November | 2011 | Tracy Krulik

Going Back to School

November 30, 2011 8:44 am \ Tracy Krulik

Because two undergraduate degrees and an M.B.A. just aren’t enough, I’m going back to school!

Here’s the story. I worked in marketing and fundraising until my body screamed, “NO MORE!” due to that nasty tumor on my pancreas. While I convalesced after spending New Year’s Eve at Sibley Hospital for pancreatitis in 2005, I decided to go back to school to pursue a degree in music with the goal of teaching college. The first week of my final year at George Mason University, I learned that I had cancer, and my life flipped upside-down.

For whatever reason, after my cancer diagnosis, my interests changed — I no longer had any interest in music. I forced myself to graduate a year later (summa cum laude, thank you very much!), but I still had no interest in music. Thinking that it would be a shame to quit that career path and then one day wake up to find my interest returned, I applied to and got accepted into the University of Maryland School of Music as a graduate teaching assistant in music theory. A year and a half into that program my interest in music still had not returned.

This past January I decide to take a leave of absence from Maryland to figure out what I wanted to be when I grew up and see if I missed music at all. The next day I started writing my book I Have Cancer. And I’ve Never Felt Better! and by the end of the week we had sold our piano. I felt tremendous relief no longer having to force work that I had no interest in and no longer having to feel like a fish out of water among the music students.

I wake up every morning now excited to write blog posts, work on my book, and pitch and write articles, but, ever the overachiever, I want to improve my writing and learn all I can about writing as a career. So a few months ago, when Tommie and I were walking around Old Town Alexandria we both had an epiphany that I could return to school once more. We started out just looking for local writing workshops, but then we found the Johns Hopkins University Masters of Arts in Writing program. I submitted an application in early October and learned this week that I’ve been accepted.

I’ll take one or two classes each semester in my area of study — nonfiction writing — and we’ll see where it leads. I have enjoyed writing about my life and my health care experiences, but I’m pretty sure I don’t want to just write about “me” forever. I’m curious to learn what other types of writing interest me and how well I do with them. Most students apparently find first-person writing much more difficult than third-person, but I’m the opposite. I feel somewhat naked when I can’t throw an “I” in a piece. Time to shake up my comfort zone!

So that’s my news. Classes start in January, and I’ll be taking a core class taught by Cathy Alter (who wrote the fabulously entertaining memoir Up for Renewal), where among other things I’ll read a variety of forms within nonfiction and then write pieces in each one. I bet I do well in some and then really suck in others. Should be interesting.

It feels good. Four plus years since my cancer diagnosis, I feel like my health is on track (despite the fact that I’ll probably always have tumors in me), and I’m finally on a career path I love. Now if only it would stop raining so that I could get back out on my bike!

Posted in: As I See It

The Skinny on Obesity

November 29, 2011 9:32 am \ Tracy Krulik

Things I’ve learned to not talk about if I want civility among friends: religion, politics, and now, obesity. There is a fire burning in our country, and it seems to me to be hotter than the anger against Wall Street — weight loss.

I’m an evangelical wellness freak. No doubt. But I am this way because I was sick as hell for a decade, largely due to the failure of the medical system, and then I became healthier than ever. I thought I was dying of cancer and then realized that as my body got stronger, the cancer got weaker. And I’ve learned that I’m not crazy to think that with healthy eating and an active lifestyle I can beat this disease. There is a growing body of evidence that proves that by maintaining a healthy weight, eating a predominantly plant-based diet, and getting at least 150 minutes of moderate exercise a week, we can prevent and reverse diseases like cancer, heart disease, stroke, diabetes, and Alzheimer’s just to name a few.

And yet, time after time I offend someone when I talk about taking control of our health, eating well, losing weight, and getting off of our couches. At first I thought, “Who am I to tell someone who is obese that they have control over their health? Maybe that person has some type of physical condition which makes their body fill with fat despite how much they exercise or how little they eat.” But after multiple nasty and defensive responses I’m seeing a pattern: those who fight with me about their weight always have an excuse as to why they can’t lose weight, why they can’t exercise, why they can’t buy healthier foods, why they can’t find the time to cook for themselves, why they can’t why they can’t why they can’t!

