WHAT EXACTLY IS MEANT BY THE TERM "IMMEDIATE" RECONSTRUCTION

Dear Plastic Surgeons;

With all due respect, please stop using the term "immediate" breast reconstruction.

Please consider changing this term to one that does not mislead your patient.  One that does not encourage an abundance of misinterpretation.  One that does not give a previvor/survivor a false sense of hope.

How about "primary reconstruction" or "principle reconstruction" or "advanced reconstruction"?

The term "immediate reconstruction" is tossed around the breast reconstruction community without any thought given to the affect it may have on a vulnerable patient.

Is there really such a thing as "immediate reconstruction"?  

First lets define "Immediate"

im·me·di·ate

iˈmēdēət/

adjective

1. 1.

   occurring or done at once; instant.

   "the authorities took no immediate action"

   synonyms:

   instant, instantaneous, swift, prompt, fast, speedy, rapid, brisk, quick,

Can someone please explain to me what is instant about breast reconstruction?  

The fat grafting is not instant.

The nipple tattooing is not instant

The nipple reconstruction is not instant

The fine tuning and adjustments are not instant

The healing of the scars are not instant

Do plastic surgeons tell their patients the real story?  Do they give them a realistic idea of when the ordeal might come to an end?  

Do they tell their patients that following the mastectomy with "immediate" reconstruction, there may be YEARS of fine tuning, adjustments and then nipple tattooing and reconstruction if desired?  

And that is if the first technique used is successful! 

What if the surgeon has to start over, using a different technique, or a different type of reconstruction?  

Do surgeons tell their patients the real probability of this happening, and that if it does happen, it may extend the entire ordeal up to 5 years or more?  For example; in Ontario, Canada, once you have had the mastectomy and a first attempt at reconstruction, you are then pushed to the bottom of all wait lists if you need to change plastic surgeons to try another technique.  You are not considered an urgent case as there is no longer active cancer.  Your wait for a second attempt at reconstruction will be 2-5 years.

Are patients advised to seek psychotherapy to assist with the stress, anxiety and depression that stems from not having breasts for years following a mastectomy?  

Are patients given a true realistic idea of what they may be looking at in the mirror every day, following a mastectomy for perhaps years until the project is complete? Are they shown photos of worse case scenarios?

I doubt it.

This needs to change, and needs to change fast.

Plastic Surgeons, I implore you to be brutally honest with your patients.  Give your patient's the worse case scenario.  Talk to your patients about your failures, not just your successes.  Tell your patient's what you have learned from your failures.  

Show your patients photos of "not so great" results, and results that are in progress. And when you do show success photos, share statistics and facts such as how long it took to get to that result, and was the patient happy, what was the age, weight, height of the patient, did they have issues prior such as tubular breasts, or excess tissue or sagging, or radiation?

Plastic Surgeons, I implore you to take the time to discuss all of this information with your patients well in advance of a surgery date.  Discuss post-op care well in advance of a surgery date as well. 

Allow your patients to make arrangements for childcare or employment commitments based on realistic expectations.  Will there be follow up appointments?  How many, how often?  Will there be a need for massage, physiotherapy, exercise, counselling?  How often, and where?

I underwent a bilateral mastectomy with immediate reconstruction over 3 years ago and we are nowhere near finished!  And to think, I was under the impression that I was going to wake up in the recovery room and look down at my newly reconstructed cancer free foobs.  I am an intelligent person, and yet I feel like the most ignorant patient.  

I truly don't know how I will survive another 2 years of procedures.  But I don't exactly have a choice do I?

5TH BREAST RECONSTRUCTION ATTEMPT AND HOPEFULLY THE LAST!

I have not posted anything in a while, mostly because there hasn't really been anything new to report.  Until now!



My original plastic surgeon had referred me to a new surgeon in hopes that a product called alloderm would benefit my reconstruction.  Click here for more information about ALLODERM At this point I was still hell bent on not giving up on the implant method of breast reconstruction.  I didn't feel that we had exhausted all options yet for success.  And all of the cons re: the DIEP FLAP reconstruction still existed, such as greater risk of clotting, lengthy surgery, many hours under a general anesthetic, grueling recovery, possible loss of muscle mass etc. etc.


I left the new surgeons office with a wonderful sense of new hope!  She felt that she could alleviate my discomfort and give me a more satisfying set of Foobs. 


I signed all of the consent forms and was told that I would receive a surgery date approximately 6 months down the road. 


