I am sitting in a basement playroom with three men, aged 22, 25, and 29. They are playing Contra on an old Nintendo and we are drinking homemade brown ginger beer.
I've been on vacation for a month. School starts tomorrow.
Today my boyfriend helped me tune up an old French mixte racing bike I got at a yard sale. I've been riding an old Schwinn fixed gear with fashion wheels for a couple years. I've got my current bike set up more like a European city bike as opposed to the aggressively traffic taunting track bikes that have given fixies a bad name. I mostly have stuck with riding fixed because of how much control I have at slow speeds, which is really handy for a klutz like me in the snow and rain and permanently eroding Chicago streets.
A few months ago I changed neighborhoods. My new place is on the top floor and full of light. I am so happy to be able to see nothing but sky out my windows, but the extra
mileage and extra stairs have my leg muscles feeling like old crumbly rubber
bands.
After M trimmed my new bike's bars and redid the brakes and derailleurs, I did a lap around the block. It took me a while to get used to the pedals not moving when I stopped pedalling.
Life's been too good to write about without sounding schmatlzy. It scares the crap out of me sometimes. I keep waiting for the catch. I get a little bit closer to being able to let go and relax and be happy.
Sometimes it feels so good to stop pedalling and just coast.
Sunday, September 05, 2010
Wednesday, July 07, 2010
very long paper
The Dietary Management of Endometriosis
Sue Cook, July 2010
“Therefore if people pay attention to the five flavors and mix them well, their bones will remain straight, their muscles will remain tender and young, their breath and blood will circulate freely, their pores will be fine in texture, and consequently, their breath and bones will be filled with the essence of life .” The Yellow Emperor’s Divine Classic
Endometriosis is a disorder in which endometrial tissue proliferates outside of the uterus. This tissue most commonly implants within the peritoneal cavity, binding to the surfaces of the organs. It grows and bleeds in response to hormone changes, causing inflammation and scarring. Typical symptoms include dysmenorrhea, dysuria, chronic pelvic pain, pain during intercourse, and infertility. In advanced cases where tissue has implanted outside of the abdominal cavity, there may be nosebleed, coughing of blood, and rectal bleeding. While the etiology is still unknown, the most common theory is that endometrial tissue leaves the uterus through the fallopian tubes in a retrograde form of menstruation and is transported through the body via the lymphatic system. Another theory posits that the tissue develops from peritoneal cells in a type of metaplasia.
Endometriosis is typically diagnosed by a biopsy obtained by laparoscopic surgery. Treatment ranges from NSAIDS for management of inflammation, to the prescription of birth control pills to regulate hormone levels. In extreme cases, an artificial menopause may be induced using GnRH agonists. Surgery to remove endometrial implants is also advised, although the tissue usually regenerates. In very extreme cases hysterectomy may be performed .
New research has correlated endometriosis with high levels of prostaglandin E2 (PGE2), a signaling molecule involved in the regulation of immunity and inflammation. High levels of PGE2 inhibit phagocytosis by macrophages, preventing the destruction of abnormal tissue by the immune system. PGE2 also allows endometriotic cells to synthesis their own estrogen, which in turn stimulates mitosis, producing more aberrant cells. A number of genes that share common markers with tumor angiogenesis are also common to these cells .
Although dietary modification is not a common modality in the biomedical treatment of endometriosis, enriching the diet with natural PGE2 inhibitors and anti-angiogenic foods is a logical step. The Angiogenesis Foundation’s website lists a number of these foods: turmeric, broccoli, cinnamon, green tea, blueberries, pineapple, garlic, ginger, and red wine, to name a few. New research also suggests that eliminating trans-fats and increasing Omega-3 consumption can both reduce risk of developing endometriosis and ameliorate its symptoms. Omega-3 fatty acids are a vital component of prostaglandin E1, which inhibits PGE2. Bromelain, an enzyme found in pineapple, has demonstrated anti-inflammatory and tumor-fighting abilities and may also prove useful . Regular exercise and stress reduction techniques can also help, both by boosting immune response and by modulating pain through endorphin release.
Because of its non-invasive nature, Chinese medicine is becoming more and more well-known for its treatment of chronic diseases. Diagnosis is performed through methodical questioning, careful palpation of the pulse and body, and inspection of the tongue. Diseases are typically categorized according to temperature, location in the body, type of pathogenic influence, and organ system. Treatment is based on the “Four Pillars:” acupuncture, herbal therapy, diet, and exercises such as qi gong and tai ji.
According to Bob Flaws’ book Endometriosis, Infertility, & Traditional Chinese Medicine, modern Chinese medicine divides endometriosis into four main categories according to symptoms: qi stagnation and blood stasis, accumulation of cold causing blood stasis, heat congestion with blood stasis, and qi and blood vacuity with blood stasis.
Qi is an ephemeral substance that powers the body. The functions of qi are to activate, warm, defend, transform, and contain. It provides the force behind the body’s metabolism and growth, sustains the immune system, regulates the production of blood and other bodily substances, and maintains the circulatory system, both by propelling the blood through the body and by restraining the blood within the vessels. When the body’s equilibrium is disturbed, either by external causes such as contagious disease or by internal causes such as emotional turmoil, the qi can become stagnant or weak. Such a disruption inevitably results in disease.
Blood is formed by the interaction of qi and the nutrients received from food, water, and air. It has an interdependent relationship with qi. Qi is the commander of the blood, and blood is the mother of qi. Blood can become static, hot, cold, or deficient, usually in combination.
The body is seen as an equilibrium of yin and yang. If the body is thought of as an machine, yin would be the oil that cools and lubricates the moving parts while yang is the gasoline whose fiery combustion powers the movement of the engine. Qi is primarily yang, blood is primarily yin. Each balances the other and keeps it in check, as well as containing a seed other the other within itself. If the yin and yang become unbalanced, heat or cold can develop within the organs.
There are three main organs involved in gynecological disorders: the Liver, the Spleen, and the Kidneys. The Liver in Chinese medicine is the organ responsible for governing the free flow of qi within the body. It stores the blood and controls the amount of blood released into the vessels. The Spleen regulates digestive function. It transforms food and water into qi and blood and distributes them throughout the body. It is said to hold the organs in place and prevent prolapse. It also prevents the blood from leaving the vessels. The Kidneys are said to store the essential qi that serves as the substrate for all bodily functions as well as to house the ministerial fire that controls the metabolism of water throughout the body.
The first diagnosis, qi stagnation and blood stasis, represents a disruption of Liver function. The Liver is especially susceptible to stress, which causes a sort of internal “traffic jam.” When the qi can’t circulate properly, the blood also becomes sluggish. The blood can also become static from trauma causing obstruction in the vessels or from use of birth control medications, which prevent menstrual blood from being fully discharged. Static blood can in turn cause the qi to back up and become stagnant. Symptoms of stagnant qi and blood are
lower abdominal distention, lower abdominal crampy pain, premenstrual breast distention, a stuffy, tight chest… stabbing, sharp, fixed, and lancinating pain, clots in the menstrual discharge, the relief of dysmenorrhea after the passing of clots… possible palpable lumps or masses, and poking pain with intercourse.
The tongue will have a dark or dusky appearance and the pulse will be wiry or choppy. Treatment will focus on moving the qi and blood. Acupuncture protocols with this aim will select from a combination of points such as: Lv 3, Sp 6, Sp 10, LI 4, Ren 3, Ren 6, St 25, Bl 25.
The second category, cold causing blood stasis, is mainly generated by an external cause. Cold can invade the body during exposure to low temperatures, through excessive consumption of cold and raw foods. However, it can also invade when the ministerial fire of the Kidneys becomes weak, generally from severe illness, aging or prolonged overwork, as well as from a lack of Spleen yang. Symptoms include
cold, fixed pain in the lower abdomen relieved by warmth, a dark, clotty, menstrual discharge, aversion to cold… Lumps or masses may be felt on palpation of the uterus and the patient tends to be chilled.
The period may be late or excessively long and heavy. The tongue will be pale or purple with a wet coating, and the pulse will be deep and tight. If the Spleen is deficient in yang, there will be signs of digestive cold such as excessive mucus, diarrhea, loss of appetite, and vomiting. In this case the tongue coat will be thick and greasy and the pulse may be slippery. If the Kidneys are deficient in heat, there may be low back pain, sore knees, edema in the lower limbs, leukorrhea, and frequent urination. The pulse in this case may be very thin and weak. The treatment strategy is to warm the uterus, dispel cold, and move the blood. The warming functions of the Spleen and Kidney should be strengthened as needed. Acupuncture protocols will use points such as Sp 6, Sp 10, Ren 3, Ren 4, St 28, St 36, Bl 23.
