Three years ago

Today in medical nutrition therapy class we learned about bone marrow transplants. I shared a couple of things I had learned due to participating in part of that process as a donor. Some of my classmates had wanted to hear the story. So, here it is! I wrote this one year after my donation. I’m going to tell the story from the beginning, starting with Once Upon a Time.

Once upon a time I went to a blood drive. I was in college and it was in the dorm and it was all pretty simple. A friendly volunteer came up and asked me if I wanted to be in a bone marrow registry. All it would take, she assured me, was a painless swab of the inside of my cheek with a q tip. “Sure!”, I responded, and gave her a tiny piece of my inner cheek in exchange for a cute pin that said, “Will you marrow me?”

Knowing the tiny odds of someone being a match for an unrelated stranger is exceptionally tiny (1 in 540, to be specific), I didn’t expect to hear any more from them. Somewhat surprisingly, I did, a mere six months or so later. I agreed to do the follow up blood work, where I went to a doctors office and got a few vials of blood taken out. They told me they’d test my blood, both for the quality of the match between my genes and the ones of another and for the presence of any nasty little viruses in my blood, but explained that being a preliminary match does not mean that you’ll actually end up being the one donating. Sure enough, when they next called me, they said that someone else had been a better match.

Primed by this experience, when I got a phone call in 2012, another three years or so later, I expected that once again the nice marrow people would look at my blood and find it not quite right. After the bloodwork, I got my follow up phone call and, noticing that my phone was near death, plugged it into an outlet and sat in the floor so I could talk while it charged. This ended up being fortuitous, as the phone call was both lengthy and dramatic enough that I was glad to be sitting.

I was a match. A woman, somewhere in the world, 33 years old, had an awful case of cancer and I was the person with the best odds of providing her with the cells she needed to rebuild her immune system and prolong her life.

The scientific details made up the majority of the phone call. In all likelihood, this was based on my own interest. I was in (what I now know was) the last months of a crappy job and craving a return to learning about science and heath, what I envisioned in what became the grad school program of my dreams. Science: the nice person from the marrow registry explained that when a patient’s doctor entered him or her into the registry, they could rank what treatments they thought would best work for their patient’s needs. A bone marrow transplant, the older of the two procedures I’ll explain in this post, is what most people are familiar with. The donor goes to a doctor’s office, is put under local anesthesia, and has a large needle inserted into their bone, from which bone marrow is removed. However, bone marrow donation was not what this particular patient’s doctor was requesting as their first choice of treatment.

Rather, what they requested, and what I ultimately provided, was a peripheral blood stem cell donation. A quick explanation: many people are familiar with embryonic stem cells, because they are a bit of a hot-button political issue. Embryonic stem cells can become any kind of cell- they are blank slates. The hope is that someday someone with, for example, a degenerative nerve disease could get embryonic stem cells implanted in their body, and grow new nerve cells. However, there are also other types of stem cells, which are still around when you are out of the womb, and when you grow up into adulthood. Blood stem cells are in this category. Think about it: our blood cells go through considerable wear and tear (any time you get a cut, for example). They also are made more frequently than many other types of cells.

So, blood stem cells are used to make every kind of blood cells- red blood cells, and the different types of white blood cells that comprise your immune system. For someone with leukemia- like the woman who received my stem cell donation- those white blood cells are what aren’t working. In leukemia, the body produces enormous amounts of immature, poorly functioning white blood cells (which is why people with leukemia often learn their diagnosis because they get sick a lot- their white blood cells don’t function well enough to fight off infection).

In a traditional bone marrow transplant, those blood stem cells are sucked out of the bone marrow. In a peripheral blood stem cell donation, you receive injections of a drug called Nupogen, aka filgrastim (which was a drug originally developed for people who had received bone marrow transplants). It causes your body to make a tonnnn of extra blood stem cells. Those extra stem cells crowd into the bone marrow and get pushed out into the bloodstream, joining the small amount of peripheral blood stem cells that are already in the bloodstream. (The number of peripheral blood stem cells in the bloodstream without getting filgrastim are too low in number to work for a transplant).

Anyway, lots of science. What did this mean for me, and the woman who now knew she was going to receive a transplant? Hint: it was a lot easier for me.

To prepare oneself to receive a bone marrow/peripheral blood stem cell transplant (I’m going to use the terms interchangeably from this point on, trusting y’all know the science now!), you basically have to get your immune system nuked. The woman who received my stem cells had already been through the hell of cancer (specifically acute myelogenous leukemia, a particularly nasty breed, that she’d been exceedingly unlikely and unlucky to get at the age of 33). She’d gone through the conventional treatments (because of the extremely high risks of a bone marrow transplant, it is a treatment of last resort) and they hadn’t worked, or she wouldn’t be on the transplant registry list. Now she received even more chemo, and likely radiation too (because of privacy laws, I don’t know the details of her treatment), in an effort to knock out her own immune system so intensely that she wouldn’t reject my cells. This of course left her incredibly vulnerable to infection, and in isolation in a hospital ward.

