Canadian Winter Stir-Fry

… Not Nearly as Expensive:
(c) 2016, Davd

Day-to-day cooking should not need expensive ingredients. A good cook should be able to make the good, staple foods taste delicious—not exquisite, maybe, but delicious. As seasons go ’round and prices change over the years, some foods may go from staple to expensive, as broccoli and zucchini do from summer to winter, and back again; and shrimp have gone up in the past ten years. Some would say beef is now too expensive for regular cooking—but i expect beef prices to ease sooner than shrimp prices, and indeed this January 2016, beef can be bought for less per kilo than can shrimp. I’m eating less beef; i haven’t bought shrimp in six months or longer.1

In a Canadian winter, especially this winter when the Canadian dollar is “down”2, economical cooking means making good use of four basic winter vegetables: Cabbage, carrots, onions, and bean sprouts.With pork or chicken, plus of course rice and soy sauce, those first four basic winter vegetables can make you a delicious, economical, nourishing meal.

The meat should be cut no larger than 1”[25 mm] on its longest dimension, and ¼” [,7 cm] on its thinnest. This will facilitate browning and make sure it is fully cooked. The onions should be chopped fairly small, but not “fine,” The cabbage and carrots should be in strips which may be a wee bit longer than the meat [maybe 3 cm] but thinner—an eighth of an inch, or 3mm, would be about ideal. (The [mung] bean sprouts are the size they are, and need no cutting, duuuuuuuhhh.) If you have mushrooms (and in Edmonton in January 2016, mushrooms cost less than half the per pound price of broccoli!) they can be cut roughly the size of the pieces of meat.

I haven’t used a wok in months, perhaps years. They are useful and effective, but awkward to fit in and work around in an undersized kitchen; and i can do an acceptable job with a frying pan—of which i have three good cast iron examples.

Stir-fry technique starts with hot oil4 in a seasoned pan. Then you put in the meat, and as it starts showing that it’s browned, the onions. When the onions are lightly browned, add the carrots (and mushrooms if you have them), and almost immediately, some vegetable stock. (If you have plenty of meat stock to go with cooked meat that you are using, add that; with raw meat or smoked ham, vegetable stock will do fine.) Add a little soy sauce also, lower the heat under the pan, and cover while you are cutting or assembling the carrots and cabbage.

If you’re new to cutting carrots into small strips, start at an easy pace rather than hurrying; the knife can slip because carrots are cylindrical rather than rectangular in shape. It helps to cut them in half lengthwise, and lay the flat sides on the cutting board. It helps to use a vegetable knife rather than a generic cook’s knife. Until you get used to cutting carrots into strips, cut them before you start cooking, so you won’t feel a need to rush.

Cabbage can be cut more easily because it naturally comes layered, and in more neatly flat layers than onions. I sometimes use Fiskars cook’s scissors, sometimes a vegetable knife [which in my case is also Fiskars brand—both items made in Finland5.]

After a minute “or three” of wet cooking, check the stock level and if the carrots are getting close to tender, add the cabbage. After another “minute or three” add the bean sprouts. The goal is to have sprouts, cabbage, and carrots, three very different vegetables, all at the bright and slightly crisp state at the same time the meat and mushrooms are just fully cooked.

If you want a thickened sauce, mix some corn starch into cool to cold stock, stirring preferably with a fork,while the vegetables are cooking. Add this when the sprouts and cabbage brighten, quickly stir into the hot stock with a fork, and as the stock returns to a boil, it will thicken.

You can add rice to the pan, or put the rice on plates and then top it with the meat, vegetables, and sauce. A bachelor eating alone can add the rice and eat from the pan, for minimum dishwashing burden.

As you get used to making stir-fry meals, you’ll also get used to how fast the meat and vegetables cook in your particular pan on your particular stove; and to how much soy sauce to add, when. You might get it just right the first try; but be willing to settle for “pretty good” on the early efforts. You are using economical foodstuffs to make an “upper middle grade”, one-dish meal that can even become a presentation item. (It does not, however, carry well to potlucks away from home. It should be eaten within minutes of becoming done.)

If you “run into” a specially low price on sweet bell peppers, pineapple, or broccoli, they are very good in stir-fry. I tend to steam broccoli tops and slice the peeled stems like i do carrots, but a little thicker, into stir-fry. When using broccoli, reduce the cabbage accordingly.

I stir-fry often, with chicken, ham6, raw pork, sometimes leftover beef. Fish hasn’t worked well for me stir-fried with vegetables; and has been delicious steamed, or poached in salsa (or for the stronger, fattier fishes, grilled, fried, pickled, or smoked. Salmon and trout are good raw-salted.) Chicken “burgers” have been an economical form of mostly meat with a little breading, which has also worked for stir-fry meals.

This year, the high US dollar and low Canadian dollar, plus the fact that most Canadian stores stock US rather than Canadian grown vegetables, has driven prices well above a dollar per pound for most.

The sensible answer to Canada’s vegetable supply predicament is to grow plenty of good winter vegetables here, store them as our grandparents did (and have larger scale storage for urban stores), and use them as our staples when our gardens are not producing. Stir-fry is one way to do that which is quite different in taste and texture than the Euro-Canadian staple, stew. If the Asians who showed us the basic technique, insist on exotic vegetables, let them; i’ve learned to use staple vegetables i can grow myself to produce a reliably good result with chicken, ham, pork, and when it’s less expensive, beef. (Meatless stir-fry also works; but with meat, it has better protein balance.)

Part of the pleasure of eating, is having chowder from time to time, Likewise for stew, steamed fish, pork chops and porridge, … and stir-fry. Adding this technique to your repertoire will make your meals more diverse and enjoyable for many winters to come—and come fresh garden broccoli, beans, and tomatoes, those will make a stir-fry repertoire different enough to give a change of pace. Then next winter, the winter version will be less repetitious—and again, nourishing goodness from plain staple foods.

 Notes:

1. This fall, pink and then sockeye salmon have been the most economical seafood in Edmonton (and Edmonton is far indeed from being a port city.) From what all i know, they are more nourishing than shrimp. So while six years and longer ago i ate quite a lot of shrimp and very little sockeye, this winter i eat shrimp only when somebody else serves it, but lots of salmon. That calls for quite a change in cooking techniques. Changing from summer to winter stir-fry, doesn’t.

2. In the stores in mid-January, i looked at the bags of carrots and saw California, not Canada, as the place of origin. I know damn well that Canadian grown carrots can be stored in sawdust or even their own greens, in buckets with air holes too small to admit mice, in a cold room or cellar. That’s how i stored my home grown carrots last winter and the winter before.

3. Sorry, but so far i haven’t had any good experiences using beets, parsnips, or rutabagas in stir-fry. I’ve already written-up a good, easy way to cook beets that provides a change from plain boiling; i eat turnips white and yellow, sliced raw with a sprinkling of salt, or as lazy man’s pickles; and parsnips remain outside the range of my cooking. (Anyone care to tell me the great, easy way to really enjoy them? There’s a contact link you can click near the top of the page.)

4. If you are cooking children and have some saved chicken fat, or likewise for beef, pork, or turkey, use that or a mixture of fat from your meat animal, and canola oil. Olive oil does not usually perform well at meat browning temperatures; US readers might want to use corn or safflower oil. Soybean oil will work, but with canola oil so inexpensive in Canada and my preferring its taste, i use canola.

5. I’ve been quite satisfied by Fiskars kitchen and garden tools made in Finland, where the firm originated; but not with Fiskars garden tools made in China. Quality control is a fairly general problem with “outsourced production”… indeed, “Made in Japan” once symbolized low quality, while today, Japanese goods are respected for the same high quality that made the katana famous centuries ago.

6. Mushrooms don’t seem to go as well with ham as with other meats.

 

Print Friendly
Posted in Davd, Food | Leave a comment

Tolerating two “Foul-Mouthed” Women

… as seen on the Edmonton bus system:
(c) 2016, Davd

On the way to church one recent morning, the bus was at least half full. Edmonton City Transit was making expenses, i’d say, maybe doing better than that, on that post rush hour run; and i was glad; because the more people ride the buses, the more likely they will be rescheduled to run more often. Nobody i have ever met likes waiting around for a bus in January in Canada’s Prairie Provinces.

I did find a seat facing the back door, with an empty seat between me and a young man. After a mile or two, he got off, and soon a young woman who had just got on, took the seat he had been using. There was one empty seat between her and me; and i was thinking mostly about the church service i was headed toward, but also about where the bus was along its route and how soon it might reach the stop where i should “get off and walk.”

