressive, and I have not had it very long. I have global sclerosis (scarring) on about 45-50% of glomeruli (filtering bits) and this is not reversible. This is some form of auto-immune issue that has my system turning on itself. The most likely treatment will be 3-6 months of immunosuppressant therapy which could stop the progression. (We decided there was not enough reason to try that since we had no way of knowing if it would work. But more on that later.) Best-case scenario, this will go away with treatment and I won’t lose any more kidney function. (Hah!) Worst-case scenario, it will slow down but not stop, which will eventually lead to dialysis and transplant. (Yeah...) My doctor was very clear that at this point, I should definitely not get pregnant (not that we were planning to…) because of the added strain this would cause to my kidneys. Whether or not I will ever be able to carry a pregnancy has yet to be determined, and we have no reason yet to NOT be optimistic on that. (There's a lot more on that.)

This is not kidney failure! It could lead to kidney failure untreated, but luckily we caught it and will get treatment for it quickly. I’m going to get a second opinion in the Houston Medical Center (in addition to the first one from the UT Medical School in Dallas) and we will decide on the best course of treatment in the next few weeks. Until then we are trying to get my blood pressure under control and keeping an eye on my anemia (which didn't actually show up for another year).

There isn’t really a known cause other than random chance, but those of you who are related to me should probably take any change in blood pressure seriously. (I guess that is just a good idea anyway.) I am very thankful that the Waco doctor I randomly chose out of the phonebook was so thorough in doing the tests to catch this right away when I came in for my new patient check-up.

As for me, I’m a reasonable amount of worried, but I think I’m handling it pretty well. I know this will be ok, even if it is a little scary and very inconvenient and expensive in the process. There are many worse things to have. I feel fine (other than the biopsy related stuff) and I am switching to a much healthier diet, which I probably should have done anyway. I appreciate y’all’s concern and prayers and I’ll keep you posted as I get more information.