Kevin's Kitchen: Dinosaur BBQ Chicken

Your slow cooker is a quick road to dinner heaven!

A thyroidectomy requires a life change. That includes changing eating habits. The purpose of Kevin's Kitchen is to help those with no (or little) cooking skills to create great meals.

This is so easy! Just put five pounds of chicken breasts in a crockpot, dump in a bottle of Dinosaur BBQ sauce (or whatever sauce you prefer) and let it cook all day.  Start it before you go to work and dinner is waiting when you get home. You don't have access to Dinosaur BBQ? Use whatever BBQ sauce you prefer. 

Put the chicken on a roll for BBQ Chicken sandwiches or serve the chicken straight up. Easy, meaty, and oh so good!!!

Vegetables for Lunch: Burrito Bowl

I do not enjoy eating vegetables, but I know I need to get more vegetables into my diet. It can't all be salad, I need to find new and creative solutions. I am exploring a bunch of different options and I'll bring you along with me!

Today I am trying the Healthy Choice Simply Steamers Unwrapped Burrito Bowl. It has 270 calories and microwaves in about 4 minutes. After cooking, we mix the contents into a sauce that resides beneath the cooking tray.

The first obvious problem with this dish: there is no green! Vegetables are very stark. The dish is mostly beans and rice. The beans were dry and overcooked. The sauce was very spicy.

Would I try this again?  YES. It should have more vegetables, so, maybe I would dump it over top a salad. And I would try cooking it 3.5 minutes to see if the beans turned out better. 

Exercise to fight Thyroidectomy fatigue

In my research after diagnosis, I learned about weight gain that is typical after Thyroidectomies. I was determined that would not happen to me!

The thyroid influences your metabolic rate (the rate that you burn calories). If your thyroid hormones aren't in balance, the body will be inefficient at burning calories, which will lead to weight gain. You can change the math to your favor by exercising. Exercising can increase your metabolism and can sometimes replace the problems occurring with the thyroid hormones.  Your doctor will clear you for exercise usually after 10-14 days following surgery. 

For several weeks after surgery, I was full of energy. Exercise would not be a problem! Then I 'hit the wall' and was exhausted. According to Health Central, post-cancer fatigue is estimated to occur in up to 90 percent of patients, and I was no exception. I was too exhausted to exercise.

Korean researchers studied the impact of exercise on post-thyroidectomy fatigue. The exercise included walking for 150 minutes per week, resistance exercise twice per week, and flexibility exercises. The research determined exercise significantly reduced the fatigue in addition to having other benefits.

But that's the catch... you need to exercise to reduce the fatigue, but you can't exercise because you are fatigued! It wasn't until around 14 months post-thyroidectomy that my medicine was adjusted and I had relief from fatigue. For that 14 months, I chased away the sleepy fatigue with poor diet habits that packed on the pounds.

The Korean research provides promise that by pushing through the fatigue and doing the exercise, the fatigue may go away. 

Support Groups: What to expect after surgery?

I scour the support groups for some of the best questions and answers. Everyone's names are removed for privacy. Answers may be summarized and/or edited.

QUESTION: "Hi Everyone! I was diagnosed with papillary thyroid cancer and having total thyroidectomy next week. Any advice on what I should expect after surgery. Suggestions on what I will need post surgery, comfort wise"


ANSWER:

• Just don't over do it, and I liked warm broth only because it soothed, and Jello, but after the first day I could eat anything
• What is helping me most is soft foods/warm liquids the first few days, 
• lots of pillows so you can sleep somewhat upright (laying flat feels like I’m choking)
•  a lot of rest. 
• alternating between Tylenol and Motrin and have Oxycodone if I really need it. They’ve been helpful. 
• Left the hospital and hit up chick fil a cause I was starving. A bit uncomfortable but meds covered that. 
• I was able to drive and go back to other regular activities about a week after my first surgery, 
•  had a hard time straightening my neck for awhile. Just give yourself time....it all works itself out in the end
• Watch your calcium level after surgery. Mine was very low but with meds came up very quickly. 
•  I didn't need anything as far as painkillers, even right after the surgery. My neck just felt tight. 
• I did the LID diet then had RAI. Both were fine too, just very tired while not on meds for RAI. 
• I suggest finding a support group in your area just so you can meet people who know what you are going through and how you feel.
• You may feel a burst of energy after surgery, several people I know did, but if you overdo it you will pay for it. Take it easy
• Ice is your friend, so have a couple gel packs that you can rotate to keep on your neck. It will help the swelling
• Dont be surprised if you get super emotional for a few weeks after, your body is upset with the hormone changes it is making.
• For the scar, As soon as your bandage/tape comes off, start using an oil on your neck at least a couple times a day. It helps keep the skin elastic, the massaging helps your body reabsorb fluids that cause swelling, and it prevents scarring. 
• For the scar, Sunscreen whenever you leave the house. I used a stick sunscreen from the baby aisle which was 50SPF and kept it in my purse.
• Stay as elevated as possible even while sleeping.
• Get some physio lined up to gently release your neck after surgery
• Pillows, keep yourself propped up when you sleep. 
• for about 3 months after my surgery I had really bad GERD issues and if I slept like normal I often woke up choking
• get yourself a pill box. Like a big one for 7 days and times of day, just a few bucks at Walgreens because for a few months you'll be on a lot of meds and it makes it easy.
• easy to make meals.
• Don't feel bad for taking time to relax and recover. 
•  If you have tingling in your face or hands eat Tums like candy as my surgeon put it, it's a sign of calcium deficiency.
• listen to your body. Have a comfy couch.
• I was very emotional, dealing with the changes in the way. I felt physically adjusting to the hormone replacement. I suggest having someone you can lean on for support.
• the important part is to regulate your medicine levels.. if you feel too sluggish med levels go up.. anxiety or heart palpitations meds need lowering
• Sucrets!