She got out her mobile telephone and called someone. Her first remarks were about food; and then, as or shortly after the bus crossed the Yellowhead Highway, i began to hear “F[***]” and “S[***].*” I listened just enough to make sure that—as i expected—she was not referring to copulation, nor defecation. The rude words were used for some other reason, than to say what they mean.

For two or three miles she continued to use those words, never that i noticed to mean anything like their meaning in say, cattle or pig farming. She did not shout them, but they were the most prominent words she said; i’m more than 90% convinced that if she used any other words as often, those were common words like “and”, “he,” “if”, “she”, and “the”. Nobody tried to offer her any lessons in good manners; all of the 30-50 people on that bus ignored, or pretended to ignore, the “vulgarity”

I don’t mind hearing those words used accurately*. Indeed, i use them myself on those fairly rare occasions when i am talking about what they mean—and am not in the hearing of someone who i know considers them offensive, nor in a place full of strangers like (for instance) a city bus.

It occurred to me, as i was getting off the bus to walk to the church, that i haven’t heard any men, or boys, using those same words on a bus. If i or another man on the bus had used them equally often, methinks he very, very likely would have been shamed. If 50-60 years ago the F-word and the S-word were sometimes tolerated when spoken by working-class men and larger boys, but forbidden to decent women and girls; today the reverse is true.

One week later, on the same midweek “ride to church” a different woman, of a different race, was repeatedly “foul mouthed” on the bus; and again, no one intervened.

I don’t know the women’s names; i don’t want to know them. Neither is a personage to me, any more than the “foul mouthed” boys and occasional young men were, who used such language on street corners in the 1950s. What’s important about them, from my perspective anyway, is that they each used that kind of language, many times, without good reason, in a confined public bus full of strangers; and even more important, were tolerated, more tolerated than if they had been male.

Notes:

This is not a statistical social survey; it’s a report of one incident involving the toleration of a hundred or more repetitions of the two standard “dirty words”, by a few dozen bus riders, It’s the kind of typification that anthropological field work often contains: A reaction or lack of one, is reported as typical because many people haphazardly assembled, do or do not react to behaviour. Its context includes the presence and absence of the behaviour in populations observed at other times, who represent the same society. In this case the context also includes past reactions to the same behaviour: 50-60 years ago, uses of the F- and S-words by women were far less tolerated than uses by men. In this decade, uses by men are less tolerated, as indicated by their rarity as well as by reactions. (cf. Nathanson and Young, 2006: ch 3, 39-40, 49-50).

I can’t recall hearing any men using such rude language—definitely not so much rude language—on the bus, in the four months i’ve been riding Edmonton Transit. Between 40% and 60% of the people riding with me have been men and boys, of all races—as the women have been of all races.

* I find this website’s “PG-13” policy vexing at times, and this is one of them, but it does remind me that if any reader wants to go into the erotica selling business, “The F-Word” would be a cute name for an erotic boutique.

 

References:

Davd, 2012. “If The Genders Be Reversed: a Test for Equal Treatment. The Spearhead website [no longer accessible] Reprinted May 2015, on this everyman.ca site.

Nathanson, Paul, and Katherine K. Young, 2006. Legalizing Misandry: From Public Shame to Systemic Discrimination against Men Montreal: McGill-Queen’s University Press.

 

Print Friendly
Posted in Davd, Female Privilege | Leave a comment

New Year’s Resolutions

… some Review Principles for 2016:
(c) 2016, Davd

Because i had to re-install my Linux operating system New Year’s Eve, this post not only won’t get up that day; by the time it is published, it will be January 2nd in English time, which for some reason, seems to be what the everyman.ca web server uses. But New Year’s Resolutions are famous for not being kept. If you’re not going to commit the effort to keep them, don’t say them. This is about making resolutions worth keeping. It might help you make resolutions after The Day, or edit those you made.

Remember, this is voluntary. You don’t need to make New Year’s Resolutions! And if a “resolution” is not expressing your personal philosophy of life, it is really not yours—it’s somebody else’s resolution imposed on you. For instance, if you are fat, overweight anyway, and you’re getting pressured to resolve to lose weight, that’s not a resolution, it’s a capitulation. If the person putting on the weight loss pressure is your Mother, or your wife, or anyone who cooks your food—then rather than resolve to lose weight, you can agree to eat what they cook for you—but there are better ways to lose weight than “dieting,” as we shall see.

That same classic post-holiday resolution, “to lose weight”, is fine if you want to weigh less badly enough, to plan how you will lose that weight. Then it’s a real resolution. I intend to lose some weight myself, but i’m not making that a resolution. In the form of a resolution, i’m resolving to get out of the Big City1 to someplace where i get lots of exercise, including arm and shoulder muscle exercise, and have men friends around me... and the guiding principles that follow all support that… indeed, helped me to word it.

1. Don’t let Feminism, or any other-people’s perspective, be a basis for how you think and feel about yourself! Because this is a men’s website, and Feminism has been “Politically Correct” lately, it’s the ideology, the perspective, that i name first; but it’s not the only one that may try to tell you how to think and feel.

Instead of letting some ideology from outside tell you what to think and-or feel, make personal choices of perspective and “ideology”. Choose your outlooks, and your beliefs. Maybe you have chosen perspective[s] and beliefs already; if not, spending some time this year, choosing and clarifying your philosophy of life, would be an excellent specific New Year’s Resolution.

Personally, i’m Christian, meaning i have thought long and reflectively about the Christian Faith, the teachings of Jesus, and decided voluntarily to make it one of my perspectives. Not the only one—probabilistic science is another perspective that is mine by choice, and overlapping with probabilistic science, there’s ecology. Those perspectives influence what i think and feel because i have chosen them. But Feminism, i never chose, nor profit-motive capitalism, nor bureaucratic socialism—nor even the notion that punishment is the best way to motivate good behaviour. Those ideologies, those ways of seeing things, are foreign to me. Living in the countryside, there’s less pressure from them.

Refusing to let your mind be pushed around by Political Correctness, choosing and clarifying your philosophy of life, are not easy resolutions to keep. Don’t kick yourself too hard if you notice a “slip-up”. Do stop and ask, when a foreign ideology or perspective tries to boss your mind around—what’s a better basis than that, for how i feel and think? If you don’t have a philosophy of life, then forming one, or more than one, is a good resolution just because it gives you something better than yielding to social pressures, to live by.

Along with a philosophy and perspectives of your own, comes an appreciation of the difference between pleasing others by choosing company who find you pleasing, and making it the reason you do things you’d rather not.

2. Don’t try too hard to please anyone else—especially not a woman who thnks it’s your duty to please her. In my Christian philosophy of life, one of the Teachings is: Don’t judge others. Assess them, if it seems fitting, as i’ll assess “Geoff”, below; but don’t judge them and, reversing the direction, don’t let them judge you. Be good, in the sense of the classic virtues, but don’t be nice. “Being nice” amounts to letting somebody else judge your worth.

It can make sense, short of letting someone’s feelings be the chief influence on your conduct, to let people of both sexes influence you naturally. Pleasing someone is better than not pleasing him, if it costs you no more to please. It might be better if it costs you a little more to please. It’s not if you have to go to a great deal of trouble.

And you might just have noticed—i wrote “pleasing him”, not “… her”. Most of the readers of this site are men; and we are more like other men than we are like women, indeed, the sexes are more different than the races. Which implies, we benefit more from learning from other men. And because they’re more like us, other men will usually be easier and more enjoyable to please.

3. Give Yourself Enough Elbow Room: In Time, in Money, in Space:

There’s a friend i’d like to see more of, talk longer with, but he’s always “behind”. He’s late to meetings, late to meet friends, late getting home to his family. (I’ll call him Geoff because he is English and Geoff is no part of his real name.) Geoff is late for ‘most everything except his church services (which are always the same time Sunday morning). He makes promises he doesn’t turn out to have time to keep—not on rare occasions, but more often than not, that i’ve noticed.

Geoff calls himself an extrovert, and feels good about that. For other people to feel good about it also, he needs to discipline that extroversion. And even more important, he needs to provide enough time in his planning, to be available, to be present, close to when he says he will be. I’ve started avoiding Geoff, started viewing him as unreliable, not because he lacks good will or competence, but because he lacks time. He expects things to go smoothly, to take a practical efficient minimum of time, always—and that’s not realistic.

It’s not realistic to expect everything to take the length of time you estimated it would—even if you are very good at estimating. It’s not even realistic to expect traffic to always flow smoothly, or a chore to take the usual length of time. It’s not realistic to expect no interruptions if you walk to a meeting. It’s not even realistic to expect appointments to begin on time—if they did, waiting rooms would be far smaller than they are.