Well....6 months came, 7 months came, 8 months came and then I decided to phone her office to see if I could hurry things along.  When I called her office, I got a voicemail.  I left a detailed message explaining that I had been waiting 8 months for a surgery date and was getting really anxious.  I asked if they could return my phone call and give me even a general idea of when I might go under the knife again.  I have a full time job, 3 children (one with ASD), a dog........ well you get my drift.  There are a lot of things that must be organized and planned for well in advance. 

Guess what happened next?

I get a voicemail message "Hello this is Dr. Zhong's office calling.  We are sorry to inform you that Dr. Zhong will be going on maternity leave in January 2015 and therefore will only be performing immediate reconstruction on patients with active cancer.   Thank you for your understanding"

That was it!  No "please call our office so that we can discuss other options"  No "please call our office so that we may refer you to another physician"  NOTHING

I was shell shocked.  Heart broken and hopeless once again.  In no way do I feel that I am more of a priority than women with active breast cancer.  However......

I had my bilateral mastectomy in April 2013.  I was supposed to have immediate reconstruction with permanent expander implants but that didn't go exactly as planned.  My husband and I attended weekly outpatient appointments for saline fills for months, then we waited and we waited to let my body heal, then I underwent an attempt at nipple tattooing and reconstruction, that failed.  The nipples were created by skin grafting using the excess tissue on my breast, and they peeled right off at my first post op appointment when we removed the gauze.  Then we waited again and waited to let my body heal some more.  Then I underwent a capsulectomy and fat grafting.  Then we waited and waited some more.  Then I underwent another capsulectomy with more fat grafting.  Then we waited again.  My implants once again, became incapsulated, they fell out of pocket, they drifted very far apart and became very hard and painful.  Finally I asked for a second opinion and I was referred to Dr. Zhong at UHN because of her experience and access to the acellular dermal matrix called alloderm.  I felt like alloderm was my saviour. 

After my bilateral mastectomy, I grieved the loss of my breasts.  More so than I could ever have imagined.  Perhaps because I was expecting "immediate" reconstruction and I now know all too well that there really is no such thing.  Due to the trauma I experienced in the operating room that day, the horrible sight I was exposed to each day in the mirror, the ongoing pain and treatments and surgeries that seemed to be completely ineffective, I was diagnosed with PTSD.  Panic attacks, insomnia, night mares, social anxiety, depression you name it.  My life has changed dramatically in a way that even my family and friends can't understand.  For example; I am unable to cope in a large busy social setting.  Parties, loud music, lots of people bumping into me or crowding my personal space is enough to make me scream at the top of my lungs and jump off a bridge.  Another example of how PTSD has changed my life is driving a motor vehicle.  The simple act of driving to work or driving the kids to activities is all that I can handle.  Running errands.....not enjoyable.  I am no longer able to go to multiple grocery stores in one day.  I have to spread these tasks out over a period of time.  And from that I have learned.... there is nothing that can't wait.  I literally don't go anywhere unless I have to.  At this stage in my life, I believe that if someone wants to see me bad enough, they will come to me.  I am not going to experience panic and fear just for the sake of visiting someone especially in front of my children.  They deserve to see a mother who is strong and invincible, not one who is broken.  How can they expect me to solve all of their problems, fix all of their broken toys, put together countless loom bracelets, and help them with homework if I can't even manage to drive to a relative's house.  With time, it is getting better.  Therapy and a support group is helping, so I have hope.

The appointment with Dr. Zhong brought me out of a very dark place.  I saw hope again. 

But then...

To have that hope pulled right out from underneath me-safety net withdrawn, was devastating.  This whole process now has taken 19 months.  And after everything I had been through, I was now left to do my own research and find a surgeon willing to take me on as a patient.  Not just as a delayed reconstruction case but a revision.  Not all surgeons are even willing to get involved in a revision case.  I began calling and emailing doctors all over Ontario and Canada.  I was given wait times of 1-3 years.   At that rate, I might as well sit back and wait for Dr. Zhong to return from maternity leave.

But that meant, 14 more months (or longer) of sleepless nights, depression, worry, anxiety, pain and chronic discomfort.  I couldn't sit back and do nothing, I had to find another surgeon. 

Then I finally found a surgeon willing to give me a consultation with in 2 months.  My husband and I performed hours and hours of google, yahoo, and breast cancer site blog research into this surgeon.  We were confident that his experience and dedication to breast cancer reconstruction awareness warranted a consultation.  And so we went...

