The Coumadin and I

As we approach the end of the year, it's time to look back on the things that changed us. I can't deny that this year was one of ultimate change, but for me, even a layoff was less difficult than dealing with a drug known as Coumadin, a common blood thinner usually given to people later in life, but I will take from the age of 27 onward.

I should probably start at the beginning when it comes to this, though...

At the age of 21, I fought for my life. In January 2004, I was diagnosed with five blood clots in my body, three of which had become pulmonary embolisms and lodged themselves happily in my lung. It was found that I have a genetic disposition for producing blood clots. I was given a course of Coumadin for six months, but the doctor gave me a warning as I weaned myself off the treatment, "One more clot, and you're done." That meant Coumadin for the rest of my life.

July 31, 2009, and I was done. Blood Clot #6 made its appearance in my left calf. Although I wasn't hospitalized like the last time, it meant Coumadin until the day I left this earth. It also meant monitoring my diet like mad. For those who aren't familiar with this drug, it is thrown off by the simplest things, whether it's the amount of exercise or the foods that you eat -- mainly, dark green leafies and green tea. This is due to the presence of Vitamin K, which is a clotting agent. It messes with your blood levels, which you get tested at the doctor's office on a regular basis.

Let's get something straight: I live in southern California. Here, salads and vegetables are more than just a little side or precursor to a meal. They are a way of life. If Californians could eat salads for breakfast, they would (so far, the only people I know who do that are the Israelis, with their delicious tomato and cucumber concoction). With our access to beautiful vegetables year-round, how could we not enjoy salad to the fullest? It doesn't help that as a kid, I loved my vegetables. Broccoli were "little trees" which I ate to my heart's content. And don't get me started with spinach. Popeye's got nothing on me.

The worst part was that every time I talked to my mother on the phone, another food was taken away from me. Since my uncle, father and I were all on Coumadin, everyone was able to share information from their doctors with the other (it doesn't help that my uncle is also a doctor). There were the outside peels of cucumbers and zucchini. Then came the cranberries and cranberry juice, followed soon after by mangoes. It was hard enough with my limitations for keeping kosher. Now I was keeping Coumadin, too.

I soon reached a depression. The Coumadin was changing my life completely. When I met Ari, it seemed like blood clots were a distant memory and I could go about things normally, with the exception of soreness from the scar tissue in my right lung when it became overcast and a left leg that's bigger than my right. But Clot #6 reminded me of painful truths, such as the inability to have my own children due to the danger pregnancy posed on me, and that I would be completely dependent on a pill -- and I hate being dependent on almost anything.

It turned out that for me, having a normal life was something that other people would get to enjoy while I was stuck taking pills. It didn't help that two weeks after Clot #6, I was laid off. It gave me more time to focus on everything I lost. By Labor Day weekend, I was beginning to crumble, breaking down in tears when Ari's grandmother told him how many children we were going to have and how great it would be, knowing that my uterus would probably be barren while his brother had three beautiful kids that I love, but still aren't mine.

I continued going to my doctor, as my levels were testing high. One day, she looked at me, and said, "Well, we can do one of two things. We can either adjust your dosage, or add back green leafy vegetables."

My brain suddenly switched on. I could have my broccoli back? I could eat salads like a normal Californian? Visions of spinach danced around in my head with glee.

"Veggies!" I cheered. She smiled, saying that I could bring them back for two to three times a week. Eventually, it was brought to four or five times a week, and my levels check out every time. Dark green leafies and I were reunited, much to the joy of my stomach, and salads made a comeback in the Kutner household. There was much rejoicing.

I am still adjusting to the changes that Coumadin has made to my life -- having people wishing that Ari and I would have children when we know that probably won't be able to happen, being careful about being cut and wearing a Medic Alert bracelet when I go out. But at least my dark green leafies ground me, and I get to eat all the spinach and "little trees" I want. I may not have a normal life, but at least I have my vegetables.

B'tayavon!

Spinach Macaron

1 large onion
½ cup (one stick) of butter or margarine
1 pound elbow macaroni
1 box frozen spinach
Small container of sour cream
4 eggs, beaten
1 cup parmesan cheese, plus extra
Salt and pepper to taste
Non-stick cooking spray

Sauté onion in the stick of butter or margarine until onions are translucent. Boil macaroni until al dente. Defrost spinach according to package directions and drain, making sure to squeeze out all the water. Let all of them cool.

Combine macaroni, onions, sour cream, eggs and parmesan cheese, as well as salt and pepper to taste. Fold all the ingredients together as not to destroy the macaroni.
Spray the casserole dish with non-stick cooking spray. Put the macaroni mixture in. Put extra parmesan cheese on top. Bake for one hour at 350 degrees until it gets golden on top and the bottom gets crusty. Serve with salad.

Quick Tip: Due to all the butter in the dish, I like to use healthier alternatives, like whole wheat macaroni and light sour cream in lieu of regular. However, in the case of the sour cream, light doesn’t have as much flavor as the regular, so make sure that you season your mixture well with salt and pepper.