Allow time for “random errors and interruptions”! If you go to an appointment, a class with a scheduled time, a church service, or a meeting, plan to be ten minutes early if the journey is short (walking a few hundred metres, for instance); fifteen minutes early if it’s a few kilometres, half an hour early if it’s an hour or more one way, and an hour early if it’s two hours or more. Have something to do if you arrive early—a nearby library, for instance, a shopping errand, or some notes to work on. But if you can talk with somebody you know who’s also prudently early, and don’t see often, do that instead. Keeping your network active is a benefit of arriving early!

(Mobile phones can be used almost anywhere; so if you do have a wait of more than ten or fifteen minutes—get out your mobile phone, and you should easily find people to call and “touch base with”, people you’ve wanted to call, even phoning and “texting” chores you have to do “sometime soon” that you can do now, while you’re waiting.)

I could conjure up more examples, but i think you get the pattern: Add extra time into your schedule to make room for the random unpredictability of life. Don’t fill the day cram full with appointments, meetings, tasks that need specific times. Leave room for delays and for opportunities to keep up your friendships.

In the case of money, “elbow room” isn’t so clear, because you can borrow money but you can’t borrow time. My own philosophy has been “stay out of debt”, all the way back to my student years. I have not kept it perfectly, but i have borrowed less, for shorter times, and lived more simply, than other men (or women, that i have noticed) with similar incomes. I believe this old-fashioned perspective on money has served me well.

As for space, my resolution to get out of the Big City says much: I want to meet more people i know than people i don’t, in a day. I want to go for walks with Fritz and when he lifts his leg on a tree or a post, i want to be able to do likewise, not have to drag him back to the house early so i can use a toilet. And i can say from recent experience, that walking outdoors with other men i know, i can fertilize a tree instead of hurrying indoors to piss, and they won’t mind. Strangers are another matter.

What “enough elbow room” means specifically for you, i won’t say; maybe you have enough elbow room in your time, your personal space, and your finances, now. If you know you don’t have, a New Year’s Resolution is a good way to “explain” a change to fewer promises and more free hours, less spending and more saving.

Some of your “elbow room” time can best be spent, if you don’t use it up on delays, doing useful, manual work… work that can save you money and grow you healthier food than the stores typically have, and rural spaces make it easier.

4. Value manual labour is my fourth New Year’s Resolution guideline: Manual labour is good for your health and your thinking power. Exercise helps you avoid overweight, even reduce your weight if you’re overweight now. Twenty minutes a day ought to be your minimum.

Walking counts as exercise, and i do a lot of it myself; but a study done recently on 54 older women, showed that “upper body resistance training” (muscle building) stopped “white matter” brain deterioration while balance and flexibility exercise did not. And the muscle building participants also maintained a youthful walking speed. (As the CBC News article said, “gait often slows about 10 years before cognitive impairment.” That normal walking speed implied ten more years, for most of them, of thinking competence.) The MRI images and the walking speed both indicated, that keeping and improving their upper body strength went with keeping their brains functioning well.

Walking is good for you; letting your muscles atrophy above the waist is bad for you. And a lot of men’s work is “upper body resistance exercise”: Digging your garden by hand counts. Chopping firewood counts. Changing tires by hand, counts. Helping a friend or relative build a house or a garage, counts. Even pushing a lawn mower instead of riding one, counts. Shoveling snow counts, this time of year.

So if the job’s manageable, do shovel that snow. Do dig your garden with a spading fork. Do keep using a push mower. And do get in your own firewood: If the wood is really big in diameter, say over a foot across, accept that neighbour’s loan of a hydraulic splitter—and then go help him load, unload, and pile his firewood, to get the “upper body resistance exercise” the machine spared you, in an easier form.

Manual Labour, in the forms you most enjoy it or need to get it done, is good for your body and also for your mind. 20Th Century society over-mechanized “work”. Many things can best be done by skilled human muscle, and men have significantly more of that muscle on average, than women. Now we’re learning just how valuable manual work is to the worker, as well as the ecological state of the Earth and thus, the human condition overall.

5. Include plenty of buddy time in your future. My father went bowling and fishing, played squash and snooker, with a total of maybe two dozen buddies from work, from college, from church. He was active in the Elks Club (membership was much more widespread in his time than it seems to be today) and in his fifties, joined the Masons and became a Shriner.

My grandfather2 lived on the other side of town, near where he worked before retirement; and kept in touch with the men “from the shop.” He also had a few women friends who were buddies of a sort; i think their common interest was gardening. He belonged to the Odd Fellows, a lodge which has declined even more than the Elks. Like my father, he counted buddy time as a normal and important part of his day to day life.

Buddies—the word seems obviously to have formed as a variant of brothers—have the sort of “male bonding” relationship that men formed hunting together in prehistoric times. Men bond by sharing hard co-operative work and at least a little adversity. Violence is not a requisite. Sports can and often do substitute for the work of hunting, fishing, farming, and teamwork generally (in Grandfather’s case, maintaining railroad equipment.) Boys who grow up as brothers, bond by sharing chores and the adversities of school. I doubt if urban office work or solitary work like bus driving, can bond men like barn raising, harvesting together, fishing together, or being together on a sports [or charity] team.

For some men today, especially urban men, the first task is finding the buddies. Sports are one way that often succeeds. Hobbies, and church men’s programs, can lead to buddy friendships. Choosing a line of work where you will have plenty of men co-workers and plenty of time to work with them rather than separately, might be the best way to assure having buddies; most skilled manual tradesmen seem to have several.

Feminism attacked all-men organizations in the last century; but blessed and praised all-women organizations. That’s neither equal nor good human social life; in an old folk saying, “Turnabout is fair play.”

If you are married, or “cohabiting”, the woman in your house probably spends considerable time with her women friends. You are equally entitled to spend comparable time with men friends… and you have equal claim to supervise her women friendships, as she has to supervise your men friendships. In my boyhood years, the main rightful limit on same sex friendships, was the avoidance of using them as a means to adultery or the appearance of pursuing it.

(And it’s a sign of gender inequality, that i even saw any need to write those last two paragraphs.)

It is with your buddies that you will form much of your perspective on and philosophy of everyday life. In the days before history when human nature was being formed, men and women lived in tribes of a few dozen to a few hundred people. Men and women usually slept with a spouse, but spent more of their waking and working hours in same-sex company. Most people, including most men, would probably be happier living in that kind of social context, the one that formed our nature. It provided men [and women] with plenty of buddy time, plenty of manual, arm and hand and shoulder work, plenty of uncommitted time to philosophize and to catch up on unfinished tasks that had not got done as fast as predicted, little pressure to cater to the feelings of the other sex (and even less toleration for cruelty.)

I encourage you to reflect on those five “guiding principles,” maybe even memorize them. I also encourage you to reflect on how well they are calls to “be true to your nature.” An old short maxim-in-a-verse, famous when i was a university student, put it this way:

This above all: To thine own self, be true
and it will follow as the night the day
that thou cannot be false to any man.

References:

Lenski, Gerhard, Jean Lenski, and Patrick Nolan, 1991. Human Societies: An Introduction to Macrosociology. 6th ed. New York: McGraw-Hill. 333-5:

Turnbull, Colin M.1968. The Forest People. NY: Simon and Schuster paperback.

Notes:

1. I’m in a Big City now because i spent the autumn on prostate cancer treatment. Click that link and it will take you to the first of the Movember blogs,.. seven of them in total.

2. .. the one i knew as a boy. My other grandfather lived 800 miles away and i only met him once or twice.

 

Print Friendly
Posted in Davd, Male Lifestyle, Men's Health | Leave a comment

Easy Picklish Beets:

…Suitable Hot or Cold for Holiday Meals and Parties..
and Easy to Boot

(c) 2015, Davd

The beet, or beetroot in real-English, is a classic winter vegetable: It stores well in a cold [but not freezing], damp cellar. It is just about as good taken from storage in April, even May, as it was dug fresh in October or even September.

The big difference, that makes beets much more a winter than a fall vegetable, is that from early December or late November onward, the gardens have stopped producing. The sweet, slightly crunchy boiled beet slices that were outshone by broccoli, lettuce, kale, maybe fall peas in September and October, are just as good in the first four months of the New Year when those other vegetables—never mind cucumbers, tomatoes and zucchini—simply aren’t available fresh.

You can look, and there will be “fresh” vegetables in the stores. “Fresh”, in winter and the early spring “hungry gap”, means “never frozen, neither canned” After a long truck ride from the Southern United States or farther away, including probably a wait at the Border, and then the usual warehouse treatment, no vegetable is fresh.

