SOUL food "Seasonal, Organic, Un-Processed and Local"

Quite a few years ago I was having a conversation with someone and we were discussing the concept of how to be present for the fantastic things in life.  The basic concept is, just keep doing what you are supposed to do, such as, feed the animals, wash the dishes, go to work, visit with your family, pay your bills etc…, and then, when something fantastic comes along, you are able to be present.  I know this sounds like an ultra simple formula and everyone should know how to do it; however it isn’t. 

When we lose contact with our surroundings, we may get side tracked, off in our own world of events.  For one reason or another we are not looking at or planning for the next week or the next month and we are caught up in our own super important life.  When this is happening, our own super important life takes precedence over the super important life of our loved ones, and we might miss being present for a fantastic event.

Last night, my wife, daughter and I were honored to be present for our son Cooper’s “Chef Showcase Dinner”.  Cooper started Bauman College of Holistic Nutrition and Culinary Arts last Spring.  He entered the six month Natural Chef Program.  We are very proud to announce that Cooper graduated this fantastic program and is now a Certified Natural Chef.  He has many opportunities ahead of him and we are all excited to see which direction it will take him. 

This was one of those events that I was incredibly fortunate to be present for.   My wife, Susie, graduated from this program about ten years ago, which was another fantastic event to be present for, so I generally knew what to expect with regards to the meal and the program. 
 
What I wasn’t prepared for was the overwhelming love and praise expressed to us from the three gifted and amazing Chef Teachers and the Chef Kitchen Manager.  The words they expressed and the emotions my wife and I felt from them about how they took Cooper “under their wings” and watched him grow from a kitchen neophyte to a Certified Natural Chef is something we will remember for the rest of our life. 

All twelve chef students had a role to play in the process of this Showcase Dinner.  Cooper, at 20 years old, was the youngest, by far, and they all volunteered him as the greeter and presenter of the meal.  Before each meal came out, Cooper would explain the meal, what went into it, and share a bit of his comical personality.  The meal was tremendous and all of the Chefs did a tremendous job.  I couldn’t help myself wanting to take a picture of each course to share with you in this blog.
 

Appetizer:  Tres Amigos
Sunny roll, Asian-infused tempeh bites, seasonal vegetable pockets, almond dipping sauce
 

Soup:
Roasted Beet Soup with Horseradish Goat Yogurt

 

Salad:
Romaine Boats with Vegan Caesar Dressing and Shiitake “bacon-bits”
 

Main Course:  SOULful Vegetable Stack with Filet of Portobello
Fresh corn polenta cake, herbed cannellini cream, baked breaded zucchini, caramelized onion jam, beefsteak tomato, tomato chip, basil leaf, marinated Portobello mushroom, balsamic reduction, basil oil
 

Desert:  Raw-some Rockin’ Buddha Cake
Cashew cream, acai powder, wild foraged blackberries, cacao nibs, medjool dates

 Tea:  Sweet Ruby Tea
Rooibos tea, cardamon, honey
 

Congratulations Cooper, we are all super proud of your accomplishment!  Thanks for letting us be present for your Showcase.

Thanks
Steve

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What Does Asthma Feel Like?

In the pharmacy, I have had people describe an asthma attack as: 
  • It feels like I am suffocating.
  • It is as if an elephant is sitting on my chest, crushing and I can’t catch a breath.
  • If you can imagine a fish out of water, unable to filter any oxygen and unable to breath.
  • Wheezing, coughing, shortness of breath and chest tightness.
It is interesting to note that asthma affects more than 24 million people in the United States and is the most common chronic child hood disease afflicting over 7 million children.  This disease involves airway inflammation, partial or complete airway obstruction, and an over active responsiveness of the bronchioles. 

Many different pharmacologic agents are available, and are used in a “step-up” fashion to treat asthma.  The treatment plan for any specific patient is dependent upon which stage of asthma the patient is in: 
  1. Mild intermittent
  2. Mild Persistent
  3. Moderate Persistent
  4. Severe Persistent
Each stage has its own set of parameters, including symptoms or the severity of the symptoms.  As patient progresses from one stage to the next, the level of treatment also progresses. 

My goal is not to discuss each and every treatment option for asthma, but rather share with you the different inhaled steroid options currently available.  Inhaled corticosteroid medications are used to help prevent the symptoms of asthma, such as shortness of breath and wheezing.  These medications works by helping to decrease the inflammation and swelling in the airways of your lungs.  It is important to note, inhaled corticosteroids are not used to treat acute symptoms of a sudden attack.  If you have an acute attack of asthma, use your quick acting inhaler as prescribed to relieve your immediate symptoms.

Inhaled corticosteroids are to be used as a maintenance treatment (on a regular basis) in order to be effective in preventing asthma symptoms.  Before you begin treatment with an inhaled corticosteroid, it is important to understand how to use the inhaler.    Currently, there must be 4 or 5 different types of inhaler mechanisms for the delivery of the medication.  The inhalers come with a package insert diagram that shows you how to properly use the inhaler.  When you pick up your inhaler for the first time, be sure to have the pharmacist explain exactly how to use it.  If you have any questions at all about how to properly administer a dose of your medication or how to operate your inhaler, call your pharmacist or doctor and ask for instruction.

