Sunday, 30 June 2013

The small miracle of salt-free (well almost)

Here she goes, with some moral lesson about salt. Perhaps Jesus' words about salt? Or an analogy of Christians being salt in the world?

No, I just want to talk about the white stuff in a shaker on your table.

Less salt or no salt is important for all of us, but for heart patients, it's a must. Excess salt causes water retention, which makes the heart work harder. If your heart is already compromised, this isn't good.

But how much do we need? And how much is too much?

"The Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 mg a day — or 1,500 mg if you're age 51 or older, or if you are black, or if you have high blood pressure, diabetes or chronic kidney disease. Keep in mind that these are upper limits, and less is usually best, especially if you're sensitive to the effects of sodium. If you aren't sure how much sodium your diet should include, talk to your doctor or dietitian." 1

The bottom line is, even without ever picking up a salt shaker, most of us use too much. It's in everything, and difficult to eliminate.

When Bill was sick, I began to learn how to cook without salt. It's difficult, and I made many mistakes. I learned that a little salt in some things makes them palatable. Salt-free butter tastes like lard. Bread without salt tastes like sawdust. Salt-free chicken broth is so tasteless, you may as well save your money and use water.

It's not the small amount of salt in butter or bread that's the problem. The first step I took was to eliminate all processed meat from our diet. With that went all packaged soups, and the crackers that went with them. I learned to read labels, and compared things like salad dressings and other condiments.

I learned to make decisions. We decided reduced reduced-salt ketchup tasted acceptable, but nothing but the real thing would do for mayonnaise. (I  make a wonderful tasting mayo, but it does have some salt in it.) We ate bacon less, but it was regular bacon. I can't live without cheese, but found stronger cheeses have wonderful flavour and less can be used. A small handful of grated cheese enhances an omelet without adding a lot of salt.

Now that I was cooking most meats, pastas and egg dishes from their raw form, I had to learn to make them tasty. I discovered dried vegetable flakes that spiced up most dishes. They contain a bit of salt, but also many other flavours, and the combined effect is delicious. I discovered fresh herbs, and a whole new world of flavours. I discovered hot sauce--something I didn't know existed and wouldn't have thought to try. In small amounts, it gives just the right tang to a bland dish. We bought a pepper mill, and I learned to love fresh ground pepper in foods.

I learned to use some items differently. I settled on several low-salt salad dressings we liked, and used a small amount in stir fries for flavour. I flavoured a tuna sandwich them, and left the mayo in the fridge.
I'm not an expert, and I still have the occasional failure, but our salt intake is low. We have trained our taste buds, so that when we eat in a restaurant, I find the food too salty. We have learned to appreciate other flavours. The use of salt is often a lazy way to flavour food.

 We don't own a salt shaker.

I challenge you. Start to reduce the salt in your cooking, and making salt-free choices. Your heart, blood pressure and kidneys will thank you, and you may just save yourself from a world of grief as you age.

Your tongue will thank you, too. It's been pickled into a salty haze. Wake it up with fresh basil and a dab of hot sauce. There's a whole world of tastes out there, just waiting for you!

Wednesday, 26 June 2013

Caregiver Wednesdays- My role is changing, too.

I'm not the man I was.

Not that long ago (or so it seems to me) I looked after my wife and family. I made decisions. I had a job and made money. I bought things. I went places. I had fun. I had purpose and meaning.

Now, life seems muddled. I can't find things, and some days, I can't remember which of my clothes to put on first. I look for something that isn't there, so I keep looking. I am suspicious, but I'm not sure of what. I wander, trying to find my family. I can't even find myself.

Who am I? Am I still a father, a husband, a brother? There are days when I feel like I've lost myself.

Your role is changing, and I know that confuses you sometimes. Sometimes I need you to just be my wife, but often you are the caregiver. But do you understand how I feel? I don't know how you could, because most of the time, I don't. I don't know who I am any more. In this terrible journey of my disease, I have lost myself. Sometimes that makes me angry, and often i am afraid, but mostly I just wander in a fog.


Have you ever wondered how changing roles affects your loved one? Perhaps they don't have dementia, as the man I described, but their physical frailties are changing what they can do and who they know themselves to be. It can change a person's perception of themselves to be unable to be independent in the bathroom, or with walking. Depression is often close behind.

How can the caregiver help? Understanding that every situation is different, here are some suggestions.

1. Acknowledge the situation if they express it. "That must be so frustrating. I can see that makes you angry?" etc.

2. Look for ways to show that you still respect them. Ask for their opinion or give them opportunities to make decisions. Ask them questions about their past that will take them, through memory, to a happier time.

3. Look for ways to keep life "normal." Talk about your day and tell funny stories, as you would have done before you were a caregiver.

4. Ask their advise about a situation that's troubling you. "I'm just not sure--what do you think I should do?"

When your loved one struggles with being cared for, when all their life they have done the caring, give them the gift that reaches past the disease to the soul within.

