This week’s post was inspired by an amazing event that Hawaii Pacific Health held for female physicians.  It was an evening dedicated to restoring balance in our work, personal and family lives.  As a working mom, I know sometimes I feel completely overwhelmed by all of my responsibilities -work, motherhood, wifehood (is that even a word?).  I want to do it all and I feel guilty when I take a little time for myself.  Anyone else feel the same?  And, for my friends who stay at home –  they’re even in more desperate need for time for themselves.

So, Kapiolani organized this event which had an hour long yoga session, followed by a cooking demonstration by Chef Russell Sui of 3660 On the Rise.  The yoga was nice and relaxing.  Not hot yoga, where you’re getting all sweaty and trying to get in shape.  This was yoga at its purest – good breathing and stretching.  I felt invigorated afterwards.

OK, this shot was staged.  This is me in my backyard, but I forgot to take pics of the yoga session.  Don’t I wish I had the motivation to do yoga by myself in my yard?  I’m doing tree pose, but i look more like a leaning pine than a tall, stately oak.

Then, the the fun stuff — the food! Chef  Russell  Siu is extremely entertaining.  He prefaced the demo with the caveat that he was asked to prepare healthy meals. “So, if you are still hungry afterwards, its not my fault!” he said half-jokingly.  Throughout the demo, he mentioned places in the recipe he might otherwise want to use butter or cheese, but couldn’t because of the “healthy” limitation.  Hmmm…I got the sense he would have far preferred cooking without the healthy limitation.  But it was delicious nonetheless.

Here’s my friend, Dr. Deborah Yang, a dermatologist at Kaiser Permanente, and I eagerly awaiting our first course.

 

And, the Chef himself.

So, on to the meal.  Oops – I ate the soup without taking a pic first (I was very hungry after a one hour yoga session after all!).  But, here’s the recipe.  All recipes are courtesy of 3660 On the Rise.

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Chicken Soup

With Cilantro, Onion, Tortillas and Grilled Shrimp
Service for 6 people

Ingredients:

  • 12 ounces chicken breast, small dice
  • 1 each onion, small dice
  • 1/4 cup diced tomatoes in juice
  • 48 ounces chicken stock
  • 1 clove garlic, finely chopped
  • 1/2 tsp. oregano
  • pinch of cumin
  • 1 each bay leaf
  • 4 wedges of lime on the side
  • 1 each 8 inch corn tortilla, fine julienne, fried
  • 6 each shrimp, 21-25, peeled and deveined
  • 1 clove garlic, finely chopped
  • 4 Tbsp. oil
  • 1/4 tsp. basil
  • 1/4 tsp. oregano

Directions:

  • Sauté onion with 2 Tbsp. oil in a soup pot until transparent over medium heat. Season chicken with salt and pepper and add to pot and sauté for about 2 minutes.
  • Add garlic, oregano, cumin and bay leaf and sauté another 1 minute.
  • Add diced tomatoes and chicken stock and simmer for about 20 minutes over medium heat.
  • Season with salt and pepper

Shrimp:

  • Marinate shrimp with 2 Tbsp. oil, basil, garlic and oregano for about 1 hour.
  • Season with salt and pepper and grill.

 

I did remember to take a pic of the second course, halfway through (I would be a lousy food blogger, I can’t restrain myself from eating before taking the photograph of the food!).  It was delicious as well, though I don’t like tomatoes.  I was surprised at how sweet the raw corn was in this meal.

And, here’s the recipe for the chicken pasta.

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Grilled Chicken Over Pasta Shells

With Slivered Onions, Cherry Tomatoes, Cucumbers, Kahuku Corn
Basil Vinaigrette
Service for 4 people

Ingredients:

  • 12 ounces chicken breast
  • 1/2 cup slivered red onions
  • 12 each cherry tomatoes, cut in half
  • 2 each cucumbers, Japanese. Medium diced
  • 1 each kahuku corn, kernels only
  • 1 1/2 cups pasta shell, raw
  • 1/4 cup parmesan cheese, grated

Directions:

  • Marinate chicken breast with 1/2 of the basil vinaigrette for about 2 hours and grill until cooked.
  • Slice and reserve in a warm area.
  • Toss rest of ingredients with the basil vinaigrette with half of the parmesan cheese.
  • Top salad with balance of parmesan cheese and top with the sliced chicken.