Excessive heat in the body can congeal the blood into stasis. Stagnant qi caused by Liver dysfunction can cause friction, which turns into heat. Heat can also be generated by improper diet or by a lack of cooling yin in the organs. If the heat is a result of depressed Liver function, there will be symptoms like migraine headache, emotional lability, red and painful eyes, itchy vaginal discharge prior to menses, and painful urination. The pulse will be rapid and wiry and the tongue will be red with a yellow coating. If the heat is due to a lack of yin, the patient will experience night sweats, a sensation of heat in the palms, soles and chest, mallar flush, imsomnia, irritability, as well as possible dryness of the mucous membranes. The pulse will be rapid, wiry, and floating and the tongue will be reddish with a dry or very thin coat. The menses may be scant or early and there may be vaginal dryness . The pain will be hot and burning and there may be palpable heat and inflammation in the back and pelvic region. The treatment strategy is either to clear heat and move the blood or to clear heat, nourish yin, and move the blood. In the first case the acupuncture protocol will include a selection from Lv 2/3, LI 4, Sp 6, Sp 10, GB 26, GB 34, GB 41, Ren 3, Ren 6, Bl 18, Bl 19, St 29. For yin deficiency with stasis: Kd 3, Kd 6, Ht 5, Ren 4, Sp 6, Sp 10, St 36.
The last pattern, vacuity of qi and blood with stasis, is a particularly common and self-perpetuating cycle. The blood and qi becomes weak due to blood loss itself, poor diet, overwork, stress, or external disease; when there is not enough blood or qi for the qi to flow evenly through the vessels it causes a concurrent stasis of blood and qi, which in turn prevents the generation of more qi and blood. This pattern may be differentiated by whether the qi or the blood is more deficient. If the blood is more deficient, the period will be short and scanty or may stop altogether. The cramps will not be improved as the cycle progresses. The patient may have restless fatigue, insomnia, poor memory, heart palpitations, dry skin, hair and nails, and vertigo. If the qi is more deficient, there will be a dragging sensation in the uterus as the cycle progresses, profound fatigue, and pain made worse by activity. Both types may be accompanied by Spleen cold symptoms such as diarrhea, lack of appetite, abdominal pain during digestion, bloating, and feeling chilled. The treatment strategy is to strengthen qi, generate new blood, and move the static blood. Acupuncture should be accompanied by moxibustion, a modality in which the dried form of the herb mugwort is burned over acupuncture points to supplement the qi and blood. Sample points are St 36, Sp 6, Lv 3, Lv 8, Ren 4, Bl 18, Bl 20.
While Chinese herbal therapy has proven extremely useful in treating endometriosis, many patients may resist taking herbs, often for financial reasons. Dietary modification is extremely useful in these cases. It also allows the patient to recover a sense of control over their body, which can relieve the antipathy many chronic pain patients feel toward themselves.
Chinese herbal and dietary therapy are both based upon the five flavors: pungent/acrid/spicy, sour, sweet, bitter, and salty. Each flavor corresponds to one of the five elements: pungent is the flavor of metal, the element of the Lung; sour is the flavor of wood, which is the element of the Liver; bitter is the flavor of fire and the Heart; sweet is earth and the Spleen; salty is water and the Kidney. The elements follow a specific cycle in which one generates the next: wood, fire, earth, metal, water. Each element also restrains another: wood, earth, water, fire, metal. Each flavor also has an action: acrid promotes motion, sour preserves and contains, bitter drains, sweet nourishes, and salty dissolves. Herbs and foods also have a corresponding temperature, either hot, warm, neutral, cool, or cold. Therefore for a condition of heat from deficient yin and blood with concurrent static blood, the herbs and foods used should be sweet to nourish yin and blood, acrid to move the blood, and a balance of cooling and neutral. When using sweet foods, it is important to include ingredients that boost the digestion, primarily those that are bitter and acrid.
Foods that are said to move the blood include adzuki beans, black beans, peaches (both the fruit and the kernel within the pit), hawthorn berries, chestnuts, chives and green onions, eggplant, chili peppers, brown sugar, cinnamon, wine, acrid spices like cumin, coriander, and turmeric, and vinegar. Foods that move stagnant qi and soothe the Liver include oranges, carrots, plums, greens, celery, and vinegar. Herbs and seasonings that move Liver qi include onions, basil, bay leaf, cardamom, cumin, rosemary mint, and lemon balm. Raw and sprouted foots can also restore function to a stagnant Liver, especially when there are heat signs present. Foods that strengthen qi, yin and blood are miso, oats, rice, grapes, raspberries, longan fruit, lychee, goji berries, peanuts, beets, broccoli, spinach, sweet potatoes and yams, molasses, seaweed, kale. Animal products such as dairy, eggs, and meat all build blood as well, but their temperature must be carefully considered. Red meat like beef and lamb are hot in nature, while duck is cool. Pork and most seafood is neutral. In cases with pronounced cold, hot and warm natured foods like garlic, black pepper, cloves, cinnamon, ginger, lamb, and walnuts should be favored. Conversely, they should be avoided in cases with heat, and cooling foods such as watery fruits and vegetables, mung beans, barley, wheat, and seaweeds should be consumed. Dairy, sugar, and white flours as well as excessively bitter/spicy foods are particularly taxing to the Spleen and tend to contribute to digestive complains as well as damp conditions such as yeast infections and chronic phlegm and should be avoided.
It is often overwhelming for a patient to look at a list of foods and try to come up with something to prepare, especially if they are overworked and tired or have little background in cooking. Sample recipes such as those that follow at the end of this essay can relieve this stress as well as giving the patient a sense of responsibility for their own recovery.
In Healing with Whole Foods, Paul Pitchford recommends a number of supplements for blood deficiency: vitamins A, E, and the B complex, iron and zinc, as well as Omega 3 and 6, chlorophyll and spirulina. Dietary supplements can sometimes be more appealing to patients than herbal which need to be taken several times a day and which often require purchasing a bottle per week. In this case taking a single-herb supplement like turmeric extract should also be suggested.
It is interesting to note the overlap between the list of anti-angiogenic foods provided earlier and the list of foods that build and move blood. The Angiogenesis Foundation website also notes the anti-cancer properties of several mushrooms, namely shiitake, wood ear, and Ganoderma, which are said in Chinese medicine to boost the defensive qi, which corresponds to the immune system. Consumption of these mushrooms, either in extract or as food, may also help promote the destruction of abnormal endometrial tissue by white blood cells.
A diagnosis of endometriosis from a gynecologist can feel like a life sentence. To be forced to choose between sometimes crippling pain and hormonal treatments with unpleasant side effects, exploratory abdominal surgery followed by excision and cauterization, or even hysterectomy is the harsh reality that often faces these women. In contrast, Chinese medical modalities such as acupuncture, herbs, and dietary therapy can provide both temporary and long-term care in a gentle, self-empowering way. By using the “five flavors,” women with endometriosis can find not just relief, but actual recovery.
Sample Recipes:
Curried Sweet Potato and Lentils
ingredients:
2 T organic butter or vegan butter substitute (preferably the flax-based type)
1 large purple onion, diced
2-3 cloves garlic, pounded to a paste or minced
2 inch piece fresh ginger, grated or 1 tsp dried ginger powder
2 large unbroken bay leaves
1 tsp each cumin and fenugreek seeds, powdered
1 tsp turmeric root, powdered
1 large sweet potato or yam, diced
2 cups dried red lentils
water to cover
1 large ripe tomato, chopped
salt or Bragg’s Liquid Aminos to taste
directions: Heat a heavy-bottomed pot, using a pressure cooker if available over a medium flame and melt the butter. Add the onions and bay leaves, stirring frequently until the onion begins to brown, then add the garlic, ginger, and spices, stirring to prevent sticking, and cook for 2 minutes. Add the sweet potato and lentils and pour in sufficient water to cover by at least one inch. Bring to a low boil, then reduce the heat to a simmer and cover. Simmer for approximately one hour until the lentils are soft. Puree if desired. If using a pressure cooker, close the lid and allow to boil until the pressure sensor goes off, then lower heat and cook for 20 minutes. top with fresh tomatoes. Makes approximately 4 2-cup servings.
Analysis:
onions, garlic, cumin, turmeric and bay are warm and acrid and move Liver qi and blood; they also prevent gas during digestion of the legumes. butter is warm and sweet and also reduces stagnant blood. ginger and fenugreek are warm and strengthen the yang of the kidneys and spleen and stop abdominal pain. lentils are sweet and neutral and strengthen the essential qi of the kidney, and are rich in iron and B vitamins. sweet potato is sweet and strengthens the qi overall, especially of the spleen, as well as the yin of the kidneys. they balance estrogen levels and are rich in vitamin A. tomatoes are sweet, sour, and cooling. they nourish yin and generate stomach fluids and purify the liver; they are rich in lycopene which is a powerful antioxidant.
this recipe would be helpful for cold-type blood stasis, i.e. for the woman who feels freezing cold all the time and has painful stabbing cramps relieved by a heating pad, and who also tends to have diarrhea during her period. it is warming and strengthening without being too drying. in cases of severe cold the tomatoes may be removed.
