Houston Grub

Whilst in Houston I was more disciplined than ever about eating humbly. More than any other time in my life I ate at home and brought my lunch to work. I also threw away practically no food, I ate almost everything I bought. Surprisingly, I did not miss eating out. It was not for lack of options. There are more places to eat-out in Houston than any other place I have ever lived or visited. Seriously, there are ten restaurants on every corner.

However, I did eat a few times and can whole-heatedly recommend these fine Houston eateries:

- Zabak's Meditrerranean Cafe
Hands down best, cheapest falfafel sandwich($5) I have ever had. Genuine, friendly service. I went twice in 6-months and would have gone every week if my budget would have allowed it.

- Brasil Cafe
One of my few complaints about cafe's and bars in the SF Bay Area is the lack of not only outdoor seating but also the size and stability of tables. This Houston cafe far surpasses any local cafe or bar. Tons of outdoor seating and small but very stable tables. Perfect for sitting and studying. Plus, the food is great and reasonably priced AND you can can get coffee/tea or wine/beer. Favorite place to linger in the afternoon with a study material.

- Boudreaux's Cajun Kitchen
I was first introduced to Boudreaux's by way of fried dill pickle chips. Not something that prior to living in Houston I would have considered tasty or delicious. But fried dill pickle chips = tasty and delicious. You do however need to split an order with at least three people because you're satiated early with the salty and yummy treat. Boudreaux's has an extensive menu with almost any fried item you could possible want (and many items prepared in other ways too but really why bother). Casual and fun. A little expensive but ample portion size. Great drink specials before 7 pm.

- Big Woodrow's
A fellow intern intern worked at Big Woodrow's throughout the internship and loved it. She insisted that we introduce the incoming class to traditional Cajun food here, specifically boiled crawfish. Crawfish are widely distributed in the southeast and considered a delicacy, rightfully so. I thought it was so great we took my dad when he came two weeks later for crawfish. When ordering crawfish for the first time make sure you find out how spicy they are. I loved it but my dad was a little overwhelmed by the spice.

And who could go to the almost South and not partake of BB-Q:
- Goode Company
Everything they say about Texas BB-Q is true. It is soo good. It also widely available but believe it or not, I only went for BB-Q three times while I was in Houston - twice at Goode Company. Just go, don't think about splitting a plate, get a combo and try as much as you can. They say the pie is also good at Goode Company but I ate so much BB-Q I never had room.

Mangalista Mania

Several months ago I agreed to purchase a pig (I don't think it was the pig pictured above) from a high school friend, Kylan Hoover. Six months before Kylan and I had gone for lunch together, while catching up, Kylan casually mentioned that he was interested in returning to pig farming (He had raised pigs for the fair in high school). I had just been reading on Michael Ruhlman's blog about a pig-purveyor in Washington who was looking for a northern California outlet for his prized Mangalista. One thing lead to another and Kylan was the proud daddy of more than 50 pigs in less than a month. Given the introduction I feel a connection to his "herd" of piggies.

When given the opportunity I had to have one. Some girls have to call their fiances and say "I went a little crazy and bought another pair of shoes", I had to say "I kinda just bought a pig... with your checkbook." Lucky for me Andy (and my mom) really like bacon. Even a small pig yields far more pork than two can reasonably eat so I solicited friends to purchases "shares" of our new friend.

I have never bought a whole animal for consumption before (chicken's don't count). I didn't know the pertinent questions to ask:
Q: How will the Mangalista go from living to dining?
A: The swine along with nine other friends were transported in a horse trailer from their home in the Livermore Valley to a small family owned slaughterhouse in Modesto on a Monday. Where they met their end quickly and humanely. The whole hogs were transferred in a refrigerated truck to Star Meats in Berkeley where my pig "hung" for several days. Hanging is necessary to allow natural chemical reactions to occur taking the meat from icky to amazing. Kylan left directions for the cutting and on Friday morning the pork was cut. Friday afternoon we picked up many neat brown packages.

The other pigs went on to the French Laundry where they were processed for curing and aging. They will make a prominent appearance early next year on the menu.

