Cancer

Vegetarian Low Iodine Diet Redux [LID]: Week 1

by Jonathan Sterne on October 19, 2014

It’s Sunday.  Time to watch football and cook a lot.

Here are some vegan/low iodine things we’ve been making. Recipe links are posted when available. I’m too lazy to type things out if they’re not already typed out online or in our electronic recipe book already (there’s a lot of copy/paste in this post, but it’ll be new to you). Also, I had planned to do this daily but that’s too much. So instead you get massive weekly updates, like this one.

When on the low-iodine diet you can either make everything yourself, or eat boringly. I lean toward the make everything myself because it’s frankly enough unpleasantness to put a giant dose of radioactive material in my body at the end of this. Why shouldn’t I have a little fun now? The other thing is even if it’s boring, I still have to plan it out.

Dinner #1: Stew and sides. We made this Friday night.

–>Bulgarian Red Pepper Stew from Sundays at the Moosewood.  We served it to guests and got another meal out of it. 

Normally you have it with sour cream or yogurt. Since I can’t do that right now, I went for cashew cream courtesy of the Post Punk Kitchen and Isa Does It.

Soak 1 cup cashews in a bunch of water overnight. Drain. Put in the blender and puree with two cups water, a little fresh lemon juice and salt.

Serve the stew and put just a small spoonful of the cream into the bowl and you get some nice creaminess.  I don’t find cashew cream all that good by itself but it works to add texture.

Our side was roasted brussels sprouts and cauliflower (also made a ton and ate leftovers for another meal):

Slice brussels sprouts in half

Cut cauliflower into florets

toss with olive oil and salt

roast at 425 degrees about 45 minutes or until the sprouts are melty.

I also made another no-knead bread, this time with 1 cup each of white, wheat and rye flour.

Coconut Milk Ice Cream

For LID people, you need to check the label for additives. The kind I got was organic with guar gum as the thickener. That’s LID-approved.

Two cans coconut milk

1t vanilla

1/2-3/4 cup sugar (to taste)

Put all the ingredients in a blender. Blend. Put blender jar in fridge for a couple hours. Then freeze it in your ice cream maker. We served it with berries. You could also flavour it however you like. Tonight we will try it with cardamom and rose water if we have it (to go with the Indian).

–>Corn muffins from Isa Does It (on a quick look online I don’t see a similar recipe).  We both loved them for breakfast this morning. We had to substitute Yu rice milk for soy milk since YU is the only LID approved non-dairy milk in Canada (unless we made it ourselves).

–>Tacos (aka “breakfast tacos” aka regular tacos, but eaten at different hours than usual)

Fresh tortillas with no salt in them are fair game.  Then it’s off to the races. I used the following veggies but any will do:

Onions

Garlic

Poblano Peppers (tons, they’re from the market)

Nance Carrots

I stir-fry them in oil, and add chill powder (we just happen to have a little free jar from Penzy’s that doesn’t have salt in it–otherwise I was prepared to roast and grind peppers), cumin, salt, pepper, and a little paprika.  I do the spices visually.  A big dusting of chill powder, and less of everything else to add a few “notes” to the flavour.

Then I added some seitan, which is the only veggie protein you can have on the low iodine diet. (Lentils are also an option, but there are lentils in the stew and lentils in the Indian, and so I wanted a break.)

Tacos were eaten for lunch Sunday and then will be rotated across different meals as the inspiration strikes.

I took the leftover cashew cream and made an experimental “nacho sauce” for the veggie tacos.  It’s based on this recipe, except I substituted mustard powder for miso since I can’t have miso (homemade mustard would have been better but was too much work). I skipped all the veggies except for garlic, but I did put in a dried chipotle.  The result is not exactly like nacho cheese sauce and not amazingly delicious straight, perhaps because I didn’t follow directions properly.I found it a bit strongly flavoured as a background to the tacos and not in a good way–I think I might just whip up more regular cashew cream instead, and/or make pickled onions since I can’t put on a vinegar based hot sauce.

Baked Seitan (adapted from Cooking with Seitan, a cookbook I bought mainly because the title is fun to say out loud)

(Skip this if you’re gluten free. This would be a bad thing to eat in that case.)

Preheat oven to 400 degrees.