While she went through that hell, I prepared myself to donate. On the registry folks’ end (incidentally, the National Marrow Donor Program is staffed by some seriously awesome people, and does some seriously great work, and is worth your interest and support), my coordinator Cathy wrangled my GAZILLIONS of doctors appointments and lab visits. My tests included but were not limited to: the most thorough physical of my life that asked gazillions of questions about my medical history and physical and mental state (the funnest part definitely being the nurse practitioner and I both sifting through the paperwork figuring out exactly how to classify my outpatient surgical procedure for removing a large chalasian from my eye); a chest X-ray; an EKG; a CBC (which told me about all the different types and numbers of blood cells, which I found FASCINATING!); urinalysis; a nutrition panel (after which I was given leave to eat as much steak as I wanted cause my iron was hella low); and roughly 10,000 pregnancy tests.

Meanwhile, I spent a lot of time thinking about the woman who would get my cells. Praying for her, her family, her doctors. Wondering whether she had kids (being a 33 year old woman). Trying to envision where she lived, with limited success. My case was a bit unusual because the woman who received my cells lives somewhere in Europe. The registry is international, so she still got matched up with me, but the whole procedure for eventually knowing about/meeting the person who got your cells is complicated, because different countries have very different privacy laws about knowing who gave you your cells. (Which, of course, makes sense- what if someone needs an additional donation and the person who gave cells the first time opts not to do it again. What would that mean if you could track that person down?) Still, I try to picture her. My mom’s hairdresser’s friend (ha! My mom really enjoyed telling EVERYONE SHE KNEW about this procedure) said that she knew someone who’d donated bone marrow and met her recipient, and said they’d both ended up laughing upon seeing each other because they looked alike! Which makes sense given, by necessity, their genetic similarity. I think of myself as a uniquely American genetic mutt- a dad who’s half English, half South African (well, Dutch via South Africa, I spose) and a mom who’s mostly Greek with a little dash of Irish thrown in for fun. Where but America could this kind of genetic mix occur?

I was really scared for this woman. As I said, to get bone marrow, you get your immune system NUKED. Which means that the common cold can kill you. Then, once you get the new stem cells, they can attack your own cells (graft versus host disease). This happens a lot too.

However, the process, when successful, is pretty flabbergasting. When the transplant works, when the donor’s cells enter the recipient’s body, they know where to go. Specifically, through the blood stream, into the bone marrow, where they start building the person a brand new immune system. Truly mind boggling: if the donor and the recipient are two different blood types and the transplant is successful, the recipient will become the blood type of the donor.

Fast forward to donation week, which meant injection time. The way the process works is that there’s a cadre of people for the week- in other words, me and five other people would all get our injections on the same schedule and then all donate together on the same day. This fostered a nice sense of camaraderie. Because I lived literally five minutes away from one of the best apheresis centers in the country, I did not travel for my donation, but most other people had. The National Marrow Donor Program flew folks into town and gave them hotel rooms (they also reimbursed us for travel to and from doctor’s appointments, any medical tests we had to pay for out of pocket- in my case, none, because they arranged all of my appointments- and the meals we and our loved one we brought with us ate on the day of our donation. I ultimately opted not to submit my receipts because I thought they were such a great organization that I’d let them spend that money on better things!) Something that I found fascinating was that at LEAST fifty percent of the people in my group were in the military. I take that as a sign that there must be some sort of mandatory (or at least highly accessible and encouraged) way for military members to enroll in the registry.

We arrived that first morning and got thoroughly briefed on the possible side effects of filgrastim. The filgrastim injections? Yeah, those hurt like a BITCH, and you had to get them in each arm. To take home, we were given our own individual containers of extra strength Tylenol, which we were told to take around the clock, before the pain started, because once it did it would be too hard to get on top of. We were also told to quit vigorous exercise, but to walk as often as possible because it helped the drug move through your bloodstream and reduced bone pain. Bone pain, especially in the large bones like your hip bones and femurs, is the most common side effect. We were told what serious side effects to look for, and asked daily questions about our side effects so that the staff could give us any medications we needed. I also received a phone call every morning from Cathy, my coordinator at the office of the National Marrow Donor program.

For me, I experienced two main side effects from the drugs. The first was the promised bone pain. My lower back just killed me for a couple of days. Walking definitely helped, and bad weather meant that I dragged my nice boyfriend to the museums downtown with me and walked around there. Another rainy day I spent walking around the mall picking out wedding presents for a friend. My second side effect was nausea. Now, I maintain that I was lucky, because another friend I had (crazily, a friend I went to summer camp with who donated stem cells at the exact same hospital a month earlier than I did) had gotten absolutely awful nausea that required her to be hospitalized from so much vomiting. I did not throw up during the process. However, I now have an extraordinary sympathy and respect for women with morning sickness, because holy crap it is AWFUL being nauseous all the time! They gave me phenergen for the nausea, but with the caveat that for the drug to be most effective you should take it two hours after eating or one hour before eating. By the end, eating was awful and I wanted to avoid it as much as possible. I remember taking the phenergen, knowing I had to eat in an hour, and calling my then-boyfriend crying because I didn’t want to. He talked me down and recommended buttered noodles, which worked beautifully.