Basil Vinaigrette

Ingredients

  • 1/4 cup red wine vinegar
  • 1/4 cup extra virgin olive oil
  • 1/2 cup orange juice
  • 1/4 cup onion, sweet, diced
  • 1 clove garlic
  • 8 leaves basil, fresh
  • 1/2 tsp. orange zest
  • 1/2 tsp. Dijon mustard
  • 1 Tbsp. honey

Directions

  • Blend all the ingredients in a blender until smooth. Season with salt and pepper.
  • For a sweeter sauce add more honey.

 

The next course was a pan seared salmon and was one of my favorites. I think this is easy enough that I could actually make this without a bunch of sous chefs. As you can tell, I enjoyed it and then remembered to take a picture.

 

But, luckily, a few physicians weren’t able to make it to the event, so there were leftovers, which I brought home for Jeff.  Here’s his plate and he just put everything on there at one time, so it has the chicken pasta and the salmon on it.  The recipe is below:

 

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Pan Seared Salmon

Orange Honey Jus, Parsley Red Potatoes
Service for 4 people

Ingredients:

  • 4 each salmon fillet, skin off (6 ounces)
  • 2 Tbsp. extra virgin olive oil
  • 1 clove garlic, sliced
  • 4 leaves basil, chiffonade
  • 1 Tbsp. black pepper, cracked

Directions:

  • Marinate salmon in a ziplock back with above ingredients for about 1 to 2 hours.

Orange Honey Jus

Ingredients

  • 1 cup orange juice
  • 1 tsp. orange zest
  • 1/2 cup white wine
  • 1 Tbsp. shallots, brunoise
  • 2 Tbsp. honey
  • 5 leaves basil, chopped
  • 1/4 cup butter, unsalted

Directions

  • In a sauce pot over medium heat, add orange juice, orange zest, white wine, shallots, honey and basil.
  • Reduce mixture by 25%.
  • Whisk in butter and season with salt and pepper.
  • Strain through a chinois and keep hot.

 

I mentioned that the salmon was one of my favorites and that’s because the dessert – a vanilla bean panna cotta was my absolute favorite.  Unfortunately, since this was not “healthy”, we were not given the recipe.  I don’t even like pannacotta and I thoroughly enjoyed this one.

 

I love my work – there is nothing I would rather do.  Every day I am rewarded. I love the relationship I am able to have with my patients here in Hawaii and I truly enjoy caring for them.  I love my boys – I am blessed with 2 wonderful, sweet and healthy sons.  But, I’m a firm believer that as a woman, I also need to take more time for myself – whether it’s doing yoga, going out to dinner with my girlfriends, reading, anything that recharges me.  When I’ve had that time, then I know I’m a better physician, mother and wife.  So, thank you Hawaii Pacific Health and all associated hospitals for such a wonderful event!

 

We live in Hawaii and allergies are a huge problem here compared to the mainland.  For 8 years, I lived smack in the middle of Manhattan and the pollution and dirt never caused a problem.  But, my first month of living here, the flora and VOG of Hawaii put my allergies on overdrive!  And along with allergies and the symptoms you think of  runny nose, sneezing, coughing, comes ocular allergies.

In children, allergic conjunctivitis can present like this:

The video cannot be shown at the moment. Please try again later.

 

His eyes are only slightly red, but he has a little cough (which isn’t associated with a cold) and a little sneezing and there’s that non-stop blinking.

First, I should back up – what is the conunctiva?  It’s the mucous membrane of your eye – the white part and the pink part on the inside of your eyelid.

