I realized tonight that I have never come right out and said on any blog (only in MDJ and MWJ) what's wrong with me now: I have congestive heart failure as a result of idiopathic dilated cardiomyopathy (IDCM). It's not a big secret - I did have to explain it to MDJ and MWJ readers in September and October, but I've only hinted at it on the blog. The full story of the diagnosis and impact is available now on the MacJournals news blog, since it came from MWJ content.

I don't like using the "IDCM" term because some older pages say there's a very poor prognosis for IDCM patients, perhaps as low as 50% survival rate five years after diagnosis. Today's studies tend to find it more like 80%, and while it took a while to diagnose my condition, I still feel they caught it fairly early. Not one doctor has told me that this will shorten my life, and there is about a 10% chance that the heart muscle will recover some function on its own or assisted by drugs like CoReg. I have another echocardiogram this week to see if there's been any improvement since early October.

The food thing, though, continues to really frustrate me. I was already in a job where I could have used another two hours per day, and now I'm sleeping better most nights than I have in the past year, but it's hard to find food. I'm limited to 2000mg of sodium per day, and one level teaspoon of table salt is 2400mg of sodium.

There are a few things I miss (Italian and Mexican restaurants are right out), but the real frustration is how much time it takes to find food. The short version is that there's almost no pre-prepared food that I can eat. Almost every cheese, bread, cracker, frozen entree, fast food, dip, chip, canned soup, or anything similar that I can eat - they all contain way too much sodium to be a single part of a day that maxes out at 2000mg of sodium.

A few examples, mostly off the top of my head:

• One fast-food bean burrito: 1200mg sodium

• One can of Progresso soup: 1900mg sodium

• One ounce of ham: 890mg sodium (one "serving" of ham is 3 oz)

• One slice (1/8 of a 14" pie) Pizza Hut "Veggie Lover's" hand-tossed pizza: 1030mg sodium (make it "Meat Lover's" and it jumps to 1690mg - for one slice

• Two tablespoons of an average salsa: 250mg sodium (a small salsa cup is usually about 1/2 cup, or eight tablespoons)

• One slice of most commercial breads: 200-350mg sodium

• One flour tortilla: 350-400mg sodium

• One 4-ounce serving of regular chicken: 70mg

• One 4-ounce serving of chicken "enhanced up to 15% by weight with chicken broth" or "with a solution of water, salt, and sodium phosphate" - the only kind of fresh or frozen chicken available at the Wal-Mart grocery store that's closest to my house: 330mg of sodium (so one pound of chicken has 1300mg of sodium instead of 300mg)

You just really have no idea how much salt is in everything. And it's not just salt, like I said in the MWJ article - it's sodium bicarbonate (baking soda and baking powder) and MSG, too. I made navy bean soup for my aunt for Christmas. For one gallon of soup (more than five 3-cup servings), the ingredients include 12 ounces of ham and 1.5 teaspoons of salt. Just those two ingredients mean that the soup has nearly 1900mg of sodium in a three-cup serving. I can use salt substitute in such cases, but I can't buy salt-free ham, sausage, most cheeses (swiss is often an exception), crackers, bread, and so on. Salt-free chips are available in Oklahoma City, but not here.

So here's a little bit of the frustration I've had in the past few months in certain food situations.