Roasted Duck with Blueberry Sauce and Shiitake Wild Rice
ingredients:
1 fresh duck
3 T brown sugar
1 tsp minced fresh rosemary
one pint blueberries
1 cup thinly sliced shiitake mushrooms
1 shallot, minced
1 cup brown/wild rice mix
3 cups water
1 tsp turmeric powder
2 T corn starch
sea salt
directions: preheat the oven to 350. rub the duck with the brown sugar, rosemary, and a pinch of sea salt mixed together, then place in a roasting pan. bake for about 40 minutes covered with foil, then remove the foil. at this time spoon off a few tablespoons of the fat into a saucepan and cook another 20 minutes until the skin is crispy and the temperature of the meat of the thigh is 170 degrees. remove from the oven and pour off the fat into a jar. remove the duck and let it rest. scrape the brown drippings from the pan into a small saucepan.
after removing the foil from the duck and spooning the fat into a saucepan, heat the pan over a medium flame. add the shiitakes and shallot, stirring frequently until brown. add the rice and stir to coat evenly with the fat, then add the water and bring to a boil. cover, reduce to a simmer, and cook until all the water is absorbed, approximately 35-40 minutes.
while the rice is cooking, prepare the sauce: dissolve 2 T corn starch in 2 cups of water, then whisk into saucepan with the drippings, the blueberries and about 2 T of the duck fat. reserve the rest of the duck fat in a tightly lidded jar for a sad and gloomy day. let the sauce simmer until thickened. mash the blueberries against the side of the pan. salt to taste.
Serve the duck over the rice topped with the sauce. This can feed two people for several meals or a group of 4-6 once.
Analysis: duck is sweet and cool and nourishes kidney yin and essential qi. blueberries are sweet, cold, and nourish kidney yin; they are also anti-angiogenic and full of antioxidants and fight cancer. brown sugar moves and tonifies blood; it contains B vitamins. rosemary is warm and acrid and moves qi; it is also anti-angiogenic and anti-inflammatory. shiitakes are sweet and neutral and strengthen the lungs and stomach; they are anti-angiogenic and boost white blood cell counts and fight cancer. shallots are sweet, acrid, and neutral. they strengthen the qi of the lung and stomach and help to break down the fats in the meal. turmeric is warm and acrid and moves liver qi and breaks up static blood. wild rice is cool, bitter and sweet, brown rice is sweet and neutral. they strengthen qi overall and contain B vitamins to build blood and strengthen the nervous system.
this recipe is well suited for a woman with a mixture of yin/blood/qi deficiency. she would feel hot, irritable, restless and exhausted before, during, and after her period. this would be a particularly suitable meal for winter months as it is extremely nourishing. if she has difficulty digesting heavy foods, orange or tangerine zest may be added to the sauce to help break down the fats and prevent stagnant qi in the belly.
Endnotes didn't seem to work so I am cutting and pasting them. I will re-edit this post later to make sure they show up: I sure don't want to be thought to plagiarize.
Veith, Ilsa, trans. The Yellow Emperor’s Classic of Internal Medicine Los Angeles: University of California Press, 1973. (109).
Beers, Mark H. et al, Eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co. Inc. 2009. (2089-92)
Wu, Meng-Hsing et al. “Prostaglandin E2: the Master of Endometriosis?” Experimental Biology and Medicine, Vol 235, number 6. 2010. (668-677. ) Retrieved from http://ebm.rsmjournals.com/cgi/content/full/235/6/668
Angiogenesis Foundation Website, online at http://angio.org/news.php
Missmer, Stacy A. et al. “A Prospective Study of Dietary Fat Consumption and Endometriosis Risk.” Human Reproduction, Vol 25, number 6. 2010. (1528-1535). Retrieved from http://humrep.oxfordjournals.org/cgi/content/full/deq044
Mynott, Tracey et al. “Bromelain, from Pineapple Stems, Proteolytically Blocks Activation of Extracellular Regulated Kinase-2 in T Cells.” Journal of Immunology, vol. 163. 1999. (2568-2575). Retrieved from http://www.jimmunol.org/cgi/content/full/163/5/2568
Flaws, Bob. Endometriosis, Infertility, & Traditional Chinese Medicine: a laywoman’s guide. Boulder: Blue Poppy Press, 1989. (28)
Wiseman, Nigel and Andrew Ellis, translators. Fundamentals of Chinese Medicine. Brookline: Paradigm Publications, 1996. (19-20)
Wiseman, 22.
Wiseman, 64-67.
Wiseman, 59-60.
Wiseman, 68-70.
All acupuncture protocols are cited from: Flaws, Bob. A Handbook of Menstrual Diseases in Chinese Medicine. Boulder: Blue Poppy Press, 1997. (543-544).
Endometriosis, 32-33.
Endometriosis, 34-35.
Endometriosis, 36-37.
see Subhuti Dharmananda’s excellent summary of recent research in China, available online at http://www.itmonline.org/journal/arts/endometriosis.htm
Wiseman, 7-14.
Pitchford, Paul. Healing with Whole Foods: Asian traditions and modern nutrition. Berkeley: North Atlantic Books, 2002. (327)
Mattson, Brendan, DAOM. "TCM Dietary Guideline Reference Table." Eastern Nutrition class lecture handout, Pacific College of Oriental Medicine, Chicago. Spring term, 2010.
Pitchford, 388.
Sue Cook, July 2010
“Therefore if people pay attention to the five flavors and mix them well, their bones will remain straight, their muscles will remain tender and young, their breath and blood will circulate freely, their pores will be fine in texture, and consequently, their breath and bones will be filled with the essence of life .” The Yellow Emperor’s Divine Classic
Endometriosis is a disorder in which endometrial tissue proliferates outside of the uterus. This tissue most commonly implants within the peritoneal cavity, binding to the surfaces of the organs. It grows and bleeds in response to hormone changes, causing inflammation and scarring. Typical symptoms include dysmenorrhea, dysuria, chronic pelvic pain, pain during intercourse, and infertility. In advanced cases where tissue has implanted outside of the abdominal cavity, there may be nosebleed, coughing of blood, and rectal bleeding. While the etiology is still unknown, the most common theory is that endometrial tissue leaves the uterus through the fallopian tubes in a retrograde form of menstruation and is transported through the body via the lymphatic system. Another theory posits that the tissue develops from peritoneal cells in a type of metaplasia.
Endometriosis is typically diagnosed by a biopsy obtained by laparoscopic surgery. Treatment ranges from NSAIDS for management of inflammation, to the prescription of birth control pills to regulate hormone levels. In extreme cases, an artificial menopause may be induced using GnRH agonists. Surgery to remove endometrial implants is also advised, although the tissue usually regenerates. In very extreme cases hysterectomy may be performed .
New research has correlated endometriosis with high levels of prostaglandin E2 (PGE2), a signaling molecule involved in the regulation of immunity and inflammation. High levels of PGE2 inhibit phagocytosis by macrophages, preventing the destruction of abnormal tissue by the immune system. PGE2 also allows endometriotic cells to synthesis their own estrogen, which in turn stimulates mitosis, producing more aberrant cells. A number of genes that share common markers with tumor angiogenesis are also common to these cells .
Although dietary modification is not a common modality in the biomedical treatment of endometriosis, enriching the diet with natural PGE2 inhibitors and anti-angiogenic foods is a logical step. The Angiogenesis Foundation’s website lists a number of these foods: turmeric, broccoli, cinnamon, green tea, blueberries, pineapple, garlic, ginger, and red wine, to name a few. New research also suggests that eliminating trans-fats and increasing Omega-3 consumption can both reduce risk of developing endometriosis and ameliorate its symptoms. Omega-3 fatty acids are a vital component of prostaglandin E1, which inhibits PGE2. Bromelain, an enzyme found in pineapple, has demonstrated anti-inflammatory and tumor-fighting abilities and may also prove useful . Regular exercise and stress reduction techniques can also help, both by boosting immune response and by modulating pain through endorphin release.
Because of its non-invasive nature, Chinese medicine is becoming more and more well-known for its treatment of chronic diseases. Diagnosis is performed through methodical questioning, careful palpation of the pulse and body, and inspection of the tongue. Diseases are typically categorized according to temperature, location in the body, type of pathogenic influence, and organ system. Treatment is based on the “Four Pillars:” acupuncture, herbal therapy, diet, and exercises such as qi gong and tai ji.
According to Bob Flaws’ book Endometriosis, Infertility, & Traditional Chinese Medicine, modern Chinese medicine divides endometriosis into four main categories according to symptoms: qi stagnation and blood stasis, accumulation of cold causing blood stasis, heat congestion with blood stasis, and qi and blood vacuity with blood stasis.
