sadder days

So I had a bit of radio silence, obviously.

I spent several days trying to articulately put together a post about the death of someone without whom the world is a much darker place. But I didn’t get very far.

Suffice it to say that I’ve lost family, not related-by-blood family but related-by-godparenting and love and all the real family stuff family. Shortly after my parents’ divorce my mom, sister and I started attending a new church and met Susan and Joe and the rest was history- they’re the best people ever. They looked after Malindi and me (ages 5 and 8, respectively) while my mom sang in the church choir and ended up being invaluable friends to our whole family. We must have been practice children for them, because they now have two beautiful daughters. We got to watch them bring the girls home (they were adopted from India)  but then had to love their family from afar because their family up and moved to Saint Louis in 2005. My mom and Susan continue to have phone calls that are infrequent but legendary because they often top two hours in length. We got to see Joe in person when he made an occasional business trip to the DC area. We admired their oldest daughter’s Etsy store and bought some of her fabulous merch.

And then, because there is no justice in this world, Joe got a brain tumor that ended his life way, way too soon. All I can really say is that Joe was very, very kind. And gentle spirited. And funny. And dedicated. And took care of everybody. And was a walking embodiment of what a good Christian, a true Christian, is. And all the horrible human beings walking around in perfect health make me so so angry sometimes. But of course that is not kind.

Anyway, a silver lining to my current (seemingly terminal) state of unemployment is though I am broke as a joke the resource I do have available is time. Time I can use to be there for others.

So, I drove to Saint Louis to attend the funeral (my mom was there too for this part and I got- more silver lining- unexpected time with her). And then I stayed a few days extra to spend some time with the girls (now aged 14 and 16).

Obviously pictures were largely not appropriate, BUT I loved their cat, who was clearly just incensed at how many people had invaded her house. When I was sleeping on their fold out sofa, she came in and just stared at me with this hilarious expression on her face.

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My mom and I took one of the girls to the (remarkable) Saint Louis Zoo. I was reminded not for the first time that I am not even remotely spatially oriented, and it took us five-ever but we managed to find these penguins hidden in the back of the zoo. Worth it. I love penguins so stinkin’ much.

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And we also got manicures with teenage girl enthusiasm.

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Driving from NC to MO was quite the undertaking, and I’m proud of myself for being a capable 21st century woman and pulling it off. I thought I was so savvy checking both the NC and MO weather, but neglected to consider that I’d be driving through West Virginia mountains en route. Driving through the snow was quite intense, but honestly the gnarliest part was how disgustingly filthy my car got from snowfall and the nasty de-icing stuff they have on the road.

On the return trip, my sanity was tested when I was on what was supposed to be the last hour of my trek, near Winston Salem, NC, and for God knows what reason these four cop cars pulled out unexpectedly, lights on, and blocked every single lane, forcing us to drive behind them, no exaggeration, at five miles an hour. I guess it was meant to prepare us for construction and ultimately the highway’s narrowing to a single lane. But why we had to do this for 20 minutes before reaching the construction area I don’t know. Also, when it was first happening my first thought was that there was some kind of motorcade (I actually checked the POTUS twitter feed) and my second thought was that this was a punishment, a la Bridgegate, for one of the most liberal regions of North Carolina. Because in these dark times I am much more of a conspiracy theorist than I used to be. (We’d already had a suspicious water outage, JUST SAYIN).

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I returned from Saint Louis sick. Not really a surprise- one of the girls was sick (poor thing had been spending tons of time at the hospital with her dad, hadn’t been sleeping, had obviously been incredibly stressed) and traveling always does a number on your body.

The cat was so so precious and took good care of me. I was coughing lots and my whole chest was inflamed and having a sweet warm fluffy thing on it was amazing.

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My eating is APPALLING when I’m sick. All carbs all the time. Though actually there’s some evidence this may be adaptive when you have a virus (but not a bacterial infection!) But anyway my diet consisted of a lot of crackers and chips.

This popsicle (local company) was super great.

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And the first “meal” (<< loosely defined) I actually “cooked” was:

  • a Thai Kitchen soup packet
  • threw in some kale because then it’s healthy yeah sure
  • fried egg on top
  • hot sauce

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I spent too much money on fluids because my throat got unbearably dry if I went about 30 minutes without drinking something.

This is freaking delicious:

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Less-exciting iced tea. I finally got out for a walk and then had to stop for a few minutes to sit and get my air back at a coffee shop.

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And then once I was well I celebrated by making chili. Let’s be real, the best thing about making chili is the toppings. Cheddar, avocado, Greek yogurt (sour cream is more delicious but Greek yogurt is more versatile).

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And to apologize to my body for the days and days of chips and little else, I made a few green smoothies.

  • fruit: sometimes banana, sometimes clementine, sometimes both
  • milk
  • protein powder (I have chai spice flavored, mm)
  • kale

I have learned that an immersion blender does an astonishingly good job. You are volume limited, but I still find it waaaaaay better than the cheapo blenders I have traditionally owned. And more versatile, and so easy to use for soups and things.

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recent cooking- when winter acts like spring

A trip to the arboretum, whilst listening to review recordings for the RD exam.

You would never guess it was supposed to be winter, right?!

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All these blossoms are beautiful, but make me scared, one because there might be another frost and they’ll die and that’ll be sad, and two because eventually they will be everywhere and there will be pollen and North Carolina will again try to murder me via allergies.

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How I eat during fake winter with warm weather:

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A lovely breakfast- Trader Joe’s multigrain waffles with a chopped up pear and lite syrup on top.

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An egg delivery from my friend Steph! As you can see, her chickens are Nasty Women- yes, that is chicken sh** all over the eggs.

But no worries, once you wash them, they are delicious. Lola agrees.

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A common misperception is that eggs are fresh and high quality if they have bright orange yolks. While bright orange yolks can be from chickens out free ranging and eating a wide variety of nutritious eats, they can also be artificially made in feedlot chickens by giving them food with pigments in them, like marigolds.

