Until that moment, she’d been too busy to give all this medical stuff much thought. The weekend before the scheduled surgery she was in Montgomery helping with a wedding. When she came home, she made enough food for her four sons, three daughters in law and six grandchildren to eat while she was in the hospital.

“I had too many hurdles I was jumping to get ready to get to the hospital,” said Geraldine, fifty-four. “I didn’t realize the seriousness of what was happening to me until I woke up, and the nurses wanted me to walk,” she said. “That was the hardest walk down that hall in the hospital.”

That Tuesday in July 2012, the Opelika woman had a quadruple heart bypass. Now came the second hardest part: facing the fact that she may have avoided the whole thing if she had listened to her doctors years earlier.

Lottie Sides was clipping back the branches that were taking over her tomato vines on a clear August day last summer. The eighty-seven-year-old Auburn resident snipped the branches and carried them in bundles to the roadside. When she had enough, she headed out of the sun.

“I sat on the porch and picked up the newspaper, but I couldn’t function so I put the paper down, “ she said. “Then I came inside the house and lay down on the floor, but when I did that I got nauseated. I knew something was happening to me; I felt so weird, and I was sweating.”

She took a shower to shake it off. It didn’t work, and now her left arm hurt. She called her niece, a nurse at East Alabama Medical Center. It was time to call an ambulance, her niece said.

What Lottie found so strange was the lack of pain.

“It didn’t hurt. When the guy in the ambulance asked me how I would rate the pain, from one to ten, I said, ‘Well, if I have to say anything it’s a one, because I don’t feel anything.’

Sallie Joiner, an eighty-year-old Opelika resident, didn’t really feel she was pushing too hard. “Surely I didn’t know I was stressed,” she said. “I knew I was running busy and going here and there, but I did not feel stressed.”

She was accustomed to driving from Opelika to Phenix City where her daughter lives, and Tuskegee, where her sister and two of her four sons live.

In October of 2012, she took her daughter in Phenix city to the hospital for outpatient surgery and then headed to Tuskegee where she was to speak at the funeral visitation of a close friend.  She made it to Tuskegee by five for the visitation and spent that night at her sister’s house so she could attend the funeral the next morning.

“My sister noticed I’d gotten up during the night. She heard me walking around, and I told her it was because of leg cramps,” Sallie said. “She knows me for having cramps in my legs at times. But I was really having chest pains and sweating.”

She kept that part secret and went to the funeral. She wouldn’t admit something was truly wrong until she got back to Opelika, where she drove to urgent care in TigerTown.

She might as well have carried a sign, so clear were the symptoms of a heart attack. The doctor immediately gave her baby aspirin and a nitroglycerin tablet to put under her tongue. An ambulance took her to East Alabama Medical Center. She was almost a week.  

Welcome to the world of women with heart attacks.

Forget every movie you ever saw where the guy clutches his chest, gasps, and falls dramatically to the floor. Oh, sure, that can happen, but heart attacks are often far more sly, particularly in women.

A 2003 study of five hundred women who had heart attacks showed fewer than thirty percent said they had chest pain before their heart attack and forty-three percent said they never had chest pain.

“It’s important to understand it’s not the intensity of the discomfort that is the most concerning aspect, it’s the duration,” Dr. Allan Schwadron, a cardiologist at the East Alabama Heart and Vascular Clinic. “A mild pressure in the chest that lasts a couple of hours could be a serious heart attack, and an intense sharp pain that lasts seconds or so could be totally unrelated to the heart. That advice goes more so toward women, who tend to be the stoic caregivers and develop the disease later than men.”

Symptoms in women can be unpredictable, including indigestion, sleep disturbance, weakness in the arms. One study showed seventy percent of women felt unusual fatigue, forty-eight percent experienced sleep disturbance, forty-two percent were short of breath, thirty-nine percent had indigestion, and thirty-five percent experienced anxiety as a major symptom of their heart attack. Other symptoms include cold sweats and dizziness.

Five years before Geraldine Barber woke up from her quadruple bypass, a cardiologist told her she had high cholesterol and high blood pressure. She inherited part of that problem, and then contributed more by her diet. Finally, she refused to take the medication her doctor recommended.

“I was all about natural remedies; I just did not want to be on any prescriptions. I ate a lot of cinnamon, because I heard it was good for cholesterol, and also fish oil, omega3, and garlic,” Geraldine said.

Not too long after the cardiologist warned her of her risk factors, Geraldine and her husband, Chuck, headed for South Lake Tahoe, California, to visit one of their sons. But the mountains left her breathless — and not because of the scenery. She couldn’t seem to get enough air. She felt dizzy and disconnected, her perceptions arriving on some odd time delay.

It must be dehydration, she thought, so she bought water. She couldn’t keep it down.

“I knew then something was wrong with me, and I told my husband I have to have help; I’m just not right,” she remembered.

Paramedics waved away her symptoms as a passing response to high elevation. No need to worry, they said. It happened to visitors all the time.

“Only recently did I put it all together and realize it was probably my heart not being able to get the oxygen due to not only elevation, but the blockage I didn’t know I had,” she said.

They returned from their trip, and she didn’t think another thought about what had happened. Geraldine returned to the gym for her regular water aerobics classes and walks around the track. In December of 2012, she walked the track with a friend. As they walked, her upper chest hurt; the pain was worse than she’d ever had before, but still, she tried to hide it.

Later that day Geraldine complained to the wife of her walking companion about pains in her legs and hips. She was going to see an orthopedic doctor, she said. That would take care of things. Her friend wasn’t having it. If you don’t fix your heart, she told Geraldine, you won’t have to worry about fixing your hips.