Roots and cabbages take long waits from harvest to use, better than lettuce, cucumbers, sweet corn, etc. Broccoli, cauliflower, sometimes sweet peppers can survive the trucking in good enough shape to be worth buying—at a reasonable price. (I bought some broccoli myself, this week, at just under $1.50 per bunch, after preferring steamed cabbage with caraway for most of the autumn when broccoli cost $5-$9 per kilo.) This winter, import prices are high, and we can give thanks for the staple winter vegetables: Roots, cabbages, canned tomatoes—and bean sprouts, which you can sprout economically at home.

The usual way to cook beets is, of course, boiling. Steamed beets, i have never seen, nor baked, nor fried. They’re not bad if boiled in plain water; but a little spice and vinegar can give them a different taste, one which many people prefer and most people find a pleasant “change of pace”. Instead of one good winter vegetable, then, boiled beets can give the menu diversity of two vegetables.

Especially if you’re trying to use local produce as much as possible, that extra flavour is well worth a little extra work; and it is only a little. To make picklish beets, you simply add allspice, chopped onion, and white vinegar to the cooking water.

Of course, there are recipes for pickled beets that are much more complicated; and some of them make quite impressive pickles. If you want to “can up” a dozen or several dozen jars of pickled beets for the future, those recipes are worth trying, perhaps varying, and choosing among. What “picklish” beets offer as a technique, is quick, easy results that taste good—and taste pleasantly different from ordinary boiled beets.

For the Solstice holidays, (often mislabeled as “Christmas”) a picklish taste is generally more welcome than the plain taste of a good vegetable—hence, this technique goes up now, for the last week-plus of December* as well as for the occasional winter use until home grown vegetables are again possible in most of Canada.

Start with a beet or two—if you’re not confident how much to season it, take a small or medium sized one, and slice it about 3/8″ thick, (err toward thinner.) Put the beet slices into a cooking pot, and add water enough to cover them. Then take out the water long enough to measure its volume.

To the water, add about 10% as much vinegar: In the trial i cooked up while writing this blog, i put ¼ cup vinegar in 2½ cups of water—one tenth as much vinegar as water—and added about the same amount of chopped onion as vinegar, plus a rounded teaspoonful of allspice. That cooked two small beets. They came out so good that i recommend you start with these ratios—10 parts water, 1 part white vinegar, 1 part chopped onion, a slightly rounded teaspoonful of allspice per half litre of water—and then change to your tastes after the first batch, which i predict you’ll like well enough already.

I slice my beets about 1 cm thick—that’s three-eighths of an inch in English measure—so they will cook in a bit over half an hour’s time. Cut off the top where the leaves were, and the “tail” or taproot; and then you can slice the beet in half to make it lie flat on the cutting board, or slice it straight across if you prefer a round slice and have good control of your vegetable knife.

Use, in general, the smallest stainless steel cooking pot that will cover the smaller size element of your electric stove. If the water [plus vinegar] covers all the beet slices, you have enough liquid; and in general, that’s easier to accomplish in a smaller pot. (If you cook on a woodstove, you probably know how to choose a pot to suit the job; if in doubt, use one in which the beets and liquid total 3-5 cm [1¼” to 2″] deep.)

Bring the seasoned water to a boil on high heat, then lower the power to the level that just keeps the pot gently boiling. Expect beets, even sliced this thin, to take at least a half hour to cook—mine did, the two times i’ve made picklish beets this autumn. (The vinegar may turn the surface of the beet slices whitish while they are cooking; when my test batch had cooled from boiling to eating temperature, they were a good beet red color again.)

Don’t use a clock to decide when they are done—use a fork: The beets are cooked when a fork will easily penetrate through the slices. A sharp pointed “salad fork” is OK to use for testing them; and if in doubt as to whether the fork penetrates easily enough, let them cook a few more minutes at that gentle boil. They won’t turn from too-crisp to mushy in ten minutes.

My test batch of beet slices took more like 45 minutes than a half hour, to cook, so to be prudent, i suggest you allow at least an hour (but don’t expect to need that long.) They weren’t as strongly flavored as the pickled beets i’ve been served by households that can them up at harvest; but they were very good, and sweet despite no added sugar.

They’re good cold, too, and can go on the pickle tray at a holiday party—or any other party this winter that has a cold tray.

Notes:

* This technique should ideally have been posted around December 20; but my attention was on something more important just then. I was working with a few other men toward founding a co-operative household. So far, nothing of our activity is worth writing up; i hope to post something in the first half of 2016.

The reason i write ”mislabeled as Christmas“ is that Orthodox Christians fast during the weeks running up to December 25, and i see no Christian basis for calling typical December partying a form of homage to Jesus Christ. A feast on the 25th, or later under the Julian calendar, yes. A feast for the poor on St. Stephen’s Day [Boxing Day in British usage], yes!  Shopping mania, no!

 

Print Friendly
Posted in Davd, Food | Leave a comment

After Movember

Men’s Health Still Matters…
,,, and We Can Promote Men’s Health with Intentional Brotherhood.

(c) 2015, Davd

Movember ended before Radiation Treatment did, but barely: My last session with the narrow slippery table and the elaborate attack-X-ray machine was December 3. My days are no longer dominated by Radiation Treatment, the times when others chose to schedule it, and the Special Toilet Training it required.

I celebrated the end of those constraints by lunching on pirogies, a Ukrainian folk meal which might be uh, anti-laxative. For those who live well east of Winnipeg, or outside Canada and Ukraine, they are made from wheat pastry, stuffed with flavoured mashed potato, and usually boiled or fried rather than baked. The standard dressings for them are chopped onion fried in bacon fat, and sour cream; with those dressings, especially if the potato be flavoured with cheddar cheese, they’re delicious.

Pirogies eaten—with an apple to help sequester cholesterol and saturated fat—i rested a lot during the rest of that Thursday. I rejoiced in having more days when my support dog Fritz and i can enjoy one another’s company all day, when i need not leave him locked up in a basement apartment wondering what i’m doing that he cannot join, locked up homeless as he and i have been homeless these past four and a half months. Friday afternoon, he smiled as he slept… we were together all day

Reflection time, “windup” time; Movember is over and now, so is my Radiation Treatment. My next scheduled time to be at Cross Cancer Institute, they told me as i left, will be for a check-up in March. Until then, and probably all of 2016, i will remain a pharmacological eunuch. Between now and then, i should expect my body to gradually recover from the radiation damage, while the tumor, with luck, will remain devastated. Odds are, i was told, i will not need to return to Cross Cancer Institute for further treatment, just for one or more follow-up examinations.

An appropriate setting, this first week of December, for a tentative assessment of the diagnosis process, the treatment, the likely consequences.1 It seems much more likely than not, that i’ve gained 3-15 years of lifespan from getting into treatment this year. This fall has not been fun, for me or Fritz; we’ve been going through the unpleasant part and next year, we should gradually get back into the pleasures of retirement and being wise old characters.

It does seem clear that changing physicians in 2014, got my prostate cancer diagnosed and into treatment before it spread; and men over 55 should insist on PSA and those uncomfortable finger examinations. That points to a dangerous flaw in the system: Physicians who don’t do basic prostate cancer screening shouldn’t be in primary charge of older men patients2.

Cross Cancer Institute and the Alberta Cancer Society have treated me well. I’m not planning to complain about my provincial taxes next spring, probably not for years. I can’t drive for others as others have helped me get to treatments, not with these old eyes in the state they’re in; but maybe i can do something toward providing lodging during treatment for men who need it, especially men who have support dogs. The many PTSD sufferers who served Canada in Croatia, Rwanda, and Afghanistan are getting older; and more prostate cancer patients will need dog-friendly lodging as time goes on.

Men’s health—in my experience and opinion—deserves more attention than it gets; and mimicking women’s health initiatives won’t always, maybe not usually work. For instance, men are more likely to work long hours, more likely to work in remote or shifting locations, and thus, less likely to have regular connections to the medical care system.

Movember Clinics providing PSA tests [and finger examinations, perhaps other men’s health examinations and advice] look to me like a good use of Movember donations—and for that matter, of public health spending generally3. They shouldn’t be restricted to Movember, but it’s a good month in the sense that most farming and fishing and a lot of forestry work is wound up, daylight is short and so construction overtime tends to be less, and the snow’s not deep yet in most of Canada—most men have time to go to clinics, and decent driving or bus riding conditions in which to get there, in November. The Movember emphasis is appropriate… but Movember clinics are not all there is to improvement.

Health promotion for men (like education for boys) should take into account our greater need to be physically active. Sports for fun (especially fishing and hunting), commuting by bicycle, even pushing lawn mowers and getting in the firewood, are more valuable to us than to women.

Health promotion for men should confront misandry, and especially the lie that men are privileged. Living a lie is mighty unhealthy, and the notion that men in general are privileged, is a whopper. That “if the genders were reversed” test is one good way to estimate misandry, and social programs that flunk it should be revised. Self respect is not pride, and if my Ph.D. in sociology serves me well, much of the depression among men is a symptom of oppression.