To really tell if an egg is super fresh and high quality, look at how the yolk stays centered and upright in the white.

Like this exhibit- amazing, right?! A yolk mountain!

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A summery brunch (brunch, meaning once again I didn’t get my life together enough to eat breakfast, so this was an extra-big lunch that included components of both meals): tomato soup, roasted carrots and apples (I roasted them with some leftover hard cider poured on top- THAT was a tasty choice!), and a piece of toast topped with a fried egg and some smoked mozzarella.

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A less gigantic lunch: tomato soup with some leftover roasted potatoes mixed in, and a piece of avocado toast.

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THIS! THIS WAS GREAT!

So initially when my best friend convinced me to go to Sweetgreen in DC, I scoffed. I found it offensive to pay that kind of $$$ for salads.

Buttt, guuuyyys, Sweetgreen is so so delicious. And if like I do you like your salads with a gazillion toppings, it’s not all that cost-effective to make them at home, particularly if you live alone, because you have to buy big quantities of those toppings, the excess of which can end up going bad and being wasted. Wasted along with your money!

So I’m on board with getting Sweetgreen every once in awhile when I’m up visiting the fam. The last time I got in on that, I had a nice autumnal salad that, for once, seemed fairly easy to make at home because a lot of its ingredients were staples.

So once I was back in NC, I sought to recreate it! Here’s the mise en place.

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Toppings are: fresh basil (I’d already bought for some other recipes), fancy white cheddar (since I was only buying ~3 oz to make two batches of this salad, I went for it and got a local crumbly crystally raw milk cheddar that was freaking incredible), pecans, apples, and pears.

Plus a homemade balsamic vinaigrette made with dijon, maple syrup, balsamic (obvi), and olive oil, emulsified with my immersion blender.

At Sweetgreen they put this on top of  mix of kale and spring greens, but I just used kale. It’s much more of a staple for me because it is much slower to go bad.

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I think using a big mixing bowl for salad and using tongs to toss it makes it SO much more delicious. It evenly distributes the ingredients, makes sure everything is coated in the yummy dressing, etc. A little more work/dishes but a much bigger payoff.

Also, it’s always a good day to use my adorable pink pig tongs (thanks Malindi!)

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HIGHLY recommend this salad. Super delicious.

Another free-spirited meal.

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Shredded carrots with more of that balsamic vinaigrette, topped with poached eggs (a Mark Bittman suggestion that’s so much more than the sum of its parts).

Plus, less healthily, bread and pimiento cheese 😍😍😍

I made another batch of the carrot/poached egg mixture, and served it with some leftover eggplant cutlets (bought frozen at Trader Joe’s- delicious!)

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Despite the fact that I have literally never fed Lola from the table she is ALL OVER human food. Little punk.

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The eggplant cutlets were left over from THIS amazing creation:

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  • Eggplant cutlets, baked per package directions
  • Tomato sauce mixed with crumbled sauteed tempeh
  • fresh basil (more utilization of leftovers!)
  • Sprinkling of parmesan (without this, the recipe would be vegan, and still delicious. But of course with cheese it was even more delicious!)

Finally, I was quite inspired by this post in Cup of Jo and noted that quite a few readers gave a shoutout to this recipe for pasta with Greek yogurt and caramelized onions. So I made it (halved the recipe but otherwise pretty much followed it exactly), and enjoyed it for dinner with my sister. It was indeed delicious.

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So now that I’ve done all this sharing about my meals, what has everyone else been making lately?

recent cooking- when winter acts like winter

We had a North Carolina “blizzard” in January. The weather blokes forecasted all kinds of gloom and doom and 9-12 inches of snow and of course this is what we ended up with.

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Which was fine with me. It was pretty. And we didn’t lose power. I actually came to some pretty powerful self-realizations about my need for control because I get SO ANXIOUS about power outages! Like, what is the worst thing that will happen? You feel cold and have to throw food away. It’s hardly the end of the world. Yet it triggers powerful, even physical, anxiety symptoms. Something for me to think on further!

But power stayed. And we spent cozy days mostly in the house, staying warm.

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Plus occasional outings on foot so as to prevent cabin fever.

I admired the many species of nightly visitors to my front yard.

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This is as good a time as many to mention that my roommate received one of the funniest holiday cards I have ever beheld.

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As for the food- as promised, I have been doing more cooking at home and it’s been very good for me. It’s amazing how quick that mental reset happens if you just dedicate a few days to committed home cooking- your brain goes from “Where am I going to buy dinner?” to “What will I make for dinner?”

Which is a relief. Behavior change seems daunting as one contemplates it, but then doable once it’s begun.

Breakfasts:

Nothin’ wrong with oatmeal! This one with apples, almond milk, and pepitas on top.

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This one with banana, milk, and PB2 mixed in (I don’t think I’ll buy PB2 again. Not as fun as I thought it’d be)

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Truthfully I am not always the most reliable about breakfast. One day I went out and ran errands (actually maybe this was a babysitting day too? My post-graduation schedule has been so odd) and then I wanted to stop at the library because it was geographically convenient but I hadn’t eaten or had caffeine so I was a little woozy.

AND THEN THERE WAS A POP-UP COFFEE STAND AT THE LIBRARY.

Coffee. Plus free book rentals. The mother ship calling me home.

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Some typical lunches and dinners:

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English muffin with 1/2 an avocado mashed on top and (new favorite) Trader Joe’s all purpose seasoning. Plus a bowl of carrot/cashew/chickpea soup.

These way-too-expensive but way-too-good chips rounded out the meal.

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This meal was also Trader Joes’ fault.

I thought to myself, “It’s Thursday and the storm isn’t supposed to start til Friday night! I’ll go to Trader Joe’s after the dinner time rush and stock up! How crazy could it be!”

Well, I guess the teeming hordes had already passed through but the shelves had a rather Soviet Russia look to them. Everyone had already frantically gathered the ingredients for their all-important milk sandwiches.