At the orthopedic physician’s office, her husband mentioned the pains she’d been having. The doctor made an appointment for her with a cardiologist the next day, where an EKG showed some abnormalities. The cardiologist recommended cholesterol medicine to “keep her out of the ditches.” She took a stress test and thought she did pretty well walking on the treadmill. But the cardiologist wanted to see her again. The tests showed that three arteries providing blood to her heart were significantly blocked.

A nurse began to describe the procedure she needed. “Why are you telling me?” she asked. “I’m going to be asleep!” Her husband was as white as a sheet. “Stop scaring my husband!” she said.

But still, she did not recognize the gravity of the situation. She tried to delay surgery. She didn’t want to miss an upcoming convention or the wedding in Montgomery. But her husband prevailed, and surgery was scheduled in less than a week.

“My husband wouldn’t even let me go up stairs, because he knew I was going to have a heart attack. He wouldn’t let me lift anything. He went with me to the wedding to make sure I didn’t do any work,” Geraldine said. “If I didn’t have him I still wouldn’t have mentioned my pains and gotten the appointment with the doctor. Now I want to make sure I don’t ever scare him like that again.”

When Geraldine woke from surgery, she learned doctors had found and repaired a fourth blockage.

Her recovery goes well. She goes to the gym daily, has lost twenty-five pounds.  Because she has the kind of cholesterol that diet won’t control, she remains on medication to lower it. And she continues taking cinnamon, garlic, and fish oil.

Genetics, gender, and age are disease risks no one can control, and together they determine your risk of heart disease, and how well you can tolerate those external risks of a high-fat diet, obesity, and smoking. Female smokers are at six- to nine-times the risk of heart disease than nonsmoking women. Male smokers’ risk is twice to three-times higher than nonsmokers.

It’s important to know family history. If a mother or a sister had heart problems before age sixty-five, you’re likely at an increased risk. Men’s risks increase if a male relative had heart problems at fifty-five or younger.  “If they come to me and say all their grandparents died of heart attacks in their seventies – that’s not really a risk factor,” Schwadron said. “Family members having a stroke in their forties is a much bigger risk than if they had a stroke in their seventies.”

Diabetes also elevates the risk of heart problems. A person who has diabetes when they have a heart attack is considered equivalent to someone who does not have diabetes having their second heart attack, Schwadron said.

Lottie Sands learned not long after she arrived by ambulance at the hospital that she had had a heart attack. Two arteries were blocked. The following day, a nurse gave her a valium. As she dozed, a doctor threaded a tube through an artery and up into her heart, where he deployed a stent, a small metal tube which expanded to form a passage way in the blocked vessel.

“I feel great now; I didn’t have any complications,” Lottie said. “I just think that if I hadn’t decided I’d clip the rest of the tree limbs later and kept working, I might have died, wouldn’t I?” She emits a short laugh at the thought of her luck.

Her heart attack was a surprise to her, an active woman whose only link to heart problems was hereditary.

Sallie Joiner, who drove herself to an urgent care center after feeling heart attack symptoms for more than a day, now realizes she had not made the best judgments.

“I should not have driven myself to the doctor. And I’ve promised not to hide it from my family again. They didn’t find out until I called them from the hospital.”

“They were very, very angry,” she adds, chuckling about it now.

Sallie, Geraldine, and Lottie all explain that without rehab, they wouldn’t be in as good of a condition as they are now.

For Geraldine, rehab has given her a place to get back in shape during recovery. Lottie is happy sweeping leaves and keeping up her yard as her own form of rehab. For Sallie, rehab is not only a physical workout, but a mental one.

“I didn’t realize it’s such a slow process for the heart to heal. I’m having to realize and develop patience, because I want to get up and do a lot of things, but I can’t. Rehab has helped me keep my direction. The staff tells me I’m where I need to be even though I don’t feel like I am,” Sallie said.

She laughed and added, “I’ve told the staff I’m going to keep coming as long as my old folks’ insurance keeps paying.”

Joyce Chocklett of Salem was reaching for something when she felt a sharp pain, like a pulled muscle, and went into a cold sweat.  A few days later, she visited the doctor for a scheduled appointment.

“It turned out I had a vessel ninety-nine point ninety-nine percent blocked. The doctor said it would not have been much longer before it would have taken me out,” she said.

Doctors repaired the blockage with a stent, and she was out of the hospital the following night. When she finished rehab, she began exercising on her own, and her thirty-nine-year-old son, Daniel, making sure she keeps it up.

“My husband says work is enough exercise for him, and my daughter says her two-year-old keeps her busy enough, but my son will get right in there with me,” Joyce says. “He’s my biggest fan, always pushing me.”

“I am blessed to be here,” she says. “Very blessed.”

I started this year with an international flare. I’m not talking tacos and spaghetti — not that I’m dissing these everyday staples. I just wanted my family to explore new things like curry, tagines, and jerk.

While I’ve made couscous many times, it never “wowed” me, but Raisin and Honey Couscous made me smile, and it goes really well with Chicken Tangine or Pork Marsala.

Ragu Asian Style is definitely fast food for a house full of company, and a warm pita filled with Chicken Curry is kick-back-Friday-night-and-watch-a-movie food.

Chicken Tagine

I confess I was skeptical of a recipe that combined dates, artichokes, and peas, but it came together beautifully. This Moroccan dish will definitely be in rotation this year.