It’s bad advice—it’s misdirection—to send men to women for support if other men can provide it, in a social milieu where so many women feel entitled to privilege. Men with good marriages will get support from their wives without being told to; men with bad marriages shouldn’t be asked to rely on them; and the same goes for relationships other than marriage. There are good women, millions of them—and there are other millions of women whose effect on men close to them, in today’s biased legal and bureaucratic system, is too frequently toxic. If in doubt, i recommend, choose buddies—the word is based on brother, and we Christians are supposed to treat our fellow Christian men as brothers (as likewise with Muslim men4).

It’s not only monks who can benefit from intentional brotherhood. Monks provide us with examples of men living, successfully, as brothers not born to the same mother nor father, and successful for centuries. Their examples can be adapted for men who have other main interests than religious ritual5. Indeed, students in “fraternities” at universities and colleges are basically adapting the monastery model. Millions of men of all ages, who have been abused by misandry or have seen others abused and become wary of marriage, can benefit from the social efficiency of intentional brotherhood

Developing intentional brotherhood has had to wait this autumn, while i camped in an apartment and went every weekday to Radiation Treatment. I was willing to proceed but my first attention had to go to treatment and its special requirements. Now that treatment is done, my healthiest choice is not a solitary apartment but the fellowship of intentional brotherhood—and it’s not mine only. Fellowship is healthier, it’s more efficient, it’s more fun. The most challenging part, especially as we begin making intentional brotherhood a common choice and a respected alternative to marriage, is probably to identify sets of buddies who can group up into successful households. As intentional brotherhood becomes commoner and more respected, ways of identifying will develop; and the pioneers will make the going easier for those who follow.

My grandfather was a pioneer, and my favorite relative. The development of the PSA test that got my diagnosis started, was a different kind of pioneering than Grandfather’s. It’s the wrong time in history for me to walk halfway across the continent like Grandfather did; i don’t have the biochemical and physiological training to devise blood tests; but maybe i can contribute to the development of intentional brotherhood. It’s an appealing idea; i have experienced intentional brotherhood among monks and enjoyed it; now it seems i have been given a few more years in which to spread and live that way of life.

I’ve got work to do. Care to join me? Brotherly fellowship is good for men’s health.

Some References:

Brown, Grant A., 2013. Ideology And Dysfunction In Family Law: How Courts Disenfranchise Fathers. Calgary and Winnipeg: Canadian Constitution Foundation and Frontier Centre For Public Policy

Nathanson, Paul, and Katherine K. Young, 2006. Legalizing Misandry: From Public Shame to Systemic Discrimination against Men Montreal: McGill-Queen’s University Press.

Wells, H. G. 1920: The Outline of History: The Whole Story of Man. New York: Macmillan. Cited in the Project Gutenberg Ebook edition, 2014.

Notes:

1. “Tentative” is not meant as any affront. The March assessment should produce the first prognosis; and even then, it’s all estimate. As an Arthur Hailey novel pointed out, the final diagnosis is made post mortem.

2. To keep the details clear—the physician who didn’t do basic screening wasn’t practicing in Alberta; i came to Alberta for treatment, on the advice of clergy, because i have close relatives here and not there… and i’m much more likely to stay here than return.

3. Perhaps there are some already, just not where i’ve been this past decade or two.

4. The classic Islamic reference seems to be to Muhammad’s last speech at Mecca (e.g. Wells, 1920: ch. XXXII Muhammad And Islam, § 4); the Christian references are many (e.g. Matt 12: 46-50, Matt 23:8, Matt 25:40,45, Mark 3:32-35, Luke 8:21, 11:28 … plus Jesus’ tendency to refer to his disciples and followers generally as “brothers”.)

5. Religious ritual is a better use of time than many, but it’s not for everyone, not even for half or a quarter of all men. To those who are called to religious ritual, i say, enjoy. To those who are not, i say, let’s learn the distinct virtues of a co-operative household.

 

Print Friendly
Posted in Davd, Male Lifestyle, Men's Health, Movember | Leave a comment

Less Common Prostate Cancer Treatments

… that I Myself Didn’t Experience
(draft*) 2015, Davd

“I got the usual.” What you’ve read about this Movember, in the previous 4-5 blogs, is what you’re most likely to face if you have prostate cancer and it’s detected relatively early: A biopsy, followed by either “watchful waiting”, if the tumor is benign, or androgen suppression and then daily radiation beams (except weekends) for 6-8 weeks.

Radiation Beams seem to be the commonest prostate cancer treatment, with androgen suppression “before and after” in a supporting role. This is the treatment pattern i’m in as of Movember 28, with the radiation about 90% complete. After the last radiation session next week, i can expect some follow-up examinations, and to remain a pharmacological eunuch through 2016 and partway into 2017. I don’t have a real prognosis yet, and probably won’t until the first or second follow-up.

I did not get “chemotherapy”: which is probably the kind of cancer treatment that has most visibly increased in variety and hopefulness over the past few decades, and yet remains quite scary. The scans and chest X-ray found no indication that the cancer had spread. Chemotherapy is rare for prostate cancer that has not spread; usually a tumor local to the prostate is treated by radiation, perhaps combined with or preceded by androgen suppression, or else by surgery. If i hadn’t changed general practitioners last year, and my cancer had been detected only after spreading, i might likely have got chemotherapy—which from all i’ve heard, is a much harsher kind of treatment than radiation, with poorer average results, at least in the case of prostate cancer.

The scuttlebutt i’ve heard, says that when people get chemotherapy, they nearly always vomit and are nauseous for days. Even the American Cancer Society website seems vague about chemotherapy, probably because there are so many different chemicals used, each with a different profile of effects and risks. I’m glad not to be in it.

Radiation by Surgery is called brachytherapy. It’s a half-day procedure, from what i’ve read, and if radiation leaves you fatigued, the restrictions demanded after brachytherapy imply weakness well beyond mere fatigue: One rule i’ve heard said, lift nothing heavier than a 10 kg sack of flour or sugar, for 8 weeks after surgery.. maybe 25 pounds [11 kg] might be allowed.

There are two varieties of brachytherapy, and if you are considered for either, you’ll probably read and hear about both. Not having been through either, i’ll just say that they don’t seem as drastic as chemotherapy; but how the oncologists decide who gets one or the other of them, is beyond what i know.

Direct prostate surgery didn’t seem to be available to me; and most of the men i’ve talked with didn’t seem to have it as an option, either. One man had had it, and suffered incontinence [inability to hold the urine in his bladder] until a second surgery installed—this is not a joke, he told me—a valve he can turn on and off. When he goes to piss, he reaches down into his underwear and opens the valve; when he’s done, he shuts it again. I have no information on how common such secondary surgery is, but it is impressive that it exists. In my father’s friend Bill’s day, that would have been either impossibly precise or impossibly expensive.

The Canadian and American Cancer Societies have websites which can give you some further information about those treatments and what to expect—but neither told me the sort of detail that i described about the radiation beam experience. It would be good to find writers who can tell their stories of “Chemo”, brachytherapy, and direct surgery ,… but i’m not one of them; androgen suppression and radiation beams are what i’ve been prescribed, what i’ve been through, and so, what i can write about from experience.

Movember’s near its end for 2015, and radiation treatment is near its end for me. Next Movember, i’ll probably have a good idea how well my treatment succeeded, and roughly how long my remaining lifespan will be if i don’t get killed in a road accident.

It does seem clear that changing physicians in 2014, got my prostate cancer diagnosed and into treatment before it spread; and men over 55 should insist on PSA and those uncomfortable finger examinations. Without them, my father’s friend Bill died not that long after diagnosis; without them, i might not know yet that i have prostate cancer. I might have found out too late, like Bill did; while with those diagnostic tools, i might be cured of cancer by the time i would have known of it, without.

Note:

* I label this blog “draft” at first posting, to allow for possible technical improvements and corrections by readers. .

 

Print Friendly
Posted in Men's Health, Movember | Leave a comment

Special Toilet Training:

… It’s Not as Easy as What You Got at Age Two:
(draft) 2015, Davd

Did anybody yet warn you, that if you get radiation to the pelvic region—as most prostate cancer patients do—you have to go through Special Toilet Training? That “not going in your underwear”, which has been “good enough” ever since you were two years old, is no longer good enough?

Nobody told me, when i was first told to expect pelvic radiation beam therapy, that it would include an exacting, difficult bowel and bladder discipline. Perhaps someone should have, and perhaps there should be a “toilet training course” for men scheduled to receive radiation beams to the pelvic area1. We’re better able to learn than we were at age two; but this special toilet training is more difficult than the toddler version.