Soon enough it was donation day. I arrived at the hospital at the crack of dawn to get my final injection, then instructed to walk around for an hour or so to let it kick in. I ate breakfast (a bagel with butter, which actually tasted pretty good), and returned to the center.

Let me be candid: I was told that the donation process would be not dissimilar to donating blood. You’d get a needle put in one hand, have it suck out your blood and send it through an apheresis machine that would pull out the stem cells, and get the regular cells put back in your bloodstream through the other hand. While all of that is technically true, that process also sucked. For the blood to successfully flow out of your veins and into the machine, and to avoid clotting, you are pumped full of blood thinners and your blood must be kept extremely warm, which means that you are covered in hot heavy blankets and hot water bottles. You also watch your own blood flow out of you in enormous quantities in a lot of tubes, and it can really skeeve you out. By far the worst aspect, however, is the tourniquet. You have a tourniquet wrapped around the arm that’s getting the cells sucked out, in order to control the blood flow. Within about an hour, it literally felt as though someone was stabbing me in the arm- my nerve cells were all, “THERE IS NO BLOOD FLOW I AM GOING TO FALL OFF IF YOU CONTINUE THIS PROCESS!” I am normally pretty stoic about pain, but, particularly embarrassing in the presence of all these military folks, I started crying like a baby. Which of course happened the moment my then-boyfriend arrived with an also somewhat embarrassing balloon and teddy bear.

The nurses were so kind to me and loosened the tourniquet and gave me a break (and also helped me with the VERY tricky business of using the bathroom during the donation. You have to keep the hand where the blood is being sucked out COMPLETELY STILL, leaving you with just one hand, which also has a needle stuck in it, to use. Zippers are a hoot, let me tell you). My mom insisted in taking the day off of work (the donation day and the next day too) and watched cheesy movies with me to distract me during the donation process (fact: I now associate Mamma Mia and Date Night with pain and discomfort and I never want to see them again).

And, of course, the whole process was worth it, and I knew that my level of discomfort was nothing, nothing, compared to the woman with cancer who was receiving my cells.

Still, I was glad when it was over!

Immediately after my donation, I felt surprisingly good. RAVENOUSLY hungry, which means I got to do justice to a big Moe’s burrito, which was the first thing that had tasted good in many days. I took the following day off of work. Sidebar: I didn’t miss a ton of work for the process. The marrow registry was really good about scheduling my appointments on my lunch hour at a Labcorp near my work, or in early morning at a hospital near my house. My injections began on the Saturday of Columbus Day weekend, so the only day I had to contend with before my donation day (a Wednesday) was Tuesday, on which I think I worked mostly a full day at work. I did take the Thursday off after the donation because I basically slept all day. As in, was awake for maybe six hours of the day. It was pretty great.

So that’s the end of the donation story. In terms of the followup, it gets really very good, though there are some blanks.

In the life of the recipient:

1. One month later: I had to make my nurses some delicious cookies, one to thank them for treating me so well and one because I had to bring them over along with my good news. Fact: nurses are an integral part of the donation process, but don’t get to find out about what happened to the patient! So I made them some macaroons and delighted with them with the news that my patient had engrafted (accepted my stem cells) and was out of the hospital.

2. Six months later: I got a voicemail from Cathy, my faithful coordinator at the National Marrow Donor program. I heard the smile in her voice as she told me she had good news for me. Imagine my delight when I returned her call to learn that my patient’s health continued to improve, she’d had very few side effects, and that she was preparing to return to work part-time. I could correspond with her anonymously (something with which I’ve been struggling to figure out how to do… what do I say?!) for the next five years and upon the five year mark, if we both agreed to it, we could meet.

In the life of the donor (aka me):

1. One month later: I completed my last day at my crappy job! Nothing like thinking about someone with cancer to make one recognize that LIFE IS SHORT.

2. One year later: the experience of donating stem cells was all kinds of things for me. I’d absolutely do it again, crappy side effects and all.

One thing it made me do is appreciate my body. Our bodies are amazing, and learning about the science of the bone marrow (or stem cell) donation process really demonstrates that. It’s hard to buy into our body’s ridiculous obsession with how our bodies look on the outside when you witness that, on the inside, with just a little help from some meds, your body can make 340 million blood stem cells (in my case; they need 300 million for a transplant, mine made a little extra. One guy made billions and billions!) If we just let our bodies be our bodies, they can do fearful and wonderful things, and we can quite literally give of ourselves.

Another thing is that it is deeply, purely validating to the self to do something so unequivocally good. I do a lot of “shoulds” and self criticism in my life (an ongoing battle for me, believe me). I constantly feel that I’m not doing enough, or I’m not doing things the right way, or I’m caught up in stupid little things, or that I should just be better at my job/relationship/healthy lifestyle. But doing something purely good, something that is voluntary and purely and simply good is a feeling I highly recommend.

mo biochem mo problems

Here are some photographs that somewhat capture week in which biochem was melting my brain. My stress level and level of absorption in all things hormone signaling, fat and cholesterol metabolism, starvation and metabolic stress gradually increased throughout the week. By the weekend– which I’m calling my Lost Weekend– I’d cut all social ties with anyone who wasn’t a study buddy (thus requiring me to cancel pumpkin carving, brunch with my friends and their adorable baby, brunch with a friend visiting from New York City, MY OWN BIRTHDAY DINNER, etc.).