Q: How many pounds of meat will the piggy yield?
A: When all is said and done I still don't know. By conventional standards my pig was small weighing just shy of 200 pounds at the end. I weighed most of the individual cuts in order to fairly divide among shareholders. However, I did not weigh the head, heart, kidney's, liver, lard or intestinal bits. Some of the poundage is lost during butchering I think its safe to safe in the end I had over 150 pounds of pork.

Q: What happens to the head, heart, kidney's, liver, lard and intestinal bits?
A: I kept and rendered the lard myself.
I met my limit at "processing" the other offal so I arranged a trade with Hank Shaw. Who made excellent use of the other nasty bits and publicized Kylan's business a bit on his blog Hunter Angler Gardener Cook.

Q: How do you fairly divide the pork among shareholder's?
A: We laid all the neat brown packages out on a table in the garage. We took out several "odd" pieces including the pork shoulder that I roasted for the party. We weighed the pieces and with Kylan's help we just started making "equal" piles. On the day of distribution I used my own share to swap with people who wanted different cuts. It just worked itself out.

The list of questions goes on and on.
Needless to say most of us (including me) don't really know how our dinner starts.

Let me tell you this dinner was damn good even knowing a little bit more about where it came from.


Photos courtesy of Andy Bliss - More photos of the pig party.

Daily Grind - Food Service Managment

Compared to my almost grueling 10-week clinical rotation, my 4-weeks of Food Service has gone by lightning fast. I barely have blinked an eye and I am done.

Once again I was assigned to a hospital within the Texas Medical Center, that's where the similarities between the experiences stop. Unlike my clinical rotation: I arrived at 7:30 am and was almost always gone eight hours later at 4:30 pm; I saw patients only in the halls of the hospital, I don't think I uttered more than ten words to one; I spent a lot of time in the basement (where most hospital kitchen's are located); I had more than enough time to complete the tasks assigned to me; Everyone was really, really nice, all the time.

I wish I had a quarter for every time I have heard: "I didn't get a degree (or two or three) to work tray line", "I hate to cook", "I don't do food service". Seriously, the way many dietitians talk you would think nutrition and food were completely unrelated. Most dietitian despise the words "food service". So, I hate to admit it... I kinda of like it. Although industrious employees who take great pride in their attention to detail, food service doesn't take its self quite so seriously. Your fellow employees come from a greater slice of life. Not everyone has a college diploma (or even a high school diploma); its a little less idealistic, a little more r-e-a-l.

Typical tasks performed during this rotation:
- A lengthy "Patient Services" check-list to get familiarized with all the jobs and tasks required to get meals to patients.
- Audits of: Patient identification and proper hand washing among food service employees (No need to worry: Everyone appropriately identifies patients, everyone washes their hands), the proper use of formula order form among physicians, and kitchen inspections of the hospital and food court kitchens
- Documentation of food service related charges in a doctor's lounges of a newly opened unit of the hospital
- Development of independent learning activities for food service employees who missed customer service training
- Development of a bulletin board marketing a customer service program to employee's
- Data collection and presentation of clinical dietitian monthly productivity
- Analysis and recommendation of provision for emergency food supplies (MRE's v. recognizable, microwavable product).
- Development of tool to track quarterly changes in food cost

Yes, some of this work was tedious. However, I was exposed to the breadth of tasks required in food service management. My days also could not have contrasted the relative sameness of the days of a clinical dietitian more.

Twilight

There is something completely absorbing about these books.

They are the absolute epitome of a fairy tale and the
sickening reality of adolescence woven together.
Highly recommended

Hurricane Ike

Hi all!
Thanks so much to all of you who e-mailed, called, texted or just thought about my safety over the past 24 hours.

I am happy to report that I have survived my first (and hopefully my last) hurricane unscathed. Many others in the gulf cannot say the same, I feel very lucky. Hurricane Ike came through over night, the real action lasted about 5 hours. Jenny (my roommate) and I dragged a mattress and pillows into the hallway and slept there. It was loud and a little scary but all-in-all okay. Our power was out for about 6-hours but came back on this morning (Most people in the area are not expected to regain power for a few days.) We are LUCKY.

