Things I Want Right Now: "C is for..."

Can tubies gain weight?

Scratch that. I know we can gain weight. I've heard countless stories from tubie moms whose kids put on weight after switching from formula to blended diets.

What I mean is, can tubies get fat?

Believe it or not, that fat man is me on steroids in 2006. The bear is obviously on steroids too.

That picture is of Fat Brian and his friend, Fat Bear. I was on an extremely high dose of Dexamethasone (decadron) to try to combat the side effects of radiation damage. Decadron and radiation (and jaw surgeries too!) had a couple similarities: they suck and they were of questionable benefit. One of the side effects of decadron is that it caused me to put on weight really easily and it was nearly impossible to lose it.

Could I have avoided putting on weight if I had a feeding tube? Maybe you saw the headlines a few years ago about people trying to lose weight by eating through a feeding tube. Here's a more recent article about a doctor in North Dakota (Doctor Spencer Berry) who thinks feeding tubes are the answer for Diabetes: (click here). I like the quote from a different doctor at the bottom of the article: “To receive nutrition via a feeding tube is not a realistic long-term method of nutrition. Plus using a feeding tube for a prolonged period of time can increase a person’s risk of infections.” If I live to be 90--or rather, when my friend, Jesse Jones, lives to be 90--I hope she's still around so I can ask her about that.

I think I agree with Dr. Berry's critics though. Weight loss is about losing weight and keeping it off. Once those diabetic people have lost 100 pounds and the tube comes out, will they suddenly start eating well and exercising regularly? I'm thinking their first thought will be the same as my first thought if I ever get rid of this feeding tube, "I'm going to the grocery store, buying a tube of chocolate chip cookie dough, and I will not rest until that cookie dough has been consumed in its entirety. 'Murica."

All that 'gluten free no sugar' stuff is going right out the window. I'm not proud.

Once people get a feeding tube for weight loss, they'll have to keep it in or they'll slide right back into the diabetic life. So, since I have a tube permanently, does that mean there's no way I'll get obese? My opinion is that it's possible to be overweight with a feeding tube, but it's much harder. There's an obesity problem in this country because it's so easy to eat junk. Sitting on the couch watching the game? How about a 20 oz. Coke and a bag of Doritos!! Not enough time for breakfast before work? Stop for a few doughnuts at Krispy Kreme or buy a couple Pop Tarts from the snack machine in the office! Kids whining for dinner but nothing prepared? Order pizza, or better yet, make it a McDonald's night! We eat processed crap because it's more convenient. Or we do it because we're idle and have nothing better than to eat, so we choose to eat the best tasting stuff--the stuff with all the sugar and weird sounding chemicals in it. Even worse, we eat crap because it's less expensive than the healthy stuff.

Not so simple for me to eat crap food. I ate some doughnuts on occasion before I went gluten free. But there are extra steps there. Gotta throw it in the blender, get a good amount of fluid in the pitcher to thin the mixture, sit at the table to push it in (doughnuts aren't something I can casually eat on the couch or while I'm driving anymore), then flush with water. Granted, I've done this long enough to get the amount of time down, but it's still a whole production whenever I eat. Not to mention the fact that I don't taste what I eat, so where's the joy in eating a doughnut? If I'm going to take the time to make a meal, it makes more sense to make it healthy. Too much work to get fat with a feeding tube. Hard enough just maintaining the pounds I've got.

This is not to say that you can't eat an unhealthy diet with a feeding tube. My last post was all about sugar, and how sugar--mostly corn syrup--makes up many of the calories in processed formula for tube feeder. Having a diet with a large percentage of calories coming from sugar won't necessarily make you obese, but it does give you a whole host of other problems. Sugar is bad for you in so many ways. I really feel like I need to find a university study demonstrating why sug--

http://m.ajcn.nutrition.org/content/101/6/1144.abstract 

What the...Where did that peer reviewed study from The American Journal of Clinical Nutrition come from?? I think my health-conscious big sister somehow knew I was writing a post about cookies and sent the link all the way from her home in Germany!!! She further says that this article is, "Gold-standard research revealing the traumatic effects of simple, highly processed carbohydrates (sugar and flour and the products made from them) to your heart." She's got about 100 more studies showing how bad sugar is for you, but I actually just pulled that link off her facebook page and I'm too lazy to ask her.

So anyway, all this talk of the damaging effects to our body from sugar, both last week and this week, makes me hungry for cookies; how about you? It's time for another installment of "Things I Want Right Now!" I think I mentioned above that the first thing I'd do if I could swallow was eat a tube of cookie dough? The truth is, I'd drive straight here:

The happiest place on earth

Since a very young age, I've been crazy about cookies. Especially when they're soft, sweet, buttery, fresh from the oven. I'm drooling on my keyboard thinking about it.

Where did I learn this addiction?

My mom made some awesome cookies when I was growing up. Chocolate chip, snicker-doodle, sugar, apple sauce (yes, there are apple sauce cookies and they're delicious), oatmeal. But the best cookies by far? Mom's ginger snaps.

It's time to do something a little hypocritical on my blog. Something that is the exact opposite of what I was preaching about in my last post.