Thank God that some study dates involve cats, or I’d fail everything. (Actually, one of my study buddies has chickens, too, so that’s also nice).

This is Sadie. She helps. (She also loves hair ties, and her ultimate challenge is to get every single one of her human’s hair ties underneath the dishwasher).

IMG_3254

During the week before the test we were discussing metabolic syndrome in class and my professor made these very erotic drawings to demonstrate body types with and without visceral fat.

sexy bods

(Our professor is super peculiar. VERY VERY blunt. You can’t have too many feelings around her, but I find her very entertaining in her meanness. And obviously her artistic talent is formidable)

 

I took a brief break from biochem. Not for fun. Rather, to go to a professional development workshop. Behold, my professional values: things I want in my grown up career. (We ended up having to further narrow down our values to just six of these cards!)

IMG_3250

So chronicling Lost Weekend:

On the Friday night prior to the test, I went wiiild and wandered around on a trail while studying with friends x_x At least it was nice to get some fresh air and sunshine with our discussion of hormone sensitive lipase and so on. Had a little breakthrough talking about LDL transporter signaling in cells, too. It’s the little things.

Also, we got burrito bowls for dinner.

IMG_3255

And then because everyone’s brain was broken (and one of my poor study buddies actually started to cry at the burrito place) we put away our flashcards, drank wine and watched Nashville!

Saturday was all studying and no fun. Hour upon hour upon hour of flashcard making and reviewing, textbook reading, diagram constructing. I’d take occasional breaks to roll around on the floor in Happy Baby yoga pose when my lower back started to spasm from sitting too long. I also took a brief break to shove sushi in my mouth, giving me an opportunity to see my dear sweet sister, and hope that the omega-3’s would help my brain.

 

Sunday involved more vigorous studying at my friend Steph’s (and a brief chicken break in which I became distressed at learning that Steph’s nicest chicken was sick. She has subsequently left this earth for chicken heaven, *sob*)

I’m usually on the verge of scurvy by the time I’m done studying, as was the case the Sunday of the Lost Weekend.

Because hours and hours and hours of biochem are just not conducive to eating well.

Anyway, I got Weaver Street Market hot bar. Look at all the colors! (Of course, Steph and I ran flashcards while walking to and from the market).

IMG_3271

Blessedly, the test came and went, and I did well! And then it was time to have all my chums over and celebrate! I made an open Facebook invitation to everyone in our cohort (yes, we call ourselves a cohort, because we’re in public health and it’s an epidemiological term and we’re nerds).

I had limited mental resources so Trader Joe was entirely in charge of food.

I made this whole wheat butternut squash gyoza in about five minutes.

IMG_3256

Not mind bogglingly good, but fun.

IMG_3257

Plus my new favorite fall appetizer (seriously, TRY THIS COMBINATION. Pumpkin cranberry crisps and honey goat cheese! Yes!)

IMG_3258

Plus unpictured spanikopita, PLUS then one of our classmates who couldn’t even make it to the party sent us an Insomnia Cookies delivery because she’s the best.

Obviously, the main point of the party was to drink wine. I purchased these, and ended up not even needing to open two of them because my classmates were very generous about bringing more adult beverages.

IMG_3259

Shoutout to the second from the left- it was my classmate’s recommendation, ALMOND CHAMPAGNE OOOH AHHHH. Sold at Trader Joe’s. I thought it could’ve been gross but I do generally trust Jaclyn’s taste.

Anyway, it didn’t need to get opened at the party, because after making that rec then Jaclyn herself ended up bringing champagne and grapefruit juice for a lovely mimosa variation. So the almond champagne got popped during a Halloween scary movie night a few days later. It was EXCELLENT and different!

So now I’ll only have one more biochem test (the final). Oh and then one more biochem semester. Heh.

school week eats

Soup

IMG_3136

  • Veggie stock (made of leftover veggie trimmings- carrot tops, onion skins, celery hearts, etc.- cooked in water in the crockpot for a few hours)
  • Chickpeas (cooked from dry- just soaked em and boiled em til tender. Gosh it’s amazing how much better they are when they aren’t canned. A worthwhile thing to do for days you’re lazing around the house anyway).
  • stale bread
  • kale

Spaghetti squash

IMG_3242

  • roasted a smallish spaghetti squash, and scraped out its innards
  • mixed with Trader Joe’s tomato sauce
  • topped with lotttts of melted cheese

Nibbles

IMG_3138

  • scrambled eggs cooked suuuuuper slowly, yesssss
  • kale chips
  • apple slices with cinnamon (forgot how good this was!)