• 2 pounds boneless, skinless, chicken thighs
• 1 teaspoon ground cinnamon
• 1 teaspoon ground coriander
• 1 teaspoon ground cumin
• 1 teaspoon hot paprika
• 1 teaspoon turmeric
• ½ teaspoon kosher salt
• ½ teaspoon black pepper
• 1 tablespoon olive oil
• 1 small sweet onion, sliced
• 4 teaspoons grated fresh ginger
• 2 garlic cloves, minced
• 2 cups chicken broth
• 8 ounces pitted, chopped dates
• 1 tablespoon lemon zest
• Pinch saffron threads
• 1-14 ounce can quartered artichoke hearts, drained
• 1 cup frozen peas

Chop the chicken into bite-size pieces and place in a plastic bag with the cinnamon, coriander, cumin, paprika, turmeric, kosher salt, and pepper. Toss to coat. Leave chicken in the bag for at least thirty minutes and up to four hours. Heat oil in a large skillet; add the chicken and sauté until brown on all sides. Add the onion and cook until tender. Stir in the ginger and garlic followed by broth, dates, zest, and saffron.  Simmer until the chicken is fork tender. Add artichoke hearts and peas and cook until heated through.

Raisin and Honey Couscous

Couscous originated in the Southern Mediterranean countries and Northern Africa. It was made with a variety of grains such as millet and barley, and in some places, cornmeal. As it became more generally accepted, people made it semolina flour, which is the sort of couscous we find in grocery stores here. It makes a great side dish, a suitable stand in for potatoes and rice.

• 2 teaspoons olive oil
• ½ cup chicken broth
• ½ cup apple juice
• ½ cup golden raisins
• 1 tablespoon honey
• 1 tablespoon lemon zest
• ½ teaspoon kosher salt
• ¾ cup dry couscous

In a medium saucepan heat the oil and add the broth, apple juice, raisins, honey, lemon zest, and salt. Bring to a boil over medium heat. Remove from heat and add the couscous.  Cover the pan and let the couscous stand 5 minutes. Fluff and serve.

Pork Marsala

This easy Italian dish is delicious and elegant; great for dinner on a busy Sunday.

• 2 pounds pork tenderloin cut into ½-inch thick slices
• 2 tablespoons olive oil
• 2 tablespoons butter
• 1 cup flour
• Salt and pepper to taste
• ½ pound button mushrooms, sliced
• ¼ cup onion, finely chopped
• 2 garlic cloves, minced
• 1 tablespoon flour
• ½ cup Marsala wine
• 1 cup heavy cream
• ¼ cup fresh parsley, chopped

Place the tenderloin slices between two pieces of plastic wrap and pound to a ¼-inch thickness with the flat side of a meat mallet or a heavy can. Combine the flour, salt, and pepper in a shallow dish; dredge the tenderloin slices in the flour mixture. Heat butter and the oil in a large skillet and add about half of the tenderloin slices. Sauté, turning once, about 3-4 minutes per side; remove pork and cover to keep warm.

Sauté the mushrooms until softened; add onion and garlic, and cook until softened. Stir flour and deglaze the pan with the Marsala, stirring to loosen any brown bits from the pan.  Add the cream and bring to a boil; simmer for two minutes. Pour the sauce over the pork and sprinkle with parsley to serve.

Cucumber Salad

When I was growing up, if cucumbers were in season, my Oma had them on the table. I’m not sure if it was a German thing or if she just loved cucumbers. With the seedless English cucumbers available year round, this recipe works all year round.

• 2 seedless English cucumbers sliced very thin
• ½ cup champagne vinegar
• ¼ cup sugar
• Pinch of red pepper flakes
• ½ teaspoon sea salt

Place sliced cucumbers in a glass bowl. Whisk vinegar, sugar, red pepper flakes, and salt. Pour over the cucumbers; stir gently. Refrigerate until ready to serve.

Jamaican Jerk Chicken Wings

I had a hard time with a few of the jerk recipes I tried. The ingredients were so extensive and the infusion of “hot” from scotch bonnet peppers was a wee bit much for my crew. The jerk seasonings on the market are good, but this jerk recipe is spicy enough without taking the skin from the roof of your mouth. My family gives it two thumbs up.

Jerk seasoning

• 2 tablespoons dried, minced onion
• ½ teaspoon ground cinnamon
• ¼ to ½ teaspoon cayenne pepper
• 2 teaspoons ground allspice
• 3 teaspoons dried thyme
• 2 teaspoons ground black pepper
• ½ teaspoon salt

Mix all together and set aside.

• 2 cups mustard-based barbeque sauce
• 2 tablespoons low-sodium soy sauce
• 1 (6-ounce) can crushed pineapple
• 1/3 cup brown sugar
• 1 teaspoon ground ginger
• Salt and pepper to taste
• 2 tablespoons olive oil
• 16 to 20 chicken wings

Preheat oven to 425 degrees

Mix the barbeque sauce, soy sauce, pineapple, brown sugar, ground ginger, and salt and pepper in a medium saucepan. Cook until heated through.

Mix olive oil with the jerk seasoning and rub onto all the chicken wings.  Place on a broiler pan and bake for 20-30 minutes, until it reaches an internal temperature of 165 degrees. Toss the wings with the sauce and serve, or put wings back into the oven and cook for about 5 minutes to set the sauce.

Ragu Asian Style

Nothing can be as simple as carry-out Asian food, but this ragu with rice noodles was a real crowd pleaser for a group of college kids I fed.