It's time to share a very unhealthy recipe. I'm only doing this so you'll see the types of things you shouldn't be eating. PLEASE PLEASE, whatever you do, don't run out, buy all the proper ingredients and make these cookies!!! Also, don't take pictures of yourself eating said cookies and absolutely don't send the pictures to me so I can vicariously enjoy the cookie consumption. Betsy really wants me to make chocolate chip cookies because they're her favorite, but I just use the Nestle-Toll House recipe for them so I thought I'd share my mom's ginger snap recipe instead. Betsy is the only person on the planet who doesn't like these cookies so I guess you're out of luck, babe, sorry!

--------------------------------------------------------------------
GINGER SNAPS

Ingredients:

2 cups flour                                   1 cup sugar
2 tsp. baking soda                          3/4 cup shortening
1/2 tsp salt                                    1 egg
1/2 tsp cinnamon                           1/4 cup light molasses
1/4 tsp ground cloves
1/4 tsp ginger

1 bowl of sugar

Directions:

Preheat oven to 375. Sift dry ingredients. In a separate bowl, cream sugar and shortening. Mix in egg and molasses. Add dry ingredients. Roll balls of dough in the bowl of sugar. Place on a greased cookie sheet, sugar side up. Bake for 9 minutes.
--------------------------------------------------------------------


Now, let's put those directions into action!! For this portion of my blog I really need someone to hel--

Look, it's Grace and some other strange kid!!

Where in the world did they come from?? All I did was think about cookies and Grace popped into the kitchen. Plus, our neighbor showed up with mixing spoon in hand. How does this happen?? I guess all you need to do to get your kids to quit playing Minecraft and spend time with you is make sugary, unhealthy treats with them!!! Parents, take note!!!

WARNING: flour has a tendency to fly out of the bowl when vigorously stirred!

The recipe also has shortening in it. Shortening was developed at the turn of last century using partially hydrogenated cottonseed oil. It was touted as the "healthy alternative" to lard because Mr. Procter and Mr. Gamble wanted to stick it to the meat industry. Listen to this podcast exploring the early history of Crisco; it's actually really fascinating. Today, Crisco is an unholy mix of soybean oil and palm oil, and butter is, surprisingly, a healthier alternative. Yet shortening makes the cookies softer and, although it doesn't give you that buttery taste you love in chocolate chip cookies, ginger snaps have enough other spices that you really don't need a buttery quality. Here's another interesting link on the science of fat and why it makes cookies taste so good, because I know you're dying to read more about fat!

"Stir, you little punks, or you won't get dinner again tonight!!!"

Besides adding butter, I also could've used gluten-free flour in the recipe so I could actually enjoy these cookies, but I made the decision to make it just 'like mom used to make' and keep it as unhealthy as possible. Also, I'm trying to cut back on sugar so I prefer to feed this poison to those I care the most about, like my only daughter (in my defense, she has the audacity to eat popcorn right in front of me).

Not only is there a cup of sugar in this recipe, but there's also molasses! Though, to be fair to molasses, it's actually not as bad for you as sugar. When sugar cane is processed to make refined sugar, molasses is the by-product, so it contains many of the nutrients from the plant that are lost during refinement. Plus, molasses has a lower glycemic load. I don't know what that means either, but apparently molasses is a safe sweetener for diabetics. I actually didn't have light molasses in the house, but I had black strap molasses (the type with the most nutrients so "yea me!"). It made the cookies look a little darker, but Grace still thought they tasted good.

Other than Grace, and some random neighbor kid who happened to wander by, who did I feed these sugar-bombs to? To my fellow disabled veterans at the horseback riding thing I do every Friday, of course! Also, to my in-laws because it seems like more of them are moving to Knoxville every day and I may have to resort to drastic measures to put a stop to them.


 

If I didn't have a feeding tube, all these would be mine

My 8 year-old daughter informed me this morning that she googled my name and found my blog. She told me she read every post and especially liked the one about Red Lobster because I made mommy look like a vampire. This made me: 1) suddenly very nervous about what exactly I said in my past blog posts (haven't there been a lot about alcohol??) and 2) frantically look up parental locks online so my kid doesn't wander into some porn site when I'm out of the room. So, Grace, I know you're reading this, so I thought I'd make you a special picture just from daddy:

Who's the scary monster now??

In response, she made this:

Not too bad for her first try

The Forty Year-Old Tubie

40.

The big 4-0.

Over-the-hill.

Four decades.

Forty trips around the sun.

I still remember when my parents turned 40. I thought they were old. The gray hairs were coming in. Hairline started to recede. I think my dad went and got bifocals around that time. Hearing started to go bad. Nose and ear hair started to be an issue, as did 'regularity.' 

It doesn't seem as old now as it did then. Maybe because so many of my friends are already in their forties (clearly, I need new friends). Maybe because I'm the youngest in my family and I still find that I'm treated like the 'baby brother' by my mom and sister (don't try to deny it!). Of course, the obvious reason it doesn't feel old is because I'm forty. Hell, when I was 10 years old, I thought college kids were ancient! It's all relative, right?