Cooking for one is really an egg parade, actually

IMG_3090

  • quiche, ish: egg, tomatoes, and corn chucked in a pie pan. Sprinkle cheese  on top. Bake til firm.
  • plus toast with guacamole on top

more eggs

IMG_3112

  • random leftover veggies (eesh truly don’t remember what except clearly it involved tomatoes)
  • fried egg
  • guacamole

socca:

IMG_2814

  • socca (chickpea flour pancake) made using the Mark Bittman methodology with olive oil and lots of black pepper
  • cheese melted on top

There are always leftovers, yet it’s hard to figure out what happened to the original mealIMG_2810

  • overnight oats I clearly never made in the morning and didn’t eat (I had some cherries that had been getting soft so I pitted them then roasted them and they were REALLY good in this)
  • kale chips

I wish this meal had ended up more colorful… and flavorful…

IMG_2789

  • couscous (Trader Joe’s whole wheat kind)
  • cabbage sauteed with Trader Joe’s Korean-flavored chicken sausage

Also, sometimes (too often) I just give up and get something easy to go.

Harris Teeter sushi:

IMG_2817IMG_2815

Weaver Street Market hot bar (I was pleased with myself because of the variety of food groups in this dish- Caribbean seasoned greens and potatoes, delicious Italian-style tomatoey chickpeas, roasted tofu, and spicy sesame noodles with broccoli).

IMG_3117

Also sometimes (often) I just give up and eat way too many sweets.

Alli (my fabulous roommate) brought me this AMAZING piece of pie that her friend had made. It had homemade (SO SO FLAKY) crust topped with lemon curd and blueberries cooked with thyme.

IMG_3092

JUST INCREDIBLE. I ate it for breakfast one day!

IMG_3091

Also, one of my classmates went to Spain and brought everyone whiskey chocolates. We ate them in class, teehee!

IMG_3119IMG_3122

autumnal delights

I took a nice afternoon walk and there was a miniature horse just hanging out in a random yard in the middle of Carrboro. Because Carrboro. (I texted my sister: Lil Sebastian is in Carrboro!)

2015-10-11 17.35.50

Also on my walk, I see Biscuit a lot. He hangs out on the back step of a coffee shop. I greet him, he meows in a crochety fashion, he sits on my lap, and he stays there for approximately half an hour and he whines at me and is like “You were supposed to stay here forever!”

2015-10-11 18.50.22

Biscuit has attitude.
IMG_3297

But he is also very sweet and loving!

IMG_3300

One time I went to hang out with him and they were randomly setting up the set for a short film (?!) We watched the bustle for awhile, and various moviemaking folks gave me amused looks.

2015-10-11 18.50.29

Now let’s talk food! This fall I have done a lot of fun hanging out stuff with family, welcoming Malindi to town. It’s the coolest thing, now having a cousin and a sister living here. Other relatives, I’m coming for you!

Malindi and I got brunch with my cousin Sophia and her husband Mike at Lucha Tigre. There was a lot of service-related drama around this banana nutella empanada, which I won’t get into.
IMG_3061IMG_3062

Lower drama was this froyo. Malindi, Malindi’s roommate (who is also my classmate!) and I went to Yogurt Pump. This was peanut butter froyo with strawberries. Excellent!

IMG_3109

Then it was time for my cousin again, or rather my cousin’s cat. Sophia and Mike went out of town and Malindi took over their house and tended to their lovely fat orange cat, Hobbes. I hung out with her for awhile there. We raided the freezer!

IMG_3116

And then we used two of the guest passes Sophia and Mike had been kind enough to leave for us to go to their CLASSY gym!

More autumn stuff

Truth: yes, autumn is when my birthday is, and yes, everyone and their Mama says autumn is their favorite season, but I get depressed during autumn. Being surrounded by death and decay. The impending darkness and cold. WINTER IS COMING!

Something that helps me with the depression is buying lots and lots and lots of pumpkin things. This was a day I went pretty bananas at Trader Joe’s

IMG_3125

Then I had some friends over for an autumn feast. Appetizer was pumpkin cranberry crisps with honey goat cheese ❤ ❤ ❤

IMG_3126

Then other people brought MORE cheese, and some apples.

IMG_3129

And then I served lots of apple cider (I got some and Camille brought some!), pumpkin ravioli, salad, and pumpkin joe joes for dessert.

IMG_3128

Another thing that happens in the fall that I love is the Carrboro music festival. Alas, this year there was a week of rain that was predicted to continue through Sunday afternoon. Sunday afternoon is traditionally the most amped-up portion of the music festival where they shut down roads and everywhere in town turns into a venue and you just wander around dancing. But they canceled nearly all of the outdoor events. And then it didn’t rain. Sigh.

Anyway, we made do. We sat on the back deck of Second Wind and listened to the music drift outside. We got free coozies, and Malindi used hers around her kombucha (komboozie: patent pending).

IMG_3134

Then we hit up Looking Glass, which has an overhanging under which the band can play. This woman had the most seeeexy, bluesy voice!

IMG_3135

And now, moving ahead, more fall fun of course includes Halloween!

It began with Sophia (different Sophia than my cousin- this one’s my classmate) making the most AMAZING pumpkin spice fudge. Homegirl went to culinary school and holds herself to extremely high standards, and she claimed this was too sweet. I claimed it was like the best thing I’ve ever tasted.

