Parenting the Parents – Part XI. The Cataract Chronicles.

If you have aging people in your life, at least one has probably had cataract surgery. I think I might even know a few people who’ve had this often life-altering procedure who don’t fall into the “aging” category. In either case, you may have heard about the procedure, and the preparation and follow up care that is required. For people without cognitive impairment (or unsteady hands, or eye/ eyedrop phobias), I’m certain the whole thing barely rises above a minor inconvenience, especially considering the abundant payoff.

With mom’s particular brand of dementia, no appointment or procedure can be taken lightly. Leading up to even routine doctors’ appointments, she scrutinizes the weather forecast for a week in advance; lays out her clothes the night before; and asks me at least twice in the two days ahead of time what time we’re going to leave. When you’re talking surgery, especially not long after having had an unscheduled pacemaker implantation, the unknowns gather themselves into a category 5 hurricane of anxiety. The eyedrops; the preparation for the surgery and the surgery itself; the immediate post-surgical follow up; the eyedrops; the ongoing follow up appointments; the eyedrops. . . none of it can really just happen “in the flow.”

The surgeries were going to take place a month apart: left eye at the end of February; right eye at the end of March. They would be performed at an eye surgery center about 15 miles away, where our ophthalmology group, and apparently several others, perform various procedures all day, every week day. (At the second visit, my curiosity piqued by the volume of patients who moved through the waiting room in the time between our arrival and post-operative departure, I asked how many surgeries they perform in a typical day there. I was astounded to learn that it was between 40 and 60).

Before the first surgery we needed a pre-operative physical, which had to be completed within a week of the first surgical date. Mom kept getting confused about the timing of that appointment and worrying that we hadn’t scheduled it at the right time. Once it was clear the timing was OK, the worry shifted to whether there would be something wrong that would prevent her from having the surgery, or if her pacemaker would present an obstacle. Could they do cataract surgery so soon after she’d had a pacemaker? (It would be 7 weeks post-pacemaker by the time her first eye was on the docket). I assured her that doctors perform cataract surgery on people with pacemakers all the time. I’m not entirely sure her anxiety allowed her the luxury of believing me.

So yes, complicating this was also the fact that we were still in the wake of post-pacemaker implant follow up appointments, and while I was keeping it all organized, it was thoroughly overwhelming her. It didn’t help that the hospital’s cardiology group, not realizing mom now had her own cardiologist, had scheduled a series of follow ups before mom was even discharged from the hospital that were then also scheduled separately by her cardiologist. It took me a couple of rounds of appointment change and reminder calls from the hospital’s group to figure out that these were duplicate activities and that I could cancel the ones with the hospital’s group, but with the calls coming in to my parents’ phone rather than mine, poor mom was completely confused. I think I’ve now informed all her doctors that appointment reminder calls should come to me. If you are in the world of caregiving for someone with dementia and haven’t yet managed to get yourself on the HIPAA privacy releases at their doctors’ offices and those reminder calls switched over to you, my advice is to try to get that in place sooner than later. It’s a sanity-saver. For everyone.

A week prior to the first surgery, mom was supposed to stop taking one of her over-the-counter supplements because of a potential complication that could arise with it. The surgical center had apparently informed her of this when they called her to tell her what time to plan to arrive on the day of the surgery, but somehow that directive escaped her. I discovered it when I saw that she’d written some notes down about an arrival time and the address of the center on a random slip of paper, so called them myself to confirm what she’d written. They mentioned the over-the-counter medication to me. It was now 5 days pre-op, and I asked if that would pose a problem. They said it wouldn’t.

She was supposed to fast from midnight the night before each procedure. She had written it in her calendar, and I reminded her when I left after administering her last round of eyedrops the previous evening. For good measure, though, I arrived early enough on the day of each surgery to intervene as she woke up, just in case.

As for those confounded eyedrops, most unimpaired people likely don’t give them a second thought. If we lived under the same roof, I might not have either, but I don’t. Even though I’m only 3 minutes away,  the “Eyedrop Episodes” were folded into the overall outline of my days. For each eye, we began a regimen 3 days in advance of the surgery: 3 different drops, at least 5 minutes apart, 3 times a day. Each morning I’d motor down the hill, typically sometime between 9 – 10 a.m., to administer the first dose. Then, between 1:00 and 2:00 came the second dose, with the third usually falling between 5:30 and 7:00. We were supposed to administer at least the morning drops the day of the surgery; because the first surgery wasn’t scheduled until mid-afternoon, I did two rounds. I figured more would follow after the surgery.

The pre-op instructions from the doctor suggested that the patient have someone stay with them the night of the surgery in case of any complications, so that morning I packed my things. I included my muck boots, because light snow was forecasted for that afternoon and overnight, another factor stressing mom out, and, if I’m being totally honest, me too – even light snow falling at the wrong time of the day could sometimes spell a 2 hour odyssey for what should normally take 35 minutes or less, and we’d be getting out of there right in the thick of rush hour. I didn’t really relish the thought of being stuck in traffic in the snow on the way home from surgery, so with an abundance of caution, I left all my overnight stuff in the back of my car. Worst case we’d stop at a hotel. Gratefully, the weather gods smiled and the snow had no impact.