2 cups gluten flour (you can make your own but it’s a hassle)

1 cup veggie stock (I used unsalted), cooled

1 cup rice milk (soy or whatever ok if you’re not LIDing)

1/2 t each garlic powder, dried onions, salt

Stir up the dry ingredients in a bowl, stir in the wet.  The dough should be spongy and not too sticky.  Roll into a log with about 3″ in diameter.  Slice into 1/2″ cutlets. Lay them out on an oiled baking sheet. Bake for 10 minutes, oil the tops, flip and bake 10-15 minutes more. Seitan cutlets will get a bit puffy.  This recipe is pretty bland but the texture is good and since I want to use them in Mexican and other recipes, I didn’t want to flavour it one way or another. For the tacos, I sliced the cutlets thin, added them in right before the veggies were done, dumped in all the spices and about half a cup of water with the heat on high and the seitan soaked up the flavour. Normally, you’d do something else with the cutlets, like simmer them in broth or stuff them.

–>Indian dinner This will make tons of good leftovers for the week that can be reheated in a few minutes. Key when you’ve got lots of late afternoon meetings like I do.  

Biryani (adapted from Neelam Batra’s book)

6 medium cloves garlic, crushed (lots)

1-2” piece fresh ginger, minced (lots)

1/2 c fresh cilantro, chopped

1c tomatoes, chopped

1 large onion, chopped

6 or more cups fresh vegetables (carrot, cauliflower, bell pepper, frozen peas[leave out the frozen peas for LID], etc) — we got a beautiful cauliflower from the market, and have some left over broccoli and string beans. And some more bell peppers and carrots.

1 cake tempeh, cubed [skip if on LID--no soy allowed!--we made the lentils below for protein instead]

2t garam masala [for LID, you need a masala without salt--we have a rose masala with no salt that we have been wanting to try]

2t ground cumin

1t crushed red pepper

1-1.5t salt

½-1t turmeric

oil for stir frying (I recommend coconut oil)

+

2 cups brown basmati rice

4 cups water

5 black cardamom pods, lightly pounded

1 cinnamon stick

1.5t cumin seeds

1t salt

oil

Preheat oven to 350 degrees.

Heat oil in saucepan big enough to hold all the rice and water. When hot, add cinnamon stick, cumin seeds, cardamom pods. When they pop after a few seconds, stir in rice and water, crack a little pepper in (or use a few whole peppercorns if you dare), bring to boil, then simmer for 45 minutes or until done. Rice can be a little wet when it’s done.

In a very large, oven-safe dutch oven, stir-fry vegetables and tempeh in the usual order (hardest to softest), add spices, add tomatoes and coriander at the end and cook a few minutes more. Stir in cooked rice, put in the oven for 15 minutes. (or transfer to baking dish if you don’t have anything that works on the stove and in the oven).

Watch out for cardamom pods and cinnamon stick when eating.

To go with it, we made the everyday dal from Curries Without Worries, using red lentils. (this is the only adaptation I’ve found online, we do it a little differently)

–> Dinner if necessary. Stir fry as yet to be determined. With rice.  Quick and easy, veggies available at the corner on the way out of the metro and left over seitan. As long as it’s not soy-based we’re good.  Perhaps Carrie or I will make this:

Carrie calls this “Jon’s Dry Coconut Curry Delight” which means, when she makes it, I like to call it “Carrie’s Jon’s Dry Coconut Curry Delight”

1 large onion

1 leek

1 sweet bell pepper

2 cans mock duck (or 1 large cake tempeh or tofu) [for LID, it would have to be home-made seitan or just put lentils in the rice for protein]

½ cup desiccated coconut

oil for stir-frying (coconut recommended)

1.5 tsp black mustard seeds

1.5 tsp cumin seeds

¼- ½ tsp asafetida

1 dried hot chili or ½ tsp red pepper flakes or to taste

2 tsp good curry power [LID: make sure it's a curry powder without added salt--and hey, we have fresh curry leaves in the freezer so we might try that]

½ tsp salt or to taste

Slice onion and leek thin, chop the bell pepper small and cut the protein as you see fit.

Heat the oil in a large skillet. When hot, dump in the mustard and cumin seeds. Once they start to pop (which will be almost immediately if the pan is hot; be ready), add the onion, leek and bell pepper. Sautee until almost done. Add the protein and coconut. Then add the spices and salt to taste. Serve over rice. Goes well with fruity hot sauce and yogurt if you’re not on the LID.