• 8 ounces rice vermicelli, cooked according to package directions
• 2 tablespoons coconut oil
• 1 onion chopped
• 3 garlic cloves, minced
• 2 tablespoons fresh ginger, grated
• 2 tablespoons red curry paste
• 1 pound ground beef sirloin
• 1 cup chicken broth
• 2 tablespoons soy sauce
• 1 teaspoon brown sugar
• Fresh basil, chopped
• Fresh mint, chopped
• Dry roasted peanuts for garnish

Heat oil in a large skillet over medium heat; stir in onions, garlic, and ginger, and cook until the onion is tender. Stir in curry paste; add the ground sirloin, stirring and cooking for about 5 minutes until browned. In a bowl, whisk broth, soy sauce, and brown sugar; and pour over meat mixture.  Simmer for 5 minutes. Stir in the rice noodles and serve in bowls topped with basil, mint, and peanuts.

Jean wanted to take Zumba, barbell fitness, and yoga classes. She wanted to ride a bike with her granddaughter and walk through the woods with her husband. That’s what she told Dr. Bob, her orthopedic doctor of many years. She had had it with her knees and was ready for him to get in there and cut!

Jean had worked her way up to walking two miles at a brisk pace and lost two pant sizes. Then the pain and swelling in her knees came back. She had learned to live with intermittent pain, but the new, constant pain made her feel like she was injuring herself further. It stopped her in her tracks. She tried many remedies over the years. Some of them worked for a little while, then one wrong move, a long car drive, or even a change in the weather and ouch! Sixty-five years old was too young to make the rocking chair her only workout; plus sitting made her hurt even more. Surely Dr. Bob could do something.

Robert McAlindon, MD, is a respected surgeon in Lee County — the man knows knees. He told Jean that her X-ray looked good. She had very minimal arthritis, but she had small tears in the menisci in both knees. Meniscal tears are very common with aging, but not all need treatment. He couldn’t in good faith offer a surgical cure. Instead he prescribed the exercises that she learned over the years in physical therapy and was supposed to be doing daily. Jean, who had hoped for a permanent fix, was crushed.

Nicholas A. DiNubile, MD, in his book, Framework for the Knee, is in complete agreement with Dr. Bob.  DiNubule is an author, speaker, and as an orthopedic surgeon to the stars, works with professional athletes and prima ballerinas. Ninety-nine percent of what he does is knees. DiNubile writes that age is the weak link in the health of our frame. The older you get, the greater the probability of a problem, and the greater the severity.  The degree of healing, muscle mass, strength, level of growth hormone, and reaction time also diminish as our years add up. Bones lose density, ligaments weaken, and collagen melts away.

All is not lost, however. Here is a bullet list of things that we can do at any age, but especially as we age, to help keep our knees, and ourselves, happy.

• Stop smoking and avoid second hand smoke.
• Perform moderate aerobic exercise for thirty minutes at least three times per week. This includes water workouts, riding a stationary bike, walking, using an elliptical trainer, and doing interval workouts.
• Cross train including stretching and strengthening all muscle groups including your core.
• Drink two quarts of water every. Water juices the thick fluid that surrounds certain joints, including the knee.
• Watch your calories if you are overweight. Every pound you carry, your knees think is five.
• Don’t provoke the enemy – inflammation – by eating fried food, saturated and partially hydrogenated fats, bakery goods, and sweets.
• De-stress by practicing relaxation breathing, talking out problems, and finding ways to avoid pressure build-up. Know your triggers and practice positive thinking.
• Sleep more than six hours and less than nine hours each night.

Jean committed to doing her exercises regularly. She is going to focus on having sweet dreams and not eating sweets. With that information, she should soon be back into Zumba shape.

My attic is now occupied by bears, giraffes, elephants, monkeys, dogs, cats, and rabbits.

They are there because my ten-year-old son cannot bear to let any of his stuffed toys go, and I don’t have the heart to make him. But I also cannot take one more day of walking into his room and seeing a floor of soft toys instead of the carpet. I’m tired of the safari-like hunts for his missing backpack, complete with several species of predators blocking our way. I’m fed up with trying to tuck him in at night and giving a goodnight kiss to a monkey because I can’t find my son among his lovies.

I’ve had enough.

John, unfortunately, hasn’t. John LOVES his stuffed animals.

From the time he got his first one as a gift from his Great Aunt Barb, he has tucked a stuffed animal under his arm almost everywhere he goes. When he started school, he had to tuck a small one into his backpack each morning.

He’s outgrown that habit, but the stuffed menagerie has over taken his room. Every birthday, holiday, and vacation finds one more addition to the zoo.

I understand his attachment to the green fuzzy puppy, appropriately named “Puppy,” because it was his first. Puppy is now dull, matted and missing half of its stuffing.

What I struggle to understand is his attachment to the other 117 stuffed animals he has received in his lifetime.

“There is no way you NEED all of these,” I told him last week as he perched in his stuffed-animal rescue shelter.

“I don’t NEED them, Mom,” he said. “I want them. I love them. And they love me.”

I sighed. Nothing like a little boy with melting big brown eyes sending out guilt waves.

So, we cut a deal. Half of the stuffed animals needed to go to the attic.

“Like in Toy Story?” John said. “Only, they will be safe and you promise to keep them?”

Yes, yes, I said. I agree.

So I got a box and we started deciding who goes to the attic and who stays in the bedroom.

“How about Sharkie?” I said, grabbing a stuffed shark.

“Noooooo,” John wailed. “Not Sharkie! I got him when we went to the aquarium in Kentucky!”

OK. How about this blue monkey?

“No! That’s Jerome. Dad got him for me when he went to Chicago.”

All right. This horse?

“Mom! That’s Bob the Horse! Uncle Michael got that for me.”

No store-bought spud can match the flavor of a freshly dug potato.

And that’s not the only advantage to growing your own. Your homegrown potato can be pesticide free. Pesticide accumulates in potatoes, especially in the skin. It’s a good argument for organic if you don’t grow your own.

