Food and Drug Interactions

A few days ago, I did a post on making soup for a neighbor who had just had surgery. If you are thinking about doing this too, good for you! However, before you begin shopping and cooking, you need to know that there are some drug and food combinations that do not go well together. So it is a good idea to find out if the recipients of your goodwill are coming home with diet restrictions because of the medications they have to take.

Here's an example. It is common for people to be on some type of blood thinning medication after surgery. These drugs prevent the formation of blood clots in the vascular system, thus reducing the likelihood of certain complications. When I had my hip resurfaced, my surgeon prescribed Lovenox for this purpose. The up side was that I could eat whatever I wanted; the down side was that I had to give myself a shot every day for a while.

However, most people on anti-coagulant therapy are given a different drug, one called warfarin (brand name, Coumadin). It has the advantage that it can be taken orally. The down side is that it can be more or less effective, depending on the amount of certain foods in the diet, so extra care must be taken.

I knew that my neighbor was on this drug, and I had a handout listing the dietary precautions. So when I made my choices, I avoided soup recipes that called for leafy greens or foods from the Brassica family (cabbage, broccoli, Brussels sprouts, cauliflower). The dietary guidelines for this drug are more involved than just these choices, so if you are preparing food for someone on this medication, be sure to ask for a complete list of the specifics.

When you check about drug/food issues, also ask if your friend or neighbor has food allergies. Then you've covered all the bases. Don't let any of these considerations discourage you. There are lots of good ingredients to work with, regardless. Combine them with good information, and you're well prepared to create something healthy and healing in your kitchen.

My Left Hip

I used to have a website called, "My Left Hip," that told the story of my disability and surgery. I took it down last fall because I didn't want to identify with disability anymore. As I told a friend of mine recently, it feels like all of that happened to someone else, long ago.

Still, there is value in sharing some information about my experience with others who are facing the possibility of hip surgery. This post is for them:

I had a lifetime of difficulty with my left hip and leg, often accompanied by low back pain. Seemingly out of the blue, I would have muscle spasms in my back, shooting pains down my leg, a catch in my hip, and at times my leg would go out from under me when I took a step. 

I started experiencing acute episodes like this when I was 20, which were followed by stretches of time when I felt fine. When I felt good, I thought maybe I was over it, whatever "it" was, but my condition gradually worsened. By the time I was in my 40s, I remember getting up almost every morning, walking across the floor with some amount of stiffness and discomfort and thinking to myself, "Someday I'm going to have to find out what is wrong with me." But in a short time, the pain subsided, I forgot about it and went on about my day.

There came a time, however, when the pain did not go away. In the spring of 2001, I had one of my familiar episodes. I tried all the tricks I had learned over the years to "fix" it, but nothing brought me relief. It took several years, with ever increasing disability, but I did finally find out what was wrong with me. And shortly after I had given up on cures, and made up my mind to have the best life I could in spite of my condition, I learned about a surgical option that could change my life.

In November of 2008, at the age of 59, I had hip resurfacing surgery to repair my left hip joint. Today I am walking normally, without a cane. It is a miracle.

Because I did not have a total hip replacement, people often ask me questions about my surgery. For me, resurfacing was a good alternative. It offers many advantages, particularly for younger patients. It isn't for everyone, however. People with osteoporosis, for example, might not be good candidates.

That said, keep in mind that the total hip replacement is a procedure that most orthopedic surgeons feel very comfortable with. They have performed these surgeries many times and the success rate is good. The resurfacing surgery is more difficult to perform and not many surgeons are trained for it. When you ask about options, be sure to get an opinion from a surgeon who has experience with both procedures. Surgeons who lack experience with resurfacing may be inclined to steer you away from it in favor of what they prefer.

Here you see a normal, healthy hip joint. It happens to be mine - on the right side.

And here you see my left hip before surgery. You can see that the head of the femur is deformed and slightly dislocated.

Here is my left hip after having a procedure called Birmingham hip resurfacing (BHR). This technique, developed in Birmingham, England, has been used successfully in various parts of the world since 1997, but was not approved for use in the US until the summer of 2006. The video clips below explain how this procedure differs from total hip replacement.