HOWEVER. They still had samples. Samples of macaroni and cheese and hot dogs aaaagh!

Then I made my own and I added kale. So it was nutritious right. Right? Right. *wince* *salivate too though*

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This was not a combination I regularly received as a child but dang it made me feel safe and comforted nonetheless.

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Kiwi afterwords.

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Let’s be real, in the winter we want hot carbs. That is just life.

This night I had the oven on so I went all-out.

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Oven fries with olive oil and more TJ’s all purpose seasoning aaaand… cornbread in a cast iron pan ❤ I used this Cooking Light recipe and, per the advice of recipe commenters, added a few tablespoons of maple syrup to the mix to add a bit more moisture and sweetness.

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Grilled cheese and tomato soup for another meal. Classic for a reason!

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Have we gathered yet that this is a real carb parade?

Another day I legit ate stuffing for dinner. I semi-recreated a recipe I’d made for Thanksgiving that included roasted artichokes and parmesan. Added some extra veggies (lots of mushrooms, and carrots). Still pretty carb-y!

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This one below is definitely not the most appetizing looking thing I’ve ever made but it was pretty good:

  • First I made sauteed brussels sprouts (used frozen). But they were kind of mushy and I wasn’t wild about the seasoning mix I’d used.
  • Then I thought ooh! I’ll make brussels sprout tots! So I whirred them up with some potato/garlic/seasoning/kind of forget what else. But it still wasn’t so good.
  • So then I thought ooh! I’ll make tater tot nachos! So I topped the tots with Trader Joe’s veggie chili, sauteed mushrooms, reduced-fat shredded cheese, hot sauce, and plain greek yogurt. At that point it was pretty tasty. But that’s basically cause the original taste of the brussels sprouts was lost, hahaha.

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I’m a big fan of the TJ’s veggie chili.

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The day I made the recipe with avocado it was even better. Obviously.

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As for the treat department:

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Camille brought some of these yuuuummy ciders from her hometown when she was staying with me over graduation weekend. This one is made to be champagne-y (no idea how that works in the brewing process?) and is delicious.

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Claire brought me this cardamom chocolate bar from India.

Description on the back of it is freaking PRICELESS.

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Evening snack: I’ve been hanging out a lot with The Boys (Colton and Pranish). They give me a lot of sh** because, like so many men before them, they find me hysterically funny when I’m annoyed/offended. But occasionally they take their antics a bit far and I get genuinely mad at them. And then, like so many boys before them, one of them will go “Oh God, I’m sorry, can I cook you something?” Thus these scrambled eggs and this comically huge piece of buttered bread, made by Pranish. A tasty evening snack mid-Star Wars movie (Colton and I have watched the whole Original Trilogy plus The Force Awakens). I ate all the eggs but admitted defeat about a third of the way into the bread, and fed the rest of it to Colton.

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When I was home for the march, I ate lots of yummy meals and, as usual, regressed in many ways.

Here is some mashed squash to which I added (again!) Trader Joe’s all purpose seasoning, plus some cheddar. And for protein, Trader Joe’s frozen chicken-less nuggets, with honey mustard for dipping.

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This was a small meal, and my mom’s house always has tasty treats, so rest assured that I then got my snack on.

Granola bars bought in bulk from Costco.

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Choco caramel biscuits
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Etc.

On Inauguration Day I knew I wanted to spend time with good people and wholeheartedly avoid the TV.

Meanwhile, my friends were converging on DC. Claire and I were up for the march, Nate is living there and interning for the Academy of Nutrition and Dietetics (yay Nate!), and Colton rode up with me to see his bae, James.

So, I said, “Let’s all get Korean bbq in my wonderful hometown!”

So we did, at Il Mee, where the carnivores can get all the bulgogi their heart desires:

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And those of us with a more pescetarian bent can get all the sushi our heart desires.

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The crew:

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So those are some recent eats for cold and gloomy days. But North Carolina gave us about two days of real winter and now it’s in the 60s-70s. So more to come about eating inspiration for when the weather is warm (with the EPA on the chopping block and more climate change to come, probably more relevant! 😁)

trust me, I’m a dietitan!

OH HEYYYYYYY TODAY I PASSED MY RD EXAM! Registered Dietitian right here, hollaaaa! I haven’t wrapped my mind around it yet. So in the meantime, here is a long overdue post about my last internship, in which I interned in the Neonatal Intensive Care Unit (NICU) in a hospital in Winston-Salem, NC.

We’ll start with a lovely photo from the corporate lactation meeting I attended, as one does.

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To be clear, corporate lactation= meeting of lactation consultant managers from the various hospitals belonging to one corporation. Not some weird business milk-a-thon.

The meeting was really more of a retreat, at one of the lactation consultant’s lovely lake houses. So interesting to see all the complicated aspects of providing this care- both the science of helping mothers, and the management/business side of things of dealing with billing, charging for nursing supplies, etc.

Because the meeting took place in the South, there were of course complimentary meals. Say what you will about the South (and I have plenty to say, especially about the total nonsense that has been going on in NC), I really love the Southern tradition of hospitality. AKA feeding everyone who comes anywhere near your home/office, anytime resembling a meal time. It reminds me of my family’s Greek tradition 😀

This was chicken chili that was SO SO GOOD. Especially eaten by the lake.

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Okay so let’s talk life in the NICU. Here is a bed and an Elmo diaper awaiting a baby!

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Working with a NICU dietitian was SO interesting. To review my preceptor:

  1. Does nutrition assessments on the NICU babies and made recommendations to the medical team about feedings. For example, adding extra protein for a baby whose growth was poor, or adding MCT oil for a baby who seemed to be having trouble absorbing nutrients. Sometimes we had to fight with the doctors because they would “forget” about our policy not to ever use powdered formula in premature babies (here’s why) and do other silly things because doctors are sometimes silly.
  2. Conducts hospital based research in the NICU, mostly related to breast feeding.
  3. Serves as a lactation consultant for moms with a baby in the NICU (helping with breastfeeding and pumping).