In truth, the vitriol only comes from a small minority of people I encounter. Most people are extremely nice when they discuss these issues, but they offer excuses too. I can appreciate that some people have a harder time getting fit than others. There are situations like metabolic conditions or weight-gaining side effects from drugs that make it harder to maintain a healthy weight, but they do only make it harder, not impossible.

If you want to talk about excuses, I’m pretty sure that I have one of the most valid excuses for staying on the couch and getting fat: I had a tumor on my pancreas for almost a decade. During that time I was in and out of the hospital and suffered with nausea, vomiting, and constant pain. I had become so frail that I injured my right shoulder throwing a snowball at a friend and eventually had to have surgery to fix it. My entire body became so inflamed, because my muscles were so weak, that I would sit on the couch every night covered in ice packs. And I gained a lot of weight for my size, because I became so sedentary that I was consuming more calories than I was burning.

Realizing that my health was spiraling out of control, around about year four of My Life with Tumor, I hired a personal trainer who tortured me multiple times a week to strengthen my body, heal my joints, and motivate me to do cardio again. I found myself gasping for air after jogging a block (for reference I was a distance runner before I got sick). My heart rate would soar as soon as I stepped onto an elliptical trainer in the gym, because the tumor was killing me. And yet, five or six days I week, I worked out. It was painful, and it sucked, but I knew that I had to do it.

Life is hard. It is. But we all have choices: We can wallow in it, or we can say, “I want to live a better life. I want to be healthy for myself and for my family, and I’m going to do what it takes to get it done.”

I’ve said it before. I’ve faced my own mortality, and it’s some scary shit. I don’t want you to have to face your own mortality at an early age like me. But the choice is yours.

Oh, one last thought. Yesterday I told you my thoughts on the Engine 2 Diet. I have tremendous respect for the program and the folks who created it, and I promise you this: If you commit to doing the Engine 2 Diet for a month and afterward don’t feel better and haven’t lost any weight, I’ll eat my words.

Posted in: As I See It, Nutrition and Health \ Tagged: cancer, fitness, health care, obesity, plant-based

The Engine 2 Diet

November 28, 2011 9:18 am \ Tracy Krulik

A couple of weeks ago the folks who run the Engine 2 Diet Facebook page posted some nutrition labels and asked if the foods were good to consume. I got the answers wrong. The one that stood out to me was coconut milk. It’s completely plant-based and is chock full of wonderful nutrients, so I figured it was great to drink, but the fat content is more than 60% fat. According to the diet’s creator Rip Esselstyn, that is bad. He tells us that fat content should be less than 25% of calories. I wanted to know why, so I read the book. And I’m glad I did.

If you are struggling with your weight; curious about the benefits of a plant-based diet (or “plant-strong” as Rip likes to call it); at risk for or currently have diabetes, Alzheimer’s, cancer, heart disease, or obesity; looking for a good exercise regime; or just want to know more about nutrition, this book is for you. It’s an extremely fast read as Rip has a friendly, conversational tone, and the last third of the book is comprised of recipes. I never thought a diet book would be a page-turner, but this one was. I couldn’t put it down. I actually set Stephen King aside so that I could devour the Engine 2 Diet.

As I hoped, the book delivered as promised in educating me on how to determine what canned, bagged, or boxed foods are good for me. I had simply read the ingredients and calories in the past, but now I understand so much more. One lesson that resonates for me regards sugar content. Four grams of sugar equals a teaspoon, so now when I look at my cereal box and it reveals 24 g of sugar, I know that if I ate one bowl, I would eat a whopping eight teaspoons of sugar. Would you ever dump eight teaspoons of sugar in anything? I immediately threw out my Fruity-Ohs and replaced them with Familia Muesli (no sugar added). If I throw in some fruit, I get all the sugar I need for a tasty and healthy breakfast. Not only do I feel stronger after breakfast because my blood sugar stays level, but my body doesn’t need to secrete extra insulin to lower my blood sugar after a big spike.

The book reminded me that insulin is a cancer-promoter. I fuel cancer when I consume that much sugar, and as you know, part of my life’s mission is to make my body as inhospitable to cancer as possible. I’m grateful to Rip for the reminder. Sorry, Nightly Cream Soda — you and your tasty 10 teaspoons of sugar have to go. Cancer likes you too much.

