Diet

Low Iodine Diet Adventures: Craving, Experimenting, & Radiating by alec vanderboom

     I suppose Low Iodine Vegetarian Shepherd's Pie has very little to do with shepherds. Scavenger Pie? Gardener's Bake? I dunno. 
     Anyways. I started a low iodine diet last Friday. So, when coupled with the dietary recommendations from my naturopath, my dining options have dwindled significantly.
     This has actually been tougher than I thought. You see, I love food. I love to cook. Cooking is often my only creative outlet in a busy day. But now, I have been challenged, and like listening back to a bad take of a song in the studio, the results can be very unsatisfying.
     Before I get into tonight's culinary experiment, here's the down low on the low iodine diet and the reasons for it:
  • The next step for treatment after my thyroid cancer diagnosis and surgery is a radioactive iodine treatment. The drug I'm on right now, Synthroid, will be shut down through two injections of Thyrogen, and then I go for my treatment. Essentially, I will be brought a pill in a lead box (brought in by someone in a Doc Brown suit, I like to imagine), I'll swallow the pill with some water, and then LOOK OUT! OFF LIMITS! No adults will be allowed in my hospital room unless they are 1-2 meters away, and only for a 20-minute maximum visit. After three nights in relative isolation, I will be released following a scan by Doc Brown's Geiger counter--or something like that.
  • I can't be around children, pets, or pregnant ladies (I suppose adding "ladies" is redundant...oh well), so my pseudo-isolation will continue for a while after the treatment. It has been recommended to me not to be back at work for two weeks. Because the radiation will be expelled through sweat, I can't have contact with anyone, and I need to throw out towels, bed sheets, dishes, and cutlery. Yikes!
  • From what I understand, the point of the low iodine diet is to starve the body of iodine for two weeks so that when I take the pill, my now active thyroid tissue (thanks to the Thyrogen) will eat up the iodine and then the radiation will kill any remaining cancer cells. Keep in mind, I'm not an expert, but this is what I've gathered over the last couple of weeks.
  • The diet itself involves cutting out iodized salt, anything from the water (fish, shellfish, etc.), anything from a can, dairy, and anything with red food colouring. I also can't eat anything that I don't prepare at home since everything in restaurants contains higher iodine levels. This is actually quite a challenge now that I realize how easy it is to just grab a snack at a coffee shop, or even by the till at a grocery store.
Back to the food. I've never really realized what it is like to truly crave food. I mean, I'm a skinny guy to begin with, but whenever I've had a "craving" for something, say nachos, I can go out and get some--hopefully from Amigos. But now, when I want something, I've really got to think about it and go through the list of restrictions to figure out what I can have. 
I now see why diets fail. Temptation is everywhere, and eating involves habits that have been ingrained in us since birth. Like craving nachos. This is a habit. Nowadays, through recommendations from my Low Iodine Diet and from my naturopath, I can't have cheese, tomatoes, onions, peppers, corn, and so on. So, no nachos. Now some of those things might seem weird to cut out, but regardless of the reason, I'm being asked to change habits. I don't want cancer anymore or ever again, so I can change. Except, Man! Now I really want nach...never mind.
Experimenting in the kitchen tonight resulted in one heckuva tasty dish. I saw what we had in the fridge, I looked up what's traditionally in a shepherd's pie, and a little while later, I had a darn tasty dish (that I thouht was going to be terrible when I started off).
 So, here it is... Low Iodine "Shepherd's Pie" with a Quick "Sorta" Apple Sauce
Ingredients:
  • yellow potatoes (I think I used Yukon Gold. Whatever, they were in the pantry)
  • 3 beets
  • 3 fairly large carrots
  • leftover steamed broccoli and cauliflower...it was in the fridge, so why the heck not?!
  • cinnamon
  • nutmeg
  • bay leaf
  • Coarse Windsor Salt (it's low iodine friendly!)
  • honey
  • a lil' Olive Oil
  • Vegetable Stock...I made my own on the weekend and then froze it...roughly chopped carrots, celery, and cauliflower boiled and then simmered in water. With the cauliflower I actually used what I'd consider to be the "core" which I've always thrown out, but it worked!
-Boil potatoes and, later, mash them with vegetable stock, salt, pepper, and nutmeg. Whatever. Just make mashed potatoes, and make them tasty.
-While all that is happening, par boil some beets and shred some carrots.
-When the beets are done, drain them and then add the carrots, broccoli, cauliflower, vegetable stock, salt, pepper, bay leaf, honey, cinnamon. Reduce the mixture.
-With a little olive oil in a pan ( I used a larger cake dish), add the beet mixture (but remove the bay leaf), slather on the potatoes, and bake at 400 for 20 minutes or so. I also broiled it at the end to brown up the taters a bit.
-While the "pie" is in the oven, chop up some apples, add a little bit of water, cinnamon, honey, and a bit of salt. Reduce...there ya go! "Sorta" Apple Sauce! This part wasn't really needed, but I wanted a little more sweetness, and a bit more moisture to replace the traditional gravy. It worked! So, if you have time, try it!
-After letting everything cool a bit, cut out a slice of the "pie", spoon on some "sauce", and thank me later...haha.

