Good Food Made Easier: Beautiful Soup

On a cold, dreary winter day there are few things more welcome than a bowl of hot soup.  Twelve Months of Monastery Soups is a collection of recipes, arranged by month, that are clear, uncomplicated, and made with everyday ingredients.  Even though most of the soups are simple to make, the flavors are often rich and savory.  One of my favorites is Spicy Carrot and Orange Soup, which includes leeks, nutmeg, paprika, cayenne, and ginger.  Red Bean and Rice Soup is good fall and winter fare, as is Butternut Squash Soup, Portuguese Style.

The author of the book, Brother Victor-Antoine d’Avila LaTourrette is originally from the French Pyrenees and has spent time in Italy and Spain.  The recipes evoke the flavors of the south of France and the Mediterranean; tomatoes, onions, beans, and green vegetables appear frequently as ingredients.  The book is illustrated with small woodcuts of religious subjects accompanied by short texts, mostly about food or about saints.

Life in the Slow Lane

I am rowing a boat along a river.  The river is flowing down a slope and I am headed uphill, against the current; it is very hard work.  This image came into my mind in the middle of a busy day selling real estate.  It returned to me later when an endocrinologist asked what it felt like to be hypothyroid.  That doctor was the one who finally got my thyroid situation under control after almost fifty years.

The thyroid is a butterfly-shaped gland at the base of the neck.  It releases hormones that control metabolism.  When it releases too little (hypo) symptoms like fatigue, weight gain, constipation, depression, and sensitivity to cold may appear; with too much (hyper) there may be sweating, weight loss, heart palpitations, and anxiety.  Thyroid conditions behave differently in different individuals so they can be frustrating to treat, both for doctor and patient.

When I was in high school I started noticing that it had become almost impossible for me to lose weight.  At a younger age I could take off ten pounds in a few weeks; now, even if I ate 1000 calories a day, the weight stayed on.  Something was wrong, I thought.  A neighbor of ours who was a surgeon did a blood test and discovered that I was hypothyroid.  Little white pills were prescribed and I took them every day.  I didn’t feel any different; I didn’t lose weight; and nobody followed through with further tests so eventually I quit taking them.

During an extremely stressful period in my early thirties I developed an eyelid retraction (stare) so that my left eye was wider open than the right.  Since this can be a symptom of hyperthyroidism, I was given a radioactive iodine uptake test to examine the functioning of my thyroid gland.  The results were inconclusive and, after several months, the eyelid retraction mostly went away.

After a few years my life settled down and I acquired a regular family doctor.  When blood tests again indicated hypothyroidism, she got to work trying to fix the problem.  I took pills of various colors; the levels went up and back down again, often up in summer and back down in winter.  Eventually she concluded either that I was not taking the pills as prescribed or that there was something else wrong and sent me to a specialist.

From the endocrinologist, Dr. Melissa Cavaghan, I learned a number of things.  One is that you shouldn’t take your thyroid medication at the same time of day when you take calcium because the supplement can affect the medication.  Another is that levels of thyroid medication need to be adjusted in tiny increments so you don’t get the kind of swinging back and forth that I experienced.  For some people, including me, it is important to use the same type of thyroid medication because generics don’t always work the same as the brand name product.  Also, in recent years medical science had changed its opinion about treating hypothyroidism, calling for intervention at levels that were previously considered normal.  Probably my hypothyroidism has been under-treated all my life.  In any case, I now take light blue and dark blue pills on alternate days, which produces an acceptable result on the blood test and makes everybody happy.

Why I Do This

A friend asked me why I devote so much time and energy to staying in shape.  “What is your goal?” he asked.  Perhaps he thought I was planning to live forever, but that’s not the reason.  Like all good pragmatists, I have my Living Will signed and notarized and my Health Care Representative selected.  As I watch myself getting older, I have two main objectives: to remain independent for as long as possible and to avoid pain.  Being in good shape after the age of sixty is a luxury; eating what Michael Pollan calls “real food, not too much of it” and working out are the price I pay for that luxury.

Stilbestrol and Me

My parents were married in June of 1942.  The following year a male child was born and died shortly afterward; he was a “blue baby” with a congenital heart defect.  Ironically, it was only two years later at Johns Hopkins that surgeon Alfred Blalock and his laboratory assistant Vivien Thomas performed the first surgery to correct one type of “blue baby syndrome,” a story told in the film, “Something the Lord Made.” http://www.imdb.com/title/tt0386792/

Shortly after that, my father went to Europe, where he served as a chaplain for the remainder of the Second World War.  He returned to the US in 1945 and my mother became pregnant in September.  Having lost her first child, she was especially concerned for my safety so when a highly esteemed ob/gyn suggested she take a new medication that was supposed to prevent miscarriage, she did it.  She gave birth to a healthy daughter on June 11, 1946.

In the early 1970’s I started reading about diethylstilbestrol  (DES), a synthetic estrogen that was given to pregnant women from the 1940’s on, but was now found to increase the incidence of a rare cancer in women prenatally exposed to the drug.  I asked my mother if she had taken DES and she told me she had taken “lots of it.”  Two points were especially galling about the situation.  It was an example of misdiagnosis:  DES was supposed to treat miscarriage but the problem was not with my mother; my would-have-been brother had a heart defect.  It also showed blind over-confidence in a drug that had not been sufficiently tested; my mother and others like her were unwitting guinea pigs and so were their daughters.  DES was later shown to be of no use in preventing miscarriage but to have a number of adverse effects on DES daughters and sons and possibly on the third generation as well.

The next step was to find out whether I had cancer.  The recommended test was something called a colposcopy and at that time only one doctor in the Boston area performed them.  My mother and I paid him a visit.  Before examining me, Dr. R assured us that I couldn’t possibly be a DES daughter because I was too old; my mother must be mistaken.  The test proved otherwise, however, and I was told that I had a “pre-cancerous condition” caused by DES. 

For a while I worried about this.  The number of women who got a DES-related cancer was small but what if I turned out to be one of them? I also tried to participate in a lawsuit against Abbott Laboratories, one of the manufacturers of the drug.  My claim was disallowed – I no longer remember why.  The next several years brought a series of problems related to my reproductive system, culminating in a hysterectomy in 1978 at the age of 32.  Did DES cause my infertility? We’ll never know.  It may have resulted from my hypothyroidism or my very stressful professional and personal life.  My smoking habit probably didn’t help either.  The good news is that I never got cancer and, almost forty years later, I’m very healthy.   I do get regular physicals just to be on the safe side.

Dr. Gustafson, I am grateful to you for bringing me into this world but, when it came to stilbestrol, I wish you had left well enough alone.