On the fitness side, I’m reminded once again why I need to get moving every day, and I’m excited to try the book’s workout routine. It is designed for at-home use, and it incorporates both cardio and strength training — a gem of a find for the winter months.

My only complaint about the book would be the recipes. To be fair, I haven’t tried any yet, but I’ve been cooking long enough to know what I like and don’t like. There are a lot of mock meats and jarred sauces included in the recipes, and even if Rip does tell you which ones are healthy to eat, my palate prefers simple dishes completely made from scratch. I plan to make a couple of recipes this week, however, and will let you know my thoughts.

Overall, I loved the book and highly recommend it. It’s hard to make the argument that only hippies and scrawny people eat plant-based diets when you have a world-class triathlete and firefighter talking about the success that he and his buddies in the firehouse have had from their plant-strong lifestyle. Great book, Rip. Thanks for sharing your secrets for a healthy life with us and for giving me additional tools to make Cancer’s life more miserable.

Eff you, Cancer!

Posted in: As I See It, Nutrition and Health \ Tagged: book, diet, exercise, fitness, plant-based

Is All Cancer… er… Cancer?

November 23, 2011 10:36 am \ Tracy Krulik

If I didn’t have tumors lying dormant in my liver and chest for the past four years, this question would be a no-brainer. If I didn’t know what I know now, and if we just found the tumors in my body, my reaction would be, “Kill all the motherfu*kers now!” In fact, four years ago when we found the tumor on my pancreas and then subsequently found the metastases, my exact words to my doctors were, “I want to kill all the motherfu*kers now!”

We all freaked. Me, Tom, my parents, my friends, and my doctors. All of us, because we’ve been trained that when we hear the word “cancer,” we have two choices: fight or flight. Everyone is terrified of the word “cancer,” but every cancer is different. Can you really call a slow-growing cancer like mine where I could live with tumors inside me for decades the same thing as the aggressive pancreatic cancer that can take lives in a matter of months?

The New York Times published an essay this week that addresses this issue. It discusses the dangers of advanced scanners finding forms of breast and prostate cancer that might never grow, or just grow so slowly that it wouldn’t matter. One of these breast “cancers” comprises 20% of all breast cancer diagnoses. Are all those women undergoing chemo and surgeries unnecessarily? What a massive failure of the health care system if they are.

Over and over again I say that medicine is maybe more “art” than “science.” If your doctor tells you that you have cancer, the most important thing you can do for yourself is learn. Get multiple opinions and conduct your own research. The website UpToDate is a brilliant medical resource for patients and doctors alike. If you don’t have access through a school or business, you can pay a small fee for access to the site to learn about your condition.

Some of my doctors wanted to take out half of my liver in addition to the diseased portion of my pancreas and the primary tumor. We decided to leave my liver alone and just do the pancreas surgery. Everyone assumed that once I recovered from my surgery I would need chemotherapy or radiation therapy to get rid of the tumors in my liver and chest. I haven’t, and I’m healthier than ever.

So, do I have cancer? Yes, according to the broad definition, of course I have cancer. A tumor grew on my pancreas and metastasized to my liver and chest, but does that mean that I’m dying? Doesn’t seem to be affecting my health at all now. I wonder how healthy I’d be if I’d undergone chemotherapy or removed half of my liver? Sometimes the treatment is more dangerous than the condition.

Posted in: As I See It, Nutrition and Health \ Tagged: cancer

Holiday Time! What the Heck Am I Going to Eat?

November 22, 2011 8:48 am \ Tracy Krulik

It’s that time of the year again. Time when everyone else overindulges and Tommie and I search for a few healthy-looking side dishes to eat.

When I was a vegetarian simply for ethical reasons I gained weight like the rest of the country over the holidays. In fact, I probably ate worse than most, because rather than the lean turkey meat, I ate sweet potatoes with butter, cream, and marshmallows, noodle pudding, and pumpkin pie. Now that I’ve also cut out all dairy and eggs, and I’m limiting my sugar and fat intake for my health, the holiday pickings are slim.