I would think that I'd be wiser by this time. Sure, I'm not the world-traveler my sister is. She lives in Europe, spent last Christmas in Kazakhstan and this Christmas in Israel. I live in Tennessee. My idea of a big journey this year was a road trip to Florida. Yet, I've had experiences. I've been to college, traveled out of the country a few times. I've overcome my share of health problems. I've raised a daughter (fairly well). Shouldn't I have gained some wisdom from this? 

I wish I had something truly poignant and eloquent to share at the age of forty. 

"Wear sunscreen." (sorry, that's from somebody else's graduation speech)

"There's no greater gift than friendship." (just watched The Polar Express with my daughter)

"Everything is awesome!" (The Lego Movie; all my quotes are from cartoons now)

"Do not taunt Happy Fun Ball." (old SNL skit)

"Don't put liquid dish soap in the dishwasher." (somebody else did that--not me)

If I've learned one thing so far in life, it's that I'm pretty ignorant. I had the opportunity to spend a weekend with my grandparents before Christmas.

They've forgotten far more than I've learned in forty years. My grandfather turns 95 next month. Forget 40! That's a milestone. They've been married 72 years. Seventy-Two! Their marriage has been a member of AARP more than twenty years! How could I write a revelatory tidbit of wisdom that could compare to everything they've experienced over the last century?

The secret to their long, happy marriage is the wine

I'll admit I've had some regrets in the last 40 years. I regret not learning a language. There's still time for this, I suppose, but it would've been so much easier if I'd stuck with German in college after two years in high school. Instead I took Arabic. Do I remember anything from Arabic class? Nope. I can say 'yes,' 'no,' I can call a room to attention, and say that the class is ready for instruction (we had to do that every day; I'm sure that will come in handy...NEVER).

I also regret not really talking to my brother about how he felt while he was going through cancer and not really listening to my sister when I was younger.

It's hard to regret decisions I made about my health. Do I regret getting radiation treatment? I could be worse off now if the cancer was never completely eradicated without radiation. Grace told me yesterday that she wished I'd never gotten cancer. I said that cancer was one of the best things to happen to me because it set me on a path to adopt her. Without radiation I probably wouldn't have met Grace. I'd still be in the Air Force (assuming cancer hadn't come back), but I'd never have met all our great friends in various hospitals or in Tennessee. Similarly, if I'd never gotten that last jaw surgery, then I could still be able to swallow, but I might be worse off too.

Without my regrets, I probably wouldn't have started writing a blog. I've discovered that I really enjoy writing. I might not be very good at it--my punctuation is atrocious (I think I use dashes and parenthesis far too liberally). But, I like doing it. It's cathartic for me. Hopefully, over the next 40 years (or however long I'm sticking around this place), I'll be able to watch Grace grow up into a happy, confident, young woman and I'll get better at writing about it.

They just had to go out and get me a balloon.

The Birmingham Macaroni Grill

There are two reasons I've heard for restaurants not accepting my blender (thereby not allowing me to eat). The first reason is because of liability. If the restaurant were to break my Vitamix, then they'd be afraid I could sue them. I can see where they're coming from in today's overly litigious society. No matter how much I reassure them that the Vitamix has an excellent warranty and I'm not the type who goes around suing restaurants, or anyone for that matter, there's still that fear that I'm an asshole. So, let me just say right now, restaurants: Vitamix will replace my blender!!! Feel free to use and abuse it!!

The second reason is that the blender is 'unsanitary.' I heard this at the Chile's here in Knoxville. We took my sister-in-law, Sarah, out to dinner there for her birthday a few weeks ago.

Sarah with Grace and Sarah's adorable daughter, Harper (unfortunately, Sarah's husband was at work)

Harper loves her big cousin, Grace!

I ordered my meal and Betsy gave the waiter the run-down on how I eat and how to handle the Vitamix. The waiter came back a few minutes later and explained that the kitchen needs to be absolutely certain every dish they use is sanitary. They didn't know where my blender had been so they couldn't use it for my dinner. I was bummed out until the waiter told us that if they could run the Vitamix pitcher through their dishwasher before they put the food in, then it would be sanitary enough.

I was left thinking uh...why did you even feel the need to tell me that? I have no problem with any kitchen washing out my pitcher before they use it. Just blend the food up and bring it out. Use the blender as you see fit!

"I want my baby back baby back baby back"

So, maybe that was a case of too much information from the restaurant. At the same time, I appreciate it when the chefs and servers communicate with me to make sure my food comes out the right way. I'm asking restaurants to go a few steps beyond what they'd normally do for my meals. Not only will they need to prepare the food, they also need to blend it properly and bring it out in the pitcher. I'd rather have the server ask me a hundred inane questions about the way I eat than have a situation where there is poor--or a lack of--communication.

Compare my experience at Chile's with the dinner I had at a Macaroni Grill in Birmingham a couple weeks ago. 

This Macaroni Grill, to be precise

We were in Alabama, staying with Betsy's parents, for Christmas, like we do every year. 

"But Brian," you say, "why don't you visit your family for the holidays??" 