I was especially lucky because my preceptor was honestly so busy she just let me work independently out of necessity, so I would get to go on rounds with the NICU medical team (attending physician; nurse practitioner and/or resident and/or medical student, who’d present each case; nurses; sometimes pharmacist; sometimes social worker).

Things you worry about in premies (obviously the neonatologists are thinking of a lot more things; managing ventilators and temperatures and crazy things like that. I’m concerned with the nutrition side of things, which is obviously also very important in premies):

  • Intake of the right nutrients. Breast is best, and that’s also true (though harder to document) in premature babies. However, premature infants aren’t really supposed to be out of the womb drinking milk- they’re supposed to be in a uterus, drinking amniotic fluid, not having to breathe, etc. So while human milk is the bomb, in the NICU, premature infants have to have their milk mixed with human milk fortifier, aka HMF, which adds extra nutrients, among them protein and bone-building elements like calcium. As someone crunchy it pains me to see HMF, a cow’s milk product going into a premature baby whose mother has abundant breast milk. Which is why it’s so exciting to see that there has now been a HMF developed that’s made using entirely breast milk!
  • Immature guts. You want to give them breast milk so they get the immune benefits (and because women’s bodies are amazing and worthy of awe, breast milk produced by mothers of premature infants is higher in protein and calories than the milk of mamas of term babies). However, feeding them too much too early can overwhelm the cells of the developing intestines, which can only absorb so much. Your worst case scenario is necrotizing enterocolitis, in which the cells of the intestines literally start to die. This can result in a baby needing surgery (and potentially getting a lot of their gut removed, resulting in short bowel syndrome or other issues with absorbing nutrients). This can also result in the baby’s death. The good news is that babies who get breast milk instead of formula are much less likely to get it (and in our hospital- and many others- we had the policy that preterm babies who were below the age of highest risk of NEC- about 34 weeks- qualified for donor breast milk if their mama couldn’t provide her own milk).
  • Immature brains- it FREAKED ME OUT how routine brain bleeds were. Like, they only treated them if they were severe. Like, wut?!
  • Reflux. I know that’s par for the course with term babies and is just an annoyance; but in preterm babies when they reflux they often stop *breathing*. This is obviously a real big problem.
  • There were babies on crazy amounts of antibiotics. Obviously an infection can decimate even a term baby’s immature immune system and kill them so so quickly, and premature babies are even more at risk- I am not at all critizing antibiotics use. However, it’s a little scary to think of the effects of removing all bacteria, good and bad, from these babies’ newly developing systems. It’s also scary seeing them on vancomycin and other antibiotics of last resort when they’re this little. What happens if they get older and get sick again and the antibiotics don’t work?!

In other news, I GOT TO SEE A C SECTION.

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A team from the NICU is always present during a C section (and also during vaginal deliveries when they see meconium in the amniotic fluid, and I’m sure other higher risk conditions too). Dude, C sections are INTENSE. I was pleased with myself that I still seem to have a solid tolerance for blood, cause it was all graphic! The incision is small (I mean it’s bigger than baby’s typical exit route- and seriously, GO MOMS FOR MAKING THAT HAPPEN) and it is pretty rough process on the baby- I saw one doctor kind of stick her hands behind this bump in the belly from the outside and start shoving HARD and the other doctor dig his hand inside the incision and yank the baby out by the head. After they announce the baby is out, a nurse hits a timer and they wait 30-45 seconds to clamp the cord (I thought delayed cord clamping was just a practice used for premies but they do it for all babies at this particular hospital). Then they bring baby around to see mama for a minute (they have a big sheet hanging up so mom doesn’t see the doctors cutting into her body, just like in the movies) and then they bring the baby over to the warming table. Ordinarily, this would be pretty much the end of the role for the NICU team- they smack the baby on the feet and rub the baby off with some towels and then the baby cries. BUT. This baby had to be revived and wasn’t breathing. It was amazing watching the NICU team at work- one had a stethoscope to the baby’s chest and would hold up her finger in time with the heartbeat, another put an oxygen mask on the baby and started CPAP, and they continued to try to stimulate and annoy the baby enough to start crying and breathing. But it ended up that the baby needed to be intubated! It all happened SO QUICKLY and SO EFFICIENTLY. I was really in awe of this team.

Fortunately, I followed that baby’s case and the baby was fine and was discharged fairly quickly. However, I’m sure it was terrifying for mom and dad (the mother’s first question was “Can I still breast feed?” because WOMEN ARE AMAZING. And she did!)

While there are circumstances you cannot control (as in the case above, in which they ended up thinking the baby had aspirated meconium and that’s why it was so difficult for the baby to start breathing), there are some you can.

How to keep your baby out of the NICU:

  • Know your STD status! Seriously. They can be managed beautifully, but only if we know about them and mama does what she needs to do to prevent transmission to her baby. I saw HIV positive mamas do a beautiful job with managing their medication during their pregnancy to prevent disease transmission to baby. However, I also saw babies in the NICU because mama had never gotten a herpes diagnosis. Yes, herpes is a drag as a grownup but if you are a baby delivered when there is an active outbreak, or without mom being treated with an antiviral, you are at HIGH RISK of getting encephalitis and dying. It is scary business. And unfortunately we saw a lot of cases where partners have not been honest about their status, so don’t rely on them for truthful information (isn’t that terrible?!)
  • Get your diabetes managed before pregnancy. That means get your sugars tested to make sure you aren’t diabetic before getting pregnant (in general, a pre-conception visit to your medical provider is a really great idea).
    • If your sugars are running high during your pregnancy they are going straight to the bebe. That means you can end up with a really really big baby and increased risk of all kinds of dangers at delivery (the baby getting stuck on the way out and getting shoulder dystocia, which can lead to permanent nerve damage; increased likelihood of a C section and all the attendant risks).
    • Also, glucose crosses the placenta but not insulin. That means that your baby gets a steady diet of SUGAR SUGAR SUGAR while they’re in the womb and their poor little pancreas has to work overtime to get the sugar out of their blood and into their cells. Then, when the baby is delivered and cut off from their mama’s blood supply, their SUGAR SUGAR SUGAR abruptly ends too, but they still have all this insulin. That leads to hypoglycemia, which can make a baby critically ill and mess up their brain. It also usually ends up with baby in the NICU to be observed, separating baby from mama and making establishment of a good breastfeeding relationship much harder.
    • But wait there’s more! Mamas with uncontrolled diabetes also deliver babies with more birth defects (major congenital anomalies occur two to four times more often in infants of diabetic mothers than in infants with non-diabetic mothers- things like mis-formed spinal cords- bad news!) The good news is that a lot of this risk seems to be associated with poor glucose control in the first trimester, so if you can get your diabetes under control before pregnancy, your baby is at much lower risk.
  • Be a healthy weight before pregnancy. Being obese increases your risk of all the dangers of a big baby discussed above. But being underweight is also a problem- it’s a risk factor for preterm birth.