The next morning she was supposed to remove her eye patch & dressings, and I was to give her another set of eyedrops before we went to the doctor for the post-op follow up visit. She wasn’t allowed to bend over (i.e. let her head drop below the level of her waist) for at least a week, which might alter some aspects of how she helped my dad when their caregiver Hannah wasn’t around (helping him with his socks and shoes, or the assists I knew she sometimes provided when he was changing a Depends). All of this made the next morning somewhat eventful for me as I tended to both of them before Hannah arrived. We saw the doctor and all appeared well; he instructed us to continue with the 3 drops a day regimen until the next appointment, a week away. On the way home I asked mom if she wanted to go out for breakfast – an unexpected treat.

Back at home that day with Hannah, the two of them came up with some revisions in how she helped dad with his footwear (and Depends) so they could manage safely on their own: mom would sit on the fold-down seat of dad’s walker and he’d lift a foot (or both feet, one at a time, in the case of a Depends) high enough for her to grab it and guide it to the edge of the seat where, from her sitting position, she could help him with socks, slippers and shoes. With the Depends, as long as she could help him get them to knee level, he could deal with the rest on his own.

At the follow up appointment a week later, I expected to be done with the drops until the next surgery, but alas, that was not in the cards. The nurse said it casually, at the very end of the appointment, after the doctor had left the room: “So you’re going to continue the drops,” thinking she was confirming something the doctor had said, but he hadn’t. The exasperation lurched out of me before I had the wherewithal to stop it: “Really?? All of them?!? 3 times a day?!?” I felt the same burning frustration I did when I used to do the Jane Fonda workout back in the late 80s and she’d pretend the excruciating set of donkey kicks was ending as my glutes were bursting into flames: “5 more! 4! 3! 2! 1! Annnd another 5!” One of the drops was eliminated, and the frequency dropped to 2 times per day, but the Eyedrop Episodes were to be a part of my life for at least another 4+ weeks – after the second surgery.

The twice-a-day routine settled itself into my life. Once or twice I had James, my 22-year-old, pinch hit. This worked once and failed once, when we’d pre-planned that he’d head over between 6 and 7 p.m. because I would be out at a dinner engagement. I arrived home at 8:30 to discover that he had completely forgotten (calendar reminders, anyone??). I yelled at him for lapsing in the one responsibility I’d asked of him that day and Tim threatened that he’d better get down there and do it. Because I hadn’t even left the threshold yet, as he emerged from his room to head down the stairs, I snarled passive-aggressively that I’d just do it myself. This was getting to me, but this was my reality, so I vowed on my drive down the hill to just suck it up and deal with it. With a smile. I needed to remind myself of the advice I gave out all the time: the secret is all in the attitude. The more I fought it, the crankier it made me. Yes, there was still another eye to go. So be it.


Border Patrol

A few weeks ago in the post I dubbed “The Call of the Wild,” I mentioned the black border I had planned around the perimeter of the bathroom floor. At that time, and in the weeks leading up to it, it would be fair to characterize Tim’s enthusiasm level for my vision as maybe a “2” on a 10-point scale: “tap cold,” though admittedly not quite a “fresh-out-of-the-fridge-dispenser-1,” or, a “solid-ice-0.”

In the intervening time, he’s finished up the rather extensive job of tiling the walls: 3 of them, including the longest one in the room, are tiled almost floor-to-ceiling with 4 x 8” Carrara marble. “Almost,” because anchoring the entire perimeter of the walls, in the first row along the floor, are larger 6 x 12” Carrara tiles, topped by half-round “pencil” molding, to form a baseboard. He also did a lovely job on a soap and shampoo niche in the shower, finished with the same pencil molding, which has a shelf. It’s set so the lower portion is accessible to someone who might be showering while seated, and the upper portion will be the right height for someone standing.

I’m trying to make this bathroom all about accessibility (though my grab bars still haven’t arrived). The concept of accessibility was the first of several battles we fought over the plan for this room, but a few key skirmishes cascaded from my audacious accessibility plan: widening the doorway; having a roll-in shower (which came along with its own set of special challenges); making the shower head a height-adjustable, removable, hand-held on a vertical bar.

As Tim rolled into the homestretch on the wall tiling, though, he abruptly changed his tune about my crazy notion of the black marble tiles around the border of the floor. He was actually excited about it, and, while I was slightly mystified, that didn’t stop me from pointing out that a few weeks earlier, he’d thought this was the stupidest idea ever. Suddenly now, he thought this was going to look really cool. (Um, yeah . . . that’s why I wanted to do it?) Go figure.

All good, because we were more or less roped into it at this point anyway, with him having laid down the rest of the “field” tile for the floor weeks earlier, leaving an empty space around the perimeter which would now be impossible to handle in any way other than, well, installing a border. I guess we could have used the 6 x 12” Carrara tiles as the border pieces, but I also had 2 boxes of that black marble, called “Nero Marquina,” sitting here waiting, and they were special-order, so there was no returning them. (I didn’t tell him that part).