I have posted a few photos at http://picasaweb.google.com/tjgirl/HURRICANEIKE#. My entire neighborhood has debris and trees down all over. Most of the street lights are out. Many of the street signs have been toppled. It just generally looks tattered. People are out and about cleaning up. Most in good spirits. You can hear generators buzzing, people are BBQ-ing. While it NO way feels like a block party, people openly express their gratitude for their personal safety and property. I think everyone's just glad its over.

I expect to go back to work at the medical center Monday or Tuesday.

Hope each of you are safe , warm and dry.

Be in touch.

Always,
~Taryn

Daily Grind - Clinical

In some ways I can hardly believe that I am already 1/2 way through my Clinical rotation. In other ways if feels like it should be long over. The Clinical aspect of the internship is the longest and most intense of the 5-rotations. It is a 10-week crash course in not only the various disease states and how they relate to nutritional status but also the mechanics of working within a hospital.

It is the practical application of everything you have learned in school
AND everything they don't teach you.

I am at a large, prestigious teaching hospital. It is ranked as one of the best hospitals in the country. Inarguably, it would be next to impossible to get a better experience somewhere else. However, it does have a reputation for being tough on interns. Within a matter of weeks we are expected to learn the lay-out of the hospital (a sprawling 5-building complex with up-teen elevators), a computer charting system, a food service set-up, the subtitles of relating to Dr's, nurses, and other essential personnel, AND see and document on 8-10 patients a day. We work under a different dietitian each week, whom each cover very different floors. Every day, every week is different than the one before. With the level of expectation building the longer we are there.

I have had the opportunity to work the following floors/specialties: Cancer, General Medicine, Cystic Fibrosis, Neuro-ICU, Neuro-stepdown (strokes and other brain injuries), Post-Gastrointestinal Surgery, Bariatrics and next week I'll follow the renal dietitian. After that I'll spend a week with an ICU dietitian before 2-weeks of practicum (working floors independently as an RD would).

So, what does a clinical dietitian do?? It is helpful to think of almost every health care provider (pharmacists, dietitians, physical therapy, speech, occupational therapy, etc..) in a hospital as acting as consultant to the MD. With nurses both playing the role of consultant and actually getting everything done.

Dietitians keep track of the nutritional component of patient care. When patients are able to safely eat, we stop by their rooms and encourage them, make sure they are getting their meals and "between meal nourishment's" (AKA snacks) and try to subtly slip in some healthy eating cues without being labeled as the "diet police". When dramatic changes are needed in a patient's diets (ex. new diagnosis of diabetes or kidney failure) we are sent with a packet of instructions and go line-by-line through a complete dietary change. When patients are unable to eat we act as a consultants, providing MD's with suggestions for alternative support. This may mean a enteral/tube feeding or parenteral nutrition/directly into the blood stream.

Every dietitian has the same mantra when working with alternative nutrition support: "If the gut works use it". Enteral nutrtion, the digestion of food through all or some part of the digestive tract is always the preferred mechanism of nourishment. If a patient is unable to chew or swallow a tube can be used. A nasogastric or nasoenteric a tube is placed through the nose and down the throat to the gut. While a PEG or J-tube is "surgically" placed directly through the abdominal wall to the stomach or intestine. Formula is than dripped or gently pumped into the body, and the gut completes the digestion and absorption of nutrients into the body. Enteral nutrition is used a wide variety of clinical conditions: It is used when a patient simply doesn't have the energy or ability to eat enough, when they are unable to swallow correctly (after a stroke for example), or when the stomach is unhappy but the gut is working properly. Enteral nutrition is almost always the preferred route for a myriad of reasons: It is more biologic, less invasive, less expensive and just less complicated than its cousin parenteral nutrition.

Parenteral nutrition takes alternative nutrition support to a whole new level. The smallest elements of food: sugar/dextrose, protein/amino acids and fats/lipids are directly infused into the blood stream no digestion required. Generally a central line directly into a major artery is used and the nutrition is continuously pumped in. Parenteral nutrition is only appropriate in a select number of patients, those whose digestive tract are unable or unwilling to digest food. This may happen when there is hole somewhere in the gut, after a surgery when the gut doesn't wake-up, with severe inflammation of the digestive tract or just complete upset of the entire system/major trauma. Parenteral nutrition may seem more straightforward than enteral but it is anything but. Our bodies are incredibly efficient at digesting and using food, so parenteral nutrition skips millions of years of evolution. It is anything but biologic, very invasive, incredibly expensive (more than $1,000 per day) and prone to complications. That said in select patients it is a lifesaving therapy.

