Mackerel noodle salad

When I was a student I'd make this dish with my best friend.  We used to serve it up in a giant mixing bowl, sit side by side and eat the lot between us, forkfuls at a time.  There's just something incredibly satisfying about this dish, so light and beautifully flavoured.  It's also cheap and simple to make (which may explain why it became a staple back then).

I often make it now when I'm in the flat alone and slurp the noodles in a disgustingly childish way, it always makes me smile.  I tend to make double the amount I need in the hopes that I'll save it for the next day, however more often than not I'll eat the lot in a sitting.  Here's the recipe with slightly imprecise measurements, I assure you that it won't go wrong!

Mackerel noodle salad

Serves 1

Enough rice noodles for a healthy helping
1/4 of a cucumber, peeled and cut into chunks
1-2 spring onions
1 large fillet of smoked mackerel

Dressing
1 tbs rice wine vinegar
1 tbs olive oil
a splash of soy sauce

How to make it:

1. Cook the rice noodles according to packet instructions until tender (make sure not to overcook as they can get claggy).  Once cooked, tip the rice noodles into a sieve to drain the water.  Pour cold water over the noodles, lifting the noodles with your fingertips, until they've cooled down.  Make sure any excess water is drained and put the noodles in a mixing bowl. 
2. Take the skin off the mackerel and discard.  Flake the remaining mackerel with a fork - throw this into the mixing bowl. Cut the spring onions (I just use a pair of scissors and cut them finely) making sure to only use the green ends, add to the bowl.  Finally, chuck in the cucumber. 
3. Add all the ingredients for the dressing into the bowl too.
4. Mix well with a spoon and season with pepper (you don't need salt because you've used soy sauce).
5. Put on a plate and be happy that you've made something super tasty and have barely lifted a finger. 

A word of caution - rice noodles can go quite hard if you leave them out, so if you want to save this dish for the next day make sure to store in an airtight container in the fridge. 

Mint and courgette fritters for a stressful day

Nobody really warns you that being off ill is a full time job - there's so much to organise in preparation for surgery.  Diet is suddenly far more important than it's been before, not only do I have to make sure everything I eat is easy on the stomach, I also have to try and gain as much weight as I can (quite a challenge when high fat foods are off the list). 

But it's more than that, it's the monotony of making good choices each day, pacing yourself, keeping up to date with appointments, filling in family.  It's not the lifestyle I would select for a 25 year old and it's not one I'm very comfortable with adopting.  What happened to going out until 3am and being reckless?  It's barely an option when you're trying to get yourself well. 

So I made these little pancakes to cheer me up a bit and give me an easier lunch.  I make these a lot and they're very versatile - you can pretty much fling in anything you fancy, particularly spices and herbs.

Mint and courgette fritters 

Ingredients 

1 Courgette (peeled and grated)

1 egg

3-4 tablespoons self raising gluten free flour

1 tsp baking powder

1-2 spring onions (finely sliced/cut)

a few mint leaves (finely chopped)

feta cheese (optional)

What you do

1. Basically all you need to do is chuck all the ingredients together in a bowl.  Be quite liberal with the spring onions to make sure the flavour is strong enough at the end and be a bit easier on the mint (it can be slightly overpowering). Mix the ingredients together well.  Season with salt and pepper.
2. Heat some olive oil in a frying pan and wait for the pan to get hot.  Once the pan is ready, take a spoon and add a large dollop of your mixture into the pan (the way you would for drop scones or small pancakes). You should be able to fit about 3 pancakes into the frying pan at a time. 
3. Cook each pancake for a few minutes on each side, flipping with a spatula halfway through.  When they're done they should be golden on the outside and cooked through.  The baking powder makes these pancakes very light and fluffly - expect them to rise a little as they cook. 

And that's all there is to it - it's a very simple recipe and the pancakes can be made in bulk and eaten over a few days.  I don't know if they entirely fixed my bad mood, but they did make me feel quite pleased with myself when I sat down to enjoy them over a long (and restful) lunch. 

Care and compassion within the NHS

I read In the Midst of Life quite a few years ago; it’s by Jennifer Worth who wrote the Call the Midwife series before they were adapted for the BBC.  The book itself is beautifully philosophical and opens up a much needed debate about how we treat those who are dying.

Surgery in the 1800s

One of the stories that stayed with me (and I’ll have to paraphrase) is of a man who was taken into hospital.  He couldn’t speak English and throughout his stay he was distraught.  He tried his best to resist any treatment, was scared of the nurses, scared of the doctors and maintained a high state of anxiety at all times.  The nurses treated him as best they good, but he remained inconsolable, becoming more agitated as the days continued.

It was only when a relative came who could translate for him that the nurses found out why he had been so terrified during his stay.  Previously the man had been in a prisoner of war camp and while there he had been tortured.  Because no one had been able to explain to him where he was or what had happened to him he had become convinced that he had been captured again.  He had interpreted his treatment as torture.

Context matters hugely in the medical profession.  Surgeons are allowed to commit actual bodily harm on a patient because they know in the long term it will save their life or improve their quality of life.  Doctors prescribe medicines that cause a host of awful side effects because those side effects are considered better than the disease itself.  In another context, without the knowledge that things will improve for the patient, what the medical profession does could be considered cruel or abusive.  It is only within the context of medicine that their actions are flipped to be considered as virtually saintly.

But does the change in context remove the distress for the patient?  Does the knowledge that the treatment is in their best interest compensate to the extent that the patient is able to psychological process their treatment has positive and helpful?

I would say that the knowledge is only enough when it is combined with a sense that those who are hurting you care about you. 