One of the reasons I chose this procedure is because I didn't want the top of my leg bone cut off, which is what happens with a total hip procedure. Resurfacing is less invasive than a total hip replacement, recovery time is shorter, and it doesn't involve permanent restrictions on activity.

This last item was particularly important to me because my favorite exercise is taking long walks. When I found out that fitness walking is discouraged after a total hip replacement, I knew I wanted to find another procedure. Every time I put on my walking shoes and head out the door, I'm glad I took the time to find the right surgery for me.

I highly recommend my surgeon, Dr. James Pritchett, in Seattle. He has many years of experience with various types of joint resurfacing procedures and he did a splendid job for me. My surgery was performed at Swedish Orthopedic Institute, which is about as nice as a place can be and still be a hospital. Every patient has a private room. The staff is wonderful. The food is great and you  order it like room service. If you have to have a surgery, this is the place to have it!

For more patient-to-patient information, I suggest that you visit Pat Walters' comprehensive site, Surface Hippy.

Finally, there are many products available that can make your life easier. If you need a cane, get one and use it. Don't let vanity get in the way of taking care of yourself. There are other products, many that you may never have heard of or seen, that help, too. For a long time, for example, I depended on elastic shoelaces to get my walking shoes on. A sock aid made it possible to get socks on my feet when I couldn't reach my left foot.

Here's a fun little video that shows you how to use a sock aid.



For more ideas, see the article "Gardening with Disabilities," on my Seattle Garden Ideas blog. 
Whatever your situation or challenge, I wish you all the best in your journey back to health. Miracles can happen!

When I'm 64

"Doing the garden, digging the weeds,
Who could ask for more?
Will you still need me, will you still feed me,
When I'm sixty-four."
- The Beatles

When I first heard that song back in 1967, I had no idea how I would feel when I reached my 60s. In fact, I wasn't sure I would live that long. Don't ask me why. Mostly, I just couldn't imagine being that old.

Well, now I am in my 60s and I can tell you that is isn't all that bad. I have a driver's license and credit cards and I come and go as I please. I treasure my independence and if there's anything I can't imagine now, it is being anything other than that - happy, healthy and independent.

Perhaps my optimism about aging is fueled by the success of my hip resurfacing surgery 18 months ago. Prior to that, I was so crippled that I could not walk without a cane. The cane was my constant companion for over three years. It is just as well that I didn't realize how debilitated I really was before the surgery, because regaining my strength, balance and aerobic capacity has taken a long time. It is still, in fact, a work in progress.

But the key word here is "progress." I continue to get better. I laugh and tell people that I am aging in reverse, because that is how I feel. I am so much more mobile now than I was one, two, three, even six years ago. I have some occasional discomfort, but I no longer live in constant pain.

Another reason I have confidence about the future is because I was able to navigate those years of pain and uncertainty independently. Of course, I have a good network of friends and health care providers. But I lived alone throughout those years of severe disability. If I had to do it again, I know I could. I have no fear about the future.

This is a blessing, really. Some of my cohorts talk about being worried about what will happen to them when they get old. Some are convinced that they will develop any and all diseases that "run" in their families. Many are concerned about who will take care of them. This seems especially true of people who never had children. Even if they are married, they worry that without kids to look after them, they will have to suffer alone.

Which is a funny idea to me. What is this talk of having children to take care of us in our old age about? I realize that's what people not only expected, but needed, generations ago. Before nursing homes, assisted living facilities, and retirement communities, there weren't many options for older people.

But we live in a completely different era. We have many choices available to us. We don't have to live our parents' or grandparents' lives. We get to live our own, complete with innovative housing arrangements and health care options. We don't have to burden our children (I have three sons but neither asked for nor expected them to take care of me - the closest lives 2,000 miles away). Like every other phase of life we Baby Boomers have lived, we will transform what it is to be "old." And I, for one, am excited about the possibilities - at 64 and beyond.