In October 2014 I met with Dr. Nicholas Guay.  Previously Dr. Guay worked out of the Ottawa hospital and was actually on my original list of doctors of choice but the thought of making the trip to Ottawa deterred me.  To our benefit, Dr. Guay has taken on the role of Chief of Surgery at William Osler Health Centre.  He is a self-proclaimed breast expert and his vast experience with breast reconstruction speaks for itself.  Even with his new chief of surgery position, he has remained focused and committed to breast reconstruction surgery above all else. Dr. Guay is the founder of The most resourceful breast reconstruction website available today His charming French accent and stunningly good looks don't do him or his patients any harm. 

Dr. Guay brought about the idea of choosing a free flap reconstruction method Autologous Tissue Flap instead of trying to succeed with implants.  His approach was different than the other surgeons.  He is confident, straight to the point/direct which had been missing from previous consultations.  Other surgeons always seemed unsure of which course of treatment to embark on.  My first surgeon instructed me to gain weight prior to meeting with Dr. Zhong.  She felt that in order to present myself as an ideal candidate, I needed to have more abdominal fat to use along with the implants.  Dr. Guay seemed very pleased with my presentation of the additional fat and gave me all of the information about the DIEP Flap.  He answered all of our questions, we did not feel rushed at all.  He then asked me to take a month to consider the option of having a DIEP Flap.  The difference this time around with the DIEP vs Implant method is that his OR time for a DIEP Flap is 4-5 hours less than other surgeons.  Dr. Guay claims that he has performed so many of them, that he has mastered a system.  This was a game changer. 

This is a great video explanation of the DIEP Flap reconstruction procedure Here

In 2005 I was diagnosed with Wolff Parkinson White syndrome a rare congenital heart disorder.  In 2007 I underwent an ablation to cauterize the whole in my heart and restore natural rhythm.   Even though I have been 95% asymptomatic since the ablation, it was a factor when considering a DIEP Flap surgery requiring 12 hours of general anesthetic.  The other factor was the recovery period.  12 weeks (maybe longer) vs 4-6 weeks with implants.  The overall risks were much higher with a DIEP.  However, many things have changed since then.  I have already undergone the removal of my breast tissue and that part of my body has healed.  Also, I have already had the opportunity to "brave the battle scars" as they call it.  I have had 19 months to accept my scars and disfigurement.  Really at this point, I don't think it could possibly get any worse.  I am now less concerned about adding an abdominal scar to my list of battle wounds.  I mean really, who gives a shit? 

The scars are a part of who I am.  They resemble courage, bravery, selflessness, beauty, love, devotion and my history.  They tell my story.  A story that I want to share with my children and God.

After weeks of research and weighing the pros vs cons, I went back to meet with Dr. Guay to let him know that I have decided to go ahead with the DIEP Free Flap reconstruction.  Because he is just setting up his practice at William Osler Hospital, the wait time for reconstruction surgery isn't bad at all.  So in April, 2016 I will take a leap of faith and let God guide me towards my path.  I have realized that I can no longer control every aspect of my life. I believe that everything has happened for a reason, and that someone has been carefully looking over me throughout this entire ordeal. 

Some great before/after photos of autologous tissue reconstruction, Here.

Today I admitted to Dr. Guay that I am extremely unhappy and uncomfortable with my weight gain.  I don't like how I feel, I don't like how I look, and my clothes are too tight (went up a size). I asked him once again to clarify "do I really need to hang onto this excess body fat?" or can I afford to lose a little and tone up prior to April's surgery.  He proceeded to poke, pull and tug at my abdomen, and chest area.  His words "I believe I have exactly what I need here to create a pair of breasts using your own tissue that you will be satisfied with." So I ask him again "Can I tone up my butt and thighs and arms?"  Basically he reminds me that when women gains weight, they gain it in more than one area.  Therefore if I need excess abdominal fat, you can be sure that extra thigh, back and bum fat will tag along for the ride.  He suggested Yoga, meditation, pilates and walking.  But nothing too extreme.  He suggested that we take a few measurements now and monitor things.  Ideally we want the measurements to remain the same.  He assures me that he will leave nothing behind. However, he did clarify that he can't help me much with the butt and thighs, that will be my battle after surgery.  And I'm looking forward to it!