IMG_3276

Halloween festivities included two separate costumes for Malindi. On the 30th, we joined Myra and Alex for a scary movie night. Well, I should say we joined Myra and Alex and Lochsie the daschund, who posed with Malindi. Malindi’s first and most epic costume of the weekend was Cat in a Cone. She definitely ordered a large animal surgical cone. Such a fabulous play on the sexy kitty Halloween costume.

IMG_3277

Then Halloween itself we hit up my cousin’s place again. She fed us delicious pizza and cheesy bread and we hung out with her pets some more. Caroline (named after UNC!) is just the nicest, friendliest dog.

IMG_3284

Sophia was in a conundrum because half her neighbors were like, “No children ever trick or treat here” and the other half were like, “Children literally bus in from other neighborhoods to trick or treat here”. She prepared for a deluge (she got ridiculous numbers of bags at Costco) and then got nary a trickle. So we watched The Addams Family (and were also introduced to Jane the Virgin, which is so cute!) and ate a lot of candy.

Then I put in a brief appearance at a party hosted by one of the School of Public Health-ers. Malindi was there too- she lives with another of my classmates and is basically now an unofficial SPHer (and hopefully an official one- she submits her application this weekend!)

Here we are dressed up, Malindi as a skeleton and me as… any guesses?

halloween

A recycling plant.

Hehe. Hehe. Get it? I stuck a bunch of cardboard/paper bags/magazine clippings to myself, put on a recycling symbol, and put on a lot of green eyeshadow and put leaves in my hair.

This was my first pun Halloween costume and people were sooooo confused. C’est la vie.

Malindi and other folks went to the Franklin Street insanity and I happily went home. I don’t have the happiest of associations with Franklin Street Halloween (involving my ex boyfriend getting stupidly stupidly drunk) so I was happy to wrap up the evening relatively early and wake up the next morning feeling good.

I made myself a nice brunch. Scrambled eggs cooked suuuuper slowly and gently, biscuit made from Bisquick Heart Smart mix, and a persimmon.

IMG_3290

Plus a cauldron of tea.

IMG_3289

A few more autumn funtivities took place the following weekend (yes, this is turning into a lengthy post!)

I went with my friend Steph to see a performance at UNC- have you heard of Butoh? It’s a form of Japanese performance art. It was really neat- I didn’t really understand it, but it was so nice seeing something cultural and activating the right side of my brain, which gets little use these days. A little more about the performance here.

Before the show started, Chirba Chirba, a beloved local food truck, was set up outside the concert hall. I got a yummy dinner!

IMG_3303

Pan fried glass noodles and soy sauce eggs. Delish!

It was also my little boyfriend across the hall’s 6th birthday (!!!) I missed the actual party (I arrived slightly too early and thought the picnic in the park had been canceled due to rain, but it hadn’t been!) but I got to experience some of the aftermath, along with my sister.

The silly string technology has really improved in recent years, and you can really get some length on that stuff now.

IMG_3305
IMG_3307

Such cuteness 😀

Later that day I went out for a birthday dinner (actually,  an exactly one month anniversary of my birthday) with Myra and Alex, two of my bestest buds. We’d all been doing a bunch of traveling, they had crazy work/I had crazy school, so it was a little late… but it was actually really fun stretching out the birthday joy even longer!

We went to Gonza Tacos y Tequila and it was hoppin’! We all ordered an adult beverage (I enjoyed their margarita on the rocks a lot).

Myra’s dish definitely won for being the most beautiful- she got the chili relleno with veggies.

IMG_3308

I got the steak tacos, which were also really yummy. Ah, homemade tortillas. Also, they came with fried plantains, so that was real real nice.

IMG_3310

And then we could’ve gotten dessert there, but we were no fools- we were around the corner from The Parlour!

So I got butternut squash pie ice cream with hot fudge. Mon dieu.

IMG_3312

Last autumn funtivity for this post: more cats! Malindi and I have seriously been going to the cat refuge about once a week.

One time we brought some of my other friends. I think Carolina is seriously in the baby zone- she spent a LOT of time rocking this kitten to sleep 😀

IMG_3318

Baby is one of my best cat buddies there. She is crazy adorable and loves climbing on shoulders.

Exhibit A:

IMG_3314

Exhibit B:

IMG_5813

How have you been enjoying your autumn?

The School Blog

Hey BTW I’m in grad school (I never really blog about it anymore except for making passing references to the misery of biochem!)

But now if you’d like you can have a look at the kind of stuff I engage with at school! We have to blog for a little one-credit class we have (we do a bit during the semester and then in January we go on a DC field trip to meet policymakers working in nutrition). My assignment for this month’s blog post was to look at the Sustainable Development Goals and talk about the role nutrition played. I went off on a Yay Women’s Rights tangent. Nothing new there 😀

I think the theme of improved nutrition permeates itself throughout all of the SDGs, because it is intimately intertwined with other key issues. The two that most stuck out to me were poverty and women’s status.