Basic toilet training has one principal purpose: Don’t mess your underwear (or any other clothing). That’s not good enough for pelvic radiation therapy. When you’re flat on your back on that strange plastic table, getting zapped—you won’t be wearing underpants (and no, they don’t welcome soiling the table!)—but the important new purpose of Special Toilet Training, is to put you on that table every appointment, with empty bowels and a full bladder.

The radiation beams [X-rays] can damage any tissue, though i read somewhere that they damage cancer cells more than normal cells. If the bladder is full it “stands up away” from the prostate; if the bowels are empty they sag down away from the prostate. Less radiation hits a full bladder or an empty bowel; that’s why the protocol demands you arrive with empty bowels and a full bladder—which combination, unfortunately, is unnatural.

Basic Toilet Training taught you (and other little boys) to go ahead and empty the both of them, every time you sat on the toilet—and to sit rather than stand, if in doubt, so you could empty them both. If you’ve ever tried to do only one while “holding” the other, you probably found it was very difficult—maybe impossible.

So while Basic Toilet Training works with nature to that extent, and amounts to knowing when you “have to go” and getting to a toilet to “go in”; Special Toilet Training works somewhat against nature: Empty bowels, full bladder, at the same time (but not, unless you are lucky, the same time of day each day2) goes against the natural tendency to empty both at once. Empty your bowels, and the bladder will naturally empty also; don’t empty your bladder, and the bowels might be too full and at risk of more radiation damage.

Being told to arrive at every appointment, with empty bowels and a full bladder, then, is not enough—no more than telling you to start doing it only in the potty, would have been enough for most two year olds. Toddlers don’t naturally take their excretory urges to the nearest potty: Toddler toilet training amounts to showing the child how to “do it only in the potty” (but accepts that if both bladder and bowels are ready to be emptied, it’s completely O.K. to empty both at one sitting.) You are being told to do something unnatural for radiation treatment, but unlike when you were two, not really shown how… and the directions arrive later than some fellow patients and their next of kin, believed they should.

One woman sitting in one of those waiting rooms, said quite sincerely that she believes you should begin practicing bladder control at least a month before your first radiation treatment. I don’t know if she was referring to her own experience or that of a male patient she knew, but that “month before” is consistent with technicians finding many patients arriving for treatments early in the series with bladders not full enough, (and a significant number with bowels not empty enough.)

The blue half page handout i received gives some general directions which are helpful but not enough to guarantee “empty bowels and a comfortably full bladder” every time:
‣ Take a laxative [“Milk of Magnesia”] every night at bedtime;
‣ Sit down and “have a bowel movement” at least one hour before the scheduled treatment;
‣ empty your bladder exactly one hour before the scheduled treatment;
‣ Quickly drink one half litre of water immediately after emptying your bladder.
‣ Do not empty your bladder again until treatment is over (and there may be times when treatment begins late.)

Easier said than done: Taking the laxative is easy enough, but as the handout itself admits, the amount to take isn’t the same for everyone. “Having a bowel movement” 1-3 hours before appointments that aren’t even the same time each day2, can be difficult or impossible. Exercise before sitting on the toilet can help, but it’s not certain to work for every man. The tendency, from limited comments i heard and my own experience, is to aim for “softer movements” than one would want otherwise. Maybe there’s a better way—but how many men will find it in a few weeks of 5-daily radiation treatments?

Emptying your bladder exactly one hour before treatment is not that difficult to do—unless perhaps you go to treatment by bus and have to head to the bus stop more than an hour before that treatment time. (Go ahead, have a laugh—imagine emptying your bladder on a bus—but i doubt many readers will actually do that.)

Drinking half a litre of water may take more than a minute or two, but within ten minutes you can probably comply with that demand. Trouble is, an hour may be too long, especially if you drink a lot of water, juice, tea … if you are normally “well hydrated.” For years, maybe decades, i’ve normally had 2-4 litres each day mostly of mild tea with Vitamin C and orange peel, but also including water, coffee, juice, sometimes even beer,. That meant that my bladder would fill in more like a half hour than a whole hour, if i drank that half litre of water. 3

The fact that i like coffee with my breakfast might also have been an influence. Coffee probably did make it easier for me to arrive at treatment “with empty bowels.”

I’m only one man, and i don’t know how men generally “feel the fullness of their bladders.” The feeling and the words used for it—among those few men who even talk about the fullness of their bladders before being told they must pay special attention—probably vary from man to man, and plausibly, even more between men and women4. (I found that in the early weeks, if my bladder was uncomfortably full, the technicians were happier with its condition, than if i had only a slight “urge to go.”) That woman who said we should allow a month to learn to perform, not merely into the potty but so as to arrive with empty bowels and a full bladder, might have been right about how long it takes, or might take.

I’m not so proud as to think i can design and describe a good Special Toilet Training course in a day or even in a month. What i’ll do here, is list some things that might help you without that course, to help your bladder and bowels flee to safety before the X-rays come; and might even be parts of the Special Toilet Training course that is designed too late for this Movember:
‣ Starting 3-4 weeks before your “CT Simulation appointment”, practice holding your bladder, full, until you’re getting worried you’ll wet your pants. Notice how that feels (and with luck, learn how to hold that “urethral sphincter” shut longer and more easily. I don’t know what to tell you to expect, and i don’t need to; you get to figure it out yourself because it may not be the same as the next man’s.
‣ Drink 2-3 litres of water or weak tea each day “so your body is normally well hydrated”.
‣ Starting a week or so before the “CT Simulation appointment”, practice emptying your bladder , quickly drinking one half litre of water immediately after, and setting a timer for one hour5. Note how full your bladder feels and how easily you can “hold it” as the hour passes.
‣ Note when you have had coffee, and how much, relative to these practice sessions.

Yes, this does take a lot of time and attention. .. and i have only given you some general ideas how to proceed, not a course outline.

Back when i was in my late teens, as i mentioned in two earlier posts, a friend of my father’s was diagnosed with prostate cancer—and castrated. He died not long afterward despite the castration. In his time, there was no “Prostate Specific Antigen” test to detect prostate cancer early; no testosterone suppression drugs to substitute for castration, and radiation treatments were cruder. In my case, those recently developed techniques give me a serious chance to die of something else, and years later than if the cancer were diagnosed as late as in his time, and treated in those ways.

One of the next steps forward might be, not another sophisticated new technology, but a superior way to learn Special Toilet Training. Being zapped with empty bowels and a full bladder, means less damage to those vital organs, and less risk that they will get secondary cancer from the radiation. All i can provide here is a general indication of the Special Toilet Training you should have, to make pelvic radiation safer, and a little advice that might help you prepare while it isn’t available as a short course. It ought to be possible to make that training more complete and more specific to specific patients’ natures and needs, than the blue handout; but one man can’t do that alone.

Finally, my apologies to any men who find the language of this blog “prissy.” The Webmaster specifies “PG-13” limits to rude words, and using the ruder words i would normally use talking among men, probably wouldn’t read well either… given that it’s a public site and the subject is hospital treatment. As many of you may have noticed, hospitals expect us to use very nice, polite language, to the point that it can be a chore for some men to translate from “the way the guys say it.”

Maybe that’s why some guys found M.A.S.H. such a fun read.

Notes:

1. Any women reading this, please remember it was published on a men’s website during Movember. The principal focus is on prostate cancer, which is exclusively male and normally treated by radiation beamed into the pelvic area. (Tumors which are managed by “watchful waiting” are “benign” and usually not called “cancers.”) Women do get radiation beam treatments to the pelvic area, but the prostate is not what’s involved, your anatomy is [duuuuuuuhhh] different from ours, and plausibly your Special Toilet Training should be somewhat different also.

2. My treatment times ranged from 8:15 AM to 3:36 PM.

3. One technician said that an hour is too long an interval for many patients, and that the bladder of a well hydrated man can refill well enough for safe treatment in 30-40 minutes.

4. i’m writing that “in the analysis of variance sense”, in case you reader are schooled in probability and statistics.

5. Most relatively new mobile phones have timer software, and provide a convenient way to time this business. Only a little subtraction arithmetic is required.

 

Print Friendly
Posted in Men's Health, Movember | Leave a comment

External Beam Radiation Therapy

“Normal Treatment,” Part II
(draft) 2015, Davd*

It’s November, the trees are bare, and there’s ice on the streets outside, but you’re looking up at a deep blue late spring sky with apple blossoms and green leaves around the edges. You’re flat on your back, on a slippery high-tech carbon fibre table, with your knees and lower legs supported by plastic frames to make it easier to lie stock still. The room you’re in has a door about as thick as the doors on bank vaults, but the lock is a lot simpler, and what it’s keeping inside is radiation, not money.