I AM NOT DEFINED BY MY BREASTS OR MY PHYSICAL APPEARANCE 

I am defined by my character and my loyalty and dedication to my family

PALEO INDIAN INSPIRED FRIED CAULI-RICE

Indian inspired fried cauli-rice can be served with so many different dishes!


I will get right to the recipe!

Ingredients:

1 Head cauliflower
2 chopped green onions
2 carrots peeled and sliced thin
2tbsp coconut oil for frying
2 tbsp tumeric  
1 tbsp cumin
1tsp garam masala
1/2 tsp cardamom
salt
pepper

Instructions:

Chop cauliflower into small florets and add to food processor
Pulse until caulifower takes on a rice like appearance (about 2 mins)

In a large frying pan or wok melt coconut oil
Add the green onions and carrots, fry until tender
then add the riced cauliflower on medium high heat
stir in all spices and keep stirring!  

Fry until the riced cauliflower is just tender

Thats it!


  

PALEO TILAPIA CURRY!

I have really been craving indian inspired and flavoured foods lately!


I recently made my Paleo Butter Chicken Recipe and the other day I tried a paleo beef curry which I will share soon!  

But this was the first time I have attempted a fish curry.  I must say it turned out pretty darn well!!
A little spicy, buttery, and went really well with my Indian Inspired Fried Cauli-Rice!

This Curry recipe was easy to prepare and includes simple ingredients that you can find at any local grocery store.

Ingredients:

2 Fresh or Frozen Tilapia Fillets cut into chunks
5 cups vegetable broth
2 tbsp fish sauce
1 can coconut milk
2 tbsp medium curry powder
1 tsp ground cumin
salt
pepper
2 carrots peeled and roughly chopped
1 cup peeled and chopped rutabaga

4 canned plum tomatoes chopped
1 yellow onion chopped
2 minced garlic cloves
2 tbsp arrowroot powder
coconut oil 


Instructions: 

In a large saucepan, melt 2 tbsp of coconut oil and add the carrots and onion to the pan
Fry for approx 5 minutes until carrots are starting to soften.
Add the garlic and cook 2 more minutes
Add the vegetable broth, fish sauce, coconut milk, curry powder, cumin, salt and pepper and stir well.
Bring to a boil and add the rutabaga and plum tomatoes
Reduce heat and simmer 15-20 minutes until rutabaga is tender
Add the tilapia chunks and simmer 10 minutes stirring often
Mix the arrowroot powder with a little water then pour into the curry and stir well.  Turn heat off and keep stirring until the curry thickens nicely.

Serve over my Indian Inspired Cauli-Rice!

 

 

 

PALEO PEACH AND BACON FRENCH TOAST BAKE

I must admit, I have been coming up with some pretty spectacular stuff lately! 


Peaches are everywhere!  I just love local fresh peaches, and peaches with bacon.....OMG.


After our trip to the local farmers market (2 bushells of peaches on hand), the kids and I were trying to think of the many ways we could enjoy these delicious fruits.  I thought.......baked peaches with carmelized peacans and coconut whip, grilled bacon wrapped peaches.....and then......my 13 year old said "can you put peaches on french toast"? Ummmmm ya!  After a couple of attempts I can now share this recipe:)


The recipe is very simple if you have pre-made paleo bread on hand.  I have tried a few different paleo bread recipes and this is the one I prefer the most for french toast from Living Healthy with Chocolate Here they use greek yogurt which I tolerate well in small quantities.  You could use any version of paleo bread that you wish.


Ingredients:

1 loaf paleo bread broken into large chunks
7 slices of cooked bacon chopped
6-8 peeled and sliced peaches
175ml full fat coconut milk
2 tsp vanilla extract
2 tsp ground cinnamon
5 eggs beaten
pinch of salt
a few drops of liquid organic stevia leaf extract (or any other natural sweetener)   I tried honey once and it worked well.

Instructions:
 
Preheat oven to 375 degrees
Using coconut oil or grassfed butter, grease a 10 inch round baking dish.
In the baking dish combine the paleo bread loaf chunks and the chopped bacon
In a bowl combine the coconut milk, eggs, vanilla, cinnamon, salt and steivia or sweetner
Pour liquid mixture over the bread and bacon
cover with sliced peaches

Bake for 20-25 minutes or until the batter has shrunk away slightly from the sides of the dish and the peaches look carmelized.

Drizzle with pure maple syrup!  