Qi is an ephemeral substance that powers the body. The functions of qi are to activate, warm, defend, transform, and contain. It provides the force behind the body’s metabolism and growth, sustains the immune system, regulates the production of blood and other bodily substances, and maintains the circulatory system, both by propelling the blood through the body and by restraining the blood within the vessels. When the body’s equilibrium is disturbed, either by external causes such as contagious disease or by internal causes such as emotional turmoil, the qi can become stagnant or weak. Such a disruption inevitably results in disease.
Blood is formed by the interaction of qi and the nutrients received from food, water, and air. It has an interdependent relationship with qi. Qi is the commander of the blood, and blood is the mother of qi. Blood can become static, hot, cold, or deficient, usually in combination.
The body is seen as an equilibrium of yin and yang. If the body is thought of as an machine, yin would be the oil that cools and lubricates the moving parts while yang is the gasoline whose fiery combustion powers the movement of the engine. Qi is primarily yang, blood is primarily yin. Each balances the other and keeps it in check, as well as containing a seed other the other within itself. If the yin and yang become unbalanced, heat or cold can develop within the organs.
There are three main organs involved in gynecological disorders: the Liver, the Spleen, and the Kidneys. The Liver in Chinese medicine is the organ responsible for governing the free flow of qi within the body. It stores the blood and controls the amount of blood released into the vessels. The Spleen regulates digestive function. It transforms food and water into qi and blood and distributes them throughout the body. It is said to hold the organs in place and prevent prolapse. It also prevents the blood from leaving the vessels. The Kidneys are said to store the essential qi that serves as the substrate for all bodily functions as well as to house the ministerial fire that controls the metabolism of water throughout the body.
The first diagnosis, qi stagnation and blood stasis, represents a disruption of Liver function. The Liver is especially susceptible to stress, which causes a sort of internal “traffic jam.” When the qi can’t circulate properly, the blood also becomes sluggish. The blood can also become static from trauma causing obstruction in the vessels or from use of birth control medications, which prevent menstrual blood from being fully discharged. Static blood can in turn cause the qi to back up and become stagnant. Symptoms of stagnant qi and blood are
lower abdominal distention, lower abdominal crampy pain, premenstrual breast distention, a stuffy, tight chest… stabbing, sharp, fixed, and lancinating pain, clots in the menstrual discharge, the relief of dysmenorrhea after the passing of clots… possible palpable lumps or masses, and poking pain with intercourse.
The tongue will have a dark or dusky appearance and the pulse will be wiry or choppy. Treatment will focus on moving the qi and blood. Acupuncture protocols with this aim will select from a combination of points such as: Lv 3, Sp 6, Sp 10, LI 4, Ren 3, Ren 6, St 25, Bl 25.
The second category, cold causing blood stasis, is mainly generated by an external cause. Cold can invade the body during exposure to low temperatures, through excessive consumption of cold and raw foods. However, it can also invade when the ministerial fire of the Kidneys becomes weak, generally from severe illness, aging or prolonged overwork, as well as from a lack of Spleen yang. Symptoms include
cold, fixed pain in the lower abdomen relieved by warmth, a dark, clotty, menstrual discharge, aversion to cold… Lumps or masses may be felt on palpation of the uterus and the patient tends to be chilled.
The period may be late or excessively long and heavy. The tongue will be pale or purple with a wet coating, and the pulse will be deep and tight. If the Spleen is deficient in yang, there will be signs of digestive cold such as excessive mucus, diarrhea, loss of appetite, and vomiting. In this case the tongue coat will be thick and greasy and the pulse may be slippery. If the Kidneys are deficient in heat, there may be low back pain, sore knees, edema in the lower limbs, leukorrhea, and frequent urination. The pulse in this case may be very thin and weak. The treatment strategy is to warm the uterus, dispel cold, and move the blood. The warming functions of the Spleen and Kidney should be strengthened as needed. Acupuncture protocols will use points such as Sp 6, Sp 10, Ren 3, Ren 4, St 28, St 36, Bl 23.
Excessive heat in the body can congeal the blood into stasis. Stagnant qi caused by Liver dysfunction can cause friction, which turns into heat. Heat can also be generated by improper diet or by a lack of cooling yin in the organs. If the heat is a result of depressed Liver function, there will be symptoms like migraine headache, emotional lability, red and painful eyes, itchy vaginal discharge prior to menses, and painful urination. The pulse will be rapid and wiry and the tongue will be red with a yellow coating. If the heat is due to a lack of yin, the patient will experience night sweats, a sensation of heat in the palms, soles and chest, mallar flush, imsomnia, irritability, as well as possible dryness of the mucous membranes. The pulse will be rapid, wiry, and floating and the tongue will be reddish with a dry or very thin coat. The menses may be scant or early and there may be vaginal dryness . The pain will be hot and burning and there may be palpable heat and inflammation in the back and pelvic region. The treatment strategy is either to clear heat and move the blood or to clear heat, nourish yin, and move the blood. In the first case the acupuncture protocol will include a selection from Lv 2/3, LI 4, Sp 6, Sp 10, GB 26, GB 34, GB 41, Ren 3, Ren 6, Bl 18, Bl 19, St 29. For yin deficiency with stasis: Kd 3, Kd 6, Ht 5, Ren 4, Sp 6, Sp 10, St 36.
The last pattern, vacuity of qi and blood with stasis, is a particularly common and self-perpetuating cycle. The blood and qi becomes weak due to blood loss itself, poor diet, overwork, stress, or external disease; when there is not enough blood or qi for the qi to flow evenly through the vessels it causes a concurrent stasis of blood and qi, which in turn prevents the generation of more qi and blood. This pattern may be differentiated by whether the qi or the blood is more deficient. If the blood is more deficient, the period will be short and scanty or may stop altogether. The cramps will not be improved as the cycle progresses. The patient may have restless fatigue, insomnia, poor memory, heart palpitations, dry skin, hair and nails, and vertigo. If the qi is more deficient, there will be a dragging sensation in the uterus as the cycle progresses, profound fatigue, and pain made worse by activity. Both types may be accompanied by Spleen cold symptoms such as diarrhea, lack of appetite, abdominal pain during digestion, bloating, and feeling chilled. The treatment strategy is to strengthen qi, generate new blood, and move the static blood. Acupuncture should be accompanied by moxibustion, a modality in which the dried form of the herb mugwort is burned over acupuncture points to supplement the qi and blood. Sample points are St 36, Sp 6, Lv 3, Lv 8, Ren 4, Bl 18, Bl 20.
While Chinese herbal therapy has proven extremely useful in treating endometriosis, many patients may resist taking herbs, often for financial reasons. Dietary modification is extremely useful in these cases. It also allows the patient to recover a sense of control over their body, which can relieve the antipathy many chronic pain patients feel toward themselves.
Chinese herbal and dietary therapy are both based upon the five flavors: pungent/acrid/spicy, sour, sweet, bitter, and salty. Each flavor corresponds to one of the five elements: pungent is the flavor of metal, the element of the Lung; sour is the flavor of wood, which is the element of the Liver; bitter is the flavor of fire and the Heart; sweet is earth and the Spleen; salty is water and the Kidney. The elements follow a specific cycle in which one generates the next: wood, fire, earth, metal, water. Each element also restrains another: wood, earth, water, fire, metal. Each flavor also has an action: acrid promotes motion, sour preserves and contains, bitter drains, sweet nourishes, and salty dissolves. Herbs and foods also have a corresponding temperature, either hot, warm, neutral, cool, or cold. Therefore for a condition of heat from deficient yin and blood with concurrent static blood, the herbs and foods used should be sweet to nourish yin and blood, acrid to move the blood, and a balance of cooling and neutral. When using sweet foods, it is important to include ingredients that boost the digestion, primarily those that are bitter and acrid.
Foods that are said to move the blood include adzuki beans, black beans, peaches (both the fruit and the kernel within the pit), hawthorn berries, chestnuts, chives and green onions, eggplant, chili peppers, brown sugar, cinnamon, wine, acrid spices like cumin, coriander, and turmeric, and vinegar. Foods that move stagnant qi and soothe the Liver include oranges, carrots, plums, greens, celery, and vinegar. Herbs and seasonings that move Liver qi include onions, basil, bay leaf, cardamom, cumin, rosemary mint, and lemon balm. Raw and sprouted foots can also restore function to a stagnant Liver, especially when there are heat signs present. Foods that strengthen qi, yin and blood are miso, oats, rice, grapes, raspberries, longan fruit, lychee, goji berries, peanuts, beets, broccoli, spinach, sweet potatoes and yams, molasses, seaweed, kale. Animal products such as dairy, eggs, and meat all build blood as well, but their temperature must be carefully considered. Red meat like beef and lamb are hot in nature, while duck is cool. Pork and most seafood is neutral. In cases with pronounced cold, hot and warm natured foods like garlic, black pepper, cloves, cinnamon, ginger, lamb, and walnuts should be favored. Conversely, they should be avoided in cases with heat, and cooling foods such as watery fruits and vegetables, mung beans, barley, wheat, and seaweeds should be consumed. Dairy, sugar, and white flours as well as excessively bitter/spicy foods are particularly taxing to the Spleen and tend to contribute to digestive complains as well as damp conditions such as yeast infections and chronic phlegm and should be avoided.