MD's are only required to take one nutrition class during their training. Dietitians fill in the gaps. Providing consultation about the appropriateness of their selected nutrition regiments and offering alternatives. For our suggestions to be relevant they must be holistic, taking into consideration the other related aspects, of patient care. Since the human body is the ultimate integrated system as a clinical dietitians we review and consider A LOT of things:

• Why is the patient here now? What is their progress?
• What is their past medical history and how does it relate to their current condition?
• Daily labs
• Medications
• Output of fluid from the body (urine, waste, drains, etc..)
• Medical therapies being used (ventilator status, hemodialysis etc..)
• What are our goals? (E.g. increase PO intake, minimize loss of lean body mass, etc..)

Unfortunately, a medical record is not a clearly delineated dossier of patient history and treatment, and everything they say about doctor's handwriting is true. So, often it feels like you are detective trying to figure out what the heck is going on with this patient AND what the heck you going to suggest for them. This process repeats itself as you work through your patient list. It can be both ridiculously frustrating and incredibly rewarding contributing to the care of very sick, very sick individuals.

Clinical nutrition is simultaneously everything I expected and an entirely different ballgame.

Ps. The opening image is of the Texas Medical Center, where I am completing my clinical rotation. Check out this link for more information about the medical center and the organization's within it.

Houston Theater District Open House

Last weekend I checked out the Houston Theater District 15th Annual Open House.
It was quite a nice event. Even though I was not inspired to become an opera singer!

Soup on Sunday's

I have been horribly uninspired to cook since I started "working".

Perhaps its because I spend at least 8 - 10 hours everyday talking and thinking about what other people eat and seeing first hand the consequences of poor dietary/lifestyle choices. Perhaps its because its not as convenient to get great ingredients (No Monterrey Market, no Berkeley Bowl, no Trader Joe's). Perhaps its because I am only cooking for me. Who knows?? Anyway I've got to get back cooking... Starting with a little soup on Sunday's.


Spicy Southwestern Soup

Soak 1.3 cups of mixed dried beans in water for a few hours.
(I used beans from North Day Trading Co, found in the bulk bins at Whole Foods)
Use a colander, drain and rinse beans.

In a large stock pot over medium-high heat saute 1/2 chopped onion, 2 -3 cloves of garlic in ~1 tablespoon of olive oil. Allow to become fragrant and translucent ~7 minutes.

Add beans back in and cover with about 1.5 inches (~6 cups) of water. Add 2 tablespoons of Better than Bouillon or 2-3 cubes of bouillon. I like chicken or veggie flavor. Add 1/2 cup of prepared salsa. Cover the pot bring to boil and than turn down allow to simmer for 60 - 90 minutes. You want the beans to be tender but not falling apart.

At the end a 5 - 10 minutes before serving (depending on how cooked you like your veggies) Add:
Handful of chopped cilantro
1/2 chopped red bell pepper
1 cup of of chopped carrots
1 chopped squash (zucchini or yellow or whatever you have and like)
Whatever else you think would be good.

Garnish:
Cheese, avocado, lime wedges

Time: 2.5 hours, mostly unattended
Serves: 4 easily - 6

EL SALVADOR

At the End of Week#1 and 5 Things U Might Not Know About Houston

Week 1 (or so)-in-Review:

Thus far, I have completed the orientation for the dietetic internship (DI). It consisted of:
Day 1 - Review of policy and procedures; Review of the rotations sites
Day 2 - Introduction to using the evidence based library, case study assignments. I was assigned metastatic brain tumors in overweight patients. My task was to prepare a ~15 minute power point presentation about the condition, the expected course of treatment and the nutritional implications.
Day 3 - In small groups complied nutritional care plans using information from the evidence based library and other journals; Case study presentations
Day 4 - Enteral and parenteral formula review
Day 5 - Introduction to medical charts at a hospital ~30 minutes outside of Houston; Dinner with the out-going interns. They made a fantastic gluten-free menu complete with focaccia bread and tiramisu. It was really good.
Day 6 - Review of charting using the nutritional care process
Day 7 - Attended the out-going interns graduation


5 THINGS YOU MIGHT NOT KNOW ABOUT HOUSTON, TX

5. NO-ONE WATERS THEIR LAWNS or PLANTS HERE
Even though its been almost 100, almost everyday...Seriously all of the plants are maintained by the humidity in the air. I haven't met anyone with a veggie-garden, I think people must water those??