This would also be delicious with some mapled pecans on top.....


 

 

 

 

 

 

 

 

NEW SURGEON, NEW HOPE, NEW ME!

After 3 months of anxiously waiting......I finally had my second opinion for breast reconstruction revision.


My appointment was with Dr. Toni Zhong, University Health Network breast clinic.  I met with her at the Princess Margaret Hospital site in Toronto, Ontario.  
My husband and I had been anticipating this moment for months.  I had so many emotions prior to meeting Dr. Zhong.  Anxiety, fear, eargerness, apprehension you name it.  Mainly, I was afraid that Dr. Zhong would take one look at me and say "this looks pretty good, you wont get much better than this". 


There are many options available to women for breast reconstruction around the world, but not all of these state of the art, new techniques are available here in Ontario through OHIP.  
Previous to this appointment, I had received opinions from two surgeons in the United States.   Both of these surgeons had suggested very similar treatment plans.  I wanted to have these outside non/OHIP based opinions prior to meeting Dr. Zhong so that I could ask Dr. Zhong the right questions, and compare her treatment plan (covered by OHIP) with the very expensive option of traveling to the USA for my reconstruction revision surgery.


As my wonderful husband and I took the train into Toronto to meet with Dr. Zhong, there was an awkward silence, yet an unquestionable feeling of being loved and supported.  I can't really explain it but it made me feel at ease.  The surgeon gave us a very realistic picture of what her reconstruction plan would look like.  She was candid, honest and empathetic.  She valued and understood the cosmetic appeal of breast reconstruction as a part of a woman's overall health and wellbeing ..something that other Canadian surgeons seem to have lost.

Her plan is to start over from scratch.  My current breast implants have been placed only partially under the muscle.  She said there are different techniques and that particular technique doesnt seem to be working for me.  She will remove my current implants, and replace them with expanders completely under the muscle.  I will attend her office for bi-weekly fills and roughly 4 months later she will swap out the expanders for permanent high profile implants.  Approximately 3 months after that she will perform nipple reconstruction and tattooing.  The whole process could take 6-8 months.  

She had all the right answers to my questions.  Including what type of bra to wear (she will have me sized at their boutique), what exercises to do, massage and she will be recommending a physiotherapist in the Toronto area.  This is when I was overcome with emotion.  All the questions that I had asked the previous surgeon, to which she really had no answers to were now answered.  By someone with clear knowledge, experience and confidence.   I broke down in tears in my husbands arms.  I felt so relieved, happy and angry all at the same time.  This experience has been so traumatic.  

The surgery will take place in early October.  Dr. Zhong will be using Alloderm to provide additional cushioning and support.  I will require extensive time off work to recover and most importantly to ensure that the transplanted Alloderm tissue is accepted by my body and has an opportunity to survive in my body.  This time around we will utilize all supports available to us through our extended benefits such as homecare, nursing care, physiotherapy and massage.  I don't care if this means I am taking the Go Train into Toronto 3 times per week.  This recovery will be ALL about me this time.  No family drama, no work drama, and no stress.  We now have a very good idea of what to expect and will be prepared!

Major Breast Reconstruction revision #2

Finally

Major Breast Reconstruction revision. 

After dealing with capsular contracture for 10 months and undergoing 2 capsulectomies, finally a second chance at reconstruction.

Removal of the cohesive gel implants and replacing them with high profile becker implants.  Recoval of the capsule or scar tissue surrounding the implants, and more fat grafting.

Most importantly the use of Alloderm accellular dermal matrix to create an internal bra to provide cushioning between the implants and my own tissue, in hopes of avoiding a third capsular contracture. 

I will start a prophylactic regimen of clindamycin and accolate.  Clindamycin to help avoid any bacterial infection and accolate has been proven to be effective against the body over developing scar tissue. 

I have gained back some weight, which was very important for successful fat transfer from my abdominal area to my breast area.  Good abdominal fat in sufficient quantities, is a crucial part of this process.  I have learned this lesson the hard way.  Without adequate amounts of fat cusioning the implants and the use of alloderm, my body will develop scar tissue and form a hard capsule again.

This recovery will be lengthy, 12
weeks of no work, no lifting, no physical activity, no bounce of any kind. 

I have enlisted the help of a nurse for daily bathing, dressing etc along with physiotherapy, and massage.   