Your pants, underwear, and shoes are back in a locker maybe 100 feet from the vault where that slippery table and you are about to get zapped. Two technicians [techs for short] have positioned you on the table, laid a cloth over your belly and pelvic region, hurried out, closed and locked the door, and are now steering a very elaborate machine around your otherwise naked pelvic regions, by remote control. First it will take X-ray pictures, then figure the trajectory of the high-powered1 beam, and give the table a little jerk to make it line up with the figuring. I don’t know how much of the figuring is done by the machine and how much by the techs—who are on the other side of the vault walls so they don’t get zapped when the table and you do.

After the table jerks, usually in a minute or less, the machine begins to whine: That’s the attack intensity X-ray, and as the machine rotates around your pelvic regions, the ray shoots at the tumor from an ever-changing angle. The tumor always gets zapped while it’s whining; but other parts of your body, only briefly.

The whine lasts perhaps a minute—that’s the actual treatment. This whole big fuss and bother, hours of work for you and among the 2-3 techs and the various desk jockeys, a total of another hour or more, is “all about” that minute or so when it whines. But don’t move when the whine stops! Sometimes, not every time, the techs will want to measure something with you still in that same exact position. If they do measure, the’ll do so before they tell you that you may pull up those funny hospital pants—or move at all.

Then the table lowers to a little higher off the floor than the top of a coffee table, and they will want you to take a metal ring in one hand while you get off. You go back to that change room, get your own pants and shoes out of the locker, dress, and move on with your day… somewhat wearily, which leads to the warnings.

The first warning, methinks, should be that Fatigue is the commonest and usually worst “side effect.” Expect fatigue. If you’re not yet retired—a rather large fraction of prostate cancer patients are retired, compared with other cancer patients and even more, with the general population—you might not be up to doing a normal week’s work along with treatment. Plan to be slower and weaker than normal, even slower and weaker than “eunuch normal”, from some time in the second week of treatments, to a month or so, perhaps six weeks, after they end.

Why? Because radiation treatment is destructive, that’s why. The big elaborate machine is so big and elaborate, so that it can rather precisely aim attack-power X-rays at the tumor from a whole lot of different angles. The tumor always gets damaged; surrounding body tissues, much less—but some damage is done. Your body will give priority to repairing the damage2, and it will take a lot of energy, protein, and other nutrition. In other words, you are being selectively injured and healing the injuries will tire you badly. In still other words, you are taking a selective beating and getting over it involves several weeks of weakness.

Second warning: Expect austerity. A very common austerity is being forbidden to enjoy alcoholic drinks. Repairing the selective damage, puts some strain on your liver. Alcohol would add to the strain. So even if you’ve been able to have a few beers with your friends or your burgers, without it hurting you; even if you’ve been able to have a half bottle of wine with a good meal, no harm; that might not be the case while you’re in radiation treatment and for the fatigue weeks that follow its end.

(I don’t know nearly as much about chemotherapy as about radiation, because prostate cancer is less often treated with chemotherapy, than with radiation… plus, my treatments were in a radiation zone and those who got chemotherapy went to another part of the building. In the waiting areas, i talked with other radiation patients. What i heard and read, seems to say that a ban on alcoholic drink is more likely, and likely to last longer, if you get chemotherapy. What i’ve seen, away from the cancer hospital, is that the ban is not always obeyed.)

You will almost certainly be told to quit smoking if you do; and may also be banned from coffee. (Remember the neighbour who died of lung cancer this year? He was a regular cigarette smoker.)

Your modesty is going to be rather well ignored in the vault, much as it was in the biopsy. You get a change room about the size of a two-holer privy with a curtain instead of a door, to get out of your pants, underwear, and shoes, and a locker to put them in3. You get a pair of pale green or maybe bluish (they look sort ot like splash pants but i don’t think they’d last long in the woods) to cover your nakedness while you wait to be called into the vault. But once in the vault, you lie down on that table, pull down the splash pants, pull up your shirt and whatever’s under it, and they line you up using those tiny tattoo marks they made a few weeks ago.

You probably won’t suffer claustrophobia—the vault is pretty large, larger than most bedrooms, and the big machine doesn’t crowd you like CAT and MRI scanners can. You can see, not daylight but at least some kind of light, and ceiling and walls, past gaps in the parts of the machine. I suppose some psychologist figured that the late spring sky graphic—not all treatment vaults have them—will help you relax; at least, it is what you might see if you were lying on your back under a skylight, at that time of year. But the vault doesn’t have a skylight, it has another level of the cancer hospital above it… and probably, radiation shielding between its ceiling and the floor upstairs.

You might suffer a more common discomfort—“having to go.” The directions for pelvic radiation treatment include “A full bladder and an empty bowel.” If you do what’s natural, plus the toilet training you had when you were two, you’ll empty both at once if the bowel has something to empty. SO—part of the whole treatment scheme, will be Advanced Toilet Training, and that’s a big enough business that just to tell you what it’s about—not actually doing the training—will take a separate post.

Notes:

* I label this blog “draft” at posting, to allow for possible technical improvements and corrections by readers. It is written less personally than the previous two, but as posted, is based more on my experience of Radiation Therapy than on technical knowledge—so to be prudent, i allow for the possibility of a mistake.

1. “High-powered” is relative; the machine is capable of at least two levels of tumor-attacking intensity. At the highest intensity, both doors of the vault are closed. At the lowest “attack intensity”, only the outer door is closed. In between, i don’t know the details, and anyway, you can’t see the doors from flat on your back on the table.

2. Tumor cells, i read in one of those many handouts, cannot repair themselves as readily or as well as normal cells, so in addition to getting more damage than surrounding body parts, the tumor has a disadvantage in its repair efforts.

3. I suggest you carry a small lock. During the time i’ve been receiving treatment, at least three patients had their clothing stolen—and if they’d left wallets in their pants, the clothing was found later somewhat messed up, but the wallets were gone. The techs were saying “lock up your clothes, and to be really careful, carry your wallet and keys into the vault with you.” There was an old chair off to the side of the vault to put personal effects on; i carried mine in a cloth bag a little smaller than most shopping bags.

 

Print Friendly
Posted in Men's Health, Movember | Leave a comment

The “Normal” Treatment I Received:

.. Part. I: Androgen Suppression
(c) 2015, Davd

That first prostate cancer story i ever heard personally, from my father’s friend Bill, happened before 19751. He wrote that treatment included “the operation that makes a steer out of a bull.” That surgery made sense, though today they use drugs much more often than surgery. Castration stopped Bill’s testosterone production; and most prostate tumors need testosterone to grow.

If Bill died a year or two after diagnosis, the reason was probably that the cancer had spread before the diagnosis was made. He never told me specifically. As a guess, some two generations of time ago, he had had a prostate tumor for years before it was diagnosed.

Prostate cancer grows slowly, compared to most other kinds. If you have finger examinations of your prostate and PSA blood tests, regularly, there is a good chance—a far better chance than Bill had in his day—that you will be diagnosed with a prostate tumor whose biopsy results, or other “further tests” indicate that it is benign—not spreading, not about to spread.

The usual treatment for such prostate tumors is called “Watchful Waiting”: More tests, perhaps ultrasound or another biopsy—but no heavy drugs, no radiation, no surgery to remove the tumor. Prostate tumors grow slowly enough that you might well die of something else before your tumor becomes something that could kill you within a few years… and as you’ve already read about prostate biopsy, and will see again below and in the Radiation Therapy posting to follow, treatment is uncomfortable, makes life less to much less pleasant while it goes on, and requires hospital facilities. If the disease is a benign, slow growing tumor, it seems fair to predict the cure would be worse than the disease.

I wasn’t so lucky; my Gleason sum score was above the line between benign tumor and cancer. The diagnosis, and diagnoses are estimates, was that the tumor might “metastasize”, or spread around the body, if not treated quickly—indeed, the bone and CAT scans and the chest X-ray were to see if it had spread. They came back negative, so i fell into the category “no sign yet of spreading, but might be about to spread”. That got me the modern equivalent of what Bill got: Pharmacological castration. Instead of removing my “balls”, they drugged them out of action.

This is also called hormone therapy and androgen suppression therapy. As the American Cancer Society website puts it, “Androgens [male hormones] stimulate prostate cancer cells to grow. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time.” For localized cancer with a Gleason sum score high enough to be dangerous, androgen suppression disrupts cancer growth and “buys some safe time” to plan and schedule radiation treatment (or perhaps surgery).