Rinse your mouth out with water after each administration session to help prevent a fungal infection in your mouth (sometimes called thrush), and please, do not swallow the rinse water, spit it out.  If your doctor has you using another inhaler at the same time as your corticosteroid inhaler, use the other inhaler first, and then wait a few minutes prior to using your steroid inhaler.

Be sure to keep your inhaler clean and keep count of the number of inhalations left in the container.  As we discussed earlier, if you have any questions about how to clean your inhaler or keep track of the number of doses left, ask your pharmacist or doctor to explain it to you.

Self-monitoring is an important aspect of treating asthma.  Realize that it may take up to two weeks of regular use before you recognize the full benefit of a corticosteroid inhaler.  Discuss with your doctor which symptoms require immediate follow-up and which symptoms you may continue to monitor at home.  Take the time to understand which inhalers are for the acute, difficult breathing episodes and which are to be used on a regular basis to help decrease the incidence of the acute episodes.  If you have used your inhaler for two weeks and are not seeing any improvement or your symptoms are worsening, please notify your doctor.

Self-monitoring also includes the use of a Peak Flow Meter.  This is a simple device which helps you measure, on your own, how well your lungs are working.  Proper use of a peak flow meter will help you measure your lung function on a daily basis.  Tracking your lung function may help prevent or lessen acute asthmatic situations.  If you don’t already use one, please discuss this with your doctor or pharmacist.

In order to learn about the different inhaled treatment options for Asthma or other breathing disorders, please visit www.AudibeRx.com, navigate to the Inhaler Page, and LISTEN to a Medication Specific Counseling Session about the particular medication you are interested in.

Thanks
Steve


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Medication Side Effects; What Is Normal Anyway?

The other day, one of the pharmacy technicians came to me with a concern.  It seems that one of the ladies at the retirement facility near our pharmacy had called and asked us to deliver a bottle of dextromethorphan (Delsym-TM) cough suppressant medication.  Normally this would not raise any issue; however, in this situation, this was the third bottle ordered by this particular patient in the last 40 days.

I appreciated that our pharmacy technician had pointed this out to us.  I am fortunate in my position that I have pharmacy technicians who are not only efficient and pleasant to work with; they are also genuinely concerned for the welfare of our patients.  After reviewing this patient’s profile, I called her on the phone.

She was quick to pick up and interestingly quizzical about my concern for her cough.  We talked about when it started, what it felt like, if the cough medication really worked, and what she thought might be causing the cough.  We then discussed the fact that she had started a new blood pressure medication about two months ago.  This particular medication is a combination product containing two different medications including benazepril and amlodipine.

These two medications work well together to decrease blood pressure by relaxing the blood vessels and also decreasing the strength of contraction of the heart.  The issue here is that one of the medications, the benazepril, may cause a slight tickle in the back of the throat after taking it for three to six weeks.  This doesn’t happen in all the patients that take this medication; however, it usually occurs about 20% of the time. 

I discussed with the patient that I would like to write a note to her doctor, explaining what has been going on over the past month and see what he thinks.  She was appreciative and I agreed to give her a call as soon as I heard back from her physician.  In the meantime, we agreed to send out another bottle of the cough suppressant medication so that she could continue taking her blood pressure medication without being bothered with this frustrating cough.

Within 24 hours the patient’s physician had written back.  He agreed with our conclusion and had changed the patient’s medication to a relatively similar medication that does not have the tickle-in-the-throat side effect.  Three weeks later, the patients cough has subsided and her blood pressure is still under control.

This brings me to the point of this particular writing; how do we know when we are experiencing a side effect of a medication?  We all have a version of what we think normal feels like.  After we have experienced a different situation for some period of time, perhaps we then begin to feel like that is our new normal. 

Over the years I have come across many situations where patients have been experiencing a symptom of some sort, only to find out later that what they have been experiencing is directly related to the new medication they are taking.  Please people, when you pick up a new prescription, take some time to discuss with your pharmacist what you might expect to feel when taking the new medication.

The medication information leaflets that are handed out with each prescription are filled with information that, sometimes, is murky at best.  Side effects and adverse reactions are thrown about, touching on just about every possible symptom you could imagine.  If you are not interested in reading and deciphering the voluminous leaflet, perhaps you might be more interested in learning by listening.  Regardless of your method of follow up medication education, your primary resource is your pharmacist.

Your pharmacist will help you understand what affects you will most likely experience, and also discuss what to do if unwanted conditions begin to appear.   If you are at home and find that you are feeling a little out of sorts or are experiencing and uncomfortable feeling, pick up the phone and call your pharmacist.  When you get our pharmacist on the phone, explain how you are feeling to them and ask if any of your current medications may be causing the symptoms.

Thanks
Steve

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