Here are some of our challenges:

Soups which sound vegetarian or vegan are often made with a chicken or beef stock and possibly milk, cream, or butter.
Potato side dishes are usually made with butter, milk, and/or cream.
Vegetable side dishes are usually made with butter.
Gravy is almost never vegetarian or vegan.
Desserts? Vegetarians would probably be fine eating the cookies, cakes, and pies, but vegans better stick to the fruit salad.

So how do we plan to eat? For one thing I always bring energy bars and trail mix with me for an emergency. My mom and brother have both said that they’d like to make something vegan for Tommie and me, which should make the Thanksgiving dinner great. But the other meals away from home? Gonna be tough.

If I may borrow Tommie’s famous Facebook status: Over the holidays I feel like “a vegetarian in a steakhouse.”

Posted in: As I See It \ Tagged: diet, vegan, vegetarian

Lance Armstrong Effect — Turning Up the Heat on Cancer

November 21, 2011 9:20 am \ Tracy Krulik

You learn something new every day.

I stumbled across this Medical News article today that talks about combining heat and chemotherapy to treat liver tumors and learned that the concept of using heat as a cancer treatment is termed the “Lance Armstrong Effect.”

Just like Lance, 70% of testicular cancer patients survive — even after metastasis. The theory is that because testicles are cooler than the rest of the body (because they are on the outside), when the tumors grow elsewhere in the body, like lungs and brain in Lance’s case, they find themselves in a warmer climate. According to the American Chemical Society journal Molecular Pharmaceutics, ”Researchers propose that this warmth shocks the tumor cells, making them more susceptible to conventional cancer therapies, which leads to a higher survival rate among testicular cancer patients.”

Researchers are hoping that by turning up the heat they’ll be able to make non-testicular difficult-to-treat tumors easier to kill. Currently doctors are literally cutting open patients and heating up the organs, but researchers are looking into nanotechnologies which could target only the diseased cells and be far less invasive.

This research is yet another reason why I work to make my body a cancer-fighting fortress. The longer my immune system can hold these nasty little invaders back, the better my chances that a new and improved treatment like this will become available for me if I need it.

Nice work, Researchers! Keep it up.

Posted in: As I See It, Nutrition and Health \ Tagged: cancer

Pumpkin Pie with Ginger Snap Crust (Vegan!)

November 18, 2011 4:54 pm \ Tracy Krulik

I learned this fabulous pumpkin pie recipe in a Sur la Table cooking class last year, and it’s too good not to share:

For the crust:

1 1/2 cups gingersnap cookie crumbs
2 to 3 tablespoons brown sugar
4 tablespoons oil, such as grapeseed, corn, almond or walnut, plus extra for greasing

For the pie

3 tablespoons cornstarch or arrowroot powder
1/2 cup almond milk, plain or vanilla flavored
2 3/4 cups solid pack pumpkin (about 400 g)
1 cup sugar
Pinch of salt
2 tablespoons oil
1 teaspoon ground cinnamon
1/4 teaspoon freshly ground nutmeg
1/4 teaspoon ground ginger
1/8 teaspoon ground cloves

To make the crust:

Preheat the oven to 350 degrees. Grease a 9 to 9 1/2 inch pie pan with oil.
Place the gingersnap crumbs and sugar in a food processor and with the machine running slowly add the oil. Process until everything is well mixed.
Press evenly on bottom and up the sides of the pie pan. Bake for 10 to 15 minutes, or until just beginning to brown. Cool on a wire rack.

To make the filling and bake the pie:

Place all the filling ingredients in a large bowl and whisk to combine thoroughly (a food processor works great for this as well). Pour the filling into the crust and bake at 350 degrees for 45 to 60 minutes, or until set and the top is browning in places. Cover the edges with foil if the crust begins to brown too much. Cool completely on a rack before serving.
Tell me how much you LOVE it!

Posted in: Recipes

Blood Sugar Issues? Doc Says “Go Vegan!”

November 18, 2011 9:30 am \ Tracy Krulik

How I test my blood sugar level at home.

I swear I’m not making this up.

Those of you familiar with my story know that since around 1999 I’ve had blood sugar issues — hypoglycemia to be exact. Normal blood sugar should fall somewhere between 70 and 120 mg/dl, but mine has been known to drop down into the 50s. When it happens I feel light-headed, shaky, cranky, disoriented, and hungry, and as soon as I drink some OJ I start feeling better.