So, last Tuesday, he began cutting the border tiles, which were also 6 x 12,” to dry-fit them into place. The border isn’t fully 6,” so there was a lot of cutting to do, and, as I’d done with the ribbon board around our front porch several years ago, I insisted on mitered corners – a small detail (and another thing we initially argued over), but one that would matter in the end, even though there would be 8 of them to deal with in this room (2 extra because of the shower, and 2 more extra due to a little jog on the left side of the doorway).

The field tile on the rest of the floor has a black and white basket weave pattern – the same floor tile we used in our master bathroom. I had decided on black grout this time, both because it wouldn’t discolor under traffic, and because it would make the basket weave pattern pop. Tim’s experience told him that he wanted to cut the perimeter edges of those tiles in such a way that only white tiles were at the edges, making for a clean line around the entire border. That was fine, but it meant that the size of the border would vary slightly around the room – there was no way to lay the field tile in such a way that the border would be exactly even around the entire room (unless we’d built the room to fit around the tile, which was not only silly, but impossible). With that, every border tile had to be cut to size for its own individual spot. Tim labeled them as he cut and confirmed their fit. Every complementary angle at the miters was also unique, and I don’t think a single one of them was the typical 45-degrees you’d expect at a mitered corner.

With all the cutting and fitting complete, we had one more hurdle to jump: the Nero Marquina tile was *slightly* thicker than the basket weave field tile, so we had to figure that out. Having a little edge sticking up around the entire perimeter, *especially* at the doorway, would be a problem – an open invitation for chipping. At first Tim thought he’d be able to pitch the thinset inward, making it slightly thicker/deeper at the walls, and angling the border tiles down to where they met the basket weave tiles. The theory proved better than the reality though, so that idea was abandoned after 2 or 3 tiles. The only option remaining wasn’t pleasant: grinding the tiles down to the right thickness. Hours of work ensued, but finally, every tile fit the way it needed to, and, just yesterday, in they went.

Tim spent today working on the sheetrock, smoothing the walls and ceiling, cutting and installing the window trim, and touching up the grout on the walls. Now that he has his sheetrocking stuff out, he’s going to hang the little bit of it that’s been missing around the doorway from the hall into the dining room. Neither one of us knows *how* long that’s been showing its skeleton of studs and header, but we’ve gotten so used to it that it will probably look really weird when it’s finished.  I’m so accustomed to that hallway being partially torn up, in fact, that I was shocked today when Tim asked me what color I wanted to paint those walls. I had completely forgotten about those. Back down to mom’s to (re)borrow my Benjamin Moore paint fan.

The floors will need to be cleaned (of course) and sealed (maybe not-so-obvious) before grouting, to prevent the black grout from staining the Carrara in the basket weave tile. That might happen tomorrow. Then the walls will get their paint. Maybe, just maybe, by Hump Day next week, we’ll actually be installing fixtures.

Parenting the Parents – Part X. How do you Solve a Problem Like Dementia?

If you’re of a certain age, perhaps the title of this week’s blog puts a certain song from “The Sound of Music” in your head. Sorry if that now becomes your earworm du-jour.

Going back a few weeks, I shared how mom’s post-surgical home-care occupational therapist performed a cognitive screen with her and her scores indicated fairly significant dementia. I wasn’t there when the O.T. (I’ll call her Nina) did the screen, but knowing how my mom had been struggling emotionally with all the challenges aging suddenly seemed to be throwing her way, I worried that she’d internalize this, adding it to her growing list of worries, fears, and perceived shortcomings. (Among them: her need for a pacemaker; a recent visit to the eye doctor that resulted in her being scheduled for upcoming cataract surgery on each eye, along with 3 separate follow-up appointments for each surgery; her ongoing bouts of word-loss – being able to picture something but not give it voice). No amount of reassurance or logic seemed to change the self-critical frame into which she painted these facts.

I asked Nina how mom had reacted. She told me she (mom) knew she “hadn’t done well,” but Nina reassured her that there was no “well or not-well,” and that it had nothing to do with her intelligence. I knew my mom. I knew she’d hear the words; but I also knew they’d likely bounce uselessly off her looming sense of diminishment. I pressed, “how did she feel about *that?*”

“Well, she wasn’t too happy, but I talked to her about it and by the time I left she seemed better.”

Nina suggested that I get mom in to see the geriatric psychiatrist my dad had been seeing (“Dr. M”). I promised I would, and wondered out loud how on earth I was going to bring this up with her. Nina reassured me that I shouldn’t feel like I had to do that right away, and that when I did, I didn’t have to make a big deal about it. The reality was that it was important that we get it checked out because we might be able to do something to improve it. My dad did seem to be doing fairly well on the medication he’d been taking, but mom’s “presentation” was so different that I was skeptical the same thing could work for her.

