The Blood Pressure Reduction Project

Age and genetics have finally caught up with me.

High blood pressure and high cholesterol run in Mom's family. My numbers have been running elevated for about a decade.

The Zanubrutinib has also been keeping my hemoglobin numbers high - indicating I'm producing MORE blood than I need.

In summary - now that the lymphoma is in remission, the rest of my physical systems are starting to recalibrate.

What makes blood pressure reduction so important is that if the lymphoma comes back before I get this under control, I'm ineligible for most of the clinical trials I've been eyeing and the CAR-T that is the current planned next step is at risk.

Yet another new unplanned priority.

Thankfully, high blood pressure is common among people my age. There's lots of tools and resources to address this.

Yes - they put me on medication.

After the hospital visit, the oncologist put me on Lopressor and told me to go talk to the primary care docs. He is going to have primary care quarterback the high blood pressure issue. Apparently, they are all talking to each other - which I am grateful for.

The next week, the primary care docs switched out my medication to Losartan Potassium (Cozaar). I haven't encountered any side effects to these medications - save for a quick Glucose anomaly in my blood test which, thankfully, was a testing error.

After a few weeks, my blood pressure is still elevated, particularly the Diastolic, but it's not as crazy as it was in November. When I saw the primary care docs this week, they raised the dosage slightly, but otherwise, things are working as they hope.

Our goal is to get the blood pressure back to a controlled normal. Historically, I would have tried to avoid the medication altogether, but since I'm already on some high-powered medications, what's another one?

They also wanted me to try the DASH diet - essentially fresh food, mostly vegetables, with no salt, fat, or added sugar. Bleh. I decided to compromise and go "Mediterranean."

The simplest way for me to implement any sort of "good for you" diet is for me to cook.

Since my diagnosis, Ryan and I have fallen into the habit of delivery and prepared food. When I cook, we eat better. When I meal plan, we get more variety.

I'm back to scouring my cookbook collection, sourcing ingredients, inventorying the pantry, and experimenting beyond my usual protein + veggie + spice mix techniques. The changes I've needed to make mostly consist of cooking less beef and more seafood.

Found a gem of a cookbook - The 30 Minute Mediterranean Diet Cookbook. Easily followed, creative recipes that don't require much physical effort beyond the usual chopping and supervision. Extra bonus - Ryan has liked the food coming out of the kitchen the past few weeks.

Typically, when I decide we need to eat healthier, his immediate reaction is "Sounds good. Let's order pizza. You want pepperoni?" He's only recommended pizza twice since we started this journey - and even found a veggie-laden one from our favorite high-end pizza joint (good, but too much broccoli).

The downside is that any healthy eating in our household is currently dependent upon my cooking and culinary decision-making. Our division of labor is such that I am generally responsible for food. Ryan is a good cook and an excellent cookie baker, but he has a limited repertoire - mostly pasta, grilled meats, and amazing chocolate chip cookies. We saw the limits of that system when I got sick.

I find that when I'm having an off day, it's way too easy to lean on delivery. We have such an amazing array of international options in Northern Virginia, so it's not like we are stuck with just pizza and bad Chinese. Unfortunately, delivery is expensive and NOT good for my blood pressure with all the salt.

We need to figure out a low-effort, healthy eating solution for the days when I'm not up for cooking beyond pulling up GrubHub.

My insurance company is now offering free wellness coaching. I had a chance to talk to a coach last week to get ideas for how to eat healthy without spending all of my variable energy shopping, planning, and cooking. She recommended that I re-visit some of the meal kit services.

I've used them before and generally like them, stopping when I find myself Iron Cheffing my way through the box.

Ryan and I talked and he is on board. We are looking at these services as a way to provide more choices, quickly executed, when my energy is low.

Over the next few months, we are going to look at some of the newer services and try prepared meals and meal kits. Ryan's going to tell me which services have easy-to-follow recipes for the meal kits since I can pretty much make anything work. We're also going to evaluate taste.

My thinking is that we'll use these meals a few meals per week (lunch or dinner) and cook the rest of the time. Dinners are the biggest issue - that's about the time when I run out of steam for the day.

What we've tried so far:

• Hello Fresh - The granddaddy of meal kit services. We have used them off and on since they started. I thought that Hello Fresh was a great way to learn how to cook and get out of a culinary rut. I typically stop my subscription when the ingredient quality dips and/or when I start improvising out of the boxes. My hope is that with maturity, they have more consistency.
• Blue Apron - Pretty much like Hello Fresh. Sadly, I didn't find the experience particularly memorable (as in - "I know we tried another meal service like Hello Fresh and don't remember which one it was so I'm guessing it was likely Blue Apron").
• Sakara - If you ever dreamt of eating like a Vogue cover model, this is your service. Prepared raw foods. Amazing quality. Interesting recipes. Delicious. Expensive. Best for a treat-yourself reset when the partner is on a boy's trip.
• BistroMD - Prepared frozen meals designed for weight loss. I tried them for a month when my weight ballooned after getting on the Zanubrutinib and my yoga pants were feeling tight. Taste - good to excellent. Ease of preparation - excellent. Texture - awful. They use WAY too many gums in an attempt to provide a fatty mouthfeel and fill you up. I may also have a high sensitivity to unexpectedly gelatinous foods. YMMV.
• Thrive Market (referral link) - This is more of a grocery service than a meal kit service. They have interesting ingredients under their Thrive Market brand (big fan of their Shiratake Noodles for soups) and a wide array of quick meals from quality, higher end brands. The prices are also good - especially for their dry goods. We are going to continue this service through 2024.

For the services we'd like to try, we're going to give each of them a short trial over the next few months just to see how we feel about them. If we find one we both like, and is easy on Ryan, we'll probably keep it. On our current docket:

• Purple Carrot (referral link) - Vegetarian. Starting week 1 with some frozen prepared meals, then a combination of prepared meals and meal kits for the next couple of weeks. We're not going vegetarian, but I figured it would be a good start to the year and may provide me with some ideas when I do my own cooking. Ryan's been making noises that we should eat more vegetarian meals anyway. I encountered a couple of random Purple Carrot frozen dinners at a local store not long ago and they tasted pretty good. We'll see how this goes.
• Sunbasket - I've heard great things about this meal service, especially in regard to ingredient quality. They are also clearer than most services around how each menu item fits into specific diets (especially Diabetes). Still vegetable-heavy, but meats are available, and the menu choices for both their meal kits and prepared meals look interesting. They also have some separately sold grocery items available as well. I'm looking forward to trying this one.
• Factor - This is Hello Fresh's prepared food arm. When you choose a Factor box, you will be eating out of that box for the week since they come as a fresh refrigerated prepared meal. This may be a one-week test to determine whether Factor is a good emergency option.
• Mom's Meals - The most "clinical" of the services I have encountered and specifically marketed towards seniors and their caregivers. Apparently, some of the Medicare Advantage programs provide benefits for this service. They have categorized their meals around various ailments - such as Renal-friendly, Cancer support, and Heart-friendly - as well as identifying meals that are lower sodium and diabetes-compliant. The menus are dominantly American comfort-food with the occasional Asian dish thrown in for variety. They even have some pureed options. This is another pre-made refrigerator meal service, so we need to plan to eat out of that box for a week. I specifically plan to test the Cancer Support options. As much as I like Chef Boyardee Beef Ravioli - I could use other options for the next time I have to go into intensive treatment.

This should be a fun experiment. I'll report back as we try these services.

Meanwhile - may you have a peaceful holiday season and see you in 2024.