Give them respect.

Thursday, 20 June 2013

Caregiver Wednesdays-- Caring for a parent

In February, I read an article that stunned me. I meet lots of family members who are caring for their parents. It is the natural rhythmn of life, and although not easy, it is expected.

What if the caregiver is 18?

I read about a young man who looks after his 48-year old mother who has an early onset case of fronteraltemporal lobe dementia (an Alzheimer-type dementia). "Austin Mobley was just 6 when his mom, Tracy, asked if he knew the owner of a black-and-white dog running around their yard. "Mom," he said, laughing, "that's Daisy," their longtime family pet. Twelve years later, Austin cooks, balances the check book, drives Tracy on errands from their two-bedroom apartment in Buffalo, Mo., and manages his 48-year-old mother's medication for the dementia diagnosed when she was 36. "The hardest thing for me," says Austin, 18, "is not knowing what an actual mom is." 1

My heart aches for the boy who expresses those words. He's never been a kid.

"Every morning the high school senior rises at 6:30 a.m., makes sure his mom takes her meds-Namenda for dementia, Valium for paranoia, Prozac for depression-and then gets a ride to school. After school, he heads home, does his homework and gets to his other job-paying bills, picking up around the house and helping Tracy cook a dinner of spaghetti, steak or pork chops. At night, he makes sure Tracy settles under a blanket in a recliner and gives her a bedtime hug; she keeps the TV on all night because it soothes her. That's on a good day. On a bad day, Austin worries about leaving her alone: Before going on the right meds, Tracy used to wander, once falling into a ravine; the sheriff was called and the dogs sent out. "I feel guilty I can't be the mom he deserves," says Tracy, who speaks lucidly about her son's sacrifices and even cracks jokes, but forgets what she said just a moment before. "I can't bake him cookies, I can't drive places."1

My heart breaks for the mother who expresses those words. She can't be the mom she longs to be.

"Yet she's accomplished what every mom hopes to do-raise a solid young person with dreams of his own. After graduation, Austin hopes to join the military or attend community college. "He told me he'd put his life on hold until I needed to go into a [nursing] home," says Tracy, who has already lined up an assisted living facility. "I told him, 'No, you go on with your life.' He's a good kid. And this has made him stronger."1

Interesting, isn't it? Austin has cared for his mother since early days, and has missed many of the nurturing experiences other kids have had. His mother can't drive him to baseball games or give dating advice. Every day, she is a little less there. Yet Austin has become a responsible, caring and nurturing young man--qualities many of us would long for in our children. 

Caring for a parent at any age can be challenging. Slipping out of one role and into another requires tact and wisdom. I hope Austin has support as he walks this journey. He, as any caregiver, needs someone to talk things over with, someone on whom to vent, someone to listen.

I also think he will find it more difficult than he imagines to leave his mom when the time comes to leave for military college. He will leave, but there are ways in which she will always be with him.

And that's not a bad thing.


Wednesday, 12 June 2013

Caregiver Wednesdays- The wife as caregiver

My role as wife started on a hot day in August, over 30 years before. I knew how to be a wife, and had fulfilled that role for a long time.

 My role as caregiver crept up on me. I had been a caregiver for a while before I even realised that I had the role. I had no idea how to be a caregiver, and I made many mistakes. Sometimes, I came on too strong. Sometimes I held back when I should have spoken up. Sometimes, I forgot I was still a wife.

And there's the rub. A wife who is also a caregiver is also a wife. The roles slip in and out, and the whole experience requires incredible flexibility, tact and creativity. And prayer.

Here are some practical suggestions:

1. Go to as many doctor's appointments as possible. Because I worked full time, this wasn't always possible for me, but if I had it to do again, I'd use holiday time--it's that important. I learned that my husband wasn't good at asking questions, or getting the answers we needed. When I did go, I took a list of questions, and made notes. An even better suggestion I heard was to tape record the appointment. It is so easy (especially under stress) to misunderstood important information or forget to ask important questions.

2. Share with a friend. There will be times when you will need a sounding board, either because you are incredibly frustrated, or your heart is breaking. Find those you can trust to share your burden.

3. Take a break. There will be times when you need to get away from the situation and from your spouse. Even grocery shopping or other chores can give you some respite, but a night out with friends is even better.

4. Take a break together. Sometimes the disease and the impairment it brings becomes bigger than it should. Find a way to have some fun together that has nothing to do with the disease. Be a husband and wife again.

5. Use email or social media to its fullest extent. Let people know what is happening through one source, and have any questions directed to that (newsletter, email, Facebook page etc.) Better still have one person manage this for you, sending out your info and keeping track of replies. That's a huge help, and you probably don't have time, but still want to keep in touch.

6. Get prayer support. This is incredibly important.

7. Do your research. The more you are informed, the better questions you can ask, and the more intelligently you are able to explore your treatment options.