 

6 Signs of Allergic Conjunctivitis:

1.  Itching

2.  Tearing

3.  Redness

4.  Mucous discharge from the eyes

5.  Allergic shiners (look like black eyes underneath the eyes)

Allergic shiners (under the eyes)

6.  Blinking

 

There are many different kinds of allergic conjunctivitis that your eye doctor can diagnose.  This is not the same as “pink eye”.  There is no infection and it’s not contagious.

Types of allergic conjunctivitis:

– Seasonal or year round (perennial) allergic conjunctivitis – some people are specifically allergic to mangoes or only to VOG

– Vernal conjunctivitis – I see this a lot.  Tends to happen in young boys and needs aggressive treatment.  These boys will have really red eyes, light sensitivity and are at risk for losing vision in advance stages of the disease.

– Giant papillary conjunctivitis – that’s for all you contact lens wearers out there.  If you overwear your contacts, you can develop a reaction to the material, making your eyes red and intolerant to wearing contact lenses.

 

I am mainly going to discuss seasonal/perennial allergic conjunctivitis in this post.

So, what causes allergies?  Allergies are mediated by a type of white blood cell, called a mast cell.  It has a special form in the conjunctiva.  And, when it gets activated by the thing you’re allergic to (also called the allergen), it releases chemicals.  These chemicals, such as histamine and prostaglandins, are what cause symptoms of allergies.  They cause blood vessels to become large and leaky, causing redness, swelling and itching.

Here’s the kind of chart that other opthalmologists like to show each other when explaining allergy.  I swiped it from my husband’s presentation he had given on allergy.

 

 

Allergic response

 

So, how do we treat allergic conjunctivitis?

  • Allergen avoidance – this is ideal, but it can be hard in Hawaii.  Can’t exactly avoid VOG, and did you know cockroaches are really allergenic?  Hard to find a place here without cockroaches.  However, I always tell patients to try avoiding touching and rubbing their eyes, which is how a lot of allergens get in the eyes in the first place.
  • Cold compresses (not warm!) – I know patients sometimes get confused, we tell them warm compresses for this, cold for that.  But for allergies, we want cold compresses to make the blood vessels smaller and leak less.
  • Systemic medications – Benadryl, Claritin (anti-histamine), Zyrtec.  These medications are taken orally, and may not be helpful for the eyes at all.  In fact, they can often cause dry eye, making the symptoms of allergic conjunctivitis even worse!
  • Eye drops

 

Let’s talk about eye drops for allergic conjunctivitis.  Many patients will self-treat with over-the-counter drops such as Visine, which constricts the blood vessels and takes away the redness, but does nothing to treat the allergic reaction.  Then there are over-the-counter drops such as Visine-A, Naphcon-A, and Opcon-A which have a weak antihistamine.  They are safe and effective for short term use, but the preservatives in these drops can be harsh and irritating to the eyes.  Also, the effect from these drops lasts only about 2 hours, so patients must overdose themselves in order to get all-day relief.

When I tell patients that they shouldn’t use Visine, they’re always quite surprised.  But, it really isn’t the best drop you can use.

There are also some people who use Similasan Eye Allergy homeopathic drops, however there is no scientific evidence that these drops work.  In general, most eye doctors discourage the use of these over-the-counter eye drops.

Fortunately, we have some much better prescription drops for allergic conjunctivitis.  Pataday, Lastacaft, Bepreve, and Elestat are some of the best drops for allergic conjunctivitis.  They not only block histamine’s nasty effects, but also prevent histamine from being released.  Pataday and Lastacaft only need to be given once a day.  All of these drops are very safe, and can be used long term.

If you have a red eye, you should see your eye doctor – don’t diagnose it yourself.  There are many different causes of red eyes which can be dangerous or vision threatening (like uveitis, corneal ulcers, trauma, angle closure glaucoma, corneal abrasions or foreign bodies).  There are also many different causes of blinking in children (tic, dry eyes, Tourette syndrome, irritation from eyelashes etc). Get it checked out first!
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