Disclaimer: I am not a doctor, nutritionist, nor personal trainer. Never take medical advice over the internet. Seek the advice of your doctor before following any of the recommendations made during this series.

Kevin's Kitchen: Beef Stew

Your slow cooker is a quick road to dinner heaven!

A thyroidectomy requires a life change. That includes changing eating habits. The purpose of Kevin's Kitchen is to help those with no (or little) cooking skills to create great, easy, and healthy home meals.

Today we are doing beef stew. PUT DOWN THAT CAN OF DINTY MOORE! I should rename this meal to: Vegetable stew with a little bit of beef, because it really is mostly vegetables. And that is awesome because eating healthy means sneaking in as many vegetables as you can.

This will take some knife skill because you have to cut everything into bite size (or smaller) chunks. Think of the size of your soup spoon - you want everything to be that size of smaller. That is a lot of cutting! Don't worry... you can do it! Just remember your Boy Scout and hunting training: cut away from yourself, slide the knife for a good cut, and rock the blade for an efficient cut. And for God's sake, keep the soft ends of your finger tips away from the blade!

Start with one pound of stew meat. Stew meat is often covered in fat, and you can remove the fat by turning the knife on its side and sliding it across the fat.






Potatoes, celery, carrots - rinse and cut them up.  For the onion, put off the ends and peal off the brown paper outer shell. Then cut it into bite sized pieces (be ready to cry!). Add a bag of frozen peas (no need to cut those unless you are bored). Use some beef broth and stew mix. Cook on low 8 hours or high 4 hours, or whatever combination fits your schedule.

Before serving, mix in some flour to turn the broth into a gravy.

This is going to be a dinner you will want to brag about!

18 month Post-Op Checkup

I had my 18 month post-op checkup with the Endocrinologist on Friday, which is weird because it has been over 19 months. But, hey - close enough! The purpose of me sharing this is because I know people get concerned and wonder what long term care is like after a Thyroidectomy. I'm not one to share personal medical things, but, I'm doing it in this blog because I hope it helps others.

These appointments have become fairly routine. I get some bloodwork done the week before. We review the results and the doctor makes any necessary adjustments. She asks me a bunch of questions, complains about my weight, and does a checkup. She then gets the resident who comes in all smiles and says "You are cured" and I have to remind the resident-of-the-day that you are never cured from Thyroid cancer. We all slap each other on the back, great day, and I leave.

The only medical change this trip was a reduction in the amount of calcium I take. I had lost two parathyroids and so I take a lot of calcium supplements. Due to my history with kidney stones (had one 15 years ago) she cut my supplement intake in half.

Test results:
Thyroglobulin Ab   1.1   Range: 0.0-4.0
Thyroglobulin Qn  <.2    Range 0-55
T4 Free                   1.8    Range .9-1.7     She didn't seem concerned that this was out of range
TSH                         .9     Range .27-4.32
PTH Intact             29.9   Range 15-65

Many people recommend T3 get tested every time. But my doctor will only test T3 if she thinks there is a problem.

My next step is to get a routine ultrasound of the thyroid bed. And then I do not need to return to see the Endocrine doctor for a year!

Where Did I Go?

Click on the video below for an update

Disclaimer: I am not a doctor, nutritionist, nor personal trainer. Never take medical advice over the internet. Seek the advice of your doctor before following any of the recommendations made during this series.

