Ottolenghi and Alison (or Cooking My Way Through Menopause)

blogmenopausal

I still remember the moment I decided to ignore the information that hormone replacement therapy during menopause could lead to increased risks for breast cancer and heart disease.

I was forty, or slightly older, with a baby and toddler, and having a hard time keeping things together.  A friend had told me about a video that was going viral on the Internet (pre-YouTube) showing a frazzled mother who had lost her keys. I’m not overstating when I say she “overreacted.”

“You might want to watch it,” hinted my friend, who is childless.

That’s when I learned about perimenopause, that undefined state that can last a decade or more, in which a woman’s hormones start going kerflooey and her emotions can get exaggerated. Superimpose that onto new motherhood. It wasn’t always pretty.

So when I saw the article about hormones and menopause, even though I knew it was important, I made the conscious decision to ignore it. “I can’t deal with menopause when I am trying to deal with perimenopause,” I decided, using the “one day at a time” strategy that experts advised for women in an enhanced hormonal state. I made the same decision about college, ignoring articles in the New York Times education supplement about student resume building and Top Ten Colleges to Watch. Views on hormone replacement therapy and college would change by the time they affected me, I reasoned, and pretty much cruised through the next ten years managing my life and my monthly symptoms just fine, with the help of some excellent dark chocolate.

theo chocolate

Lo and behold, there’s no longer any denying that in the next four years I will have to deal with both menopause and college.

Daughter #1 and I attended a presentation at her middle school entitled “High School and Beyond, Taking Charge of Your Destiny.” We learned that grades count from Day One in high school.  We learned the recommended GPAs to get into all of the colleges in Washington State, as well as some University of California schools, Stanford and MIT.  UCLA likes leaders, we were told. We left with a pocket-sized card listing the recommended college preparation steps a student should take in grades 9-12.

Around this time, my “Aunt from Redbank” (as the monthly visitor was known when my mother was growing up in New Jersey) started showing up more frequently and overstaying her welcome. Just as D#1 couldn’t escape the inevitable, neither, apparently, could I.

I turned once again to Dr. Christiane Northrup’s book The Wisdom of Menopause, which is chock full of interesting and useful medical information, but which, as I’ve mentioned before, does seem to have a not-so-hidden agenda about jettisoning husbands. I learned estrogen dominance could be the root cause of my excess bleeding and maybe even my excess belly fat (a girl can dream).

Meanwhile, Dr. Northrup advised me to contemplate who was draining my life blood from me.

J'accuse!

J’accuse!

Though I’ve mentioned I suffer from latrophobia, I actually made an appointment to see my Ob/Gyn.

The week I had to wait to see him was tough.  It’s June, a time that any mother can tell you, is crazy with end-of-year this and summer planning-that.

It’s another graduation year for our family and, though I won’t be weepy at the ceremony as I was last year and two years before that, there’s no denying that we are moving into a new phase of life and time is marching on.

To calm myself, I turned to the thing that helped me through new motherhood and perimenopause: cooking.

Unusually alone on Sunday morning and feeling under the weather, I comforted myself with a batch of shakshuka, using my standby recipe from Yotam Ottolenghi‘s wonderful vegetarian book Plenty.

Goes very well with the Sunday New York Times.

Goes very well with the Sunday New York Times.

Come Monday, the beginning of the last week in the end-of-school marathon, the week of my doctor’s appointment, graduation and a week that Jeff would be partly out of town, I found myself unable to focus on work.

So instead I focused on cooking:  My weekly batch of Early Bird granola, Lahlou Mourad’s fantastic piquillo almond dip for Daughter #2’s Global Issues celebration (I unwittingly violated the school’s “no nuts” policy, but people loved it anyway) and the “Very Full Tart” from Plenty.

tart

This soothed me in a way that no hormones or dark chocolate ever have and it got me thinking:  If Julie Powell could cook and blog her way through the “crisis” of turning 30, why couldn’t I cook and blog my way through menopause?

Maybe I’d get a book deal.

I wonder who would play me in the film?

A girl can dream.