Other notes for LID people finding this via web search:

For lunches at work, I’m going to bring in leftovers some days and other days eat a variety of portables: we’ve got a metric ton of hummus and acres of carrots, fresh fruit, some nut bars from the corners with no salt in them, more muffins, and the like. I’ll also do PBJ at least once, since that’s easy, filling, functional, and portable.

LID Day 1 + Bureaucracy, not in that order

by Jonathan Sterne on October 16, 2014

And we’re back to cancer blogging.  Yesterday I spent a couple hours at the Jewish General getting my records in order. I forgot how much bureaucracy there is to being a patient: Keeping files, updating files, moving between offices, the whole gig.  Though I have to say that prior experience has meant I know how to work it, at least at JGH.  Everyone was super helpful and nice.

Of particular importance was getting some forms to Manulife, my private insurer.  In Quebec, there is a public system but private insurance covers lots of things, some of them not covered by the public system and some of them covered but foisted onto private insurers when possible.

As part of my radioactive iodine treatment, I need my thyroid hormones to be low enough for it to work.  There are two ways to do this: 1) become hypothyroid. This involves stopping my synthetic hormone drugs for about six weeks and making myself very sick, soporific, and generally living in a miserable haze and being unable to work or do much of anything. 2) receive two shots of thyrogen, 24 and 48 hours before radioactive iodine respectively.  You can guess which is preferable.  Thyrogen costs about $1600 for a course of dosage and Manulife requires pre-approval.

You can guess what happens next.  I have my Dr’s office fill out the forms and fax them to Manulife (and have the receipt to prove it).  That was in August.  Last week I call to ask why I haven’t heard back.  They tell me they “never” received it.  So I have to get the documents again, scan and email them, and find a responsible person.  Luckily I did.  This is the third time in my experience Manulife has “lost” a claim (or part of a claim) for an expensive treatment for which they require prior approval.  What conclusion am I supposed to draw?

Also, for the record, I contracted McGill Benefits to ask for an advocate with Manulife, they refereed me to MAUT (aka, our fake faculty association), who promised me they will get back to me, just like they did in August.  I’m still waiting.

Of course if worse come to worse, I will just pay out of pocket.  It’s just that I shouldn’t have to, and I shouldn’t have to chase down my insurer on top of staying on top of various tests and other medical arrangements in advance of my treatment.

UPDATE!  The responsible person at Manulife saw my materials through the bureaucracy and got me prior approval about six hours after I contacted her.  So it was a runaround but in the end one person in a faceless bureaucracy who gives a damn can still make a difference.  Hats off to the mysterious “Kristen C.”

LID Day 1: I am now on my low-iodine diet, which requires that I (effectively) consume nothing prepared by anyone else.  If you’re curious about how it works, Thyroid Cancer Canada has a fresh and up to date brochure, based on the latest science.  The short version: for a vegetarian, it’s vegan, no soy, no dairy (duh), nothing from the sea, and nothing high in iodine (like iodized salt, which is in everything).  But non-iodized salt is ok, so I can go with that.

My first LID meal was lunch, and involved home-made hummus (including boiling the chickpeas ourselves, with some baking soda following the Ottolenghi recipe; though Carrie’s hummus skills are quite formidable at this point) and toast from no-knead bread (half wheat, half unbleached white flour).  Tonight is a salad and leftovers from a paella based on Mark Bittman’s instructions in How to Cook Everything Vegetarian, with short grain brown rice, a giant cauliflower from the Marché Jean-Talon, onion, garlic and bell peppers.  And way more saffron than he suggests.  In addition to the dry chickpeas, I had to track down salt-free vegetarian bouillon (thank you JTM Vrac), and vegan margarine for the toast (ok, not amazing, thank you Carrie for finding it at Loblaw’s).

Ambiguous Cancer Update for 2014+New Website

by Jonathan Sterne on August 20, 2014

It’s been a long time since I’ve blogged about cancer.  Partly this is because being post-treatment is part of my life.  But every year I go in for a scary scan, and every year it shows the same thing: there are some nodules in my lungs, probably metastatic thyroid cancer.  They have been growing very slowly.  This year’s scan showed the biggest one had grown by 3mm.  Since 2011, it’s been “watchful waiting,” since the alternative they offered me was exploratory lung surgery that had no curative purpose–all it could do would be a positive diagnosis.