Breafkast
Before:	Scramble 1/2 cup of Egg Beaters in a small skillet omelet-style. Fold over and cut in half to fit on two whole-wheat bagels. Microwave two pieces of frozen vegetarian sausage substitute until hot, and place on the bagels with the egg and a slice of fat-free cheese. Or, alternately, pour 1/2 to 1 cup of skim milk on a couple of cups of cereal. Total time to prepare: 5 mins or less.
After:	Egg Beaters: 110mg sodium per 1/4 cup (twice what real eggs have). Frozen no-meat sausage: 400mg per patty. Bagels: 450mg of sodium each. Fat-free cheese: 290mg of sodium per slice. And that's not counting a pinch of salt in the eggs like most people use. Each of my breakfast sandwiches, therefore, has about 1600mg of sodium counting salt in the eggs. Can't find low-sodium bagels or sausage, so no more sandwiches. I can have eggs and sausage, but I have to make my own sausage out of ground pork with salt substitute and seasonings. It doesn't microwave in 45 seconds, so I have to fry it in a pan. Making the sausage takes about 15-20 mins per pound by the time I measure, mix, and store. Cooking it takes another 8-10 mins. Most cereals have 500-600mg of sodium per cup, and skim milk has about 120mg per cup, so that meal would be 750-850mg of sodium. I can eat some kinds of granola bars for 50mg of sodium each, but that's a thin breakfast.
Lunch
Before:	Local Pizza Hut or KFC buffet, if the schedule allows and I'm really hungry. A couple of GardenBurger or other vegetarian patty on bagels or homemade bread with mustard, ketchup, and fat-free cheese. Chinese food or Italian food on rare occasions. Total time: about an hour to leave, eat, and return. 5 mins to prepare gardenburgers.
After:	Nothing but plain tacos from local fast food is anywhere close to acceptable sodium levels, so no pizza or KFC. I can make my own pizza crust and top it with low-sodium cheeses if I have some, but the crust takes an hour, the pizza takes 15-20 mins to prepare, 7 mins to bake. All gardenburger-type patties are 400-750mg of sodium, and bread is 250-400mg per slice, so sandwiches are out. Chinese food is heavy on soy sauce if not MSG. Soy sauce has 1000mg of sodium per tablespoon. Italian foods are heavy on cheese and salt; the pasta cooking water is salted, and most dishes seem to have ham or bacon or both. Domestic parmesan cheeses are four times higher in sodium than the real thing from Italy, and most restaurants don't use the real thing. I can cook my own pasta if I boil the water (20 mins), cook the pasta (10 mins), and cook a sauce to go with it (10-30 mins).
Dinner
Before:	Restaurants. Soup with crackers. Cooking recipes at home like Sesame Noodles with Chicken. 2-3 burritos from local fast food places. Risotto. Lots of other things.
After:	Restaurants are out. Fast food tacos are allowable, but at about 300mg per taco, three of them is half my daily sodium allotment, so I have to have been careful the rest of the day. Sesame Noodles with Chicken has about 6000mg of sodium in the recipe, which makes about four servings. Replacements include homemade chicken pot pie with salt substitute, which is wonderful and low-sodium, but takes an hour to prepare and 30 mins to bake, though I have two meals of leftovers afterward. I can make tacos here at home, but that's another hour of cooking, mostly standing up. I can have pizza, as noted above. Low-sodium canned soup is very bad stuff; it's what you serve to evil people.

In short, unless I stick to granola bars, salt-free chips with low-sodium salsa, raw vegetables, granola bars, some kinds of cookies, or the like, I'm stuck cooking for about an hour to have a decent meal, plus another 30-40 mins to eat it, and another 30-40 mins to clean up. My house has no dishwasher, and I've been told repeatedly that I can't have one put in without tearing up the foundation. Money's not flowing freely around here after months of erratic MDJ and MWJ publication and a huge pile of medical bills.

I can make my own onion dip for salt-free potato chips, but I have to make my own mayonnaise for it so that it's not high in sodium, then make the dip. Low-sodium chicken stock for cooking is not sold in El Reno, so I can either find a few cartons of it in Oklahoma City or I can make my own, which takes 6 hours (not active time, but probably 2 hours of preparing, stirring, chilling, straining, and freezing). I can make my own bread using salt substitute, but that takes a few hours for 1-2 loaves. I'm not even going to try the same procedure plus boiling in a 6-qt stockpot to make my own bagels.

I was really, really going to make the tacos tonight, because they're absolutely yummy and well within my requirements, but by the time I got the kitchen cleaned up from the last day or two, I was too tired. I wrote this to vent, and now it's an hour later and while I'm fully rested and have my wind back, it's now too late to cook for an hour and eat and then clean for another 30 minutes just to have a meal. I can go get tacos at Taco Bell, but I get only three small ones for the trouble, and I can't eat much later to fill my tummy because I blew my sodium allotment on fast food.

I don't mean to whine - I know I'm lucky compared to some, and I'm not hospitalized or confined to bed or anything like that. But it's harder than it used to be just to find food I can eat every day without spending 1/3 of my waking hours on the planning, preparation, eating, and cleanup. It's frustrating not to eat in 20 mins whenever I want, or to buy something at the grocery store I can eat right there instead of just buying ingredients. I like cooking, but on my own, I can't do it 2-3X per day. I do get a little bit more tired than I used to, and the effort for a full family-sized meal for one is a lot for me.

I'm still finding ways to make it easier - specific kinds of foods I can eat (one brand of sour cream has 15mg sodium for two tablespoons, where others have 240mg), but I still can't go anywhere and eat, nor buy much frozen food to nuke in the microwave in 3-4 mins. My choices are generally "take a lot of time" or "don't eat much," and I don't quite know how to do that and everything else in an average day.

I'm still working on it, and will be for a long time.