That's a good question, devoted-reader-of-my-blog (A.K.A.: 'Mom'); I'm glad you brought it up. In fact, we don't visit my mother and sister for the holidays because they live in Germany. According to some people in this house, Germany is "too far away," "too expensive to get to," and "too cold in December" (Blah Blah Blah). So, I have to spend my Christmas in Alabama, where it never snows and Santa's reindeer get heatstroke (no offense to anyone living in Alabama; at least you're better than Florida, am I right?? (no offense to anyone living in Florida)).

I can't say anything bad about these people because they're my in-laws and I see them All. The. Time.

Sorry, got sidetracked a bit there. So, we all went out to dinner and I took the Vitamix with me. I brought my blender into a Romano's Macaroni Grill in Hawaii this past summer and had no problems, so we didn't think there'd be any issues this time either. I ordered my meal (grilled salmon) and Betsy explained to the waiter how he just needed to put all the food in the blender, add about 12 ounces of water and blend on high for 90 seconds. He nodded, wrote everything down and left, like it was no big deal.

A while later, we still had my blender at the table and I was wondering when he was coming back to get it for my meal. Just then, everyone's meals were brought out to the table, except mine. Betsy asked the server if he needed my Vitamix, but he said they wouldn't take my blender. It was a sanitation issue, so they were mixing the meal at the bar with their own blender. I figured that was fine. It would have been nice if they'd let me know about it before, but I'm sure they use a powerful blender at the bar. Again: no big deal. 

Soon enough, they bring out my meal...in a large bowl. 

"No," Betsy patiently explains, "as I already said, could you please bring the meal in the pitcher so he can pour it?"

"Ok, no problem." They bring my meal back out in their pitcher and I'm given a look at their blender pitcher. Of course, I forgot to take pictures at these crucial moments so I'll do my best to describe it. The pitcher had seen better days. Half of the plastic base the pitcher stands on was broken off so it tilted at a wild angle; nearly toppling over. It was from a normal, store-bought blender, which might be fine for margaritas, but couldn't possibly liquify a serving of broccoli. I tried a few times to push some down my tube, but there were too many chunks. I should've just given up at this point, but they were only blending fish, not steaks. I thought a normal blender would be able to handle it. We called the waiter back, and told him to blend it longer. "Ok, no problem."

The broken pitcher comes back out, but I can still see the chunks in it. Nevertheless, I try pushing it in again--no luck. At this point, the bartender comes over and we explain to her that we need to use the Vitamix for my blend. She says, unfortunately, she can't use a strange blender behind the bar (but a 20 year-old broken blender is just fine) but she was willing to blend up my meal, using our Vitamix, in the small room the servers use to prepare drinks. Ok, that would be fine. We give her the Vitamix, telling her to run it on high for a minute to make sure everything is blended. Moments later, she brings the pitcher out, I try to bolus it yet again, and...no luck. There are still too many chunks. Finally, Betsy goes back in the room and blends up my meal. By the time I start eating, everyone else has finished.

I'm not angry because Macaroni Grill wouldn't take my blender in the kitchen. We've heard it before at other restaurants. My personal feeling is that those places simply aren't willing to go outside their comfort zone to feed a disabled customer, so they use sanitation as an excuse. 95% of the places we've been to have accepted our Vitamix. If they really wanted to make their customer happy, then they could have adapted to meet my needs. It could only be beneficial to them: I always leave a great tip and I give them a 'shout-out' on here. Just clean my pitcher if it's not sanitary enough. But that's not why I won't go back to that Macaroni Grill.

Unlike the Chile's here in Knoxville, they failed to communicate with us. The waiter didn't explain until after the fact that they would be using their own blender. He didn't listen, or try to clarify, how I wanted my food blended. He brought the meal out in a bowl after we told him to bring it in the pitcher. The restaurant wasn't crowded that night; it's not like our server had more pressing matters to attend. If he'd taken the time to really listen to how I eat, he could've understood that the food needed to be thin enough to fit through a narrow tube. I'm asking servers to take a couple extra steps so I can eat meals with my family. Just dump the food in a blender then bring it out to me. They don't even need to season it well; it's not like I'm going to taste it. Is it too much to ask them to keep their customers happy?

Put down that doughnut right now

Sugar is bad for you and we (I'm talking about Americans--I don't care about the rest of you people) have a sugar addiction. I'm not telling you anything you haven't already heard. The airwaves have been flooded with Washington Post articles, New York Times articles, L.A. Times, Fox News reports, CNN, MSNBC clips, no sugar diaries (or here's the shorter version), John Oliver clips, Jamie Oliver (no relation) TED Talks, other TED Talks, more TED talks, Lengthy University of California lectures, 60 Minutes segments, BBC News clips, American Journal of Clinical Nutrition studies, and other scientific studies about the dangers of sugar. That last link takes you to PubMed's website where a search for "sugar intake" articles published in the last ten years gives you over 13,000 results. I'm sure some of those are all about how sugar is the miracle drug that will cure cancer, but I'm equally sure the pro-sugar studies were done by scientists who benefited from the sugar industry (I'm talking about you, Dr. Pepper!!!). That reminds me, you really need to watch that John Oliver clip:

John Oliver #ShowUsYourPeanuts

So, sugar is bad and the government doesn't seem to be in a big rush to regulate it. It falls to us to rid ourselves of our sugar addiction. This can be extremely difficult, if not impossible, for some people though. And I'm not talking about those who are genetically predisposed to having a sweet tooth either. I'm talking about tubies. When I first got my feeding tube, my doctor prescribed a regimen of 6-7 Ensure Pluses a day. That's 132-154 grams (nearly a cup) of sugar every day. This is over 4 times the daily amount of sugar the American Heart Association recommends. Understandably, formulas can cause a sugar rush (glycemic spike) and resultant comedown after consumption.