Before they found the tumor on my pancreas, my doctors all sort of pooh-poohed my complaints and said that I should just take in more protein. (For reference, I was a meat-eater back then.) After they found the tumor they were convinced that it was an insulinoma — a neuroendocrine tumor that secretes insulin and thereby causes hypoglycemia.

Functional tumors like insulinomas cannot be confirmed from a biopsy — they have to be confirmed through testing. The test for insulinoma? A 72-hour fast. Ooh doody doody! In October 2007 I spent three bizarre and not-so-fun days in Georgetown University Hospital not eating and having my blood drawn and/or fingers poked every two-hours — even throughout the night.

During that time my blood sugar never dropped, so the docs said I did not have an insulinoma.

My blood sugars leveled out for the first couple of years following my pancreas surgery, so when the hypoglycemia returned in 2009 we all, oncologist included, believed that it was related in some way to my cancer. He still didn’t believe that I had an insulinoma, but he was concerned by the fact that the symptom disappeared right after surgery and then reappeared around the time he believed my tumors would begin growing again.

I sought out a second opinion at Johns Hopkins when my oncologist started listing different forms of chemotherapy, and the Hopkins doc basically said that the hypoglycemia was a red-herring — he didn’t think it was related to my cancer. He ordered periodic scans over a one-year time period to take a good look at the tumors and see whether they were growing or not. And at the end of that year he said, “Congratulations, Tracy,” when he determined that those little suckers were just hanging out all fat and lazy and not growing. (Well, not so “fat” actually. They’re really tiny.)

But what about the hypoglycemia, you ask? Lately I’ve been having more attacks than I’d like, and I’m tired of doctors telling me what I don’t have instead of telling me what I do. I need someone to explain to me why my blood sugar drops 20 points lower than normal and make me believe that when it happens it has nothing to do with my cancer. Feeling good is my main barometer for whether the tumors are staying quiet, so a part of me still gets jittery about them when my blood sugar drops.

Tom and I were so impressed by his new endocrinologist at the University of Virginia, that we decided to contact him to see if he could help me figure this out. He said he would, and he’d have his assistant contact me to schedule an appointment in the Insulin Resistance Clinic. Always the curious cat, I googled “insulin resistance clinic UVA” and found their website. When I clicked on the “patient information” tab I started laughing.

First heading: “Check out these links for helpful information on vegetarian diets.”

Second heading: “Reading List.” One of the books? The China Study.

Third heading: “Cookbooks,” which are all vegan.

Fourth heading: “Movies.” Which ones? Forks Over Knives, Supersize Me, and Food, Inc.

Guess Tom and I found the right medical team. Clearly they understand that our diets can dictate our health. I’m looking forward to meeting with the doctor and getting his take on my hypoglycemia. Maybe it is unrelated to my cancer and just happened to start around the same time as my pancreatitis.

Regardless, it will be helpful to know the cause so that I can better evaluate my health. Except for my periodic scans I only have the way I feel to let us know if the cancer is growing again. I need to understand what my “healthy” really feels like so that I can evaluate properly.

Posted in: As I See It, Nutrition and Health \ Tagged: health care, hypoglycemia

Obesity and Cancer Research

November 17, 2011 9:56 am \ Tracy Krulik

As I mentioned yesterday, I read through the National Cancer Institute’s latest bulletin, “Obesity and Cancer Research,” and wanted to share the findings with you.

Some basics. Obesity is defined as having too much fat. According to the bulletin, 33.8 Americans are obese and “by 2030, 65 million more U.S. residents will be obese.” If you’re curious about what that means to our country’s economic health, that “increase will carry associated costs of $48 to $66 billion per year for treating obesity-related diseases.”

While I share common concerns about our country’s fiscal health, I’m currently more concerned with our citizens’ personal health. So let’s look at the links between obesity and cancer and why they might exist.

“Many people are familiar with the evidence that obesity increases the burden of common chronic diseases such as diabetes, cardiovascular disease, asthma, and arthritis,” says Dr. Rachel Ballard-Barbash, an NCI associate director of applied research. “Surprisingly, despite decades of research indicating a strong association between obesity and cancer incidence and prognosis, obesity’s contribution to cancer has been widely recognized only recently.”