8. Don't take over. No matter how impaired your loved one is, except in the most extreme cases, they have an opinion and can make choices. Both of you will be happier if you let that happen.

If you are a wife and a caregiver, you are walking a tenuous tightrope. However, you are also the most important support and cheerleader your loved one has.

 You are needed.

Wednesday, 5 June 2013

Caregiver Wednesdays- Changing Roles in Caregiving

My parents were leaving for a road trip out west, and Dad asked me if I would take Mom shopping in preparation for their journey. She needed some camisoles and other items he wasn't comfortable shopping for. Mom had mid-stage Alzheimer's and couldn't go on her own.

In the dressing room, as I helped her try on clothes, a thought stunned me. My two-and-a-half-year-old was able to dress herself. My mother wasn't. And although my Dad was the caregiver, I realized my role was changing. I was the baby of the family--the protected one. Mom and I were close, and talked every day. I was her daughter, but I was standing in a change room, helping her untangle herself from an undershirt and filling an entirely different role.

Fast forward many years. The two-and-a half-year-old was now married with a child of her own. I received a call at work from the visiting nurse looking after my husband, who was alarmed. He was verging on heart failure, his legs were hugely swollen and in grave danger, but refused to go to the hospital. I phoned my daughter and asked her to pick me up at the station. She had the baby with her, and we went to the house to persuade my husband to make the decision that would save his life. When we arrived, he was sitting in his chair in the basement, and pills were scattered everywhere. At that moment, although I had been his caregiver for many months, I realized I would have to take control of some areas that had always been his. He could no longer manage his medications. My role was changing.

"Whenever someone requires care, responsibilities and roles often change with them. According to Nancy Mace in The 36-Hour Day, responsibilities are the jobs each person performs in the family. Roles, while connected to the duties one performs, also include who you are, how you are seen and what is expected of you. Specifically, they define your place in the family."1

Walking the tightrope between your traditional role (wife, sister, daughter) and the role of caregiver can be hazardous. The possibility for resentment and misunderstanding exists on both sides. The caregiver needs to work through the many difficulties with sensitivity and patience. One minute, you are a wife, then caregiver, then back to wife. Sometimes within a few minutes. It's confusing.

Your loved one's roles are changing, too, and they, too are confused.

This month, we're going to explore changing roles.

Monday, 3 June 2013

The small miracle of Cinnamon


This is a tribute to my best buddy. My miracle dog. My Cinnamon.

I wanted a dog for years, but for various reasons, it wasn't possible. The daycare, money and lack of enthusiasm for the idea from other family members. Then there came a day when I announced I wanted a dog, and I was going to pray for one. I had my criteria.
*two years old or younger
*good with kids
*didn't shed much

There were those in the family that snickered at the last one. I wanted a free dog to drop from heaven for me? I wasn't planning on going to a shelter. I would just put the word out. And pray.

So the day I got the call about a pure bread peek-a-pom that was available, I had to work hard at not being smug. Yes, he was free. Okay, he was three years old and he did shed, but I was willing to concede those points. He was mine, and having him met a need in me that had been present since my teen years. I needed a dog.

He came to us from an abused background. His first two weeks were filled with diarrhea, as he had been eating spicy scraps from the table to survive. It took months before he didn't cringe when I petted him. He was used to being hit. But with love and attention, he became ours. Mine.

He was a great traveller. He loved the car, and airplane travel didn't phase him at all. The first time he went on a plane, I gave him Gravol. but it wasn't necessary, and I didn't do it again. We would go together to visit my sister in Winnipeg, and he loved her big back yard. They acquired Aurora, who was a seven-month-old huge puppy when we arrived the first time. Cinnamon would sleep on the couch, and Aurora would butt him with her nose, wanting to play. Cinnamon wouldn't open his eyes, or acknowledge her in any way, except to lift one side of his lip and utter a low "grrrr." A warning. If Aurora persisted, he would snap, and she would lope away, befuddled at this strange behaviour.

Our next visit, they became friends, and ran the yard together. By this time, Aurora was at least four times Cinnamon's size.

Three years ago, Cinnamon developed shortness of breath and wheezing that alarmed me. When I took him to the vet, I found out  another man in my life had heart disease. He has been on medication twice a day since then. The dog who used to do the four kilometre walk around the lake could now only do shorter walks, and then no walks. His back end needed to be lifted up in the mornings. In the last few months, his energy seemed to be waning.

This weekend, he developed an eye infection, and I took him to the vet today, expecting to get drops to fix it. Instead, I discovered he had a serious and aggressive infection that would require surgery. However, he is not strong enough to survive surgery.

I made the very difficult decision to do the kindest thing I could think of, and end his pain. I spent the day watching him sleep and cuddling him. And then we said good-bye.

So, to my small, furry miracle, my best buddy, my reason to come home when I was alone, I say, "thank you."

You were, and always will be, a gift.