Gardeners can find several varieties of potatoes at local garden centers. They’re available in five-pound bags, or you can buy them by the pound at farm centers, such as Sykes and Tractor Supply. Look for Red Pontiac, Kennebec (white Irish potatoes), Yukon gold and even some “blue” potatoes, which I tried last year. You need to buy certified “seed” potatoes, which undergo testing to ensure they are pathogen free. Using grocery-store bought potatoes, or seed potatoes from last year risks the introduction of spores that can destroy your entire crop. Remember the potato famine in the mid 1800s in Ireland? That was a late blight caused by a fungus. Blight can still be a problem, especially in periods of cool, wet weather, like the kind we see in spring.

My yields are consistently higher with red potato varieties, but I still grow some of the white varieties.

Potatoes need fertile, well-drained soil with six to eight hours of sun.

Plant them anywhere between mid February to mid March. Do not worry if a frost nips the leaves as they will grow more and the seed potato is unaffected. Seed potatoes will vary in size. Golf-ball size potatoes can be planted directly into the ground, but cut larger potatoes into two-inch pieces of about two ounces each. Each piece should have at least two good “eyes” that appear ready to sprout but without any stem formation.

The cut pieces will need to “heal” before planting. Placing them in a well-vented area, fifty-five to sixty degrees, for one to two days will help them form a callus over the cut area, thus preventing rotting in the ground.

The traditional method of planting potatoes is to dig a ten-inch-deep trench with the corner of a hoe. Loosen the soil at the bottom of the trench with your hoe and work in fertilizer —either 5-10-10 or 10-20-20. Place seed potatoes at the bottom of the trench, spacing them twelve to eighteen inches apart, and cover with one to two inches of soil.

Another planting method uses a posthole digger in a bed with loosened soil. Dig a hole twelve-inches deep and three-inches wide. Drop a potato piece into hole and cover with three inches of soil. This works well if your space is limited; you can make use of bare areas in your landscape and garden beds.

Or, you can plant potatoes in a three-to seven-gallon containers. The larger the container, the more seed pieces you plant. In a three-gallon container, I use two seed potatoes. In a seven-gallon container, I use four to five seed potatoes. As the plants sprout and grow, mound the soil around the stems leaving only the top few leaves showing.

These plants are sensitive to soil moisture when they form new potatoes. Potatoes form between flowering to just before harvest, so withhold water until the soil is dry more than two inches down. Monitor the plants frequently looking for the Colorado potato beetle. Hand picking the beetle and destroying it is the best treatment. Also, check leaves for clusters of bright orange eggs. If you find them, clip the leaf and crush the eggs. If squishing is just too icky, dip the leaf in soapy water.   Harvest potatoes when the tops begin to die, between ninety and a hundred and twenty days after planting. I usually pull up the dead top and sift through the soil with my hands. With containers, gently pour out the potatoes. To allow the skin to set, place the potatoes on newspaper and leave them in the dark for a week. For longevity, store unwashed potatoes in a dark, well-ventilated place kept at fifty-five to sixty degrees.

You can also harvest a few “new” potatoes forty-five to sixty days after planting by gently removing some of the mounded soil, removing smaller potatoes, and replacing the soil to allow the other potatoes to keep growing. Gently wash the soil off before cooking. My mouth is already watering thinking of new potatoes.

Heavy menstrual flow can require medical and even surgical attention. But how do you know how much is too much?

There have been numerous attempts to figure out how much menstrual blood volume is normal. Women have been asked to diagram the amount of flow they note on a pad or tampon. They have been asked to weigh pads to quantify blood loss. The medical literature commonly says a woman loses about 80 milliliters of blood in a “normal” 28-day menstrual cycle. Most women, however, experience menses a few days before or after this interval. Women in the late thirties or forties, experiencing changes in progesterone production with ovulation, may notice menses every 21-24 days. Yet this would still be considered a “normal” menstrual cycle.

The most common and simplest way to assess a problem is by noting if menstrual flow interferes with day-to-day function. If a woman cannot continue her normal activities because she has to stay near a bathroom to change a pad, this by definition would be classified as a heavy menstrual cycle.

The presence of blood clots can also indicate an abnormally heavy menstrual cycle.  Although the passage of clots a quarter size or smaller is normal with menses, large clots can indicate a very large volume of flow from the uterus pooling in the vagina or uterine cavity and releasing all at once. Large volumes of blood or large clots can result insignificant cramping as the uterus contracts to shed its lining.

Another common sign that the menses are abnormally heavy is iron-deficiency anemia. Significant blood loss commonly causes a drop in iron-toting red blood cells, which carry oxygen throughout the body. Significant anemia can result in fatigue and further problems with normal activity.

When a woman has any of these symptoms, she should talk to her physician for further evaluation. Heavy periods can stem from numerous causes, and several ways to treat anemia and abnormal flow. Depending on the woman’s medical history, age, and desire for future fertility, there are numerous appropriate therapies to help her return to her normal daily routine and restore her quality of life.

There are multiple treatments available for heavy periods; your doctor will consider a number of issues in determining which is right for you: whether you plan to have more children, the degree of bleeding and resulting anemia, and the presence of structural changes such as uterine fibroids. Treatments can include oral contraceptives or a nonhormonal oral medication developed for heavy menses called Lysteda. Some women will need surgical procedures such as endometrial ablation, which uses hot water or radiowaves to destroy the uterine lining. Hysterectomy —  the surgical removal of the uterus — remains the gold standard, but it also means no more pregnancies, which is not the right option for everyone.