So, just as I used to incorporate European Chicken Night into my (almost) weekly repertoire, I am hereby introducing Mostly Mediterranean Menopause Night (though I will probably keep the name to myself) featuring mostly the recipes from Yotam Ottolenghi’s three cookbooks, with some recipes from Lahlou Mourad, my Turkish friend Sureyya, Greg Malouf (author of Turquoise) and other luminaries thrown in.

Here’s the recipe for the Very Full tart, which made me feel very virtuous when I made it. I am not the only person inspired by eggplant. (To the horror of D #s 1 and 2, I sing this song and dance around the kitchen pretty much every time I make it).

It tasted great cold the next day.

Recently some friends and I took another cooking class with Sureyya. The following week, a group of us, who first met when our high school-bound kids were in kindergarten, gathered at Sureyya’s wonderful Cafe Turko, to support a friend whose husband suffered a brain injury.  Sureyya joined our group of women and laughed and talked with us.  Later, she joined me in donating food to my friend and her family.  

May peace return to Turkey.

Here is Sureyya’s recipe for Turkish Mountain Salad with Pomegranate Molasses, Red Pepper Paste and Olives:

Serves 6

1/2 onion, finely chopped

2 T green olives, chopped

1/2 cup chopped parsley

1 T red pepper paste

1/2 t salt

2 T chopped mint leaves

1/2 c chopped green pepper

2 T crumbled feta cheese

2 cloves garlic, minced

1/2 t cumin

2 Roma tomatoes diced

1/4 cup olive oil

1 T pomegranate molasses

Mix all ingredients in a large bowl.  Marinate for 15 minutes. Serve with warm bread.

Hormone replacement therapy.

Hormone replacement therapy.

Cold Feet: The Thyroid Chronicles, Part I

I’ll start by telling you that I suffer from latrophobia, fear of going to the doctor.  Though I haven’t undergone counseling to figure out the root causes, I think this fear took hold during childhood.  Growing up in a tumultuous household, I was a bedwetter, and I found it humiliating that during my annual physical, Dr. E felt compelled to “examine” my nether regions, looking, I assume, for signs of rash. In those days you didn’t question doctors and parents didn’t ask kids about their feelings.  Even though for many years, on the eve of my check-up I would parade around the house with homemade picket signs which read:

I HATE DR. E!!!!!!!

my mother didn’t pick up on my discomfort or, if she did, didn’t think it was worth alleviating.

It was the mid-1960s, after all.

(You’ll be happy to know this is one of the issues we resolved on her deathbed.  Dr. E was apparently a celebrated pediatrician and my mother thought she was acting in my best interests).

When I became an adult, I dreaded going to the doctor for a different reason:  the weigh-in.  In some crazy, retro, pre-feminist way, I managed to transform what is supposed to be a partnership caring for and maintaining my body/machine into a self-created moral test of my character.

Even though I’m older and wiser now, I still avoid going to the doctor unless I am in desperate need of a Z-pack of antibiotics, have a sports-related injury or am having my annual Pap smear or mammogram (they don’t weigh you for those).

In other words, I don’t get an annual physical.

When I first started noticing that my body seemed different, I assumed the ravages of age and perimenopause were taking hold.

Certain friends who shall remain nameless here have gained a bit of weight around the middle, many have joked about forgetfulness (including my dear friend C., who forgot to feed my cats over Labor Day weekend.  They were hungry for more than just affection when we got home). Broken nails, my friends have seen a few.  Let’s face it, we’re not as young as we used to be.

Reference material nerd that I am, earlier this year I felt compelled to purchase Dr. Christiane Northrup’s book The Wisdom of Menopause and keep it on my bedside table for a little light reading about hormonal changes. As I read through the section on mid-life weight control, something in Step Five:  Get Your Thyroid Checked jumped out at me.

Cold Feet

My feet are always cold, even in summer.  As I read through the rest of the possible signs of hypothyroidism, I realized most of them could apply to me. (It kind of reminded me of one of those quizzes in Cosmopolitan:  Ten signs that tell you he’s cheating.  By the time you finish taking the quiz, you are convinced that he is).