It is often overwhelming for a patient to look at a list of foods and try to come up with something to prepare, especially if they are overworked and tired or have little background in cooking. Sample recipes such as those that follow at the end of this essay can relieve this stress as well as giving the patient a sense of responsibility for their own recovery.
In Healing with Whole Foods, Paul Pitchford recommends a number of supplements for blood deficiency: vitamins A, E, and the B complex, iron and zinc, as well as Omega 3 and 6, chlorophyll and spirulina. Dietary supplements can sometimes be more appealing to patients than herbal which need to be taken several times a day and which often require purchasing a bottle per week. In this case taking a single-herb supplement like turmeric extract should also be suggested.
It is interesting to note the overlap between the list of anti-angiogenic foods provided earlier and the list of foods that build and move blood. The Angiogenesis Foundation website also notes the anti-cancer properties of several mushrooms, namely shiitake, wood ear, and Ganoderma, which are said in Chinese medicine to boost the defensive qi, which corresponds to the immune system. Consumption of these mushrooms, either in extract or as food, may also help promote the destruction of abnormal endometrial tissue by white blood cells.
A diagnosis of endometriosis from a gynecologist can feel like a life sentence. To be forced to choose between sometimes crippling pain and hormonal treatments with unpleasant side effects, exploratory abdominal surgery followed by excision and cauterization, or even hysterectomy is the harsh reality that often faces these women. In contrast, Chinese medical modalities such as acupuncture, herbs, and dietary therapy can provide both temporary and long-term care in a gentle, self-empowering way. By using the “five flavors,” women with endometriosis can find not just relief, but actual recovery.
Sample Recipes:
Curried Sweet Potato and Lentils
ingredients:
2 T organic butter or vegan butter substitute (preferably the flax-based type)
1 large purple onion, diced
2-3 cloves garlic, pounded to a paste or minced
2 inch piece fresh ginger, grated or 1 tsp dried ginger powder
2 large unbroken bay leaves
1 tsp each cumin and fenugreek seeds, powdered
1 tsp turmeric root, powdered
1 large sweet potato or yam, diced
2 cups dried red lentils
water to cover
1 large ripe tomato, chopped
salt or Bragg’s Liquid Aminos to taste
directions: Heat a heavy-bottomed pot, using a pressure cooker if available over a medium flame and melt the butter. Add the onions and bay leaves, stirring frequently until the onion begins to brown, then add the garlic, ginger, and spices, stirring to prevent sticking, and cook for 2 minutes. Add the sweet potato and lentils and pour in sufficient water to cover by at least one inch. Bring to a low boil, then reduce the heat to a simmer and cover. Simmer for approximately one hour until the lentils are soft. Puree if desired. If using a pressure cooker, close the lid and allow to boil until the pressure sensor goes off, then lower heat and cook for 20 minutes. top with fresh tomatoes. Makes approximately 4 2-cup servings.
Analysis:
onions, garlic, cumin, turmeric and bay are warm and acrid and move Liver qi and blood; they also prevent gas during digestion of the legumes. butter is warm and sweet and also reduces stagnant blood. ginger and fenugreek are warm and strengthen the yang of the kidneys and spleen and stop abdominal pain. lentils are sweet and neutral and strengthen the essential qi of the kidney, and are rich in iron and B vitamins. sweet potato is sweet and strengthens the qi overall, especially of the spleen, as well as the yin of the kidneys. they balance estrogen levels and are rich in vitamin A. tomatoes are sweet, sour, and cooling. they nourish yin and generate stomach fluids and purify the liver; they are rich in lycopene which is a powerful antioxidant.
this recipe would be helpful for cold-type blood stasis, i.e. for the woman who feels freezing cold all the time and has painful stabbing cramps relieved by a heating pad, and who also tends to have diarrhea during her period. it is warming and strengthening without being too drying. in cases of severe cold the tomatoes may be removed.
Roasted Duck with Blueberry Sauce and Shiitake Wild Rice
ingredients:
1 fresh duck
3 T brown sugar
1 tsp minced fresh rosemary
one pint blueberries
1 cup thinly sliced shiitake mushrooms
1 shallot, minced
1 cup brown/wild rice mix
3 cups water
1 tsp turmeric powder
2 T corn starch
sea salt
directions: preheat the oven to 350. rub the duck with the brown sugar, rosemary, and a pinch of sea salt mixed together, then place in a roasting pan. bake for about 40 minutes covered with foil, then remove the foil. at this time spoon off a few tablespoons of the fat into a saucepan and cook another 20 minutes until the skin is crispy and the temperature of the meat of the thigh is 170 degrees. remove from the oven and pour off the fat into a jar. remove the duck and let it rest. scrape the brown drippings from the pan into a small saucepan.
after removing the foil from the duck and spooning the fat into a saucepan, heat the pan over a medium flame. add the shiitakes and shallot, stirring frequently until brown. add the rice and stir to coat evenly with the fat, then add the water and bring to a boil. cover, reduce to a simmer, and cook until all the water is absorbed, approximately 35-40 minutes.
while the rice is cooking, prepare the sauce: dissolve 2 T corn starch in 2 cups of water, then whisk into saucepan with the drippings, the blueberries and about 2 T of the duck fat. reserve the rest of the duck fat in a tightly lidded jar for a sad and gloomy day. let the sauce simmer until thickened. mash the blueberries against the side of the pan. salt to taste.
Serve the duck over the rice topped with the sauce. This can feed two people for several meals or a group of 4-6 once.
Analysis: duck is sweet and cool and nourishes kidney yin and essential qi. blueberries are sweet, cold, and nourish kidney yin; they are also anti-angiogenic and full of antioxidants and fight cancer. brown sugar moves and tonifies blood; it contains B vitamins. rosemary is warm and acrid and moves qi; it is also anti-angiogenic and anti-inflammatory. shiitakes are sweet and neutral and strengthen the lungs and stomach; they are anti-angiogenic and boost white blood cell counts and fight cancer. shallots are sweet, acrid, and neutral. they strengthen the qi of the lung and stomach and help to break down the fats in the meal. turmeric is warm and acrid and moves liver qi and breaks up static blood. wild rice is cool, bitter and sweet, brown rice is sweet and neutral. they strengthen qi overall and contain B vitamins to build blood and strengthen the nervous system.
this recipe is well suited for a woman with a mixture of yin/blood/qi deficiency. she would feel hot, irritable, restless and exhausted before, during, and after her period. this would be a particularly suitable meal for winter months as it is extremely nourishing. if she has difficulty digesting heavy foods, orange or tangerine zest may be added to the sauce to help break down the fats and prevent stagnant qi in the belly.
Endnotes didn't seem to work so I am cutting and pasting them. I will re-edit this post later to make sure they show up: I sure don't want to be thought to plagiarize.
Veith, Ilsa, trans. The Yellow Emperor’s Classic of Internal Medicine Los Angeles: University of California Press, 1973. (109).
Beers, Mark H. et al, Eds. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck & Co. Inc. 2009. (2089-92)
Wu, Meng-Hsing et al. “Prostaglandin E2: the Master of Endometriosis?” Experimental Biology and Medicine, Vol 235, number 6. 2010. (668-677. ) Retrieved from http://ebm.rsmjournals.com/cgi/content/full/235/6/668
Angiogenesis Foundation Website, online at http://angio.org/news.php
Missmer, Stacy A. et al. “A Prospective Study of Dietary Fat Consumption and Endometriosis Risk.” Human Reproduction, Vol 25, number 6. 2010. (1528-1535). Retrieved from http://humrep.oxfordjournals.org/cgi/content/full/deq044
Mynott, Tracey et al. “Bromelain, from Pineapple Stems, Proteolytically Blocks Activation of Extracellular Regulated Kinase-2 in T Cells.” Journal of Immunology, vol. 163. 1999. (2568-2575). Retrieved from http://www.jimmunol.org/cgi/content/full/163/5/2568
Flaws, Bob. Endometriosis, Infertility, & Traditional Chinese Medicine: a laywoman’s guide. Boulder: Blue Poppy Press, 1989. (28)
Wiseman, Nigel and Andrew Ellis, translators. Fundamentals of Chinese Medicine. Brookline: Paradigm Publications, 1996. (19-20)
Wiseman, 22.
Wiseman, 64-67.
Wiseman, 59-60.
Wiseman, 68-70.
All acupuncture protocols are cited from: Flaws, Bob. A Handbook of Menstrual Diseases in Chinese Medicine. Boulder: Blue Poppy Press, 1997. (543-544).
Endometriosis, 32-33.
