The writer with her sister, Lisa, on a family vacation in St. Thomas in January, 2006.

Growing up in a house of people with digestive disorders, I have always lived with bland food. My family members share an alphabet soup of conditions, from the intestinal disorder known as Crohn’s disease to lactose intolerance. I never would have thought that eating sugar and spice could give us more than an upset stomach. But these seasonings almost killed one member of our family.

My older sister Lisa has been on medication since she was 11 months old, having inherited extremely high cholesterol and high triglycerides from her birth father. Because of this, she has always had to keep an extremely strict diet—no cholesterol, no sugar. Growing up, I remember watching her cheat on her diet and struggle with her weight, but never thought too seriously about it until this past August. That was when Lisa suffered three heart attacks, and we nearly lost her the same way she lost her father when he was only 29. At 32, she has now outlived her dad by three years, but is having to re-examine her lifestyle and her diet after being given a second chance at life.

As a sibling who does not share her constraints, I have often wondered what it means to have to keep a “healthy” diet among those who don’t have the same types of restrictions. What foods does she eat, and what do they taste like? And what does it mean for the rest of our family to continually watch and worry over someone we love as she struggles with a difficult life devoid of cholesterol, sugar, and now salt in order to simply survive? The phrase “the spice of life” has begun to take on a very different meaning for all of us.

When we were growing up, I had only a vague sense of the life Lisa led. I knew that she wasn’t supposed to eat anything that had sugar third or higher in the list of ingredients. I knew she wasn’t allowed to eat the same sweets and candy I devoured constantly, and I knew she had to take medicine every day—pills and a weird yellow powder that she mixed up in juice or water. When cooking for her, my mom would always use egg whites instead of yolks, and she wouldn’t always eat what we did. I watched, but I didn’t really contemplate how such constraints played out in daily life.

I did, however, watch her cheat on her diet. She’d say things like, “Well, I’d rather live a short, happy life than have a long, boring one.” Lisa is seven years my senior, so I really didn’t see a lot of life-threatening habits—such as when she stopped going to the health clinic for monitoring, or when she occasionally skipped her medicine because it got too expensive and she didn’t want to ask for financial help.

Lisa made some spirited attempts to keep up a routine at the gym, but nothing stuck. I can’t say that I’ll ever know exactly what it’s like to be in her shoes—even if we do wear the same size—but I instinctively know that her lifestyle must be incredibly trying, and that I’m privileged because I don’t have to live by the same rules. In fact, while writing this story, I tried sticking to her diet myself. Let’s just say it didn’t last long.

To be honest, I never thought Lisa’s life was so much at risk. Maybe none of us did. I guess sometimes you have to learn things the hard way.

Although Lisa’s food restrictions have remained relatively the same since her attacks, her approach to life and her attitude have changed. For her heart disease, she keeps to a healthy low-fat, no cholesterol, no sodium diet. She tries to combine different spices to replace salt and throws in “all the vegetables you can eat” as well as certain fruits, but she still has to stay away from food high in natural sugar, such as most dried fruit. She uses a lot of Mrs. Dash, a salt-free seasoning, and sugar substitutes like Sweet’N Low. She drinks skim milk, and the breakfast foods she eats are always healthy and very bland, such as kasha, a porridge made with buckwheat—“cereal with twigs,” she jokes.

Lisa’s diet is also combined with a new zest for exercise. Right now she’s recovering and has to take things slowly, but she’s started walking on the treadmill at the gym. Once she has a second angioplasty to clear another blocked artery, she’ll start rehab under the watchful eyes of a cardiologist and a lipidologist. She is taking eight new daily medicines and keeping track of their dosage, their sizes, their side effects, and what she calls their “popping” times—enough to make the eyes glaze over.

When I ask Lisa if she finds her diet constraining, and how she feels when compared to others, she says, “Dining out is hard. When I go out with friends and they want to share platters, often I can’t, because so much is deep-fried. When I see on their plates that they’re having this or that, it’s hard. It never gets easier.”

“I try to come up with new stuff and interesting recipes. But this is something I’ve battled with all my life,” she adds.

I know Lisa has a new outlook, and that she understands she has been given a second chance. She told me that at the park the other day. Just watching the lake and the birds made her eyes well up with tears. The nurses in the emergency room called her the “miracle girl” because she only had about 30 minutes to get to the hospital before she surely would have died. She is one of the lucky ones.

Beginning again

Of course, the rest of us want to do everything we can to ensure Lisa will be with us for a long time. We are trying to make changes in our individual lives to share this challenge with her. Lisa’s husband has cut certain fatty foods from his diet, and has begun eating similar things as she does. “My husband eats more salads, tries more vegetables, and opts for low-fat salad dressings instead of creamy ones,” says Lisa. “He’s trying fish, and we’re making healthier choices.” The two go to the gym together. As for me, sometimes I exchange recipes with her—or helpful hints such as the one about replacing salt with lemon—something I learned from my roommates.

I fly into town for a weekend—it’s Canadian Thanksgiving, and we’re also having a surprise birthday party for my dad. The night before the party, my sister’s husband and I pick up chocolate and chips at the grocery store for an evening of movie watching. My sister picks up a bag of pretzels, then puts it back—a past stand-by snack that’s now off-limits because of the sodium.

I can see her frustration build. Everything has salt or fat or too much sugar. She keeps apologizing for taking so long, and even though I want to grab her and tell her she can take as long as she wants, all I can muster up is a weak “really, it’s okay.”

The next day I help prepare the Thanksgiving birthday meal. Lisa makes squash, and we all agree to add cinnamon but to leave the brown sugar on the side. We make a turkey with garlic. Our stuffing is made simply of bread, apples and shallots. A honey Dijon sauce is reserved for the vegetables, which we also leave on the side for those who can’t eat it. We use salt-free, low-fat margarine in place of butter.

And then we feast.

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