First, poverty and income inequality- being a world of “haves” and “have-nots”- manifest themselves in diet quality. When the nutritional transition occurs (more animal foods, salt, sugar, and refined carbohydrate) what often results is our system in the US: it is quick, easy, and cheap to get food of poor nutritional quality (like McDonalds). It is time-consuming, difficult depending on one’s neighborhood and access, and often more expensive to get food of higher nutritional quality (like fresh fruits and vegetables). I won’t belabor the point, since we have spent much of our coursework engaging with these topics. I want to emphasize, however, how much having greater disposable income helps one be healthier. Greater access to care to catch nutrition-related diseases earlier, before they progress. Living in neighborhoods with better food availability. Time and energy to prepare food. Cash to buy fresh produce.

Women’s status (economically, politically, and socially) has a huge effect on population nutritional status. As we have discuss at length, one’s early upbringing (in utero and the first 5 years of childhood) has an enormous impact on future health status. If a child is breastfed, they have protection against obesity. If a child eats nutritionally poor foods, they may get on an overweight growth trajectory unlikely to correct itself later in life. During these critical times in a child’s life, they are predominantly under the care of their mother: first literally within her body, and then with her as their primary caregiver, as she is in the vast majority of societies.
Actions taken to improve the status of women demonstrate beneficial effects in the whole family’s nutritional status. An example is a de-facto experiment of micro finance in Bangladesh. In the micro finance model, poor people living in the same geographic area pool together to receive small loans to start businesses (more about micro finance here). In this Bangladesh case, villages were randomized to have loans made either to groups of women or groups of men. Women’s loans increased school enrollment for both sons and daughters, and improved the nutritional status of both sons and daughters. More about that study here.
Another way to improve women’s status and thus household nutrition is through improving access to family planning services. The following information is from a USAID study entitled Family Planning Improves Nutrition: Evidence from Studies in Low- and Middle-Income Countries.

  • In developing countries, 225 million women of reproductive age have unmet needs for modern contraceptive methods
  • Access to contraception means that women can space pregnancies, which is good for nutritional status. Studies show that women with closely spaced children may suffer from unhealthy weight loss, anemia, and micronutrient deficiencies. Using nutritional reserves during pregnancy and breastfeeding may deplete the mother. Infants conceived within six months of a prior birth face a higher risk of low birth weight. Closely spaced pregnancies also increase the chance that a child will be small for gestational age. Close spacing and poor nutritional outcomes at birth are also linked to poor nutritional status during childhood, including stunting.
  • Limiting the number of children a household has may help improve those children’s nutritional status. Fewer mouths to feed may help in and of itself. It may also help with specific deficiencies; a study in Ethiopia showed that children with two or more siblings are more likely to have vitamin A deficiency than children with one sibling or only children.
  • If mothers die (1 in 40 women in Africa die due to maternal causes) their children may not get breastfed, and the nutrition needs of older children may go unmet. Motherless infants, in a study in Bangladesh, were significantly more likely to experience undernutrition and die from diarrheal disease and nutritional deficiency than those with surviving mothers.

The same report also found that improving a mother’s educational status is also good for her children’s nutritional status. In Malawi and Zimbabwe, women with at least 10 years of schooling had a significantly lower chance of having a stunted child than women with no education. Better educated mothers may themselves have a better nutritional status. They also likely have greater knowledge of nutrition and improved income and status due to education.

burfday

I was very spoiled on my 27th birthday. I was nervous about it. Which was silly. In a good year, birthdays are an opportunity to realize how many wonderful people are in your life.

I arrived to school (I had biochem on my birthday, yeurgh) and had all these wonderful things waiting for me.

One friend gave me a wine glass full of goodies (a carrot cake cupcake and lots of chocolate!) and some pumpkin tea. And my adorable sister Malindi lives with my classmate Claire. Malindi packed up a plate of goodies (candy and cookies and gummi worms!) and Claire biked to school with them. Don’t know how she did it!

IMG_3204IMG_3205

Then after class I went to a happy hour with my coworkers (I have a job helping on a research project for one of my favorite professors. The project’s about healthy eating and food attitudes during pregnancy. I love it!) We went to Glasshalfull, which is now one of my favorite restaurants!

I got an amazing cocktail that involved jalapenos and fruitiness. Like a margarita, but spicy and not sweet. True confession: it was at this point on my birthday that I came to terms with the fact I was sick (I had just gotten back from FNCE and one of my classmates had been suuuuuuper sick for the whole conference, so it wasn’t really a surprise).

Was a cocktail a good idea? No, probably not. But the spiciness soothed my throat, and I got tipsy hilariously quickly.

2015-10-07 17.30.07

Also fun about Glasshalfull- my buddy Nate works there! And he was our waiter! He was nice enough to bring me a free birthday dessert- pumpkin flan. Yummmmmm. We split it three ways and it was awesome.

2015-10-07 18.23.32

I’d already made plans with my sister. I called her, slightly abashed, and went, “Uh, why don’t you pick me up since I’m not in driving shape right now?” So she did, and we went to Hillsborough for a lovely pizza dinner! I like Radius Pizzeria a lot. They have a big ol’ fancy pizza oven, and a beautiful patio. On the patio we got to bond with a sweet and friendly dog named Lulu for a bit.