4. STOPLIGHTS ARE HORIZONTAL HERE
There also a lot of blinking yellow lights

3. EVERYTHING IS BIGGER HERE
For example, I went to the mall over the weekend. I thought I knew how big it was going to be: I was wrong. Its huge... There's a post-office in it (unlike at the airport), and an ice rink and anything else you could possibly want.

2. IT IS MORE FORMAL HERE
Unless you are friends with someone, you call them Ms. or Mr. (especially women) until directly told not to. No one swears (not even in damn, definitely not s-h-i-t and never anything stronger) in public. The tone is just - different. I can't decide if I like it or not.

1. IT IS AS HOT AND HUMID HERE AS THEY SAY IT IS (like you didn't know that..)
During the weather forecast the temperature really means nothing... Its the "heat index" that really tells you what its going to feel like. Generally, its hot or miserable... Unless there's a tropical storm or a hurricane, than its quite lovely (humid but lovely) but a little scary because you don't know what's going to happen.

CA - to - Houston, TX

I am a GRADUATE!

SFSU Graduation '08

Dude - My dad is cool

Think about supporting him in this important cause:

Hello friends and family,

I am joining with 9 other co-workers on our Bio-Rad, Redmond WA company team on Sat May 17, to raise money for the American Diabetes Association. We are taking part in the 2008 Seattle Tour de Cure.

We will each be riding various distances from 15 to 100 miles in this fund raising event.

I would appreciate your sponsorship for this worthy organization, as Taryn, I am sure will attest.

You can make a donation under my name by going to this website:

http://main.diabetes.org/site/TR/TourdeCure/TDC451018030?team_id=272528&pg=team&fr_id=5050&et=syMYbtx8AcRFZB_ait0_zw..&s_tafId=166229

So far, our WA team has raised just over $1600.

Thank each and everyone of you for your support.

Sincerely and God bless,

Ross

Last big push

This has easily been the hardest semester of my college career.

I knew it would be hard, I am taking a very heavy load of classes: Seminar in Clinical Dietetics, Advanced Nutrition, Nutritional Assessment, Food Service Layout and Design and Principles of Financial Accounting. I have continued to work nearly 40-hours a week between Trader Joe's and my responsibilities with the P-family. That coupled with with my mom's knee injury early in the semester, initial wedding thoughts and planning and attempting to maintain some semblance of a life has left me with NO free time.

No free time for reading (other than for class), no free time for movies, no free time for social events, no free time for elaborate cooking, no free time for just about anything... So, please forgive me if I never seem to regularly take photos or post about cooking. Maybe its the business of it all that nourishes me.

While I can't wait for it to be over (I am literally counting the days...) I also realize I don't know what its like to not live like this, with every second of everyday accounted for. Believe it or not, its a little scary to think about what I would do with extra time.... Free time??

Realistically its something I don't think I'll have to worry about for a while since after these last few weeks of school comes the preparation for and the move to Houston, 6-months of internship, real wedding planning, preparation and execution and whatever else happens to occur.

We should all be so lucky.

DI - University of Houston

Matching Results

I am pleased to inform you that you have been appointed (computer matched) to the University of Houston.

Texas.... baby!

Houston, Texas

Serendipitously digging in the dirt

Today I serendipitously ran into my friend Leslie. I woke up with a head-ache (an all too common event) and was unable to go to class. After trying to sleep it off, I got up and decided to just start checking things off my daily "To Do" list. After a cheese roll at Cheeseboard, I went to Monterrey Market and while I was mentally making sure I had picked up everything for dinner, there she was in front of the chard. She was on her way to Berkeley Horticulture (maybe the best nursery ever) for the very first time. She tagged along for my grocery shopping, I tagged along to the nursery. After a stop at the butcher we had a lovely fresco lunch before parting ways. Both happy for coincidentally being able to be together.