If someone is administrating painful treatment and they console them during the procedure this teaches the patient a few things:

• Firstly, the patient learns that they are worthy of care and compassion.  For someone with a chronic illness this is vitally important.  If you are consistently being treated by doctors who are aloof and act as if your pain is inconsequential, it is difficult not to internalise that to some degree and begin to think that all pain inflicted on you is inconsequential.  It is only by having professionals that treat you consistently with compassion that you learn that your pain should be extraordinary to your everyday experience.
• Secondly, the patient learns what are the acceptable limits and boundaries of pain in everyday life.  If a doctor allows you to experience a lot of pain during a procedure, they reinforce the idea that this level of pain is acceptable.  This in turn will lead to a patient believing that pain from their illness is acceptable and therefore will continue to live with a lower quality of life.  However, if the doctor provides good pain relief and takes the pain of the patient seriously then the patient learns that they are only expected to tolerate so much.

The NHS is splitting at the seams, some hospitals have compensated by becoming excessively bureaucratic in order to ensure that that they provide a streamlined, efficient service.  However, this streamlining comes at the considerable cost of compassion, empathy and time.  For those with chronic illnesses, who spend a lot of their lives in hospital, it is difficult not to internalise this treatment and make it part of your lived experience and expectation. 

If I could change one thing about the NHS, it would be to make sure each professional is trained in a way that empathy, compassion and interest in the patient is valued just as highly as their technical skill.  Unfortunately, as the government increases cuts and puts more value on competition and profit it seems as though this hope will be increasingly lost.  

Comforting fish pie and an introduction to Jack Monroe

Today I have to prepare for my colonoscopy, so I’m off work and feeling quite sorry for myself.  Before I start the prep this evening (oh God have mercy) I decided to treat myself a bit and make my day a little bit better.

I recently got a copy of Jack Monroe’s cookbook A Girl Called Jack; it is one of the best cookbooks I own.  Not only is everything cheap and easy to get hold, Jack’s recipes are also easily adaptable to someone who’s on a restrictive diet.  Most of her recipes contain only a handful of ingredients so it’s easy to make substitutes, and to top it off all the meals are a delight to eat!

I made her fish pie today (I won’t put the recipe here – if you want it you’ll have to buy the book) and it was beautiful!  It’s such a treat to tuck into and only took me about 30 minutes to rustle up.

Pure comfort food at it's best

I made a few changes to make it suitable for a Lofflex diet:

1. Instead of onions I used leeks.  Leeks take a little longer to cook than onions so I gave them 10-15 minutes extra poaching time in the milk to make sure they were cooked through. 
2. Instead of butter I used olive oil spread – one of the easiest substitutes to make and works in nearly every recipe I’ve tried so far.  
3. The white sauce takes a little bit of practice, but I’ve found both rice flour and gluten free plain flour make a decent sauce.  For the milk I used lactose free milk, it's the creamiest and most milk like product that I can have – rice and soya milk just don't work as well.
4. I served it with some peeled and sliced courgettes, lightly fried in olive oil.  Make sure to get them nice and brown and season with salt and pepper at the end.  The fish pie is quite rich so it's good to have something lighter to go with it. 

I’m now sitting in bed feeling very happy with myself.  A meal well done. 

Cheesy Vegetable Tortilla

So simple and good it's untrue!

I was travelling back home today and needed something quick and simple to eat as soon as I got to the flat.  I went for a courgette, squash and sweet potato tortilla with a bit of cheese on top.  It’s one of the easiest things to make and is beautifully fresh.  Just use whatever vegetables you have kicking about, beetroot also works well!

Cheesy Vegetable Tortilla

Serves 3

2 tbsp olive oil

2-3 tsp onion powder

200g squash and sweet potato, peeled and diced (I buy a bag ready done!)

100g courgette, peeled and sliced

6 eggs

2 tbsp lactose free milk

50g (ish) grated hard cheese

Parsley to garnish (don’t laugh, it tastes amazing!)

1. Heat the olive oil in a frying pan and fry the squash for 5 minutes.  Throw in the courgettes and the onion powder and cook for a further 10 minutes until everything is brown and gorgeous.
2. Beat the eggs and the milk together, making sure to season well with salt and pepper.
3. Chuck the eggs over the vegetables and then sprinkle the cheese on top.
4. Allow the tortilla to cook for a few minutes in the frying pan and then move under a pre-heated grill until the top has set and the cheese has melted.
5. All done!  Sprinkle with parsley and then cut into wedges to serve. 

Goodbye bread, hello new restricted world...

Goodbye my doughy friend - you will be missed!

I love food; I don’t think there’s anything more satisfying than tucking into freshly baked bread spread thickly with golden butter to start you day.  Nearly all my friends (bar one very important one) are foodies and I spend more of my meagre income on eating out than on anything else. 

Unfortunately, my days of indiscriminately snacking on everything that comes my way has come abruptly to an end.  I was diagnosed with Crohn’s Disease when I was 15 years old.  Since that time I’ve never been fully healthy, however I didn’t feel that my symptoms could be controlled by my diet.  Even my doctors told me that, unless I had specific intolerances, my diet would not make a significant impact on my health.

But due to an emergency obstruction I was admitted to a different hospital.  This gastro team there had a very different approach and immediately recommended the LofflexDiet.  Within a week my pain has calmed down and I’ve been able to eat full meals!  It's been extraordinary.  

So, with some help from my Nana, and a bit of time on my hands while I prepare for surgery (gulp), I have the task of coming up with healthy, nutritious and fattening meals to build me up and please my highly exacting tongue.  

I thought I'd share my journey (and recipes) in case there's anyone else who's trying to achieve food perfection on the limited Lofflex. Wish me luck!  

Love, Alex x