Why do formula companies pack so much sugar into their products? I think there are a lot of different reasons for this. The main reasons, in my opinion, are taste, and because sugar packs a lot of calories and companies still operate under the belief that, "a calorie is a calorie." If a nutritionist mandates that patients consume 2,000 calories a day, and the food has to be liquid and not exceed a certain volume, the easiest (cheapest) way to pack in those calories is by adding corn syrup. Sure, Ensure has a lot of other nutrients ("26 Vitamins and Minerals!"), but from my standpoint, it's like they mixed a can of corn syrup with a Centrum Multi-Vitamin and slapped a label on it.

There are formulas out there for tubies with diabetes. Two of the main examples are Glucerna and Boost Glucose Control. These products have a higher percentage of fats with lower amounts of carbohydrates (only 4-6 grams of sugar in each, compared with 22 grams in Ensure Plus). The carbs have a lower glycemic index, so the sugar is converted more slowly before being released into the bloodstream. Plus, the diabetic formulas have more fiber to further slow the breakdown of carbs.

The drawbacks to diabetic formulas? For one thing, it's still added sugar. I have yet to find a commercial formula out there with no added sugar. This is because, if formula companies want to make any money off their product, they can't just market to tubies specifically, so they have to make a shake that tastes good. Therefore, if you're stuck on formula, but want to go on a sugar-free diet, you're out of luck. Another drawback to diabetic formulas is they're still not real food. Here's the list of ingredients for Boost Glucose Control:

DOES NOT CONTAIN: FOOD

So, specialized diabetic formulas have a higher percentage of fats with lower amounts of carbohydrates. The carbohydrates in diabetic formulas have a lower glycemic index so that the sugars are converted more slowly before they're released into the bloodstream. These formulas also contain more fiber, to slow the breakdown of carbohydrates even more. - See more at: http://oralcancerfoundation.org/nutrition/liquid-tube-nutrition.php#sthash.sWQaFVTq.dpuf

So, specialized diabetic formulas have a higher percentage of fats with lower amounts of carbohydrates. The carbohydrates in diabetic formulas have a lower glycemic index so that the sugars are converted more slowly before they're released into the bloodstream. These formulas also contain more fiber, to slow the breakdown of carbohydrates even more. - See more at: http://oralcancerfoundation.org/nutrition/liquid-tube-nutrition.php#sthash.sWQaFVTq.dpuf

Yep, whole lotta big words in there. Makes you appreciate commercially available blended meals like Real Food Blends even more. Hopefully, tubies are a large enough market that they can turn a profit!! Another drawback to diabetic formulas is that they're just that: diabetic formulas. If you don't have diabetes but would like to control your sugar intake, it can be harder to get insurance to cover the costs of all those cans of Glucerna you need every day.

If you're a tubie--or the caregiver of a tubie--and you're unable to switch from formula to blending your meals for medical reasons, then I am really sorry you have to stay on these commercial products with unrecognizable ingredients and too much sugar. I sincerely hope doctors, nutritionists, and pharmaceutical companies wake up to the fact that sugar is poison and fat isn't nearly as bad as everyone thought it was.

In light of all that we've read about the dangers of sugar, Betsy and I are working really hard to reduce, or even eliminate, sugar from our diet. In my case, going without sugar is simple. I'm completely off formula so the only sugar I get is what I put in my blends. Sometimes I have a gluten-free dessert or a dark chocolate bar, but it's not something I crave. I've already found foods, like nut butters or avocados, that are high in fat and give me the calories I need. If I want to stop added sugar altogether, the only thing I need to cut out is sunflower butter because my grocery store (Earth Fare) adds a teaspoon of sugar to it.

For Betsy and Grace, on the other hand, cutting out sugar--or even reducing it--is more challenging. Betsy and Grace don't eat gluten-free. Both of the main products with gluten--bread and pasta--have added sugar. All cereal at the grocery store has added sugar. Lunch meats have sugar.  Sugar is added to just about everything except unprocessed fresh vegetables and meat. Even more than Grace, Betsy can be a finicky eater. There are certain things she eats in the morning and all that stuff has added sugar. On one hand, she's fortunate she doesn't need to eat through a feeding tube, so she's not forced to drink multiple Ensures every day. I don't know how she'd do drinking one or more Ensures a day; probably better than I would. On the other hand, when I get a craving for a doughnut, there's nothing I can do about it. Putting a doughnut through my tube doesn't do anything for me. But Betsy can run to Dunkin Donuts anytime to satisfy her craving. We've made sugar so easy and cheap to buy that we might all need feeding tubes unless you can exercise a little bit of self-control.