A few other non-medical conclusions I came to in the NICU

  • Research is horribly difficult and I commend anyone who does it. Obviously it’s no secret that conducting a methodologically sound study requires a lot of attention to detail, but I was kind of blown away at quite how much there was when I helped my preceptor on her manuscript about human milk feeding in the NICU and brain development at 18 months. By the time I came on board the important decisions had already been made about how to track the data, what covariates to analyze, etc., but those decisions had taken relatively little time in the grand scheme of just the lengthy to do list for the project. Sometimes I feel like “Oooh, I’m so fancy, I have a masters degree, I know fancy things about biostatistics” and then I got very humbled doing the actual sausage-making of research. Also, there was a huge capacity for human error! I assume my preceptor will end up submitting spreadsheets we made along with the completed manuscript for publication, but the reviewers basically just have to trust us that we didn’t make up the numbers! That we didn’t make math errors (there is WAY TOO MUCH DATA to check each individual calculation- I did my best to check as I went but I wasn’t about to go back and go through everything!)
  • Breastfeeding is also difficult. Premature babies don’t at all have the reflexes to actually nurse at the breast until ~34 weeks gestation but even then, even at full term, it can be very very difficult! It’s a lot to ask of the baby (creating a vacuum with their mouth, which is impossible if there’s an anatomical defect; properly coordinating sucking and swallowing; staying latched on and in the right position; grabbing enough tissue with their mouth to effectively remove milk, etc.) and it’s a lot to ask of the mama (especially deciphering a baby’s hunger and fullness cues, and figuring out whether baby has actually gotten enough since the whole process is basically invisible). It’s amazing and beautiful and we need to give nursing mothers all the support we can. Everyone who wants the Affordable Care Act/”Obamacare” to be repealed- know that you’re taking away insurance coverage for breast pumps and lactation counseling for new moms.
  • Mothers still die in childbirth. We saw it happen once and it was awful awful awful. The NICU nurses (obvi amazing human beings) did everything they could to support the father and this new baby. And the hospital waived their usual policy not to give donor milk to older babies and gave this sweet little baby donor breast milk. But it is SO TERRIBLE that it happens. I think about everything my mother has been to me, for all 28 years of my life, and can’t imagine the kind of hole that leaves for the rest of a family to try to fill.
  • Watching a family together after the birth of a child gave me All The Feels. You look and you think, God, this should be such a perfect unit. Mama is this amazing baby-grower and milk-provider, and Daddy is there all supportive and anxious on behalf of mama, and they are both so so tired, and so so excited. I would think about how statistically in the coming years many of these unions would not stay intact, and many of these mothers would be left on their own (or fathers, as above). And it made me so, so sad. All these new humans avoided to be surrounded with this safe, protective love. There were lots of extended families at the hospital, which was beautiful and lovely, but honestly there were times I went into a family’s room and there was this exhausted woman who clearly wanted to just pass out and there were scads of relatives sitting on the bed and making noise. There’s something beautiful about just a baby and the two people who made it sharing this little space for awhile. (Caveats: the two people who made it can of course be two men or two women. It’s just so hard for someone to do it all alone, even if they have the support of more distant relatives!)
  • Now for a briefly horribly depressing note. One day I was taking the elevator upstairs to the NICU and sharing it with me were a pregnant woman in a prison uniform and the police officer accompanying her. My sincere hope was that she was there for a prenatal appointment and would be out of jail by the time she delivered. It still upset me- but that wasn’t even the part that I’m writing about. I told my preceptor how I’d winced seeing the woman. She said, “Yeah, what we see is typically that women who are victims of abuse are the ones who get in trouble with the law. They are in abusive situations and try to get out but don’t do a very good job.” Then she shared a horrifying story with me which you have permission to skip. So two new parents went and visited their brand new, preterm baby in the NICU. Then they walked back to return to the mother’s room in Mother Baby. As the mother walked through the door with her back to the father, he pulled out the gun he had brought to the hospital and shot and killed first her and then himself (story about the case here). I have actually struggled to talk to anyone about how much this upset me. At this point, my preceptor began explaining to me about the new safety precautions the hospital was taking since that incident (the NICU will be a locked unit, people will have to present their ID each time they want to come in, people with a criminal record will be banned. Though I heard no talk of metal detectors or anything preventing guns coming in, *sigh*). As my preceptor wisely pointed out, people in hospitals are VULNERABLE. They’re sick, they’re weak, they may have been hospitalized because they’d already been victimized in some way. I have unfortunately witnessed in my personal and professional life that domestic violence may come to a head during a pregnancy. When I was at Wake Forest (more on that later), there was a baby born with a brain bleed that was attributed to the physical abuse inflicted on his mother. SO. Public service announcement. Those of us who are RDs, or RNs, or anyone in health care, we come into contact with vulnerable populations EVERY DAY. Regardless of your setting, think of who you encounter: Older adults. Children. Pregnant women. People who are poor. People who are homeless. People with disabilities. If nothing else, we need to have the statistics in the back of our mind and we have to be aware that if it’s that common, we should be looking out for it. 1 in 3 women and 1 in 4 men are victims of some form of physical violence from a partner in their lifetime. In the last year tracked, there were 108 cases of domestic violence related homicide in North Carolina. The NC Coalition Against Domestic Violence has some warning signs to look for here. Let’s be real- it’s probably fairly easy to miss domestic violence in many patients. Yes, most hospitals work some kind of screening into the questions they ask a patient on admission (i.e. “Do you feel safe at home?”) but a bored looking CNA asking this question to someone who’s likely in physical pain and just wants to get to a doctor is not likely to elicit the most meaningful information (especially if the abusive partner has accompanied the victim to the hospital). Once the medical team gets to a patient, they’re very focused on the “Problem List” of physical ailments. Hopefully the nurses can catch something- Lord knows, they seem to know everything about patients! But I still maintain that if we’re going in to patients, we’re asking open-ended questions and coming across as sympathetic and like we may have more time to listen to someone than the average doctor who zooms in and out of their room, that we should pay attention if we end up getting a cry for help from a patient. However small. I’m not suggesting any of us go in and try to save the day, but a well-timed phone call to social work tipping them off that you got a weird vibe may be helpful. Other settings may have other things RDs can do which could help protect victims of domestic violence. Arranging for a ride for someone who has no car, who has been socially isolated by an abusive partner, who just wants to get to her mom’s house (which my preceptor did for a WIC mother last summer at the health department). Providing information on safety planning ( <— this site has really good information for pregnant women) for someone who may not be ready to leave an abusive relationship today but wants to maybe start taking steps toward doing it in the future (and needs to protect him/herself as much as possible in the meantime). Finding a pretense to get a patient alone to make sure there isn’t something that they want to say but are afraid to have an abusive partner witness.