Endometriosis, 34-35.
Endometriosis, 36-37.
see Subhuti Dharmananda’s excellent summary of recent research in China, available online at http://www.itmonline.org/journal/arts/endometriosis.htm
Wiseman, 7-14.
Pitchford, Paul. Healing with Whole Foods: Asian traditions and modern nutrition. Berkeley: North Atlantic Books, 2002. (327)
Mattson, Brendan, DAOM. "TCM Dietary Guideline Reference Table." Eastern Nutrition class lecture handout, Pacific College of Oriental Medicine, Chicago. Spring term, 2010.
Pitchford, 388.
Saturday, June 12, 2010
want to be better
today you would have been 21.
I was a condescending asshole for a lot of our friendship and I hope you knew what I was trying to say.
you were indomitable.
fearless.
gorgeous.
invincible.
you were and always will be my hero.
you make me want to be a better person.
I was a condescending asshole for a lot of our friendship and I hope you knew what I was trying to say.
you were indomitable.
fearless.
gorgeous.
invincible.
you were and always will be my hero.
you make me want to be a better person.
Saturday, June 05, 2010
the ultimate ginger
The way I see it every life is a pile of good things and bad things; The good things don’t always soften the bad things but, vice-versa, the bad things don’t necessarily spoil the good things or make them unimportant.
This week's Doctor Who may have been the most touching and hopeful one I've seen. completely turned my day around.
caught in a bad romance
six months after the video came out, watching Bad Romance still makes me relive all that anger I felt after Liza died. so much disbelief and rage that it sank down inside my body and turned to inflammation. every time I ride by her bike or go to Metropolis, I still feel it. how could this terrible thing happen? how could someone so brightly burning just be gone?
it's summer again and I think of all the things we couldn't fit in last year that we were saving for this year. there's the oil spill and the Gaza blockade and the Guatemalan sinkhole and more than ever it feels like the world is ending.
it's summer again and I think of all the things we couldn't fit in last year that we were saving for this year. there's the oil spill and the Gaza blockade and the Guatemalan sinkhole and more than ever it feels like the world is ending.
Wednesday, June 02, 2010
Soul Food for Wind-Cold Invading Lungs: Grits and Greens
Here's a recipe I came up with for my Eastern Nutrition class. it's designed to treat a clear wet cough associated with the common cold. it's easy, cheap, and vegan.
Ingredients:
GREENS:
3 inch piece fresh ginger
2 bunches fresh mustard greens
1 large purple onion
5 Chinese dates (complicated version) or 1 T raw brown sugar (easy version)
either 1 cup water plus 3 dried shiitakes (complicated version) or 2 T extra virgin olive oil plus 1 cup water
tamari or Bragg’s Liquid Aminos
GRITS:
1 c stone-ground yellow grits (polenta)
3 c water
1 tsp salt
PREPARATION: easy level
In a 2-4 quart saucepan with a lid, bring 3 cups water to a boil. Slowly pour in one cup of grits, stirring constantly to prevent clumps or a volcanic-type explosion. Lower heat to medium and stir for a few minutes, then turn off the flame and cover to finish cooking.
Rinse the greens thoroughly by completely submerging in a full sink of water and swishing to remove any grit. Remove from water and set in drainer.
First cut the root end off the onion, then cut in half lengthwise. Remove the skin. Trim off the top of the onion. Cut into pinky-finger thick slices.
Slice the ginger very thinly.
In a large pot that has a lid, heat the olive oil over a medium-high flame. Add the onions and stir occasionally until they begin to soften and brown slightly. Add the water and ginger and let boil for about 5 minutes.
Meanwhile, tear the greens into pieces, discarding the ends of the stems.
Add the greens to the onion mixture, stir a few times, and cover. Let the greens steam for about 3 minutes, then turn off the heat and remove the lid. Season with a small amount of brown sugar and tamari. Serve over grits.
COMPLICATED PREPARATION
Prepare grits as above. Wash greens and tear into pieces, discarding stems.
In a large pan, boil the thinly sliced ginger, the dates, and the shiitakes in a quart of water until it is reduced to approximately one cup. Strain and return to the pot.
Slice the onions and add to the ginger broth. Bring to a boil, stirring constantly until most of the liquid is evaporated. Add the greens to the pot , stir, and cover to steam for 3-4 minutes. Turn off the heat and season to taste with tamari. Serve over grits.
ANALYSIS (this is the breakdown according to Chinese medicine terms. ignore it, if you want.)
ginger: acrid, warm. enters LU/SP/ST. releases exterior; warms lungs and stops cough
mustard greens: acrid, warm. enters LU/LI. expels wind/cold/damp; warms lung, opens chest, stops cough.
onion: acrid, neutral. enters LU/ST. Transforms phlegm and damp.
Chinese dates: sweet, warm. enter SP/ST. tonify Spleen qi; protect middle burner from acrid ingredients; with fresh ginger, harmonize nutritive and protective qi.
shiitakes: sweet, neutral. enter SP/LU. Boost protective qi.
tamari: salty, cold. Enters SP/ST/KD. Protects middle burner. tastes good.
corn: sweet, bland, neutral. enters SP/ST. Drains damp through diuresis. Supports spleen to support the lungs.
Ingredients:
GREENS:
3 inch piece fresh ginger
2 bunches fresh mustard greens
1 large purple onion
5 Chinese dates (complicated version) or 1 T raw brown sugar (easy version)
either 1 cup water plus 3 dried shiitakes (complicated version) or 2 T extra virgin olive oil plus 1 cup water
tamari or Bragg’s Liquid Aminos
GRITS:
1 c stone-ground yellow grits (polenta)
3 c water
1 tsp salt
PREPARATION: easy level
In a 2-4 quart saucepan with a lid, bring 3 cups water to a boil. Slowly pour in one cup of grits, stirring constantly to prevent clumps or a volcanic-type explosion. Lower heat to medium and stir for a few minutes, then turn off the flame and cover to finish cooking.
Rinse the greens thoroughly by completely submerging in a full sink of water and swishing to remove any grit. Remove from water and set in drainer.
First cut the root end off the onion, then cut in half lengthwise. Remove the skin. Trim off the top of the onion. Cut into pinky-finger thick slices.
Slice the ginger very thinly.
In a large pot that has a lid, heat the olive oil over a medium-high flame. Add the onions and stir occasionally until they begin to soften and brown slightly. Add the water and ginger and let boil for about 5 minutes.
Meanwhile, tear the greens into pieces, discarding the ends of the stems.
Add the greens to the onion mixture, stir a few times, and cover. Let the greens steam for about 3 minutes, then turn off the heat and remove the lid. Season with a small amount of brown sugar and tamari. Serve over grits.
COMPLICATED PREPARATION
Prepare grits as above. Wash greens and tear into pieces, discarding stems.
In a large pan, boil the thinly sliced ginger, the dates, and the shiitakes in a quart of water until it is reduced to approximately one cup. Strain and return to the pot.
Slice the onions and add to the ginger broth. Bring to a boil, stirring constantly until most of the liquid is evaporated. Add the greens to the pot , stir, and cover to steam for 3-4 minutes. Turn off the heat and season to taste with tamari. Serve over grits.
ANALYSIS (this is the breakdown according to Chinese medicine terms. ignore it, if you want.)
ginger: acrid, warm. enters LU/SP/ST. releases exterior; warms lungs and stops cough
mustard greens: acrid, warm. enters LU/LI. expels wind/cold/damp; warms lung, opens chest, stops cough.
onion: acrid, neutral. enters LU/ST. Transforms phlegm and damp.
Chinese dates: sweet, warm. enter SP/ST. tonify Spleen qi; protect middle burner from acrid ingredients; with fresh ginger, harmonize nutritive and protective qi.
shiitakes: sweet, neutral. enter SP/LU. Boost protective qi.
tamari: salty, cold. Enters SP/ST/KD. Protects middle burner. tastes good.
corn: sweet, bland, neutral. enters SP/ST. Drains damp through diuresis. Supports spleen to support the lungs.
Wednesday, May 26, 2010
make healthy beautiful wish!
I've been shopping at Vietanamese grocery stores since I was 20, but somehow never discovered the instant cereal drink section. a girl from my Eastern Nutrition class is always eating some kind of oatmeal type packet with seaweed in it, so when I went to pick up some kuding cha for my air conditioning induced sore throat, I made sure to scour the aisle for some kind of breakfast gruel. While most of them had wheat flakes, I was able to find this lovely blend which is relatively gluten-free, if you eat oats. It contains oats, Job's tears, green mung bean, lotus seed, and oligofructose.
It's lightly sweet, bland, a little nutty. the consistency is fairly gluey with a few flakes or lumps. I made a double serving and added water to the texture of pudding, but it's probably intended to be served more as a beverage.