So, put down that doughnut right now!!!

Not you, Homer. You can eat all the doughnuts you want.

Life's a Beach

I know I've mentioned that I spent part of my childhood in western Washington. The truth is that the majority of my youth (at least the bit I remember) was in eastern North Carolina--a booming metropolis called Plymouth. Can a town of about 4,500 people be considered a metropolis? There are several stoplights. I remember when we got our McDonalds!! When we drove through there last week, we stopped at a Wendys!! Beat that, Burlington, Wyoming, population 288!!!!

We decided to spend a few days on the North Carolina outer banks in mid-March, and Plymouth is right on the way to the beaches. So, we got to stop and look at my old house. The owners were probably thinking we were casing the place for a burglary. Do you ever get pissed off when you go back to an old house and the current owners have changed it beyond all recognition? My house wasn't quite that bad. The large magnolia tree I used to climb was still in the front yard. Yet, the pine trees we planted were gone, the apple trees were missing and the owners inexplicably built some sort of guest house on the property. They also had a stupid sign at the entrance to our long driveway proclaiming it to be "Lee's Lane," or something like that. Maybe 'Bob's' Lane? Doesn't matter. There shouldn't be a sign there! They need to change everything back to the way it was!! I was about to go pound on their front door and demand a tour of the property and an explanation for the way they crapped up my house, but Betsy convinced me that they were probably pulling out a shotgun as we sat in the driveway. Ah well; one more facet of my childhood shattered by reality.

I had a Real Food Blend en route to the beach

Our destination for this trip, Ocracoke island, was virtually unchanged from my last visit. The ferry boat we took to the island looked old enough to be the same one I rode as a kid. Running around that boat, smelling the salt in the air, listening to the cries of seagulls while watching them effortlessly glide overhead. That used to be one of my favorite parts of the whole trip. It was still pretty cool, especially since I took the opportunity to try out Real Food Blend's new powder blend. I talk about that in another post.

Shortly before Betsy pushed me overboard

The small town on Ocracoke Island still has the same isolated, fishing village vibe that it had when I was a boy. The town surrounds a sheltered bay on the sound side of the island. Many of the names of the touristy shops and restaurants have changed since my last visit (fall of 2003, before a hurricane swept over the island and destroyed my grandparents home up the coast in Edenton, NC), but the town essentially remains the same. My favorite lighthouse is still there:

In operation since 1823

It is a rather short and squat lighthouse compared to the more famous Cape Hatteras lighthouse up the coast, but I still prefer this one. It feels more thick and solid to me and the pure white color looks lovely rising over the gnarled trees and town below.

Wish I could say I took this, but I pulled it off the web

Practically every store and restaurant on the island has the name "Edward" or "Teach" somewhere in it. Ok, not everything, but you see the name a lot. Even the Mexican food truck is called Eduardo's. This is because Edward Teach was the real name of Blackbeard the pirate and one of his favorite places to hang out was Ocracoke island. It's also the place where he met his untimely end during a ferocious battle in 1718.

He liked to light his beard on fire during battle because why not?

So Blackbeard and I have something in common (we both like Ocracoke; other than that I'd say we're complete opposites). I'd imagine he liked to visit the island at the same time we went--late Spring, early summer before the heat, bugs, and tourists become unbearable (FYI, the tourists during the eighteenth century were a menace). The restaurants were all just opening up and getting ready for the season the week we went. The first restaurant we visited was one of the fancier places on the island, Dajio's.

Dajio's is a nice restaurant with prices a bit more expensive than other places in town. I left my blender back at the house we rented, so I passed the time waiting for Betsy and Grace by drinking alcohol.

Some wine at Dajio's

I got some clam chowder to bring back home because I love clam chowder. They gave me a good size portion and it blended up perfectly that night.

The next day was beach day! Couldn't have asked for better weather. We brought our dog for the week. This was Aspen's first time seeing the ocean. He seemed pretty underwhelmed by the experience, but I guess he doesn't get excited for much. Compare this to our dog, Lilly, who we used to take to the beach when we lived in California. She would go crazy, running up and down the bluffs and attacking every wave that dared crash on the shore.

You'll notice in the picture below that Aspen doesn't have a leash. We figured it's a small island; there's no place he could go where we wouldn't eventually find him, right? This proved to be the case, though we lost him twice and it gave us a scare both times. The first time, I was walking down the beach looking in vain for sand dollars. The dog was slowly following me one minute and the next time I look back, he's gone. We start frantically looking everywhere. Did he find a shady spot by the dunes? Did he wander back among the dunes toward the highway? How do you loose an enormous white dog?? Turns out, Aspen once again proved he was smarter than us. I guess he got bored with the beach because we found him laying down by the car waiting to leave.