I called Dr. M’s office to see if I could schedule an appointment around the same time my dad was slated to go back for another follow up in late March (it was early February). Though the practice wasn’t taking new patients, they were accommodating considering that dad was already a patient, and even maneuvered things to schedule mom’s appointment in the time slot immediately prior to dad’s. They asked if we’d had any MRIs or CT scans and I shared with them her fainting episodes prior to her pacemaker implantation, and that 2 CT scans were done prior to her surgery. They said they’d arrange to get the images from her doctor. I was happy for all of it, but inside I was still fretting about how to tell her.

I called my sister and filled her in. She had no difficulty relating to my concern about bringing it up, so we agreed that I’d bide my time and wait for the right moment to “go there.” Several days later, I decided to write the appointment onto their two calendars, in plain sight, as a possible catalyst. It was scheduled for a Friday afternoon – as it happened, the Friday before the Monday she was scheduled for her second cataract surgery, so I figured she’d be checking the calendar as the date of the cataract surgery approached. I wanted to let it come up in the natural flow of things. Eventually, it did, two days beforehand.

Mom: “Hey, how come I have an appointment on Friday with Dr. M, too?”

Me: “Remember your occupational therapist Nina? And that test she gave you?”

“No. . . not really.”

“That’s OK. Anyway, she shared the results of that test with Dr. K, and Dr. K recommended that we get you in to see Dr. M, too. You might not remember because of everything else that was going on, but in one of our follow up appointments with Dr. K, she recommended that we have you see Dr. M.”

“Oh. Okay.”

When I headed home a little while later, I wondered if that was it – all that worrying over nothing. The next day (the day before the appointment), she revisited it: “I remembered that test Nina gave me. So what’s going to happen on Friday?” Her voice was slipping back and forth over the fine lines between curiosity, fear, and irritation.

“Well, you know how you’ve been getting frustrated over losing words sometimes? Seeing Dr. M will help us start to figure out what’s going on with that. You’ve noticed how daddy’s been doing pretty well on his medication from Dr. M, right? They may be able to do something that will help you, too, but they need to see you in order to do that.”

Once again I was relieved that she seemed to accept this explanation with little angst.

When I arrived Friday prior to the appointment, however, the angst level had clearly ticked upwards, evidenced with mom’s defiant announcement: “I don’t know what they’re going to ask me today but I may not be very nice about it. They might just kick me out.”

“I don’t think they’ll do that mom. Remember, this is exactly their specialty. They’re here to help figure out what’s going on, and to come up with things that might make it better.”

As we pulled into the parking lot of Dr. M’s office, she declared, “I just want you to know I’m not very happy about this.”

“I know you aren’t, but we trust Dr. K, and she wanted to make sure we did this.” It was helpful to fall back on Dr. K, for whom mom had developed great affection – she recognized that Dr. K’s actions the day of the pacemaker implant had probably saved her life.

The first 30 – 40 minutes of the appointment were tough. Karen, the therapist, administered another SLUMS test. In many of the areas, mom did fine, but it was hard to watch her struggle with others – not for the fact of any cognitive deficit on its face, but for how hard it was for her to wrestle with the emotions that came up when she had a tough time with something. Karen was patient and careful, reminding mom that there really were no right or wrong answers. When mom would struggle she’d sometimes prompt gently, following, I’m sure, administration protocol for the test, as eventually, it seems that scoring weighs out the differences in how questions are answered (straight away; with prompting; or not at all). She also went through a series of depression-related questions. We talked about mom’s hearing, which had also been problematic.

Ultimately, Karen walked us gently back through the results of the SLUMS test and depression screen. She shared that there were some areas where mom’s scores indicated normal cognitive function, and others where there were challenges. She also highlighted that mom’s score on the depression screen fell just below the threshold for clinical depression. She assured mom that this was not at all unusual, and that depression could be a significant factor in cognitive functioning. Very often, she noted, treating the depression made a big overall impact.

We talked. I reinforced how glad I was that we were there and how it hurt me to see mom beating herself up when she couldn’t remember things or when words wouldn’t come out. I confessed that it seemed to me that she felt it meant that she was somehow “less than,” or not smart, and how untrue that was. We cried. We hugged. The whole mood shifted – so much lighter. Karen reiterated the importance (as she’d done in the past with dad) of physical exercise and doing new things to stretch the brain. We made a list of things we might be able to do: playing set-back and re-learning cribbage. Making bird houses. Getting some new CDs to listen to. Dr. M came in and, as he reviewed the scores (and likely Karen’s notes), he echoed Karen, stating that he’d like to take a shot at treating the depression first, to see how that might go. Mom was on board.

Dad arrived for his appointment right on time thanks to Hannah, their caregiver. I brought him in to mom’s appointment, as had been the plan, and we brought him up to speed with the findings and the plan for her. Dad was his characteristic, agreeable, low-key self. We rolled from mom’s appointment into his, which was a basic check-in. It went smoothly. We made follow up appointments for both of them.

While Hannah took dad home, I took mom, stopping on the way home for some groceries. She told me, more than once, how much better she felt, and how good it was to get all of those feelings out. I told her how glad I was, and how optimistic I felt that we were on a more positive path.