Coix seeds, mung beans, and lotus seeds are all used to strengthen the digestive tract as well as clear internal dampness and heat. Internal dampness and heat are a sort of mystical-sounding Chinese Medicine concept that basically breaks down to "metabolic friction." They can manifest as skin problems, muscle and joint pain, bloating, edema, urogenital dysfunction, digestive pain, diarrhea, insomnia, anxiety, even bleeding. They can be caused by stress, improper diet, lingering pathogens, weather, or congenital predisposition.
I assumed oligofructose was the same as regular fructose, i.e. fruit sugar, but it's actually a type of fiber that is about half as sweet as regular sugar. it's called a prebiotic because it is digested by intestinal bacteria. it helps with calcium absorption and may help prevent yeast overgrowth.
one packet breaks down to 143 calories, 29.6 g carbs, 6.6 g fiber, and 4.6 g protein. it also has relatively high iron, B vitamin, and calcium content for an unfortified cereal.
and finally, the package has a lovely Engrish description on the back:
Oat and Job's tear are both annual plants. Job's tear is especially renowned for it's high nutritive value as "The kind of grass family." Oat has been proven to be good for healthy by many agricultural experts and scholars in Europe and America in their researches. The combination of Oat and Job's tear is able to compliment each other and provide excellent nutrition to keep healthy."
In summary: this shit tastes good. it'll make you gorgeous, sexy, and give you superpowers. Total win.
Wednesday, May 12, 2010
Sunday, May 09, 2010
in the days we sweat it out on the streets
my body is a temple.
my body is a cage.
hope is the thing with feathers.
I can feel them inside my lungs when I'm running along the lake path. I can't take a deep breath.
I can run twice as far as I could ten years ago. I guess I got more chasing me.
I count to five. over and over. there's little room for thinking when you're choking on a broken heart and metaphysical wings.
I will be the fittest person with fibromyalgia on the planet. you will never, ever think to look at me that I have an untreatable nervous system disorder that makes me feel like someone's been borrowing my body at night to play rugby in.
at least this way I own the pain.
for the fucking win.
my body is a cage.
hope is the thing with feathers.
I can feel them inside my lungs when I'm running along the lake path. I can't take a deep breath.
I can run twice as far as I could ten years ago. I guess I got more chasing me.
I count to five. over and over. there's little room for thinking when you're choking on a broken heart and metaphysical wings.
I will be the fittest person with fibromyalgia on the planet. you will never, ever think to look at me that I have an untreatable nervous system disorder that makes me feel like someone's been borrowing my body at night to play rugby in.
at least this way I own the pain.
for the fucking win.
Monday, May 03, 2010
Love after Love
The time will come
when, with elation
you will greet yourself arriving
at your own door, in your own mirror
and each will smile at the other's welcome,
and say, sit here. Eat.
You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart
to itself, to the stranger who has loved you
all your life, whom you ignored
for another, who knows you by heart.
Take down the love letters from the bookshelf,
the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.
-Derek Walcott
when, with elation
you will greet yourself arriving
at your own door, in your own mirror
and each will smile at the other's welcome,
and say, sit here. Eat.
You will love again the stranger who was your self.
Give wine. Give bread. Give back your heart
to itself, to the stranger who has loved you
all your life, whom you ignored
for another, who knows you by heart.
Take down the love letters from the bookshelf,
the photographs, the desperate notes,
peel your own image from the mirror.
Sit. Feast on your life.
-Derek Walcott
Tuesday, April 27, 2010
I'm starting to feel distant again
this
or this.
I'm just so fucking depressed
I just can't seem to get to get out this slump
if I could just get over this hump
but I need something to pull me out this dump
I took my bruises, took my lumps
fell down and I got right back up
but I need something to get me psyched back up...
Thursday, April 22, 2010
and it never really began, but in my heart it was so real...
it just kind of hit me. it's really over. there was never much there in the first place, just a lot of misplaced hope, a lot of trying real hard to cram a square peg into a round hole.
I wanted so much and I tried to make myself believe that too little was enough. but it just wasn't. my heart's been broken for a long-ass time and it's just now catching up to me.
I have spent almost every waking moment of the past 18 years longing for someone to take me out of myself. to give me someone to be. to make me belong. to make it stop hurting. maybe it's because I was raised on that "god-shaped hole" nonsense. maybe it's because my mom made me get on my knees as a little bitty girl and pray to Jesus for a husband.
I don't know how to be ok alone, despite the fact that I spent almost all my time alone. it's like, if I have someone specific to obsess about, then I won't feel so empty. If I can name and qualify this hurt it will somehow be lessened.
I have endless time. and endless pain. and nobody but me.
I wanted so much and I tried to make myself believe that too little was enough. but it just wasn't. my heart's been broken for a long-ass time and it's just now catching up to me.
I have spent almost every waking moment of the past 18 years longing for someone to take me out of myself. to give me someone to be. to make me belong. to make it stop hurting. maybe it's because I was raised on that "god-shaped hole" nonsense. maybe it's because my mom made me get on my knees as a little bitty girl and pray to Jesus for a husband.
I don't know how to be ok alone, despite the fact that I spent almost all my time alone. it's like, if I have someone specific to obsess about, then I won't feel so empty. If I can name and qualify this hurt it will somehow be lessened.
I have endless time. and endless pain. and nobody but me.
Thursday, April 08, 2010
steel guitar makes it real
The flag is gone from the roof of the Edgewater Beach Hotel.
how will I know which way the wind is blowing.
he says I love you just not how you want me to.
how the fuck am I supposed to process that.
what the fuck is that supposed to mean.
needs and wants and hurts
naked and bloody and veiny and shaking
alone and broken and unwanted in the dark.
it all boils down to this:
I wanted you
and you were a stone.
"and if it could start being alive you'd stop being alone."
how will I know which way the wind is blowing.
he says I love you just not how you want me to.
how the fuck am I supposed to process that.
what the fuck is that supposed to mean.
needs and wants and hurts
naked and bloody and veiny and shaking
alone and broken and unwanted in the dark.
it all boils down to this:
I wanted you
and you were a stone.
"and if it could start being alive you'd stop being alone."
Tuesday, April 06, 2010
everything falls apart
here's the thing. every time I try to have a relationship, it's never just me and him. it's always me, him, and pain. and if he's got his own pain to deal with, well, the bed just gets too small for all four of us.
maybe one day I'll be able to see the difference between me and pain. I'll quit thinking that my brokenness makes me inferior. I'll quit making excuses for the way I am when I am ravaged by pain.
I just don't know how to do that now. days like this when I just feel flayed, when my heart and lungs are raw with grief, I don't know how to separate who I am from this rotting flesh.
When I was small a teacher gave me a collection of fairy tales. I identify very strongly with the story of Catherine and her Fate. Except no fairy godmother ever came to me and asked me to decide between happiness in my youth or happiness in old age. and I have no guarantee that the Universe will ever cease to ask so much of me.
maybe one day I'll be able to see the difference between me and pain. I'll quit thinking that my brokenness makes me inferior. I'll quit making excuses for the way I am when I am ravaged by pain.
I just don't know how to do that now. days like this when I just feel flayed, when my heart and lungs are raw with grief, I don't know how to separate who I am from this rotting flesh.
When I was small a teacher gave me a collection of fairy tales. I identify very strongly with the story of Catherine and her Fate. Except no fairy godmother ever came to me and asked me to decide between happiness in my youth or happiness in old age. and I have no guarantee that the Universe will ever cease to ask so much of me.
Cascando
1
why not merely the despaired of
occasion of
wordshed
is it not better abort than be barren
the hours after you are gone are so leaden
they will always start dragging too soon
the grapples clawing blindly the bed of want
bringing up the bones the old loves
sockets filled once with eyes like yours
all always is it better too soon than never
the black want splashing their faces
saying again nine days never floated the loved
nor nine months
nor nine lives
2
saying again
if you do not teach me I shall not learn
saying again there is a last
even of last times
last times of begging
last times of loving
of knowing not knowing pretending
a last even of last times of saying
if you do not love me I shall not be loved
if I do not love you I shall not love
the churn of stale words in the heart again
love love love thud of the old plunger
pestling the unalterable
whey of words
terrified again
of not loving
of loving and not you
of being loved and not by you
of knowing not knowing pretending
pretending
I and all the others that will love you
if they love you
3
unless they love you
(S. Beckett, 1936)
why not merely the despaired of
occasion of
wordshed
is it not better abort than be barren
the hours after you are gone are so leaden
they will always start dragging too soon
the grapples clawing blindly the bed of want
bringing up the bones the old loves
sockets filled once with eyes like yours
all always is it better too soon than never
the black want splashing their faces
saying again nine days never floated the loved
nor nine months
nor nine lives
2
saying again
if you do not teach me I shall not learn
saying again there is a last
even of last times
last times of begging
last times of loving
of knowing not knowing pretending
a last even of last times of saying
if you do not love me I shall not be loved
if I do not love you I shall not love
the churn of stale words in the heart again
love love love thud of the old plunger
pestling the unalterable
whey of words
terrified again
of not loving
of loving and not you
of being loved and not by you
of knowing not knowing pretending
pretending
I and all the others that will love you
if they love you
3
unless they love you
(S. Beckett, 1936)
Sunday, April 04, 2010
definitely a madman with a box
new season. new Doctor.
newly restored faith in things getting better.
newly restored faith in things getting better.