More intense business: I also got an opportunity to spend a few days at Wake Forest’s hospital because they have a Level IV NICU. That means I got to see babies with more serious conditions such as:

  • Babies with congenital abnormalities that are beyond what can be addressed at a smaller hospital (there was a baby who they were wondering could’ve been affected by Zika aaagh!)
  • Babies who need ECMO. I did my case study on ECMO this summer and it’s crazy- like dialysis but it’s doing the job of your lungs and/or heart instead of the job of your kidneys.
  • Babies who needed surgery. Sometimes due to congenital abnormalities, sometimes due to complications they’ve suffered due to prematurity (like necrotizing enterocolitis, brain bleeds, retinopathy of prematurity etc.) Look at this gorgeous diagram below!

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Seeing the RD in action at Wake Forest was AMAZING. She was definitely practicing at the top of her field and they actually had HER teaching the MEDICAL RESIDENTS how to do things (this is a big deal; if you work in health care or know anyone who does you are probably aware of the many God Complexes on display in the medical field).

However, it was really intense seeing how sick these babies were. When trying to feed the babies, the dietitian and doctors have a LOT they are working against- fluid restriction is common with the lung complications many babies have, many of the babies end up fat restricted (we saw one baby whose triglycerides were over A THOUSAND- normal is 150 or less- so they quickly had fats removed from their IV for a few days), many end up dextrose restricted (because they end up with crazy high blood sugars and insulin in neonates doesn’t tend to support lean body mass growth, only the growth of fat cells; so they tend to try to restrict the dextrose rather than adding insulin), they have all kinds of acid-base imbalances which can only be addressed so much with manipulating the oxygen-carbon dioxide exchange in the ventilator and also involves manipulating what’s added to the IV. All of these things result in babies getting LESS nutrition, and it’s horrifying seeing these shrinking babies (there was one baby who did not gain any weight for a MONTH- the prognosis was very poor).

In the long run, I don’t know if it would be too sad working with these sick babies with such limitations in their recovery. But I know it was really energizing being in a teaching hospital where amazing research takes place. Seeing all the medical teams bustling around was really exciting (and let’s be honest, there were some extremely good looking surgical residents. Greys Anatomy in real life!)

Something else that stuck out to me about Wake Forest was their AWESOME cafeteria. Stealth health at its finest- check out this gorgey burrito bowl!

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So it looks pretty standard buttttt…

  • It contained a ton of veggies (I chose butternut squash and asparagus), lean protein (black beans and shrimp), tasty but heart-healthy toppings (hot peppers, corn salsa, and guacamole; and no cheese!), and portion controlled fatty stuff (just a wee bit of the chip strips was enough to give a satisfying crunch)

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The hospital where I was most of the rest of the time was much less exciting, and expensive, cafeteria-wise.

So I mostly went to the Starbucks and got too many pumpkin spice lattes and (SO GOOD, why had I not known about these before?!) bean chips.

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As for the ol’ social life, as I did this summer, I joined a gym just for the duration of my internship. Working out is so so good for mental health. Also, honestly, in a town with not that much to do in the vicinity of my housing, I might as well do something life-affirming (exercise) instead of something self destructive (watch Netflix every day from 6pm til I go to sleep).

Sometimes my legs die and I have to sit like this for awhile.

Photo on 10-10-16 at 5.47 PM

I didn’t super socialize with my roommates in my student housing- I was lucky enough to not have to share a bedroom the whole time, which was SO NICE and SO not a guarantee- I just got lucky. I did, however, learn that one of my roomies had a birthday two days apart from mine so we and our other roomie at that time embarked on an Italian cuisine adventure at Di Lisio’s.

I got the gnocchi with pesto which was BOMB and lasted me two delicious meals.

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Then one other night my friends Kyle and Shaylen were in town (Kyle was looking at Wake Forest Law School) and we met up for dinner. They asked me for a recommendation and I was like “Er, I mean the only place I’ve really gone is Krankie’s but I know it’s delicious and a fun hipster scene.” So I went again!

This was a hoppin’ john esque creation: rice, black eyed peas, greens, and YUMMY chow chow (kind of a tangy/sweet onion relish?) on top. Plus cornbread.