I walked away enlightened about depression and its link to dementia. Everyone’s is probably slightly (or a lot) different, and determining other areas of potential impact (such as depression) is important to coming up with a plan to manage it with the most appropriate approach. Now to get them to exercise, and to their proverbial, Sound of Music Switzerland. . .


Step Away from the Canola

If you only read and absorb two sentences here, make it these two: PLEASE STOP THINKING REFINED SEED AND VEGETABLE OILS ARE HEALTHY. THEY’RE REALLY *NOT*; AS A MATTER OF FACT, THEY’RE HARMFUL AT THE RATES WE’RE CONSUMING THEM. Let me call them out right up front: soybean, canola (a.k.a. rapeseed), corn, cottonseed, sunflower, safflower, grapeseed, peanut; anything calling itself “vegetable oil,” margarine or other butter-like spreads. This may not be news to you. If it is, though, or you keep finding yourself hypnotized by the “healthy” marketing BS that accompanies these products, keep reading.

A well-cited editorial in the British Medical Journal (“BMJ”) from March of 2014 spells out a lot of the evidence. I don’t want to go too science-geek on you with this, so I’m going to attempt to share a few of the reasons in a way that will hopefully keep your eyes from glazing over (but I’ll include citations so you can explore more deeply if you’d like).

Fact # 1: “Vegetable” and Seed Oils are High in Omega-6 Fatty Acids

Our bodies *need* omega-6 fatty acids, and cannot produce them on their own. Why, then, would consuming omega-6 be a problem? In short, it’s the old “too much of a good thing” conundrum. The presence of omega-6 competes in the cells with omega-3, also an essential fatty acid that our bodies can’t produce on their own. We should be after a ratio of omega-6 to omega-3 of less than 4:1. Estimates of the ratio in the western diet are now at least 15:1; by some estimates, in the U.S., it may be as high at 25:1 for some people. Processed foods are *full* of it, which is a big part of the problem. You can get omega 6’s naturally from seeds (e.g. sunflower or pumpkin); certain nuts (pistachios – yay! – and pine nuts, a.k.a. pignolis); acai berries. You should probably stop there.

This out-of-whack ratio is bad news. According to a 2002 abstract on the website for the National Center for Biotechnology Information, too-high omega-6 to omega-3 ratios “promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases.” To get more specific, various studies have linked high ratios to (thanks to this article on for this list and citations):

As far as I’m concerned (maybe you, too, at this point), just the above info is enough to put me completely off these oils. If you want to come with me as I pile on, though, keep reading.

Fact # 2: Most Vegetable and Seed Oils Marketed as “Healthy” are Heavily Industrially Processed

Did you know: “Crisco” was the catchy name they came up with for “crystallized cottonseed oil” when it was first created? (Because in the late 1800’s Procter & Gamble, who’d been using cottonseed oil in the manufacture of candles and soap, discovered they could partially hydrogenate the oil and it resembled lard. *Resembled* lard. Let that sink in for just a second. An oil from the seeds of a plant that we would never consider to be a food source – cotton – was something that resembled lard. What the heck? Why not try it out in cooking?!?) So P&G tested this product, which resembled lard, and found that it worked in the kitchen, and decided to market it as a lard replacement. Good. Lord.

Now that it’s pretty common knowledge that hydrogenated oils should be avoided, we’ve shifted to liquid oils. But while oils like olive, coconut, and avocado can be fairly easily produced by cold-pressing the seeds of the fruits/nuts they come from, the process to extract the oils from, for example, rapeseeds (i.e. refining), borders on the nearly mind-numbing (with attribution and thanks to this piece on for this edgy if admittedly over-simplified description):

“Step 1: Find some “canola seeds.” Oh wait, they don’t exist. Canola oil is actually made from a hybrid version of the rapeseed… most likely genetically modified and heavily treated with pesticides.

Step 2: Heat the rapeseeds at unnaturally high temperatures so that they oxidize and are rancid before you ever buy them.

Step 3: Process with a petroleum solvent to extract the oils.

Step 4: Heat some more and add some acid to remove any nasty wax solids that formed during the first processing.

Step 5: Treat the oil with more chemicals to improve the color.

Step 6: Deodorize the oil to mask the horrific smell from the chemical processing.”

I could stop there, but, one more, to help to hopefully drive the nail into the vegetable and seed oil coffin for you.

Fact # 3: Industrially Processed (“Refined”) Vegetable and Seed Oils are Chemically Unstable and Easily Oxidized

To me, this might actually be the scariest one.

Not only are these oils likely compromised during production (as noted above in “Step 2”), exposing them to air, light, and heat adds insult to injury. This happens because of the molecular structure of these “polyunsaturated” oils. Why does oxidation matter? Oxidation, like omega-6 fatty acids, is essential in the body. Oxidation creates free radicals, which, when limited to what is needed by the body to turn food into energy, is fine. Too many free radicals roaming around in the body, though, is not a good thing. This article does an amazing job of describing why, so I’m going to steal some of it for you here (emphasis added by me): “once free radicals are formed, a chain reaction can occur. The first free radical pulls an electron from a molecule, which destabilizes the molecule and turns *it* into a free radical. That molecule then takes an electron from another molecule, destabilizing *it* and turning *it* into a free radical. This domino effect can eventually disrupt and damage the whole cell.