The second time we lost the dog was while we were out eating. We left Aspen in the house's screened-in-porch with a big bowl of water and dish of food, forgetting to latch the door that led outside. When we got back home, the door was open and no dog in sight. Betsy takes off down the street and asks everyone she meets if they've seen him. He has a collar with our cell number on it, but our phones have no service on the island so we're imaging people trying to reach us to say he's been hit by a car or terrorizing the neighborhood. Eventually, Betsy hears the distant sound of screaming kids at play, walks down to the island's only school and finds Aspen sitting serenely under a shady tree with kids all around him. All we had to remember is that our dog loves children and we would've found him right away.

Turns out they are really serious about keeping your dogs on a leash there and I guess the fine is pretty steep. We got away with it because we were there before the summer season kicked in. Of course now some Ocracoke official is reading this blog and has decided to mail me a ticket because I'm an idiot and just admitted to breaking the law online. If that's the case, please contact Katie Phillips ("Hey Brian, watcha doin") in Lawrenceville, GA, and she'll handle our debt.

One of the sand dunes is actually a large dog

My entire mission this trip was to find a perfect sand dollar on the beach. Grace and I walked up and down that beautiful, empty stretch of sand, but were unable to get more than pieces of sand dollars. The next day, we tried a different section of the island and I finally found a small, sad looking sand dollar. It looked pretty ragged, but it was in one piece so we set it aside and swore to keep looking for a better specimen.

I decided there must be an army of beachcombers who stalked the shores at sunrise and took all the prize sand dollars and conch shells before the rest of us got up. I convinced Grace to get up with me in the dark the next day so we could get a jump on all the professional shell collectors. For some reason, Betsy opted to stay in bed.

So, here's the best thing that happened on that early morning venture:

Beautiful sunrise, but no beachcombers or shells in sight

Otherwise, no luck on Operation Sand Dollar. It will have to wait for another Ocracoke trip. Another thing Betsy and I wanted to do on this trip is renew our wedding vows. We renew them every year on our anniversary. It's in February, but we decided to wait until March this year because we wanted to get married on the beach.

Aspen sure does lie around a lot doesn't he?

Grace once again officiated the ceremony and did a fantastic job.

You're probably impressed she can fit in that dress, but it's completely unzipped in the back

Another place that was open before the busy tourist season was the Ocracoke Bar and Grill. They had great ambiance, with seating outside on their deck and a surfing competition on the TV. They also had tasty cocktails, apparently. Betsy wouldn't be able to put up with me without cocktails.

"There isn't enough alcohol in the world."

They kindly let me set up my Vitamix in the dining area, so I mixed up one of their Barbeque Burgers while Betsy inebriated herself.

The barbecue burger was excellent

It was a great place to eat. The staff was extremely friendly and the food looked and smelled delicious.

Nothing beats having a burger in my stomach

We also ate at another great restaurant called Gaffer's Sports Pub. Again, we encountered fantastic waitstaff who were completely understanding of my need to blend my meal. One of the problems with waiting several weeks to write a blog post is that I sometimes forget exactly what I eat, unless I take the time to write it down. So, I have to confess that I can't remember what I had at Gaffer's, but I think it was their stuffed flounder with a side of asparagus.

Whatever it was, it was delicious

Betsy really wanted to try horseback riding on the beach so we went for a fairly short, hour long ride. The weather was beautiful and I enjoyed it, though I must admit that having someone walking beside the horse leading it the whole time was kinda lame (they did that for me because they were afraid I'd fall). After our ride, we met one of the owners of a local Bed & Breakfast, Pam's Pelican. He mentioned that he was a crop-duster pilot and he often flew his plane from the airfield up the road. He said he'd give us a FREE ride the next morning if we were up for it!!! I suspected he was just being nice because he'd already had several beers and he drawled, "I love you guys, man!!" before we left them. Maybe it was just the alcohol talking? We drove down to his B&B the next morning to see if he remembered us and he was all set to go! I brought him a case of beer--a currency that likely hasn't changed since the days of Blackbeard--and he promised not to drink until we landed. We drove he and his dog, Molly, down to the airstrip, hardly believing our good fortune. 

Too bad Aspen couldn't fit in there. He'd probably just lay down and sleep though.

Molly dutifully climbed into the cockpit of his prop plane, then the rest of us piled in, and we were up in the air in no time. It was INCREDIBLE!! Unlimited visibility. We circled the town and cruised down the coast, soaring along an unpopulated island to the south.

Taken shortly before Betsy pushed me out

The coolest part was, he let me do most of the flying!!

Finally got to practice the Immelman maneuver I learned at the Academy

Grace was pretty freaked out that daddy was flying the plane, but it was too noisy in there to hear her screams for help so who cares?

Molly photobomb

My one regret is that I didn't tubefeed during the flight. Sure I've eaten meals on airplanes, but is there anyone who's tubefed while they were flying the plane?? A real missed opportunity. If there are any pilots in the Knoxville area who want to let me fly their expensive plane while tubefeeding, please contact me. I promise to not spill too much of my blend in the cockpit.

We also had dinner at a place called Jason's Restaurant. One of the foods I miss from when I could eat by mouth is crab cakes. They combine two of my favorite foods: crab and cake. Every time I'm anywhere close to the ocean, I take the opportunity to order crab cakes at least once. I got my chance at Jason's Restaurant.