Before now I have never lived in a place long off to know enough people to "just run into someone" anywhere. Today in addition to Leslie, I saw a friend-of a-friend and an old BMC buddy while having lunch. It feels lovely and familiar. I'll miss it next year where-ever we are.

So, because of this serendipitous meeting I started my garden plot for 2008.

Before:


And after:


I bought and planted:
- English peas
- Snow peas
- Artichoke
- Poppies that look like peonies (to attract pollinators)

Still to come:
- Herbs (parsley, cilantro, thyme, basil, oregano)
- Rainbow chard
- Spinach

First full day of Spring

I love this website, School of the Seasons.

In my heart of hearts, I like traditions. Events, rituals, what-not: Things that are repeated year after year.

Quietly, I have been working on my own set of traditions. In January to mark Martin Luther Kind Day we attended a gospel concert in his honor; In February for Valentine's Day: 2 Desserts and No Dinner and now the first full day of Spring....

For spring:
- Last night, while chatting with an old friend. I straightened up, in order to greet the "new year" with a "clean" house. I'll finish up tonight.
- I bought daffodils to brighten my apartment.
- I went to the Thursday Farmer's Market. Something, I wish was a weekly tradition.
- Tonight for dinner we-ll be having S - almon (keeping with a neo-Persian tradition).
- If Andy can find the last egg dying kit in East Bay, I'll dye eggs and than have deviled eggs a few days later.
- Moving or not, I want to plant something this weekend.
- On Sunday, it may be the first annual "ham holiday" and sweet potatoes because everyone knows you can't have ham without sweet potatoes

What are your traditions??

Prosciutto and Leeks + Pasta

Although I am inconsistent at best with posting on my own blog, I never fail to read other people's. Primarily, I am looking for inspiration for that age-old question, "what's for dinner??"

Last weekend I tried out this recipe from Gluten-free Girl (with my own twists of course):

Prosciutto and Leeks + Pasta
Trim, leaving just the white and light green part4-6 leeks

Under cool running water, very thoroughly rinse. Cut in 1/2 length-wise and rinse again. Leeks are notorious for being grainy, you want to avoid that effect in your meal. When in doubt rinse again.

Cut into 1/8" wide half-moons.

In in wide sauce pan (that you have a lid for), over medium heat saute leek moons in:
2 tablespoons of extra-virgin olive oil

After ten minutes of occasionally stirring. Cover leeks with:
4-6 slices of prosciutto
And cover the pan, set to very-low.

Let leeks and prosciutto cook and caramelize together for at least thirty minutes.

Boil:
1/2 pound of wide pasta noodles, according to direction on label.
(Will vary a lot, depending on whether you are using fresh or dried noodles). Drain.

Uncover your leeks and prosciutto pan. Remove prosciutto from pan and slice into very thin strips. Return and stir to combine.In a large bowl, toss pasta, prosciutto and leeks with:

Mozzarella cheese, to taste
(We used about 1/3 cup of shredded mozzarella because that is what we had around) Fresh mozzarella would be even tastier and a healthy drizzle of:
Balsamic vinegar

Serves: 2-3
Time: 45 minutes

Ps. Yeah, I know its more fun with pictures. I'll get on it!

Mushroom Risotto

Using this recipe from Simply Recipes. I made a g-r-e-a-t risotto.

It was delicious. No surprise, I made a few changes: I used more mushrooms browning and cooking some of them with the rice; I substituted sherry for the cognac and I used less butter, olive oil and cream than the recipe called for. It did not matter it was still fabulous.


A note about the mushrooms I used: I used plain white mushrooms and crimini's to brown and and cook with the rice; I used more exotic mushrooms in the cream mixture. I was afraid of cooking with more exotic mushrooms for a long time. I thought they would be over-powering and domineering in my dishes. I was wrong: They are really wonderful additions bringing mild, earthy flavors and subtle textures. The price of exotic mushrooms can also be intimidating . I usually buy some white button mushrooms to bulk up my purchase with out bulking up my receipt. And don't worry about the names, just experiment with a few that appeal to you.


Thank-you Monterey Market for the selection. If you live in the East Bay just stop shopping for produce any where else and GO TO Monterey Market. It is the best.

An amazing way to start the New Year