“The free radical chain reaction may lead to broken cell membranes, which can alter what enters and exits the cell, according to the Harvard School of Public Health. The chain reaction may change the structure of a lipid, making it more likely to become trapped in an artery. The damaged molecules may mutate and grow tumors. Or, the cascading damage may change DNA code.”

Still gonna hang onto that bottle of Wesson or canola oil? If yes, I hope you move it out to the garage with the WD-40.

no more vegetable oils

Aren’t all Houses “Passive?”

I figured I’d break things up a little bit this week so it’s not just bathroom, bathroom, bathroom (I’ll get back to that though, I promise. As I’m typing, we’re all done with the wall tiling and Tim is now cutting and dry-fitting the floor border. It’s exciting)!

For this week’s entry, though, I’m going to roll it back for some historical (and structural) perspective. When we first started thinking about and planning this project (like, more than a decade ago) we knew we’d want to make the house as energy-efficient as possible; that much was a given. While it was absolutely adorable, the prior incarnation of this place was the home-energy-equivalent of a miltary tank, where “efficiency” might be more effectively measured in “gallons/mile” than the reverse. Here, I swore if I ventured to the cold basement and stood in front of our oil tank in February, I could practically watch the gauge dropping as the furnace ran. Built in the early 1950s, the house may have been as solid as the rock that surrounds it (and that you can’t help but find anytime you try to sink a shovel into the ground around here), but it was so poorly insulated and air-permeable that you could practically see the curtains move when the wind blew at anything more than breeze level.

Tim, having been a subscriber for a couple of decades to “Fine Homebuilding” magazine, had followed energy-efficient building techniques through that publication for years. He’d been dreaming of employing those techniques on his own house for as long as I knew him. Whatever we did here, it was going to be something that went well-beyond standard building practices.

I first became aware of the European “Passivhaus” standard sometime in 2008. It was winter. There was an article in the Sunday New York Times magazine about it, and, after reading it, Tim declared that *this* was what we were going to do. I read the article with fascination, especially one specific example that has remained with me ever since, of a home out in Idaho that was built to the standard. There was no central heating system (I’ll explain that seeming insanity in a minute). The owners went away for several weeks in the middle of winter, and when they returned, the temperature in the house had dropped only into the 50’s. With no heat. For anyone who lives in a cold winter climate, that is truly remarkable.

You can read more about the standard and its history here, but here’s my quick interpretation of how and why it works: the primary principle is one of air-tightness, combined with super-insulation, sort of the same way a Thermos (or, these days, maybe a Yeti?) works. You put something nice and hot, or nice and cold, into something that’s airtight and super-insulated, and it retains its temperature for a very long time. Much of heat and cooling loss in typical homes happens because of air leaks and what’s known as “thermal breaks.” If you can eliminate, or radically reduce those things, you’re way ahead of the game. Don’t panic about the air-tightness – that’s well-addressed.

Back to the idea of how you can get by with no central heating system: the reality is that if you do this correctly, the heat of simply living (appliances such as your refrigerator, cooktop, oven, iron, dishwasher, etc, throw off heat; bodies throw off heat; showering and bathing throw off heat) is nearly, if not completely enough, depending upon some other factors, like whether you can build to take advantage of passive solar.

We did a lot of work “under the covers” to ensure we were airtight (including utilizing copious amounts of a special tape made in Europe specifically for air-sealing at every single seam of plywood, around the windows, and doors; installing windows and doors that met air-tightness standards from Canada and Ireland, respectively). We built with a double-wall construction technique that allowed for a full “envelope” around the structure, which was then filled with dense-pack cellulose insulation, meaning not only would we stay toasty warm (or blissfully cool, depending on the season), but also that we’d have the most epic windowsills ever (15” deep!). So if you’ve noticed the deep windowsills in photos, that’s why.

We did end up meeting the airtightness part of the standard (a day of nail-biting anxiety and then, elation); closely followed by installation of the air-exchange system (which came from Germany). The energy usage part is evolving (solar not yet installed), but suffice it to say that for now, our costs to heat (and light) the entirety of the house, including the basement (so about 3300 square feet) is a little less than what we were spending to heat and light the original house, which was about half the size. Solar should pay for itself in 5 – 7 years once we do install it.

So I don’t think we’ve met the full standard yet, but even if we don’t, we’ve definitely achieved Tim’s dream, and built not just a house, but a trove of knowledge on energy-efficient home building.

Happy Hump-Day, and if you like what you’re reading here, let me know: like it, comment if you’d like, and follow me on the Hump-Day House Stuff page of my WordPress site!!

trussing - west elevation

Parenting the Parents – Part IX. A New Normal.

I thought I was going to write more this week about my mom and her ongoing diagnosis. But, life. More specifically, life when your parents’ well-being becomes your responsibility.