Wednesday, March 31, 2010
but I'd trade the rest of my days for you tonight
first sunburn of the year, slow to develop, just a little glow on my forearms and face. riding bikes by the lake with my lost friend's little sister and talking about loss and love and hurt and growing up.
my heart aches. there's so many holes punched in it that I imagine it like lace, gushing and leaking inside my chest. maybe that's why it's beating so fast. 85 bpm, unrelenting, like new love, like stage fright, like being chased down a darkened hallway in the night by the wolf from under the bed.
where is my brave face. where is the script for me to follow. what is love. can I love without trusting, or is that just addiction to oxytocin and dopamine and a very specific bioelectric field.
when I was little my mom used to make me pray for a husband. now I can't imagine anything other than living and dying alone. even when I'm with someone. when nobody's going anywhere. when they're right where I need them. I'm still alone, because there's no hope of anything other than loss and loneliness and broken shattered pieces of my lacy hole-filled heart. when did I lose faith.
who broke my heart first. my dad. jesus. the world. I remember being 13 and telling myself that there was no such thing as love. losing my virginity in a tent in the woods to a stranger, before ever even having a first kiss. because nothing is special. nothing is pure. nothing will last.
tomorrow I give in to the dark side. I lose the mission. I cease to keep the faith. I go to a psychiatrist and I get pills to quiet my heart. to put me to sleep. to make being unwanted hurt less. to keep my brave face on. to live through this.
everything sticks in my throat. pills. raisins. toast. resentment. fear. maybe I'm choking on love, on insecurity. on being unable to let go and trust. to surrender control.
I first heard this song the summer of 2003. the first time I lived alone. me and the cats and a sixpack of high life writing in livejournal, bike rides to the food coop, to decleyre, to the felix house. honeysuckle and porch swings and blue shadows on the street. sitting alone in the dark listening to lucero, loneliness like a knife embedded in my chest. surrounded by love but unable to open my arms and take it. like tantalus in hades. pushing the rock of my own stubborn lack of faith and hope and trust endlessly up this hill.
so I'll swallow my pills until summer, until the earth tilts, until things make more sense. until they are better.
but it won't be tonight.
my heart aches. there's so many holes punched in it that I imagine it like lace, gushing and leaking inside my chest. maybe that's why it's beating so fast. 85 bpm, unrelenting, like new love, like stage fright, like being chased down a darkened hallway in the night by the wolf from under the bed.
where is my brave face. where is the script for me to follow. what is love. can I love without trusting, or is that just addiction to oxytocin and dopamine and a very specific bioelectric field.
when I was little my mom used to make me pray for a husband. now I can't imagine anything other than living and dying alone. even when I'm with someone. when nobody's going anywhere. when they're right where I need them. I'm still alone, because there's no hope of anything other than loss and loneliness and broken shattered pieces of my lacy hole-filled heart. when did I lose faith.
who broke my heart first. my dad. jesus. the world. I remember being 13 and telling myself that there was no such thing as love. losing my virginity in a tent in the woods to a stranger, before ever even having a first kiss. because nothing is special. nothing is pure. nothing will last.
tomorrow I give in to the dark side. I lose the mission. I cease to keep the faith. I go to a psychiatrist and I get pills to quiet my heart. to put me to sleep. to make being unwanted hurt less. to keep my brave face on. to live through this.
everything sticks in my throat. pills. raisins. toast. resentment. fear. maybe I'm choking on love, on insecurity. on being unable to let go and trust. to surrender control.
I first heard this song the summer of 2003. the first time I lived alone. me and the cats and a sixpack of high life writing in livejournal, bike rides to the food coop, to decleyre, to the felix house. honeysuckle and porch swings and blue shadows on the street. sitting alone in the dark listening to lucero, loneliness like a knife embedded in my chest. surrounded by love but unable to open my arms and take it. like tantalus in hades. pushing the rock of my own stubborn lack of faith and hope and trust endlessly up this hill.
so I'll swallow my pills until summer, until the earth tilts, until things make more sense. until they are better.
but it won't be tonight.
Sunday, March 28, 2010
I really wish I could go back on meds, that they'd work. that the side effects wouldn't be just as miserable as my baseline state is.
weeks of unending dopesickness has left me sure that my neurochemistry is irrevocably fucked.
I've read that crippling depression and anxiety are part of "secondary withdrawals," that it's going to be another month before I feel anywhere close to normal, which is way too close to rock bottom for me anyway.
I'm losing friends because all I do is whinge. I can't stand myself either. I can't stand feeling like this and all I can do is stick needles in myself and take handfuls of valerian root and drink lemon balm tea and wait for my heart to stop pounding.
I'm at wit's end. I've been having a panic attack, unable to stop crying for 3 days straight.
weeks of unending dopesickness has left me sure that my neurochemistry is irrevocably fucked.
I've read that crippling depression and anxiety are part of "secondary withdrawals," that it's going to be another month before I feel anywhere close to normal, which is way too close to rock bottom for me anyway.
I'm losing friends because all I do is whinge. I can't stand myself either. I can't stand feeling like this and all I can do is stick needles in myself and take handfuls of valerian root and drink lemon balm tea and wait for my heart to stop pounding.
I'm at wit's end. I've been having a panic attack, unable to stop crying for 3 days straight.
Wednesday, March 24, 2010
strong at the broken places
after two weeks off Vicodin I was stupid. I took a few pills when I had cramps too bad to walk, thinking surely it wouldn't be too bad.
instead I triggered another set of withdrawals all over again. fish-flopping limbs. racing heart. searing pain, like sunburn under my skin and on top of my muscle layer. hallucinations. nausea so deep it felt like dying. icy sweat.
I've been pushed to the very deepest darkest places this past month. I've been in more pain than I ever thought I'd be able to bear. I had to relive the whole Second Chance experience over again, being locked up and in pain and being treated like a liar. being forced to kiss ass and make nice to get out and get back to my life when inside I was seething with rage because no-one would help me.
and yet I go on. like a good little Newtonian. at some point these experiences will have their equal and opposite reaction. I will learn whatever it is I was supposed to learn from this and I will make myself its master.
and eventually this world will get tired of breaking me, and it will kill me in the end. even then they will gather after over the pieces of me that are left and say, she was so strong.
instead I triggered another set of withdrawals all over again. fish-flopping limbs. racing heart. searing pain, like sunburn under my skin and on top of my muscle layer. hallucinations. nausea so deep it felt like dying. icy sweat.
I've been pushed to the very deepest darkest places this past month. I've been in more pain than I ever thought I'd be able to bear. I had to relive the whole Second Chance experience over again, being locked up and in pain and being treated like a liar. being forced to kiss ass and make nice to get out and get back to my life when inside I was seething with rage because no-one would help me.
and yet I go on. like a good little Newtonian. at some point these experiences will have their equal and opposite reaction. I will learn whatever it is I was supposed to learn from this and I will make myself its master.
and eventually this world will get tired of breaking me, and it will kill me in the end. even then they will gather after over the pieces of me that are left and say, she was so strong.
Monday, March 08, 2010
see you at the crossroads
It's gonna be awhile before I can write about the past couple weeks in any sort of depth. bad reaction to Yasmin had me feeling like I'd been set on fire, my MDs decided it was narcotic withdrawal despite the fact that I was taking 60 mg a day of hydrocodone, I went to the ER, got sent to the state mental hospital, went 8 days without seeing the sky or riding my bike, got out, had Howard Brown fire me as a patient because my health problems are beyond their scope of practice, one of the nurse practitioners there somehow gave my therapist the idea that I was a narcotic addict so now she's refusing to treat me, Howard Brown refused to refill my pain meds because I won;t have a laparascopy done so now I am detoxing, I had to drop two classes, I'm weeks behind in the 3 I kept, I lost 5 pounds cos the fucking state hospital's idea of gluten-free meals are a scoop of government peanut butter and three cups of canned fruit cocktail...
hospitals trigger my ptsd like fucking hell and if it weren't for all the meds I"m on right now I think I'd be fucked out of my mind.
right now the only thing that is helping is eating bacon cherry chocolate chip pancakes 4 meals in a row.
and this beautiful amazing inspiring song, which I've got on repeat.
hospitals trigger my ptsd like fucking hell and if it weren't for all the meds I"m on right now I think I'd be fucked out of my mind.
right now the only thing that is helping is eating bacon cherry chocolate chip pancakes 4 meals in a row.
and this beautiful amazing inspiring song, which I've got on repeat.
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