My grandmother’s kitchen was utterly utilitarian. It sat at the back of the house, with only one way in and one way out. And grandma used it for one thing: cooking. I wonder what she would have made of my kitchen today. No question about it, the kitchen is the heart of the home.

I have recently created three very different designs for a 1920’s kitchen remodel.  All three stole space from an under-utilized room next to the kitchen. This was a kitchen with too many entries, so all the designs closed off one of the four of them. The new kitchen will be a total gut, a start-from-scratch project that transforms an outdated-everything room into an updated cottage style with a modern twist of beautiful materials.

If you want to embark on a kitchen remodel, start with a list of problems to solve and goals to reach.  Now prioritize that list.  When planning your space be open to new possibilities such as moving your appliances to the other end of the room.

Consider stealing space from adjacent closets or hallways or closing off a doorway.

Now that your list is in order, you need to understand the process.

Meet with a builder to consider your options. The kitchen’s final layout will be determined by many things, but your first consideration is the foundation: Is it  concrete slab or a conventional crawl space, basement, or lower level.

Concrete slab poses some layout limits because your plumbing drain lines must stay put.  That means your sink will stay where it is. Because dishwashers and sinks use the same drain line, you will keep it next to the sink — either side will do. But other appliances that have water lines can move to anyplace.

Conventional crawl space or basements allow you to create any layout you want.  Everything can move anywhere in the room.

If you incorporate another room, your contractor will have to determine if you’re knocking out a load-bearing wall. That’s not a problem, but it will add to the cost.

This is a major investment, so do your homework. Troll the Internet and magazines looking for kitchens you like. Put the images into a binder. You will be able to use these to show your contractor what you want. Your contractor will need all the information you can give him or her.

So, how much is all this going to cost? That depends. A basic kitchen remodel that keeps your fixtures and appliances where they are now will reduce plumbing and electrical costs. You can save further by painting your cabinets or replacing only the doors. Other changes that will make your old kitchen new again include upgrading countertops to the latest laminate and installing a new back splash. Other easy fixes? Change the cabinet hardware, buy new light fixtures, and paint your walls. These basic changes will cost an average of $10,000 to $20,000.

You’ll be in the mid- to upper-range remodel if your kitchen layout isn’t working for you. You need more countertop space, your appliances are in a bad spot, and heaven forbid a second person wants to work while you’re working. Everything, including the kitchen sink, needs to move, which means new plumbing and electrical. You may opt for professional style appliances, custom cabinetry, designer hardware, stone counters and a glass tile backsplash: those will be your most expensive items.  Built in seating and islands that look like furniture are the latest in kitchen design. All this can set you back $30,000 to $75,000.

Deluxe kitchen remodel – An investment of $100,000-plus might include taking the space back to the studs and starting from scratch.  You want new everything but styled in a way that it matches the architecture of the rest of your home. You opt for Hand-crafted custom cabinetry in custom sizes. You long for the kind of stove and hood you would find at a professional chef’s home, even if you have to import it. A farmhouse style-sink and faucet, granite or quartz countertops, and a wood-beam ceiling are popular in high-end remodels.

But let’s say you’re not ready for that kind of spending. That doesn’t mean you can’t give your kitchen a new look.

Kitchen DIY Project: Converting solid cabinet doors to doors with a view.

Tools: Drill with 1/2” bit, jigsaw, 200 grit or higher sandpaper stain or paint that matches your cabinets, silicone, and glass.

• Step 1:  Remove your cabinet door and place it on an elevated surface that can accommodate the drill bit and jigsaw blade.
• Step 2: Drill a 1/2” hole at each inside corner of the panel you are removing. Using your jigsaw, cut from hole to hole keeping a straight line.
• Step 3: Lightly sand, paint, or stain the raw edges.
• Step 4: Run a bead of silicone along the inside edge of your door. Place the glass and let dry overnight. Clean or cut away any silicone that has oozed past the glass on the front of the door.

Glass-front cabinets create a great space to show off your special dishes.  Paint the inside with a semi-gloss paint that highlights your keepsakes.

You’ve been here: Happy, bouncy little Fluffy manages to land a kiss right on your lips, and, oh my goodness! What did he get into? Did he find a dead fish? A rotting mammal? Stinky cheese? Don’t run off in search of puppy Listerine. Fluffy doesn’t need mouthwash. Chances are, what Fluffy needs is dental attention.

Offensive breath is only one sign that your pet’s teeth need work. Also note if your pet chews on one side of the mouth, or if food keeps falling from his mouth. Do you see small amounts of blood in the water bowl or on chew toys? Does your cat or dog drool excessively? Do you note facial swelling? Those are all signs of dental disease.  And keep an eye out for behavioral changes that may stem from oral issues.  If your dog stops playing with a favorite toy, is it because it hurts his mouth?  Is your cat suddenly only interested in easy-to-chew soft foods?

Dental disease is the most commonly diagnosed problem in pets.  A national study of almost two million dogs and cats found that nearly eighty percent had some degree of dental disease. Still, problems in the mouth are likely to be overlooked by pet owners and veterinarians.

Dogs vs Cats

Dogs and cats have very different types of dental problems, but both have a high incidence of disease.  Dogs can develop periodontal disease or broken teeth from aggressive chewing on hard toys. Periodontal disease, or gum disease, generally starts with the accumulation of plaque on the teeth.  If the bacteria-rich plaque isn’t cleaned from the tooth surface, it will harden into tarter, which causes gingivitis, or inflammation of the gum. Eventually, tooth roots become infected and teeth may loosen and fall out.

Cats often develop resorptive lesions, which are similar to cavities. These lesions will erode tooth enamel, exposing the nerve root, and creating pain. The underlying cause of resorption is still unknown, but it should be treated by pulling the affected teeth.