It’s Masters Sunday. Nearly a religious holiday in my house. Due to impending storms in Atlanta, they moved the whole final round to earlier in the day, and coverage was set to start at 9 a.m. I’m taking care of our niece’s 3 beautiful cats this weekend while she’s away, so I headed over there early (yesterday, and today), to be sure I gave the effort its due, but (today) could still watch the tournament relatively unimpeded.

I really like getting up as early on the weekend as I do during the week. Like 6 a.m. early. Mornings are my happy time. Getting up early and doing what I really need to do makes me feel accomplished. It’s also my peaceful time, before any shit has escaped to hit the fan. Plus, Tiger said at the end of play yesterday that he’d be getting up at 3:45 this morning. Who was I to sleep late?

Yesterday morning on my way back from my niece’s, my mom called my cell. Nothing to panic over, just asking me if I could pick a few things up at the store. It just so happened that I was 2 minutes away from our little market down the hill and the timing was perfect. On the way back this morning, my husband popped up on the caller ID as I neared my exit on the highway:

“Your mom just called. She sounds pretty upset. She says your dad has a fever and his cough is back and she’s kinda freaking out.”

“Okay.” (I should tell you: though I was hoping this would be a tiny, non-event-blip on the ever-spinning radar that is now life, that I took dad this past Monday for a follow up x-ray from his December/January bout with pneumonia. The doctor called a couple of days later to say that there was still a small “infiltrate” at the bottom of his left lung, so she was prescribing him some antibiotics. All this started twisting wildly in my head. How could he be getting worse when he was on day 4 of a 5-day antibiotic zap?)

“She asked if you could bring our thermometer. I told her I’d call you and have you come here first and then go there.” (They have a thermometer, but we haven’t been able to find it since their move. I decided to stop at the CVS on the way home to just get them a new one. That would be faster than going home then doubling back to their place, and they’d have their own once again).

I felt my adrenaline surge and my pulse rate increase as I hung up. I tried to breathe and settle myself down, but by the time I was sitting at the traffic light at the end of the exit right before the CVS, my brain was sprinting down a too-familiar track: what if this was it? Another fever with just a small pneumonia infiltrate. . . that didn’t make sense. Another round of sepsis? What was going on? Would I drive him to the E.R? Would I have Tim take my mom or try to keep her calm at home this time? What if this was it??

I got there. He was perched unsteadily on the side of the bed. He said he felt weak. I asked if he’d eaten anything. He hadn’t. I felt his forehead. He didn’t feel too warm. Kinda normal, actually. I cleaned the thermometer with alcohol (I’d broken it out of the package in the CVS parking lot and tested it on myself to be sure it was working – it was one of the digital kind with an 8-second read. If he was feverish and shaky, I didn’t want him trying to keep an old-fashioned mercury one under his tongue for as long as those take, but I also didn’t want to get it there and find the battery was dead or that it was a lemon). I took his temperature. 98.9. Normal. I took it again to be sure. 98.7. Phew.

I peeled a clementine for him to get his blood sugar up. He ate it. I asked if he wanted some fried baloney (his favorite – for real). He shook his head; meh – not really. That registered. Something was off. Mom asked if maybe he’d like some soup. It wasn’t 9:00 a.m., but who cared? He said yes. We got him some juice and ice water while I heated up the soup and did mom’s post-cataract-surgery eye drops. When the soup was almost ready, I supported him as he moved over to “the chair” and got him settled in. I made sure he took all his meds. I asked him if the cough felt like it was from a tickle in his throat or if it was in his chest. He said it felt like his throat, so I suggested to them that it could possibly be the increasing pollen in the air that was bothering him. What did I know, but I wanted to quell any panic that might be lingering around the frayed edges of the morning.

Before I left, I made sure he ate all his soup. He drank a juice box and had some ice water and took his meds. I promised to pick up more fruit before I came back for mom’s afternoon eyedrops, and told mom to call me if they needed anything or if anything changed with dad, then headed home to watch the Masters. When the phone rang a couple of hours later and I saw it was them, my heart jumped in my throat. I was relieved when it was only a request to pick up more bread, too, and an apology for being such a pest.

“No problem, mom. Really. You’re not being a pest. It’s no problem. I love you.”

Pepperidge Farm white bread

Helicopter Parenting gone Wrong: with our Food, and our Health

So, I finished the book. If you missed last week’s post, “the book” is The Big Fat Surprise, by Nina Teicholz. Another week of messed-up sleep patterns has transpired, with me staying up too late reading something I couldn’t put down, despite the fact that what I was reading was, at nearly every turn of the page, leaving me with that “train wreck, can’t-look-away” sensation. Every few minutes, I found myself groaning with irritation; sometimes, genuinely seething with anger, and, on several occasions, really craving a sizzling, well-seasoned ribeye, though that’s not all that unusual for me anyway.

If you read this book, which, if you’re interested in food, nutrition, and health, I recommend you do, you may ultimately find it difficult to ever think anything BUT critically about advice coming out of organizations like the American Heart Association, and, quite frankly, the USDA, among many others. It’s a story of good intentions run amok, triggered when heart disease began cranking up at an alarming rate back in the post-WWII days and the medical and scientific communities were scrambling to try to figure out why.