4 Weeks In- Good News, Good Food, Good Progress, but “The Good Cancer”? by alec vanderboom


It’s April 8th—four weeks since my surgery, and a year minus a day since I released my first solo album—and I’m feeling good.
            Overall, I’m very close to where I was before the surgery. I realize now that my energy was low back then, and I’m struggling with it a bit now, but things keep getting better. Jenn and I had our first night out on Saturday (thanks to some great friends!), and it felt awesome. We also spent some time out at my brother’s place on Sunday, and I was able to go for a longer walk with our dog, Lucy, yesterday. Again, awesome. Everything takes a little more time, but it’s okay because I just don’t want to push too hard. It was estimated that I could possibly go back to work this week, but I’m relieved that I have some more time. I definitely don’t have the energy to be back in the classroom yet. Adjusting to my new medication, Synthroid, is not as easy as it sounded at first.
            One of the reasons it may be taking a bit longer to get my energy back is the fact that my surgery was a bit more extensive than just a thyroidectomy. We received our pathology report last week and found out that I had three areas of concern on my thyroid. Dr. Christian, my surgeon, mentioned that even though the cancer was evident on both sides of my thyroid, some doctors would only do a partial removal of the thyroid. I feel lucky to have had it all come out at once. After all, there was a patient in a bed next to me after my surgery who was in for his second surgery since the first didn’t complete the task. We also found out that I had 20 lymph nodes removed, nine of which were suspicious. This lymph node dissection led to the extensive scar that has caused me the most discomfort.
These four weeks have flown by. Don’t get me wrong, a lot of it was really difficult but I’m in a good spot. This gets me thinking about something I wrote about in my first blog: Is Papillary Thyroid Cancer really the “Good Cancer”? I mentioned that Dr. Christian told me that “the good cancer” is indeed what I have. Since the surgery is so effective, there are not many procedures that need to follow. But, can cancer be good in ANY way?! I read an article that shoots down this “good” diagnosis completely, and I see why (check out http://www.huffingtonpost.com/amy-graeber/thyroid-cancer-things-to-know_b_3319897.html). No cancer diagnosis, no treatment involving surgery and a permanent medication regiment is “good.” However, when I consider all of the things I was able to do last weekend, I consider myself lucky. I am looking ahead to a radioactive iodine treatment, but this involves being isolated at the hospital for just a few days. When I think of the people who need to go through extensive, painful treatments involving chemotherapy, I realize that I am in a “good” situation. As stated in this article (http://thyroid.about.com/b/2010/09/09/thyroid-cancer-good-cancer.htm), the prognosis for my type of cancer is very good, but maybe the terminology could be changed in some situations.
            Also, as I’ve written about before, the medical care I have received has been phenomenal. My follow-up appointment with Dr. Christian and Dr. Caspar-Bell, the endocrinologist, was so reassuring. Even with a long line of patients to see, Dr. Caspar-Bell took the time to speak with Jenn and find how we are both doing emotionally. She also took the time to answer every question that we had on our minds—especially regarding diet (*see below*). These simple gestures are not ones that we often hear about when people are discussing patient care. Like schools, hospitals often get compared to factories without thorough consideration of the implications of this metaphor. Dr. Caspar-Bell’s personalized efforts put Jenn and I at ease; we didn’t feel like a number or some product that will eventually come out the other end being deemed as “good enough.”

*With regards to diet, we (especially Jenn) did a lot of research on diet recently. Both doctors reassured us that a normal diet is going to be fine from now on. Of course, not many people share the same idea of what normal really is, but our normal prior to surgery will continue to be our normal now:
·      Lots of veggies and greens- We had read that there were certain vegetables that are goitrogens—they could potentially cause an adverse effect on recovery—but as with anything, moderation is key. This also applies to meat. We were considering a strictly plant-based diet, but we are just going to choose wisely. I won’t eat meat every day, and we will continue to buy the healthiest meat that we can find (“organic”, antibiotic-free, etc.). On a side note, I love to cook, so the perspective of considering meat as a side dish is a challenge that I look forward to.
·      Iodine- we were concerned about iodine levels when preparing for the iodine treatment, but Dr. Caspar-Bell told us that this would only mean that, “If you live in Vancouver, you would have to move to Saskatchewan.” What she was implying with this joke is that unless one eats seaweed and fish every day, iodine levels won’t be a major concern. She did advise to take it easy on the sushi though.

As it stands now, it’s April 8th. The sun is shining. It’s 16 degrees Celsius after a long, cold winter. My dog wants to go outside, and so do I. I’m feeling good.