I got a pizza with goat cheese, artichokes, wild mushrooms, and oven roasted tomatoes. PERFECT crust with bites that alternated between chewy and crispy.

2015-10-07 20.14.52

Malindi got ravioli, and then insisted that we also split a side of mac and cheese. It was carb and cheese heaven. We split a dulce de leche bar for dessert.

A few days later, I went out with my buddy Camille. I decided I wanted to go to my new favorite, Glasshalfull, for the second time in the week!

It was a wonderfully girly meal. I got a great glass of wine. They do 3 oz pours, which I really like. Ostensibly it means one can try a bunch of different types. In my case, it just means that I can get a lightweight-sized portion! This was a South African red and I swear it tasted like barbecue!

2015-10-10 19.30.27

We also shared the girliest things ever- brussels sprouts (flash fried with peanuts on top- God, so good!) and a cheese plate. Then we each got individual desserts!

There was lots and lots of chit chatting with the meal. I feel so lucky to have formed some really good friendships in this program.

The following weekend I continued the birthday joy with my cat friends at the cat refuge. Every time I go there, I spend the next week thinking about how much I want all those sweet kitties to have lovely happy homes and individual attention. But if I carry that to its conclusion I’d have 400 cats, which would be a problem.

We spent two and a half hours at the refuge! An hour of which was spent in the kitten cabana. The kittens love to play Arm Game, which consists of attacking my arm. I forgive them. They’re so damn cute.

IMG_3218

When one is in Pittsboro, it’s never a bad idea to stop at Phoenix Bakery, which has wonderful donuts. I’d been enjoying them for quite some time until I realized they were baked, not fried! It’s okay, I forgive them. This was a pumpkin cream filled donut, and it was swell.

IMG_3214

Then the following week, fall break began on Wednesday, so I got to go hoooooome! To my mom. And my own cat 🙂

We ate kind of absurd amounts of delicious food. It felt nourishing, physically and emotionally.

We took a long walk along my old fave, the W+OD trail. Just off the trail in downtown Vienna is my beloved The Pure Pasty. My mom and I each got a cup of soup (she got cream of celery, I got butternut squash) and we split a seasonal veggie pasty, which contained potato, squash, celery, parsnip (<3) etc.

IMG_3229

It’s hard for me to convey how much I love this place. It’s not fancy at all, but the quality of the food is incredible. They really respect the vegetarian option, and it varies by season and always tastes really fresh and awesome.

IMG_3230

And the crust! One time I interrogated the owner about how they make the crust, and it’s definitely complicated. I know they use organic Spectrum shortening, and organic King Arthur high protein flour. I also love the tang the dough has, and the owner said they use the scraps of the previous batch of dough (which have been able to ferment to tanginess a bit) into the new batch of dough. It’s just so flavorful and flaky and toasty and incredible.

IMG_3231

We also split a dessert pasty, which was full of almond paste and jammyness. It was good, but not great.

IMG_3232

Then we continued our walk and took our usual kombucha break at the whole foods along the trail. I love grapefruit ANYTHING, and was super excited about the grapefruit kombucha. But the grapefruit taste got lost.

IMG_3234

My crazy mother reclined for a bit in the Whole Foods parking lot. I guess she enjoyed a nice relaxing fall break, too!

IMG_3233

Another night, we went to Korean Barbecue WHOO! We sat down and there was, as always, an incredible selection of pickled things. Then the menu was kind of confusing but it was basically “pick an animal, decide if you want a semi-huge selection of food, or a colossal all you can eat selection of food”. We went with a semi-huge amount of cow. They gave us brisket, bulgogi (regular and spicy), ribeye, and the BEST FLANK STEAK I HAVE EVER TASTED.

IMG_0177IMG_0179

When I’m in NC, what I miss most about the DC area are good Korean food and good Ethiopian food. I’m happy that I got to have BOTH on this trip!

My mom and I split the veggie sampler with all of the good stuff. Of course injera is beneath the whole thing and on the side (the amazing tangy Ethiopian flatbread). And then on top, from 12:00, there were collard greens, cooked cabbage n carrots and potatoes, pureed lentils, yellow split peas, potato salad, injera salad (with hot peppers and tomatoes and seasoning), raw cabbage salad, and spicy lentils in the middle.

IMG_3235

I also enjoyed peaceful times at home, a lot of which consisted of my cat keeping me from doing anything. The old tail on the newspaper maneuver. The old, “You can’t go anywhere, I’m on your lap” trick.

IMG_3236IMG_3238

I was studying biochem in bed (yep, that’s my life) and Sheila came and was so adorable I had to awkwardly angle my laptop and take a Photo Booth picture of us. (So my keyboard cover fell on top of me. It is orange, like Sheila).

I love this cat so much.

Photo on 10-17-15 at 6.53 PM

So I’m 27. My eggs are probably dying, and I’m in this weird life holding pattern while I’m in school, and sometimes I watch too much Netflix. But hopefully I’m a little wiser?