Sunday, July 16, 2017

Senate Blue Ash:

This post is significant for several reasons. One, we are sure that many of our readers have been following our journey this year from our last few posts. Two, this couple of hardcore urbanites actually drove out to the suburbs for brunch. Twice.

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Quick recap: In January, David was diagnosed with Stage 5 Kidney Disease, and we were advised that the best treatment for his condition was a kidney transplant as soon as possible or he'd need to undergo dialysis in the next few months. We immediately started a strict renal diet and a donor search. As unfortunate as this diagnosis was, we were lucky beyond belief to have amazing friends and acquaintances that stepped up to help spread the word and volunteered to be donors. Because of everyone’s efforts, we were successfully able to avoid dialysis, giving David a much better life expectancy and outcome.

There were several matches for David, but ultimately, our very good friend Rich gave us a gift we can never say ‘thank you’ enough for. The fact we were even able to go to enjoy brunch is owed to Rich. So it was fitting that Rich was honored at Senate a few weeks back by being the very much coveted ‘Dog of the Day.’ 

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This is what a hero looks like in real-life: Rich Hill surrounded by 'Rich Hill' dogs!

Senate in Over-the-Rhine is one of the OG restaurants, but the Blue Ash location just opened up earlier this year. It has a similar feel and many of the same menu items, but also features a wonderful patio, call-ahead seating, and brunch.

We visited on two occasions, once with our good friends Bob and Erin Marie Schwartz, and once with Rich, his wife Maria and their adorably feisty daughter, Vivian (Parents take heed, Senate Blue Ash is exceptionally kid friendly: a park right outside, high chairs, and even kid-sized menu items).

Let’s start with the pancakes. We need to talk about these. There are two versions of them on the menu, ‘Birthday cake’ and ‘Neapolitan.’ One is slightly more ridiculous than the other.

Both times we visited, we ordered the pancakes for the table, which is what we recommend. Birthday Cake Pancakes are covered in a funfetti glaze, sprinkles and crushed up birthday cake Oreos.

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One Sugar Mountain Supreme for the Chubby Bunny. Pancakes are under there...somewhere.


The Neapolitan Pancakes are slightly more conservative, with local strawberries, vanilla creme anglaise and crushed cocoa puffs. Still, it’s a great start to a shared meal and a big commitment for any one person to take these two dishes on.

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Next, the ‘Goetta Superstar.” Goetta is delicious. Pair it with melted cheese, velvety scrambled eggs, creamy avocado and a toasted brioche bun and you’ve got a hit on your hands. Get. This. Sandwich.

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The Eggs Benedict, served with lemony hollandaise, gently poached eggs and savory ham atop the  best English muffin in the city (made by Blue Oven Bakery) is worth the trip to the restaurant alone.

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The Chilaquiles also were very flavorful, balanced, not too spicy, and a great option for vegetarians. Personally, we found ourselves looking for some additional protein in the dish, but this is a lighter choice among some heavier brunch items, and also ideal for sharing.

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David had been eyeing the Sunday Burger since our first visit, and it didn't disappoint. Two beef patties, cheese, bacon, and a sunny side up egg, all served on a light and fluffy brioche. The breakfast potatoes are delightfully crispy and lightly seasoned with truffle.

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A burger cross section is worth a thousand words

Even one of the more tame options (Bacon, Egg and Cheese Muffin) stands out, due to the aforementioned Blue Oven English Muffin.

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We closed out our second meal with Biscuits, Gravy and Eggs. Seasoned well, with flaky biscuits and a nice proportion of sausage-to-gravy, this is another solid brunch choice.

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Finally, there’s a drink called Frosé, (frozen rose with a few additions) which is ideal to sip out on the sunny patio.

We highly recommend making the trip out to Senate’s new location, and thanks to Rich, his family and our many friends, guess what:

We’re back.

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Saturday, April 8, 2017

Biscuits Make it Better:

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It’s hard to believe it’s only been a few months since our world went upside down. There’s been a lot of progress and we are very grateful - the size of the response to David’s need for a kidney has been humbling and donors are now being tested. In the meantime, we’re trying to keep David’s blood work stable. It is easier said than done and relies heavily on a very special meal plan.

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If his values get worse, we’re looking at dialysis or, you know... death. There are no ‘cheat days’ on this diet. Since we enjoy eating out and cooking lots of things, it has been very challenging.