I don’t make a habit of kissing my dog’s mouth.  So what is the big deal?

The effects of dental disease often don’t stop at bad breath. Left untreated, periodontal disease in dogs can progress to far more serious disease with severe and expensive consequences. Studies have shown an increased risk of heart, liver, lung, and kidney disease related to poor oral preventative care and advanced dental disease.

So what can you and your veterinarian do to help combat dental disease?

Many of these dental problems can be prevented by annual veterinary dental exams, a healthy diet, and tooth brushing at home.  But don’t’ reach for the Crest in your medicine cabinet.  You can buy veterinary toothpaste and toothbrushes that slide onto the end of your finger through your veterinarian or at a pet store.  The finger brush is much softer than ordinary toothbrushes, and makes it easy to manipulate in the tough to reach places without jabbing or irritating sensitive gums.  Find a toothpaste that you and Fluffy both agree on. You need to brush at least every few days to see the benefits.  The beef and liver flavored pastes send me running for the nearest trashcan.  I found a vanilla mint product that does not gag my dog or me.

Ask your veterinarian to thoroughly evaluate your pet’s teeth and gums during your pet’s semi-annual examinations. Yearly dental cleaning procedures will help keep the mouth clean and healthy and allow a more in-depth evaluation. Dental X-rays (just like the ones you get every year) can help us recognize problems early and prevent disease progression.

Dry dog food is always better than canned diets for limiting tarter buildup; avoid feeding table scraps. Routine brushing between professional cleanings should reduce incidence of dental disease and the health issues that arise from it.

A neglected lot sits next to the Shell station at the intersection of Glenn Avenue and Gay Street in Auburn. Over the years, a couple trees took root there and grew. Later, someone built a wooden shed, and then abandoned it, leaving a “No Trespassing” sign on its door.

Aside from the Auburn football fans who use the lot for free home-game parking, it remained unused and uninspiring. Then David Bancroft took a good long look, and this summer, he bought the overgrown acre. The chef at The Clubhouse at Auburn University Club envisioned the neglected plot full of peach trees instead of kudzu, herb gardens instead of weeds, and a Southern gourmet restaurant named — what else — Acre. Right now a sign announcing the restaurant is the only hint of Bancroft’s dream, and there remain a few hurdles to jump, including the final bank OK, before he can break ground on the four-thousand-square-foot restaurant. Still if everything goes perfectly, he could be open by July.

“For me, the concept is about being sustainable on my own acre. The goal is to create an edible landscape — to plant things I could eat and use in the restaurant,” Bancroft said. “The theme will be creative Southern food, but I want it to be competitive with some of the top restaurants in the country while sticking to my roots and highlighting some of the best of the bounty we have in Auburn.”

His eyes are the color of a blue sky that has never seen rain. He wonders for an instant if he’ll ever reach the same level as other competitive Southern-cuisine restaurants, but he quickly waves the thought away. The self-taught chef moved from Texas to Auburn to attend college — both of his parents are Auburn University graduates. It wasn’t until the summer after his sophomore year that he had his first taste of cooking, and even then, it was the kitchen that found him.

He was born in Mobile. When he was four, his family moved to San Antonio, Texas, when his father took a position with the Methodist Healthcare Systems.But Alabama still helped shape him. He remembers family vacations at his Grandpa Kennedy’s cattle farm in Hartford, in southeastern Alabama along the Florida border, where he and his two older brothers helped grandpa on the farm.

“As a child I would ride on the back of my grandfather’s pickup truck across the pastures to help feed the cattle,” David remembers. “He loved driving to the chicken houses to show off his birds, then driving over to the fish hatchery to show where he was raising tilapia and catfish.”

Working on the farm gave David an insider’s view of how animals are raised for food; it gave him a feel for the cycles of planting and harvest.

In 2001, David became the fourteenth Bancroft to attend Auburn, following his older brothers to the university. (The sixteenth is in school now.) In his first year, David pledged Beta Theta Pi and decided to major in marketing.

But marketing seemed less alluring after the summer after his sophomore year when he got a job on a thirty-person barge houseboat — sort of a charter fishing barge — in Breton Sound in the Gulf of Mexico, some forty-five minutes by pontoon plane from New Orleans. “Every single thing you had to do in a house and every single thing you do as a deck hand, we had to do on the barge,” he explained. In two-week stretches he trawled for bait, washed clothes, and made beds. The rest of the time he made meals for the fishermen.

“There was a cook, and I was very nosy and I volunteered to get up with the cook every day.” He cooked the freshest of the fresh, cleaning and filleting fish pulled from the Gulf just hours before; making gumbo, trout chowder, grilled redfish, and jambalaya.

When David returned to Auburn that fall, he would hunt on family farms with his fraternity brothers, even driving the thirteen hours to his grandfather’s place to fish, and hunt duck, turkey, and deer. David’s fraternity put him in charge of the kitchen, where he prepared food for the annual rodeo, and the crawfish boil. “Any type of fraternity event, I cooked. We did catfish fries, crawfish boils, shrimp boils, low country boils, smoked Boston butts, and barbecue.

“I was cooking all the time, and [fraternity brothers] were always hunting and getting fresh things from relatives, like collard greens,” David said. Cooking for large numbers at fraternity events convinced him that  “Maybe I had what it took to be in the restaurant industry.”

In 2005, just as Bancroft’s junior year began, he got a call from The Amsterdam Café, where he had applied earlier for a summer job. He took the job. A few months later, he was promoted to sous chef, and around his one-year anniversary, he took over as executive chef. His father had been skeptical of David’s new direction. The Amsterdam experience made him a convert. “It escalated so fast,” Bancroft says, still sounding surprised. “I was offered the position of chef, and he [his father] allowed me to stop school and pursue this career.” He was senior. Quitting made him the only Bancroft to start Auburn and not graduate.