Side Effects of Thyroid Medicine

The Thyroidectomy forums are filled with questions such as "Is anyone else noticing hair loss?"

 The side effects of thyroid medicine ( Levothyroxine (synthroid, Unithroid, others))  are not hard to find nor follow - the instructions come with the medicine straight from the pharmacy with your medicine. You should be thoroughly familiar with that information. You can also check the manufacturer's website. Thoroughly read the information from the pharmacy.

Some of the side effects include:

• Partial hair loss may occur during the first few months of taking
• Rapid or abnormal heartbeat
• Chest pain
• Difficulty catching your breath
• Leg cramps
• Headache
• Nervousness
• Irritability
• Sleeplessness
• Shaking
• Change in appetite
• Weight gain or loss
• Increased sweating
• Difficulty tolerating heat
• and more.... 

CONCLUSION

Most importantly: don't take medical advice from the internet (including from me). Listen to the professionals: your doctor, pharmacist, and the manufacturer's directions.  Read the material that comes with the medicine and you'll find most of the answers to your questions.

What Time Of Day To Take Thyroid Medicine?

I have written about this before yet I still see this question come up often within the Thyroidectomy groups: what is the best time of day to take thyroid medicine ( Levothyroxine (synthroid, Unithroid, others)).

The question is usually answered with a lot of misinformation. People are all over the clock. They don't know why they take it when they do, but they don't have any problems, and they recommend you take it at that time too. This is dangerous advice!

There are several things that can interfere with Levothyroxine absorption and make it less effective: an empty stomach,  calcium, and even walnuts! Many food items, including supplements and antacids, can interfere with the absorption.

The instructions are not hard to find nor follow - the instructions come with the medicine straight from the pharmacy. You can also check the manufacturer's website. Thoroughly read the information from the pharmacy.

1. Take it at the same time every day

2. If you forget a dose, take it as soon as you can

3. Do not eat anything one hour before nor one hour after taking the medicine

4. Do not consume calcium or iron four hours before nor four hours after taking the medicine

5. Foods to avoid include Soybean flour, cottonseed meal, walnuts, dietary fiber, and grapefruit juice eaten 4 hours before or after taking the medication.


PILL MANUFACTURERS

Switching between pill manufacturers can change the results. Therefore, talk to your pharmacist about always getting the same pills. If you switch pharmacies, make sure you are getting the same manufacturer. Sometimes your doctor can help by writing the prescription in such a way that assures a certain manufacturer is always used.



CONCLUSION

Most importantly: don't take medical advice from the internet (including from me). Listen to the professionals: your doctor, pharmacist, and the manufacturer's directions.  Read the material that comes with the medicine and you'll find most of the answers to your questions.

Heart Attack At Age 45 Alive

Just in case my blog isn't motivation enough, I want to point out a great new Podcast that my daughter turned me on to: Heart Attack At Age 45 Alive.

The podcast is about dealing with a life change resulting from a medical issue. Coach Lipani had a heart attack at age 45 that left him depressed and out of shape. But he is turning that around and has a lot to tell about his journey. He got the help he needed, he walks to work, and he has changed to a plant based diet. The entire family is on board and making the change with him.

A heart attack was Coach Lipani's health crisis. Our health crisis was cancer. Like coach, we are being forced to make some life changes. Those changes are difficult - not just because change is difficult, not just because no one understands - it is difficult because our bodies have been left depleted and in a condition unlike never before.

I encourage you to check out the podcast. You'll love hearing coach's kids,  learning (as they learn) about cooking healthy with his wife in the kitchen, the inspirational stories, the encouragement provided by someone who cares, and delivered the way a coach can deliver that encouragement. You'll also hear from many health experts that he interviews.

You can read more about Coach Lipani and the podcast in this newspaper article.

Thyroidectomy Weight Control: Buying Exercise Equipment

You have decided to get in shape. You aren't interested in joining a gym. So you have decided you need a piece  of exercise equipment to make that happen. Congrats!

First, you don't really need a piece of equipment (treadmill, stationary bike, elliptical, etc). You just need to go outside and move: walk, jog, run, whatever. But perhaps going outside isn't an option (for whatever the reason) and you are determined to make a purchase.

First (as always) check with your doctor before starting exercise. You aren't as young as you used to be, and your doctor will have some good and effective ideas for you to try. For example, my doctor told me to use an elliptical because it would be easier on my joints.

Next, whatever piece of equipment you get, make sure it has plenty of handles and bars. Most people give up on using the equipment and use it, instead, to hang and dry clothes. You want to make sure there are a lot of places to hang things.