I added getting my thyroid checked to my mental medical to-do list, along with the colonoscopy I should have had last year, but of course, I didn’t do anything about scheduling either one of these important, potentially life-saving tests. (No, JDM, I have not had a shingles vaccine.  No, sister-in-law D., I have not had a flu shot either).

On vacation this summer, I awoke each morning, more bloated than the next.  It felt like more than an excess of tequila and tortilla chips, and, as I thought about it, the problem had been worsening for months.  Was I suffering from cellular inflammation or an overabundance of fat-accumulating hormones, such as insulin?   Was my thyroid the culprit?

Even dogs can suffer from hypothyroidism

There was only one way to find out.  Feeling very mature (in a good way), I called my Ob/Gyn’s office to schedule my annual Pap smear and mentioned that I also wanted my thyroid checked.  The young receptionist wanted to verify my insurance coverage and gave me the name of an insurance carrier we haven’t used for years.  “No,” I said.  My carrier is C**, the same one I had last year.  “You haven’t been here for three years,” she said coldly.

I felt like Ingrid Bergman in Gaslight.

I had to wait till I got home to comb through my insurance documents, call my insurance company and check all of my calendars for the past three years to prove that I had seen that doctor last year and the year before that.  When that turned out to be fruitless, I called the doctor’s office again to ask them to check my physical file.  This time the receptionist was more understanding when she informed me that there were no notes in my file after 2009.  “I know how you feel,” she said sympathetically.  “I was born the same year as you.”

I was not surprised to learn that a faulty memory is another symptom of hypothyroidism.

The plot and my waistline thicken

The weeks I had to wait for my appointment felt interminable, but I tried to make them productive.  I gave up alcohol, tried to stay away from carbohydrates and made sure to adhere to a regular exercise regime in spite of my achy joints (another symptom).

I researched doctors and made an appointment for a physical with one who looked promising (in my own latrophobic defense, apart from my Ob/Gyn, whom I have seen for seventeen years, I haven’t been able to find a doctor or a practice that impressed me with professional, high quality care).

One day while out for a run, I tried to pinpoint what had changed over the past six months to make my symptoms, especially the weight gain, worsen.  I’d started making and eating granola on a regular basis, but it seemed hard to believe a cereal mix could be so potent.  Then I remembered.  Around six months ago, after being diagnosed with a herniated cervical disc, I received two epidural steroid shots and also took oral steroids. Because I have trouble remembering things, I made a note on my iPhone to do some research.

At home, a quick search on the Internet suggested there could be a link between the steroids and my thyroid. (Searching for things on the Internet reminds me of writing high school essays: combing the available research materials for snippets of information to support my thesis).

Next week I will see my Ob/Gyn and hopefully be that much closer to figuring out what, if anything, is wrong with me.  Who knows, my symptoms might just be the normal by-products of aging, which require a change in my behavior, nothing more.

But at 51,  I think I’ve finally learned my lesson.  Now, more than ever, it’s important to stay on top of your health, if for no other reason than to have a baseline to work with if something is really wrong.  Perimenopause and menopause can cause some surprising symptoms (remember pregnancy nosebleeds?).  It’s worth talking to a doctor about them, instead of suffering in silence.

Check back with me in a few months to see if I’ve scheduled that colonoscopy.

This week, four diplomats were killed in Libya and my nephew was deployed to Afghanistan. As a proud former member of the Foreign Service, who served in the Near East and South Asia bureaus, my heart is with those who dedicate their lives to promoting international understanding.

In their wonderful new book Jerusalem, chefs Yotam Ottolenghi and Sami Tamimi, a Jew and a Muslim who grew up in the western and eastern part of that city, talk about food’s ability to break through religious and cultural boundaries.

Twice this week I made Ottolenghi’s recipe for Figs with basil, goat cheese and pomegranate vinaigrette from his book Plenty.

Historically, figs have been revered as a symbol of peace.  I can’t think of a better thing to eat. And they’re good for you too.