The book is about 500 pages long. Of that 500 pages, 20 pages are dedicated to post-chapter citations; fully 80 pages to the author’s extensive notes when she quotes people or makes otherwise un-cited statements; 58 pages are bibliography. I’m telling you all of that because when you understand what she’s done with this book, given our collective “knowledge” of what constitutes a “healthy” diet, drummed into us for our entire lives, it’s otherwise going to be impossible for you to not be skeptical. The science-geek in me truly appreciates that 158-or-so pages. This isn’t the interpretation of someone who started writing with an axe to grind or an agenda to support.

It may not surprise some of you to read that we (meaning Americans – hundreds of millions of us, and then, eventually, much of the rest of the world) have been subjected, for well-over 50 years, to something like a giant, macro-version of helicopter parenting. A hypothesis was formed in the pressure and heat of that post-war heart disease ramp-up; tiny sample sizes and highly flawed data sets then became the bedrock of the idea that saturated fats were the cause of obesity and heart disease; myths about serum cholesterol levels and how they were supposedly impacted by foods containing cholesterol became fact; the fallacy of a low-fat diet as the way to health insinuated itself in our brains (with the help of the above-mentioned entities, to name just a couple of the offenders). Because we’ve been told by so many authorities (our collective surrogate helicopter parents: the government, the American Heart Association, our own doctors!) for so long that we should be following the tenets of a low fat (or, more recently, Mediterranean-style) diet, it never occurred to most of us that perhaps the whole substrate of that advice might be sitting on a huge fault line.

The punch line of the book is essentially in 4 parts:

1) Saturated fats are not the unhealthy villains they’ve been painted to be for over 5 decades; further, saturated fats are the only foods known to raise “good” HDL-cholesterol levels (there’s a lot more in the book about cholesterol and how it functions, which was highly enlightening);

2) A low-fat diet, in most cases, reduces the HDL cholesterol levels in the blood, which is not a good thing to do. While it may also reduce the “bad” LDL cholesterol, that isn’t necessarily a high-impact effect when it comes to heart disease, and LDL cholesterol is actually more complicated than a single number, with “subfractions” consisting of denser and lighter particles. The dense particles are more strongly correlated with risk of heart disease, so even if you have a low LDL number, if your LDL is made up mostly of the denser particles, you can still be at risk of heart disease (and oh, by the way, saturated fats tend to cause the lighter LDL particles to increase);

3) In our quest to replace saturated fats with supposedly “healthy” fats (i.e. polyunsaturated vegetable and seed oils: canola, corn, soybean, etc., etc.), we’ve created a silent, and growing monster, and not just when those oils are hydrogenated. As a matter of fact, what we’re doing now that hydrogenation has become mostly taboo, is using these vegetable and seed oils in their liquid form for cooking and frying. Unfortunately, these oils, because of their chemical makeup, oxidize easily, and this oxidization accelerates when the oils are heated. I’ll get more into why that matters in a future post (bringing me full-circle to where I was 2 weeks ago), but I’ll give you a teaser, in the form of a quote from the book (page 279, if you decide to read it), by Gerald McNeill, a vice president at “Loders Croklaan, which is one of the country’s largest suppliers of edible oil:” “As those oils are heated, you’re creating toxic oxidative breakdown products. One of those products is a compound called an aldehyde, which interferes with DNA. Another is formaldehyde, which is extremely toxic.”

4) If we want to zero in on more likely sources of chronic disease, consistent evidence has been out there since the 1920s that sugar and carbohydrates are the more probable culprits. Chapter 10 of the book goes into the evidence and the science behind this in convincing depth.

Several questions I want to get into in the coming weeks: how big food and edible oil companies and industry groups contribute to the problem; why our doctors don’t seem to know any of this and continue to espouse low fat diets; how and why huge, influential entities like the American Heart Association became, and remain, shills for low fat eating (and, alarmingly, vegetable and seed oils); why you should strongly consider the impact of vegetable oils on your health; why the USDA still hasn’t changed dietary guidelines; the list goes on.

Oh, the places we’ll go . . .!!

Happy Food Friday. . .!?


New as of April, 2019: “Light My Fire”

I’ve added a new page as of April, 2019, called “Light My Fire.” Change happens – especially over fifty! The Light My Fire page will be a place to share stories of realization, transformation, redefinition – some will be mine, but most, I hope, will be yours!! If you’d like to share a post here, contact me. (If that link doesn’t work, just head over to my “Contact” page). Featured image is “The Goddess Pele,” by Arthur Johnsen.

Just a Quick Post for those following Mom & Dad Monday

“Love to Move”Hey everyone! I just posted this on the Mom & Dad Monday Resources page, but I recently discovered this wonderful program of chair exercises you can share (and do!) with your loved one(s). I showed these to my mom this morning (while attempting a couple of them myself – that was eye-opening . . .) – we had a ball and were laughing like crazy as we tried them. They are as much for stimulating the brain as for encouraging movement. These will definitely become part of our repertoire!! “Love to Move”