And that brings me to my third piece of advice: don't buy new. It is very tempting to go to the store and pay a lot for something shinny and new. Don't do it. Look at the classified or craig's list and you will find a lot of equipment for sale. Most people buy the equipment and then don't use it. And many of those people will get rid of it instead of hang clothes on it. Often these pieces of equipment have  only been used a couple of times! And you will pay pennies on the dollar!

I have a fully stocked gym in the basement of my house - nearly all of which stocked, pennies on the dollar, with slightly used gym equipment!

Different equipment will have different bells and whistles and stuff: digital displays, coaches, phone connection, disco lights, etc. Just set yours up in sight of a TV with a fan to blow on you and the bells and whistles won't matter. Sure the bells and whistles are fun.. the first several times you use it. Then you'll realize none of them really matters.

If you are getting a treadmill or elliptical, three things do matter: (1) The length of the track. If you are tall, you will need a long track. (2) The weight limit. They always over estimate the weight limit so if the limit is 275 pounds? You better be under 250 or the machine is going to break. (3) The incline. You want to be able to simulate walking up a slight hill. It doesn't have to be a crazy 30% incline, but you will want some kind of an incline (10% is often fine) to continually challenge yourself as your body adapts to the exercise.

If you are getting a stationary bicycle or an elliptical, you want to understand the mechanism that provides resistance. Some devices will use friction as resistance by pressing rubber pads against the moving part. Other devices will use magnets for the resistance. I find the rubber pads make a lot of noise and wear out. On the other hand, magnets must be powered by a battery or an electrical outlet. Batteries tend to give unequal resistance - all dependent on the charge of the batteries at the time of use. So, here is my recommendation: magnetic resistance via electricity - the device needs to plug into the wall. If it doesn't plug into the wall, make sure you can still purchase the optional electric cord so you can plug it in.


You want to try it before you buy it. When you try it, listen for sounds such as rattles and squeaks. The sounds might not show up until after the machine warms up a little. Small squeaks become big squeaks and will drive you (and everyone in your house) nuts. You also want to feel for nice fluid motion. Even a small bump or jolt will lead to joint pain over prolonged use. If you are handy, you can usually order the parts and repair the equipment yourself. If you aren't handy - stay away from equipment that is demonstrating problems.

When you get the equipment home, you want to place it on a rubber mat even if using the equipment on carpet. It can be a thin rubber mat or those foam floor puzzle pieces - it doesn't matter. The mat will protect your floor, will protect the equipment, and will protect you while in use.

If you decided to go with used equipment, you might not know how long the equipment sat unused. Most equipment is lubricated with a long lasting silicon lubricant. However, time, dust, and lack of use can cause the silicon to become ineffective. You should give all the moving parts a once-over with a high temperature silicon lubricant.


There you have it! My advice on obtaining home exercise equipment. Let me know how it goes, and, good luck!

Thyroidectomy Weight Control: Hunger: Reduce Fats and Eat More

My favorite meal of the day is breakfast. My favorite breakfast is the McDonalds Big Breakfast with hot cakes. It comes with egg, sausage, biscuit, pancakes, and a hash brown. I don't eat the hash brown, and I find the hot cakes are sweet enough to eat plain. Even without the syrpt, butter, jam, and hashbrown - that breakfast is around 800 calories! Afterwards, I am still hungry. How is that possible?

The answer lies in the amount of fat. Eggs, sausage and biscuit are 33 grams of fat. By now you should know that each gram of fat has 9 calories (compared to protein and carbs that have 3).  33 x 9 = 297 calories from fat, or, around seventy percent of the calories from those three food items combined come from fat.

The biscuit, egg, and sausage consist of 33 grams of fat and 129 grams of carbs, protein, and everything else; totaling 162 grams. Even though the fat is only 20% of the grams (the amount of food) it accounts for nearly 70% of the calories! If you replaced this breakfast with a fat free option, you could consume over 220 grams for the same calories (40% more food). In other words, healthier choices would allow one to eat more and still eat fewer calories.

I have a general rule: if it tastes good, it probably isn't good for you. The McDonalds big breakfast tastes really good.  What is the point of gorging all those calories and not feeling stuffed afterwards? 

Kevin's Kitchen: Kale Vegetable Soup

Your slow cooker is a quick road to dinner heaven!

A thyroidectomy requires a life change. That includes changing eating habits. The purpose of Kevin's Kitchen is to help those with no (or little) cooking skills to create great meals.

Slight departure this week: Core Life Eatery inspired meal. 4-5 pounds of Chicken breasts,  3-4 cans of mixed vegetables, celery cut up, and chicken broth. Seasoned with a bay leaf and Kickn Chicken seasoning. Let it cook all day. Serve it in a bowl over shredded kale.