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and so it begins

Scenes from the Women’s March on Washington:

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Huge (yuuuuuge?) crowds

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My date (of course at the angle taken I look like a chipmunk but you have to see our fabulous pink pussy hats, knitted by a dear friend of the family who wished to remain anonymous because she runs in conservative crowds [hahaha it’s not Melania Trump but wouldn’t that be great?!]

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Like many of the people there, we were not able to get anywhere neeeeear the stage, so I only have heard about speeches/performances/raves after the fact. So here’s what I was able to capture on my trusty iPhone!

First of all, there was a *lot* of of wit on display in the signs, some of which is a bit unprintable for this blog 😉

Something we can all get behind, though, Beyonce lyrics:

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And there was some seriously high quality Christianity on display

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Love Thy Neighbor [it reads]:

Thy Homeless Neighbor
Thy Muslim Neighbor
Thy Black Neighbor
Thy Gay Neighbor
Thy White Neighbor
Thy Jewish Neighbor
Thy Christian Neighbor
Thy Atheist Neighbor
Thy Racist Neighbor
They Addicted Neighbor

LET’S ALL GET ON THAT!

There were some amazing men present:

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(My mom was tickled pink by the sign above)

More sweet children with woke parents:

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And BEARS! Here’s a reeeeeeally high quality polar bear costume! And another angle of the pink pussy hat; me in the foreground! The pink pussy hat was clutch because it was too warm for a coat but a bit cold for a sweater.

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Aaaaand speaking of bears, a clever (disturbing?) Secretary of Education nominee joke.

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Half a million+ people there, so naturally I ran into my friend Claire in line for the bathroom with no prior planning. One of the friends she was with had had her birthday on Inauguration Day (yeow) and I was able to present her with an extra pink pussy hat, which seemed to really make her day 😀

Note that while in this picture I am in my pink pussy hat (can you tell I’m trying to use that phrase as often as I can in this post? :D) Claire was wearing a hat she got at a Dixie Chicks concert (!) in North Carolina where, following our cluster**** of a trans-hating law’s passage, the band passed out every concertgoer a hat that said “No Hate in Our State”.

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There’s not a lot I can say that hasn’t already been eloquently put across by other attendees:

  • Everyone in attendance was really kind- I saw an irritable looking bro in a Make America Great Again hat making his way through the crowd and no one bugged him (which probably disappointed him, ha!)
  • There was a really great diversity of ages, races, and viewpoints- who knows if the women with the Love Thy Neighbor shirts from their church really had all that much in common with the ones with obscenities on their signs- the point was, they had come together to march for women. I feel good about a cause when it brings so many people together (and inherently suspicious about it when it systematically excludes people based on their race/gender/religion/viewpoints- ahem).
  • The organizers were clearly like “HOLY COW SO MANY PEOPLE SHOWED UP” and were very creative about communicating messages with the crowd- one woman was doing call-and-response with a bullhorn with phrases like “If you need a doctor” “If you need a doctor!” “Please see me!” “Please see HER!” (we responded, pointing our fingers)
  • There were a lot of people with signs about an issue of particular concern to them- climate change, LGBT issues, disability rights, protecting Planned Parenthood, unions, etc.- and I’m hoping people wiser than I can make a road map of we can help advance those diverse progressive causes despite the current political climate.
  • I saw a band set up with paper mache instruments that included Fallopian Tubas and it made my life
  • The experience was incredibly encouraging and fed my soul!

visitors

VISITORSSSSSSS.

My aunt Kathy and uncle Tom came down to NC to build a cat tower for Malindi and Eric’s cat Mearl!

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He loves it! Kind of! He’s a little blind so he doesn’t totally get it.

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Okay I jest that was not actually why they came to NC (though they were indeed roped into it).

They came down to see Alejandro Escovedo. Oh and my sister and me, I guess 😉

They were nice enough to bring us along and Alejandro was AMAZING in concert. I always feel like a plant that’s been watered after I see live music. And the acrobatic strength of his drummer was quite inspiring.

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They spent Friday through Sunday with us and besides cat-ing and concert-ing (though obviously those things took up awhile) we enjoyed additional fun activities such as:

  • Exploring The Scrap Exchange, which is amaaaazing
  • Having a campus tour led by Malindi and me
  • Walking around adorable Hillsborough and admiring various art galleries
  • Visiting the always lovely Carolina Inn which was all gussied up for the holidays, including various displays for the Twelve Days of Christmas.

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Three French hens= hilarious

Always yummy food too of course.

Pre-concert, we had dinner at the reliably excellent Venable.

I had this dreamy salmon with spinach ‘n grits. Quite the balanced plate!

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Later we had a stellar brunch at the beautiful Guglhupf, where it was (just about, at least) warm enough to eat outside.

Grilled veggie ‘n mozz sandwich was lovely.

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And their last day we had yet another brunch at Acme, which was amazing.

Malindi, showing that she is a confident woman not easily intimidated, ordered the special, in which they made a salmon hand pie (!) by filling a pastry crust with salmon and various cheeses and creaminess. Then took that salmon hand pie and topped it with poached eggs and hollandaise, a la eggs benedict. Then they accompanied that salmon hand pie with hash browns. And salad. And THEN she ordered a side of mac and cheese! (To be fair, I earnestly informed the whole table that Acme has incredible mac ‘n cheese)

Anyway, Malindi was eating this meal for quite a few days

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I got the biscuit ‘n gravy (I opted for their hippie veggie gravy which was delicious) ‘n eggs (opted for runny poached, mm). Also with breakfast potatoes and salad. This lasted about two meals, but I won’t admit how close together those two meals were.

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And as always when my fun family visited what was the best part was just hanging out with them ❤ ❤

celebration upon celebration

First of all, I GOT ENGAGED!

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With gummi savers. For about two minutes (til my groom-to-be ate his ring). Oh also, the groom-to-be plays for the other team.

But doesn’t he look ecstatic at the prospect of our union in this lovely pic?