“I was being offered this executive chef position at a restaurant that didn’t have any obstacles to slow me down, that needed something to happen, that needed fixing, that needed a vision,” Bancroft said. It was irresistible. And his experience cooking collard greens grown by his friends’ mothers, preparing fresh fish on the fishing barge, and roasting venison and turkey he’d shot himself gave him a hint about what needed to change at The Amsterdam. He started looking around for ideas. That curiosity took him to the Highlands Bar and Grill in Birmingham and its owner Frank Stitt.

“I looked at their menus and noticed people’s names listed,” he said. The names of local farms were attached to various ingredients. “I was thinking, ‘Where do I buy this and find these people?’ ”

He started searching Lee County for new food purveyors, looking online, talking to everyone, and simply driving around. His search led him to Randle Farms, 200 acres in Beauregard, down Society Hill Road, where the Randle family has raised sheep and produce since 1975.

Zach Randle and his father Frank remember the day four years ago when David pulled up to their farm. He saw the grazing sheep, the thriving crops, and thought, “This is it.”

Frank Randle, Zach’s father, calls that first meeting “serendipitous.”

David was good far the farm, too, Zach said. “David would come get blueberries from us and make homemade blueberry ice cream,” Zach said. “He’d pass it out for free on the farm, and advertise for Amsterdam as well as our product.” Zach runs the farm’s Community Supported Agriculture program, a kind of subscription service for locally grown, in-season produce.

And the Randles were just the start.

“I realized we have these untapped resources — families in the Auburn area that are growing for other families, primarily, but are also selling,” David said. “It has that storytelling element. They do blueberry picks and harvests, and to me cooking is all about the flavor, breaking it down and getting reconnected with what food was supposed to be.”

Transforming the menu at Amsterdam was not easy. David began by removing just a few of the frozen foods from the menu and replacing them with fresh-ingredient dishes. The resistance was immediate.

“Mostly the customers were upset, but some of the serving staff was upset also because they had to appease the unhappy customers,” David said. “It caused a bit of a turmoil, but I stuck to my decision and kept progressing forward, testing newer and fresher ingredients.”

David’s co-worker and Amsterdam’s restaurant manager at the time, Paul Willis, stood by him while people adjusted to the change. Willis said he was inspired by what David was able to do.

“He was a little frustrated because he put heart and soul into these dishes, and some people just wouldn’t even try it and wouldn’t come back,” said Paul, now operations manager for Tailgate Guys. “I saw him take it with a grain of salt and remember what he was doing it for. He’s really good at motivating people with food; he always is onto something new and looking for the next thing.”

He went onto prove the soundness of his ideas, increasing Amsterdam revenues significantly every year for five years.

“The owners were believers. My dad was a believer. My girlfriend-then-fiancée-then-wife became a believer,” he said. (He’d met Christin the summer after his junior year at a fraternity event. They were married in 2008. Their son Walker was born July 26, 2011.)

He also invented his signature Shrimp & Grits Savannah at The Amsterdam.

It took a bit of tweaking before he came up with the right combination of flavors and textures for the perfect shrimp and grits. “The first thing for any Southerner to know is that it all starts with your grits.” His grits come from Oak View Farm in Wetumpka. At first, he served the grits in a martini glass with blackened shrimp hooked to the rim.

“We kept breaking the martini glasses. We were going through like a case a week. We realized pretty quickly that this was a safety hazard,” Bancroft said.

His inspiration for their final form was polenta. “I’d been frying polenta for years. I thought, why can’t I just do that with grits? We take our grits, load them with smoked Gouda cheese, form them into cakes, and deep fry them” – like cheesy grits croquettes. “That’s what sets them apart.”

When David left Amsterdam in 2011, he took the philosophy of fresh local ingredients with him to Auburn University Club Clubhouse restaurant. There he spikes traditional dishes with Southern creativity, featuring menu items such as gulf shrimp and crawfish pasta, a half-pound burger with sharp cheddar and beer battered onions, and a plate of roasted fall vegetables — a vegetarian option that changes with the seasons.

Coming to The Plains didn’t take the Lone Star out of the man. Texas makes appearances in in his Shiner Bock beer-braised Texas brisket with smoked poblano grits and topped with a pomegranate demi-glace, or his lobster chile relleno.

Acre will undoubtedly include some Southwestern flare, but his goal is to create unique Southern cuisine supplied from his own plot of ground.

“When I think of Acre, I think of open farmland or hunting land; I definitely don’t picture downtown and asphalt,” David said. “We will have fruit trees, rosemary shrubs, bay laurel trees, and even our own Toomer’s Oaks.”

When the restaurant is running successfully, Bancroft says, he’ll go back to AU and finish his degree. He’s no longer interested in attending culinary school, but he wants to keep the family record of AU graduates unblemished. “I’ve been fortunate enough to meet a lot of really superb chefs. I’ve reached out to a lot of them, and placed people with the top chefs around the South. So I’m already building my network.” But an Auburn degree would put an end to the family teasing. Everyone, including his two grandmothers, say he needs that degree.

David’s former co-worker, Paul, can’t wait to see the restaurant take off.

“David’s got a lot of talent, and he’s really unique because he’s self taught and not classically trained. His knowledge of food is excellent, and that is a testament to his dedication,” Paul said. “I know he can go toe-to-toe with the best chefs in the area, and since he’s always looking for the next best thing, there’s no way he could fail.”