This year, things are different.  They have decided to do another dose of radioactive iodine, combined with lithium (this part is based on new research) which is supposed to make the cells hungrier for iodine.  To refresh your memory, radioactive iodine is administered as a pill.  I am then radioactive for a week and have to stay away from people.  Happily, this can now be done as an outpatient treatment, so long as I have a toilet of my own.  I managed to get it schedule while Carrie is giving a talk at Michigan October 30th.  So I will be glowing for Halloween.  Not actually, but I kind of wish I did glow.

I went through RAI in March of 2010 and it was relatively painless apart from the unpleasantness of isolation and a hospital stay.  There can be nausea the first day or two, and I couldn’t taste sour for about a month.  For two weeks before I have to go on an insane low-iodine diet.  (The diet is insane because iodine is in pretty much every processed food and most commercially available salt.)  The outcomes of this year’s treatment, close to the 5th anniversary of my first thyroid cancer surgery, are unclear.  It might do nothing.  It might slow down the growth of the cells a little.  It might clear them out a lot.  Or it might get rid of everything (for now), which would allow me to actually claim that I am in remission.  We don’t know.  But the risks are relatively low.  And honestly, this is what I wanted them to try in 2011 when they found the growing spots in the first place.

There’s not much else to say on this subject until mid-October.  I may do a low-iodine food blog starting around October 15th, since that will be fun and experimental, and I’m not fresh off a 17-day hospital stay (as I was in 2010 when I last went on the diet).  And there’s not much for you to do.  Food gifts are unnecessary now and will be useless while I am on the low iodine diet, since if I don’t cook it myself and know exactly what’s in it, I won’t eat it.

I owe the world a voice and swallowing update, but I’ll write that separately

AND BONUS NEWS:

Unrelated to the latest treatment plan, I have created a website called http://cancerscapes.ca .  I blogged my cancer experience in 2009-10, and now it can be read in proper form from beginning to end.  I also made a series of audio projects during cancer treatment, and they are now all listenable (total duration=@30 minutes).  The “..and this is my voice” piece was  anthologized by New Adventures in Sound Art in 2011.

Cancerscapes is a living archive.  The text section of Cancerscapes will automatically add new entries as well, like this one.  And who knows, there may someday be more audio to include.

Public Speaking 101b

by Jonathan Sterne on February 1, 2012

Okay, so I’ve been going to the speech therapist to see if there’s a way I can get back to giving talks while standing without my head spinning after a few minutes. Last time we worked on breathing, which helps but not enough.

Today, I learned that I still use volume for verbal emphasis. Which is stupid because my voice just breaks up and it’s as if my breath is leaking out of my head, and my voice doesn’t get a whole lot louder. If I switch to pitch, I do a lot better. But it sounds a lot easier than it actually is. You don’t just will yourself into another style. I’m not really a sing-songy talker. Also? I try and avoid that Canadian guy uptalking thing?

Not being able to “turn it up” is also a problem at work and in my social ife. People get conversational space by speaking up — whether we’re talking about dinner parties or meetings. I used to be right at home in that milieu but now I can’t do that, even though my voice “sounds” normal. So when a person facilitating a discussion in a formal setting like a meeting says “let’s just be cool and talk” it’s actually a real problem for me. So I have taken to raising my hand even when nobody else does. It sort of works. As for dinner parties, there have been a few nights where I just wear out and listen instead of talking.

Other news forthcoming.

A “Tipping Point” Just Happened Inside My Throat

January 31, 2012

Well, that was fun. As predicted in October, the voice lift I had was temporary, and it’s pretty much gone now as far as I can tell. I’ve noticed it in my voice, which has lost strength, low end and is more hoarse (the guy at our local fruiterie asked if I had a cold […]

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Cancer Crawl, 10 Oct 2011

October 10, 2011

And now, another post about cancer! This is one of those “good news/bad news” situations. I confess to some unwarranted cockiness in the cancer department upon returning from California. As Carrie put it, we thought we’d “beaten it” for now. I returned from sabbatical many pounds lighter and a few sizes smaller than I’d left, […]

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Voice Lift Review: Or, Laryngology Phenomenology (not really, but it rhymes)

September 24, 2011

Well, I don’t really recommend the operation for a good time (graphic details below the line for the curious) but it certainly has had an effect on my voice. It sounds different and it’s easier to talk. I would definitely do it again. My friend Derek says that before my voice sounded like my old […]

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