Cancers that are linked to being overweight or obese include postmenopausal breast cancer, endometrial cancer, colorectal, esophageal, gallbladder, kidney, pancreatic, and thyroid cancer. The bulletin tells us that “these risks are not minor. In 2002, the International Agency for Research on Cancer, using European data, estimated that obesity contributed to more than one-third of endometrial and esophageal cancer cases and a quarter of kidney cancer cases.”

Being overweight does not just increase your risk of getting cancer, but it also increases your risk of dying from it.

Why? Here’s one reason:

In the past researchers thought that adipose (fat storage) tissues were just that — storage tissues. But it turns out that they are metabolically active. They are known to “pump out an astonishing array of hormones, growth factors, and signaling molecules, all of which can influence the behavior of other cells in the body.”

These secretions “feed the growth and proliferation of malignant cells.”

Insulin, which triggers your cells to take in glucose (sugar) from the bloodstream, makes some cancers grow faster, for example. If you have a rogue cell that is fueled by glucose, when your excess fat secretes excess insulin, that cell takes in more glucose and grows stronger.

Another example is estrogen. Certain cancers like breast and endometrial are fueled by estrogen. Postmenopausal women who should otherwise have less estrogen are in some cases developing cancers because their fat storage tissues are pumping out estrogen.

This research is just the tip of the iceberg on obesity and cancer. Bacterial microbes are another area of research underway. In addition, we’re only looking at one aspect of it — excess fat — but other factors might be causing the link. We know that physical activity can prevent or reverse cancer, so an obese person’s sedentary lifestyle might be a cause as well.

The bottom line is that our lifestyle choices, like diet and exercise, have a direct correlation on our health — a little more motivation to continue eating a healthy diet and exercising regularly.

Posted in: As I See It, Nutrition and Health \ Tagged: cancer, obesity

NCI Announces “Obesity Causes Cancer” While Congress Pushes Pizza in Schools

November 16, 2011 9:43 am \ Tracy Krulik

Sen. Jerry Moran says that tomato paste in school pizza is nutritious for your kids.

Last night after reading the National Cancer Institute’s (NCI) special bulletin on “Cancer and Obesity Research,” I planned to write an informative post this morning on why researchers believe that obesity not only causes cancer but also fuels cancer once you have it. And then I read today’s Washington Post.

Specifically, I read Dina ElBoghdady’s piece titled “Obama administration loses effort to make school lunches healthier.”

Here’s the situation: In accordance with federal dietary guidelines, pizza is currently considered a healthy choice for school lunches. The USDA, understanding that child obesity rates are expanding faster than our waistlines, is working to make school lunches healthier. They would like to limit the amount of “white potatoes and other starchy vegetables” to one-cup-per-week, and they would also like to reclassify tomato paste. “One eighth of a cup of tomato paste” equals a serving a vegetables under current guidelines.

Does anyone really believe that an eighth of a cup of tomato paste has the same nutritional benefits of a half a cup of vegetables?

Yes. Senator Jerry Moran (R-Kan) argues that it’s ridiculous to think that tomato paste on pizza is not as nutritional as eating a tomato. (Do I need to make the obvious joke about his last name?)

So Congress, in all its wisdom and (I’ve got to think) to appease its lobbyists, made an end run against the USDA’s plans to improve school lunches. On Monday negotiators from both the Senate and the House drafted a spending bill which includes language to force the USDA “to drop its plans regarding potatoes and tomato paste as it presses to finalize its broader school lunch initiative by the end of the year.”

Effing brilliant, Congress. With the growing body of evidence that diet and exercise play a pivotal role in preventing or fueling diseases like cancer, heart disease, and diabetes, you take away the USDA’s ability to improve the foods we feed our children? Did you listen to former Surgeon General Richard Carmona when he said in 2004 that “because of the increasing rates of obesity, unhealthy eating habits, and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents?”

I’ll post the information about obesity tomorrow. In the meantime, pack a healthy lunch for your kids. It could save their lives.

Posted in: As I See It, Nutrition and Health \ Tagged: cancer, health care, nutrition

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Monthly Archives: November 2011