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What, you don't own a microgram scale too?

Fortunately, David already created a program that uses the USDA database to reference values on nutrients, so he’s been able to put items on ‘yes’ and ‘no’ lists. The ‘yes’ list is extremely short, for some good reasons. Kidneys filter out a lot of bad things that can build up in the body. David’s are barely operating, so that means he can't eat what his kidneys are not able to filter.

The first and biggest to watch is potassium. If potassium gets too high, the outcome is death with basically no symptoms beforehand. This has already sent us to the hospital once. Despite the interesting people watching at the U.C. ER on a weeknight, we are hoping to avoid more trips.

Second, phosphorus. Phosphorus and calcium have a working relationship. When phosphorus gets high, bones start to decalcify, also not a desirable outcome. Cheese is one of the highest sources of phosphorous, which makes pizza (one of David’s favorite foods) essentially the devil.

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Third, sodium. Fluid retention is one of the biggest signs of dialysis need, and sodium excess contributes to it. To add insult to injury, sodium also elevates blood pressure, which hurts kidney function and David does not have any of that to spare.

Lastly, protein. Proteins metabolize into nitrogen based compounds, some of which are toxic if not filtered out by a working kidney.

Easy-peasy, right? Just don’t eat any meat or other high protein foods, avoid foods high in one or both of those two chemicals and banish the salt shaker.


If only. Potassium and phosphorus not only occur naturally in many “healthy foods” (greens, grains, fruits, nuts, beans) they also are used very heavily as synthetic preservatives or additives in the food industry. A real kick in the balls: they also are not required to be labeled on a product's nutritional information. Grocery shopping just got a lot more complicated, folks.

People love salt, and for good reason. Salt is tasty. But the amount of sodium David is allowed to have per day is extremely small, 1400 mg. That’s the equivalent of one bowl of broccoli cheddar soup from Panera. With no bread. For the whole day.

Even baking at home is particularly difficult, because so many recipes use baking powder, or as we have named it, “Death in a Can.” Industrial baking powder is primarily baking soda* with monocalcium phosphate, although some formulations contain potassium bitartrate. Do those ring any bells? It’s basically the worst things in powder form.

Despite all the barriers, David managed to create a biscuit recipe that won’t kill someone in stage 5 CKD and is enjoyable whether you are on a special diet or not. It’s hard to get around the sodium issue, since biscuits without salt are inedibly bland. But, a single biscuit can be worked into a sodium budget for the day if room is made for it. And the great part is that if you make them yourself, you can decide how much salt you’re comfortable adding.

Biscuit Recipe:

Makes 8 - 9 large biscuits

1 lb. (454 grams)
Cake flour**
1 slightly rounded tsp. (6 grams)
Baking soda*
1 level tsp. (4.5 grams)
Citric acid
1 level tsp. (4 grams)
Salt
1 pt. (454 grams)
Heavy cream
Optional: 2 Tbsp. (28 grams)
Butter for topping


* Always keep baking soda separate from baking powder in your mind. Baking powder is the bad stuff!
** Important: Do not use self-rising flour. It is premixed with salt and -- you guessed it -- baking powder!

Instructions:

Preheat oven to 500 F.

Whisk dry ingredients. Incorporate heavy cream by stirring briefly (less than 1 min), just until no dry flour remains. Dough will be loose clumps at this stage (below).

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Turn out onto a dusted working surface, press out firmly to dough slab of 1-2" - 3/4" thickness. Fold over on itself a few times, forming a rough square shape, then press out again.

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Cut into rounds, gently combining scraps to form remaining biscuits. Place onto light colored baking sheet, brush tops with melted butter if using, and bake in oven for 12 minutes.

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Transfer to towel-lined basket, cover, and let rest for 5 minutes. Serve while still warm.

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Estimated nutritional information:

Serving size: 1 large biscuit
Calories: 355

Protein: 5 g
Fat: 19 g
Carbohydrates: 41 g
Sodium: 375 mg
Potassium: 90 mg
Phosphorus: 74 mg

Wednesday, February 22, 2017

An Important Message from David and Laura; We Need Your Help to Save David's Life:

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A good meal can lift the spirit, and I think we can all agree a great meal can make you feel much better, mentally and physically. But food can't fix everything.

For the first time in a long time, we dusted off an old recipe (a chicken and noodle dish we fondly dubbed ‘Chicken Mush’). I needed some comfort. This is why.