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No? Fine, a few days later I went hiking with him and his real-life boyfriend. We got a nourishing breakfast first.

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(A pimiento cheese biscuit- holy richness, Batman- and 1/2 a pumpkin spice latte donut which I split with Colton. Plus coffee of course)

Though I am nowhere in the sphere of engaged, I have nonetheless had a variety of fun social gatherings in the previous few weeks (ok, months) that I’d like to recall on the ol’ blog.

First, a cat party:

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I had sweet Bill and Angela the kittens finally down in NC, meeting potential adopters (they are happily ensconced in their new home, together forever, hurray!)

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And in the meantime, Clovis’s adopter Andrieu decided to bring Clovis by to see if he remembered his onetime siblings. And Malindi came too, to hang with kittens. It was a cat party.

The kittens did not at all remember their erstwhile siblings. Hilarity ensued.

Anyway, it was SO FUN in those few days I had little Angela and Bill at my place before they went home with their new human parent.

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When you are a kitten, everything is a toy.

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Your sibling is, too.

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I love this picture- Bill is all “I AM SO EMOTIONAL I AM BURYING MY FACE IN MY PAWS”

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They all have lovely forever homes now, and I am lucky enough to get the occasional photo update from the adopters.

THANKFUL.

Speaking of thankful, another party: Friendsgiving! Reliably fun and delicious at my friend Steph’s house. I clearly focused on the carb portion of the meal.

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Her friend created this turkey stencil to top an almond cake! Talk about classy.

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Next, a party that my family was all together for the Thanksgiving holiday break!

We kicked things off with a delivery from Malindi’s boyf, who was forced to stay in NC through the interminable gubernatorial recount (which has, at last, resolved, but not without the psycho NC legislature making us a national embarrassment a few more times).

Anyway, Eric sent Malindi (and thus all of us) chocolate covered strawberries!

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I nestled myself into the bosom of my family, relishing the omnipresent avocados in my mother’s home.

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We went to the BEST Chinese place, A+J. Pictured, clockwise:

  • wheat gluten and mushrooms
  • pickled seaweed salad
  • edamame, spinach, and tofu skin
  • thousand year old egg with yet another texture of tofu

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  • Fan-tabulous spicy peanut noodles

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  • Dreamy fried chive pancake

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  • dumplings!

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Then it was time for the party of actual Thanksgiving!

Mama laid the table all nice.

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Small crew this year: myself, Malindi, Ma, and Ma’s boyf.

Traditional mashed potatoes and gravy with… salmon?

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Yes cos salmon is delicious.

Also:

Artichoke parmesan sourdough stuffing

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Poorly photographed green bean casserole, made using all Trader Joes’ ingredients: French-style green beans, fancy portabella mushroom soup, and fancy fried onions.

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Malindi’s yummy sweet potato casserole with oat and pecan streusel atop

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General gorgeousness of the table, along with a peek at my homemade cranberry sauce.

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My plate. So lovely!

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Malindi’s apple cake for dessert. A little cream poured on top, why not?

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Now we have reached the Christmas season. Which means cookie parties, apparently!

First to my friend Leesie’s house, where she had a very impressive array of cookie decorating supplies and a delicious homemade dough that involved nutmeg.

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Then to my friend Lesli’s, where we also got a feast in the savory department before the cookie swap began.

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My friend Emily made these adorable cookie shots: a chocolate chip cookie cup (bake chocolate chip cookie dough in a mini muffin tin) filled with grown up “milk” (Irish cream I think was involved- don’t know what else).

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For the cookie swap, I used the abundance of eggnog leftover from my graduation party to make eggnog whoopie pies (note that I ad-libbed a filling that omitted marshmallow fluff and included actual eggnog)

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And there was LOTS of additional bounty!

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Sam and Alex, cute newlyweds, arrived to the party wearing matching antlers. Their cuteness inspired a group photo. It was imperfect but nonetheless amazing (see Boo the cat, and the caption!)

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A party break:

I was scared after a day when I literally only ate cheese and crackers for the whole day that I was going to develop diverticulitis. So I went to Weaver Street Market and made myself this fiber bomb of a plate:

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  • BBQ-seasoned lentils
  • roasted root veg
  • sauteed brussels sprouts
  • roasted sweet potatoes and apples
  • sauteed carrots
  • mashed butternut squash

It helped.

Another celebration- it was like 65 degrees outside a few days after Christmas! I met up with my auntie and we took a magical walk along the C+O Canal towpath.

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Then we had a graduation celebration lunch of delicious sushi.

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On my aunt’s delicious porch!

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We have finally reached the last celebration- my family’s annual post-Christmas open house! This year it was held on New Year’s Day, and we had a smaller crowd than usual. Were people hungover? Were they preparing to return to work the next day? Were they watching the Redskins?

Anyway, it meant more cheese for the rest of us 😀

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Here is the main table, midway through the party. Abundance, as you can see! Our usual mega roasted turkey and ham are in the background.

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Additional yumminess:

  • crudite
  • various breads and crackers
  • labneh (from the Greek store)
  • taramasalata (from the Greek store)
  • baba ghanoush (made by my mom)
  • artichoke dip (made by me)
  • butternut cheddar dip (made by me)
  • green pea and pesto dip (made by my sister)

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Annnnnnd a closeup of even more cheese. My mom went nuts (in the best possible way) at Costco this year. A raspberry on the brie so it looked womanly 😉

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And of course the cookie department.

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  • macarons, purchased at Costco
  • rugelach, purchased at Costco
  • thumbprint cookies from Oh She Glows, made by me (gluten free and vegan)
  • chocolate crinkle cookies from Iowa Girl Eats, made by me (gluten free)<< people LOVED these
  • my aunt’s fruitcake (my grandma’s recipe)
  • my mom’s baklava
  • my mom also made the Dorie Greenspan recipe for sugar cookies (I decorated the purple one, as a tribute to Prince and the other wonderful people we lost in 2016)

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