Immediately the bone scan, CT scan, and chest x-ray came back negative (no sign the cancer had spread), i was given a large injection under the skin of my upper abdomen, and a prescription for pills to be taken daily. (I won’t name the medications, because they each seem to have alternatives, and i’m not medically trained. I don’t understand the subtleties of how specific medications are chosen, and i don’t want readers to think they ought to have something else than what they were prescribed, just because some blogger got it.)

Over the next few days, living in the same house with the same woodstove, i noticed i felt colder. My diary entry for two days later than the first injection reads in part, “Comfortable temperature … 2-3 C above what i found comfortable as a man.” Two comments: First, i was well aware that the medications were intended to suppress my male hormones, and had started calling myself “a pharmacological eunuch”. Second, if you are reading this from the US or UK, 2-3 degrees Celsius is about 4 degrees on the Fahrenheit scale you use. I needed that house, at least the part where i sat still, heated 4 Fahrenheit or 2-3 Celsius warmer than i had needed three days earlier… and for years before that.

It was 7-10 days after the injection (meaning i had also taken 7-10 of the pills) when i felt the first flush of heat. It lasted a few minutes and then i felt cooler than before the medications, again. I’d been warned about “hot flashes”, and told that women entering menopause have the same experience. Not having been a woman, i didn’t get much help from that comparison.

In my case, “hot flashes” were fairly rare, but i did notice that i could start perspiring with exertion that hadn’t got up a sweat before. I also noticed that my strength and stamina were going down. Over the months that i was “on androgen suppression” before radiation began, i lost noticeable strength, stamina, and “drive” compared to the years before. My stride was nearly as long, but walking fast, which hadn’t been tiring before, now got me breathing a little harder.

I also gained weight, though i was cooking the same foods and eating the same amounts as ever. The reason—some of you may have guessed already—was connected to the loss of strength and drive, and the need for a warmer house. My metabolism had slowed down, as could be expected: Eunuchs’ metabolism is normally slower than men’s. My body was burning less food, but my habits hadn’t adjusted—and there was some good reason for me not to “diet.”

The androgen suppression was preparation for a direct attack on the tumor. In my case, as in most cases from what i’ve heard and read, that attack would be with radiation. The radiation would cause heavy to total destruction of the tumor, and also some damage to the surrounding tissues. My body, i was warned, would need more nutrition, including more energy, to heal the damage to normal tissues and clean up the debris from the tumor.

The preparation seemed to work: My testosterone and PSA levels fell to far below ldquo;normal.” Next treatment was to be radiation, as seems to be usual for dangerous but localized tumors.

It took me months to organize for the debilitating effects that might have. I was warned i could not expect to do the chores that were normal and required for that wood-heated house in a region with heavy winter snow. So as happens to rather many men, but far from all, i had to relocate and i don’t expect to be able to go back. I don’t know how common that experience is, though; so the next “post” will be about the radiation experience, which from what i’ve heard, a majority of men with dangerous looking, localized prostate cancer have shared or will share.

Notes:

1. This is from memory—i didn’t keep a diary in those days; and i didn’t plan on writing about prostate cancer at that time—so i cannot say just what years were involved. Indeed, the word “Movember” was first used at the very end of the last century, over 20 years after Bill died.

 

Print Friendly
Posted in Davd, Men's Health, Movember | Leave a comment

Prostate Cancer Diagnosis:

My Experience of the Process
(c) 2015, Davd

The first prostate cancer story i ever heard personally, came from a friend of my father’s, more than 40 years ago; and in a year or two, he died. I’m not sure how he was diagnosed; but a Cancer Society volunteer confirmed that it couldn’t have included the blood test that started me—and starts very many men—into the process today. It’s called PSA, for “Prostate specific antigen”.

There are two meanings available for “digital prostate examination”. One involves pushing a finger [digit in semi-Latin] in a thin glove, up through your anus and feeling the prostate for size and lumps. Older men should get one of these uncomfortable examinations every year, at least every two years. (It is one good reason for men to prefer a same-sex physician1.)

The other involves computerized [“digital”] chemical analysis of blood samples, especially the fraction of PSA in that blood. I don’t believe either kind existed when my father’s friend Bill was diagnosed, nor when he was buried. Perhaps the finger version was known but because it was uncomfortable and embarrassing, seldom used until something else led to suspicion of prostate cancer. The biochemical version depends on technology that probably didn’t exist, certainly wasn’t widespread, in the 1960s.

My experience tells me, so i’ll tell you—if you’re an old man, even over 50, at least ask for both “exams” with every annual check-up. If you’re over 65, you should definitely have them.

In 2014, i was referred by a Salvation Army officer friend, to a “new” physician, Dr. K, whose practice the Major had left when he was transferred, as Salvation Army officers are every few years. There had been awkward aspects to consultations with the one that i had been sent to as “available”; and at least for now, i will not identify individuals: Few readers if any will be in either practice. I will say that while both physicians used laboratory tests, one seemed to be letting a computer software system interpret them, while Dr. K, a man whose appearance resembled my uncles when i was a boy, seemed to be interpreting them himself.

I will say that Dr. K. included the PSA test in the blood sample analysis he ordered as part of my first annual check-up within his practice. His finger exam found the prostate to be enlarged, the PSA score was higher than normal, so since i was less than 75 years old, he referred me to a urologist, Dr. V. Dr. V. repeated the finger examination and concluded that not only was my prostate larger than normal—something fairly common in old men—he felt a lump2. A biopsy was ordered for some 6-8 weeks later.

The biopsy was in fact, “day surgery”; and since the majority of readers likely have neither had such surgery nor will in the next year’s time; i’ll just report that it was messy, somewhat painful, and broke most of the rules of everyday modesty. If you or a friend get to this stage, expect it to take most of the day, leave the patient unfit to drive or appear in public, and thus, require either a taxi if you live in a city, or a driver if a taxi would be too expensive (as is usually true for rural people.) When it ends most patients will not feel like riding the bus or even standing around at a bus stop.

A few weeks later, i heard the results: The lump was a tumor with a “Gleason sum score” high enough to call it cancer. Next came a “CAT scan”, a chest X-ray, and a “bone scan”, to see if it had spread. Those tests came back negative: If there were rogue [cancer] cells outside the main tumor, they were solitary or in groups too small to detect.

I had been “diagnosed with” carcinoma of the prostate, not yet metastatic, and was immediately given two “androgen suppression” drugs to inactivate the tumor [make it stop growing, perhaps even shrink]. End diagnosis, begin treatment … and with the cancer still localized.

If i had continued in that other practice, where i don’t remember any PSA screening and know very well i never had a finger exam of my prostate, i might not know even today, that i have prostate cancer. Meanwhile, that cancer might have spread, over the months, if it hadn’t been suppressed and now is being zapped. It might have spread over more months past this Movember, months when i might still not know; to where radiation would not be enough and knocking the tumor out for longer than my remaining life expectancy, very unlikely.

I’m not “home free” yet. The radiation treatments are about half done. I will continue to be weakened by them for some weeks after they end, until Christmas or later. There is even some risk that the radiation will trigger cancerous changes in cells around the prostate and i will later have a different kind of cancer. But at 73, having a life threatening cancer changed to a dying cancer, or one knocked so far back that i’m very likely to die of something else instead, is a great improvement compared to finding out when it’s too late, like Bill did.

It’s important to know a tumor is present earlier rather than later, and to know as soon as it becomes serious enough to need treatment (if it ever does.) Older men should have regular PSA and gloved finger examinations. If you have a regular GP [General Practitioner, aka family doctor] and don’t get those two tests every year if you’re over 65, at least every other year if you’re 50-65, methinks it’s time for a change. For the men who don’t have a regular GP to go to, Movember Clinics providing those tests [and perhaps other men’s health examinations and advice] sound to me like a good use of Movember donations—and for that matter, of public health spending generally.

Notes:

1. My favorite example of an ideal medical “family practice”, was that of Drs. Guy and Elizabeth Richards, in Saskatoon. Their examination and waiting rooms were in their house; they had bought a big house and set aside part of it for their practice. They had as short a walk to work as possible; they were available to their children when not seeing patients (and could make patients wait a minute if the children needed something quickly). Guy could counsel men and boys as one who had the same kind of anatomy and physiology; and Elizabeth could do likewise for women and girls—maximum empathy and “i’m built like that too” understanding; minimum embarrassment…and family connections in health needs and care, could be easily determined between the two doctors because they shared most of their time. (I write “was” because i am now 73, and they were older than i—still are, if they are still walking the Earth.)

2. Dr. V, as a urologist, had more experience with prostate cancer than Dr. K, who is a general practitioner. Finger examination is somewhat subjective; he had a greater experience base from which to assess.

 

Print Friendly
Posted in Davd, Men's Health | Leave a comment