Earlier this year in January, David went to the doctor for a headache that wouldn’t go away. They saw that his blood pressure was alarmingly high, so they put him on two medications and ordered blood tests. The results were shocking: Chronic Kidney Disease, Stage 5 (AKA “End Stage”). Somehow David’s kidneys had been damaged so severely they were struggling to operate at 7% of normal capacity.

Meaning? Do not pass go. Do not collect $200. Go directly to a transplant program and needing a matching donor to prevent imminent dialysis this year, which is more and more likely as time passes.

We’re trying to delay the horrors and health risks of hemodialysis by managing a strict renal diet for David, so our blog posts are about to get real weird. Want to know the secrets of making Brazilian Beiju flatbread? You will.

But like I said, food can’t fix everything.

If you want to help us, there are several ways

First, anyone can help us by spreading the word about our situation. The more awareness we have, the better the chance of finding a matching kidney.

If you are open to exploring donation, here is detailed information about kidney transplants and donation. But, there are some important questions about donation that I will answer right away.

“Will I be just as healthy after I donate one of my kidneys?”

Yes! After donation your other kidney will increase in size and functionality to compensate. You will be able to return to all your normal exercise routines and physical activities after the recovery period.

“Is the donation process safe?”

Yes! Although it is a surgical procedure, the transplant team will rigorously qualify you before accepting a donation. They will never accept a donation that puts the donor at risk.

“Will the donation process be expensive?”

No! The recipient’s insurance pays for almost all costs. The only things you would have to cover is any needed basic health exams and time off work to recover.

We need you!

If David goes on dialysis, rather than a transplant, we’re looking at an average life expectancy of only 10 years, many of them hooked up to a machine of some sort. It’s an ugly thing to think about, but those are the facts. Kidney transplant is a treatment that can double his life expectancy while also greatly improving the quality of those years.

David’s exceptional transplant team is based out of U.C. Health, and he is registered there for anyone who is interested in the facts about donation. You can call his transplant coordinator, Janea Matherly, at 513-584-5573 or email her and she will be happy to take your information and walk you through a short questionnaire (also available here, can be faxed to 513-584-0881) to determine if you are a candidate. I am probably the best person to look to for any updates on David’s health. I will also be undergoing the donor testing process (I am not a match via blood type but there's another process I will be pursuing, explained below), so I should have answers to any questions or concerns that you might have. Ask away.

David's blood type is A, which mean positive or negative donors A or O could be a match. Even if you aren’t a match for David, there are programs that match donors up with other donors that could be, which actually means that your decision can start a reaction that saves the lives of multiple people! Think of it like a daisy chain. Except made out of squishy, squishy kidneys.

We’re in this together

This will be the hardest thing David and I have faced together yet. We are grateful to have access to exceptional doctors and support of family and friends. David is incredibly smart and is proactively managing his care, and I’m a force to be reckoned with when it comes to getting big things done. Still, I’d be lying if I told you that we were really ‘OK’ right now. We're both handling it a little differently.

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This is me

Situations like this really put things in perspective. Life is short and sudden onset, unexplained illnesses like this can make it much shorter. I urge you to make the most of your own and be kind to who you can, where you can and when you can.

And if you've got the time, make someone who might need it some Chicken Mush. Except not for David, since he can’t eat it right now.

Chicken Mush Recipe

Very early in our relationship, David developed this recipe from what we happened to have in our pantry. It's inexpensive to make and extremely easy -- perfect for two people with student loans living in a small apartment with a dated kitchen.

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Ingredients

8 cups water
8 cubes chicken bouillon (or equivalent, you’re looking for about 800 mg sodium per cube)
1/2 cup dry Marsala wine
1/4 cup soy sauce
1 tsp parsley
1 tsp curry powder
1/2 tsp garlic powder
2 10 oz cans chicken meat (or leftover roast chicken if you have it)
1 lb (16 oz) extra wide egg noodles
1/4 cup extra virgin olive oil

Instructions
  • Add cubes to water and bring to boil
  • Add wine, soy sauce, and spices
  • Make sure broth is well mixed, then add chicken meat with juice
  • After boil returns, add noodles and cook uncovered for 15 minutes
  • Halfway through cooking, add oil and stir noodles thoroughly
  • Enjoy or give to someone who needs it.

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