Mmmmmmm...crab cakes...

I guess it's a popular place because even though it was before the tourist season, Jason's was really crowded. Even though they were extremely busy, the staff at Jason's were awesome. Jason, himself, came out to visit and make sure they'd gotten my order right. I took the opportunity to get a fan photo with him:

They also serve some good sushi...hence the t-shirt

We tried taking a much longer ferry ride on the way home. Our ferry to the island, from Hatteras to Ocracoke, was about an hour. The ferry to the mainland--across the Pamlico Sound to the town of Swan Quarter--is two and a half hours. The boat is much bigger, with a larger dining area. Unfortunately, it was cold and overcast with a strong breeze so it wasn't a great time for standing outside looking at the scenery. 

We passed through Plymouth on the way home and stopped at the Wendy's outside town for lunch. I had a blended meal I'd prepared the night before by blending a Real Food Blend with an avocado.

The horrible stench of the papermill in Plymouth really brought back fond memories

For dinner on the drive home, we stopped at an Outback steakhouse in Greensboro, NC. The manager, Mike, was so amazing; that guy definitely deserves a raise!! He was very understanding of my feeding tube, made doubly sure his waitstaff and chefs understood how I wanted my meal blended, PLUS he gave us a bunch of money off our bill. I guess he felt bad for me because of the way I eat, and I am not above playing the sympathy card if somebody offers to buy my dinner. I have no shame.

Thanks for being so supportive of my tubefeeding, Mike!!!

I had tilapia stuffed with crab. I think I satisfied my crab cravings on this trip, but I can already feel them start to come back. I might be as crazy about crab as Betsy is....nah, nobody's that crazy.

Only 5 more hours of driving left! Yippee!

I'm a guinea pig

I have two exciting things to share about Real Food Blends!! I swear they don't pay me to talk about them; I just really like their product. However, they DO let me try out some of their new meals before they start selling them to the general public. Or another way of looking at it is, they experiment on me to see if their latest inventions cause my stomach to explode, or perhaps cause a mutant alien life form to incubate in my belly (this only happened that one time).

Their latest concoction was a powdered breakfast blend, so I took the opportunity to have it on a ferry on the way to the North Carolina Outer Banks.

And now I've tube-fed on a boat. My life is complete

They've made a breakfast blend with egg, sweet potato, avocado, and apple, only this time the meal is in powdered form. I loved this meal for a lot of reasons. For one thing, it's 540 calories per blend, which is much more of an adult-size portion for me. Also, I can see it coming in very handy while traveling, particularly on flights or when I'm hiking. Plus, they are less expensive than RFB's three other meals. And what's not to love about the ingredients?? Avocados, sweet potatoes, eggs, and apples are all foods I put in my blends constantly.

Once again, no crazy ingredients; exactly what the title says

Preparing the blend was easy. We added the powder to a blender bottle with 16 ounces of water, shook vigorously for a while, and it was ready to go. In hindsight, I think I'll bring along one of the metal oscillators that came with the blender bottles because there were still a couple clumps that were harder to push through my tube. Otherwise it went in really smoothly and filled me up that morning. I can't wait until these meals are back in stock so I can buy them by the case (*hint* Christmas/birthday gift idea *hint*)!!

Just a man and his blender bottle

The second piece of Real Food Blend news concerns my insurance. I hesitate to come out and say this because my insurance might change their minds at the last minute, but it's looking "More Probable Than Not" (#deflategate reference) that my insurance will pay for me to get Real Food Blends!!!!!! I've been calling and calling, but haven't had any luck with the DMEs (Durable Medical Equipment--the companies that provide medical supplies, including equipment for tube feeders) in the Knoxville area. Knoxville is a "Competitive Bidding Area," according to Medicare, which I would think opens us up to an unlimited number of DMEs to provide our enteral feeding equipment. Instead, this means that there is a relatively short list of 13 DMEs for me to choose from. The list does not include the DME that everyone else in Tennessee can use to get their Real Food Blends (Reeves-Sain Infusion).

Since I started trying to get my insurance to pay for Real Food Blends last year, the DMEs have all refused to recognize RFB as an approved enteral formula. They only approve the crappy formula that makes me nauseous, like Ensure, TwoCal, and Jevity. For the third time in the past year, I called Adult Pediatric Specialists to ask if they would give me Real Food Blends. Adult Pediatric Specialists is the company that one of my approved DMEs, Lincare, uses for feeding tube supplies. I know this is confusing, but this is the simplified version. Long story short - Adult Pediatric Specialists said they can supply Real Food Blends through Medicare!!!!!

They've talked to my doctor and gotten all my information. It looks like I should start getting the meals by the end of the month, but I won't really start celebrating until I get that first package in the mail. I can still foresee getting a phone call from some DME bureaucrat saying, "Sorry Mr. Liebenow, but it turns out anyone with more than 7 letters in their last name isn't covered for enteral nutrition. Please change your name to 'Doofus' immediately." As soon as I get my very first, insurance-provided, RFB, I'll post a picture on here.