We are much better prepared for major surgery this time around.  We have realistic expectations.   We know that I need a great deal of help.  I am not able to do anything.  I cant be reaching into a washing machine or dryer.  I cant be reaching up to get a plate or bowl from the kitchen cupboard.  I can't be vacuuming or cooking meals.  

We have also enlisted the help of a personal support worker.  This means exhausting whatever benefits are available to us through our extended health coverage.  Unfortunately I dont have family living close by, and any family I do have are very busy caring for their own little ones.  

But we are prepared this time and I am determined to have a successful recovery.  This has to be the last time.  My life needs to move forward, our lives need to move on.

When we embarked on this journey, I never imagined that this would be a 2 year process. 

 However surprisingly,  I have become quite comfortable with my breasts as they are.  I really hope that the capsular contracture will successfully be eliminated and my pain and discomfort will subside, but if this is not successful, I am okay with that.  I am proud of who I am and the decisions I have made. 

ITS FIDDLEHEAD SEASON!

Okay, so fiddleheads are simply the best vegetable known to mankind.  If you havent tried these little darlings, then you havent lived.


You can find fiddleheads growing in Southern Ontario along side brooks and creeks.  They like shade and moisture.  The fiddlehead season is very very short lasting sometimes only one week!  


My dad started taking us fiddlehead picking from the time we were able to walk.  We have a secret spot that I CAN NOT share with you!  Lucky for me it is actually on my way to work.  This allows me the ability to pop in regularly to check and see if the little darlings are peaking up through the ground.  You have to nab them right away or you will miss the season.  When we were younger we would go day after day to pick as many bags of fiddleheads as we could until the season dried up.  
I am talking about literally 50lbs of fiddleheads lol.  We ate them daily and my Dad would blanch them and freeze them using one of those wrapping machines that sucks the air out of the packages so that we could enjoy them all year long. 


When you pick fiddleheads, they have a thin brown film covering them that you want to try and remove prior to cooking.  This is not an easy task!  Especially with that many fiddleheads.  My dad would get a blanket and lay it out on a picnic table.  He would then spread the freshly picked fiddleheads out all over the blanket.  They 1 person would grab one end of the blanket by the corners and he would grab the other end of the blanket and we would pick up the blanket and use it to toss the fiddlehead up into the air and then catch them again on the blanket.  If we were lucky enough to have a nice breeze, the thin brown covering would blow off of the fiddleheads!


Then we would bring them all in to the laundry room sink and rinse them really well. 

It is really important that fiddleheads are cooked well.  They can not be eaten raw!  Here is a great link to some information that Health Canada posted for fiddlehead eaters! Fiddlehead Safety Tips 

I love fiddleheads cooked two ways:

for both methods I always boil them first for about 10-12 minutes.

The first is sauteed in a frying pan for about 8 minutes with lots of butter and salt.

The second is BBQ using one of those bbq vegetable trays.  I toss them first in some EVOO and then bbq them about 10 minutes.  Then I toss them again in butter, fresh dill, garlic and sea salt. Yummm!!

This is a great website that provides plenty of nutritional information about fiddleheads http://www.nutrition-and-you.com/fiddlehead-ferns.html 

PALEO ish BUFFALO CHICKEN MEATBALL SLIDERS!

These meatball sliders will please everyone! Not just paleo critics!  Trust me I know:) I served them to my entire gang last night and the response was......"Can we have these in our lunch tomorrow?"

Now, if you have been following my blog you know that I have a very difficult family to please!  So as usual I modified this recipe slightly for hubby and the boys and modified it slightly again for my daughter.  Most people do not have to go through all of this extra work but I really don't mind.  And, I see it as getting them one step closer to healthy!


I call this recipe Paleoish simply because I do allow myself some cheese once in a while and I use Franks Red Hot.  I am lactose intolerant but can handle goat cheese in moderation without any side effects.  Normally I use Daiya Cheese in all of my dishes but from time to time I treat myself with some goat cheese.  Goat cheese has come a long way since I was a kid and my Grandmother was always trying to convince us to try it.  Now there are so many varieties of goat cheese flavours, it is so smooth and creamy as well.  For this recipe I made a Goat Blue Cheese Aioli to serve with my Paleo Buffalo Chicken Meatballs.  Hence the "Paleo ish"  You could substitute the Goat Blue Cheese in the Aioli for a nice cilantro Aioli.


These meatballs could be made ahead, and refrigerated until you are ready to serve them.  I have served my meatballs as sliders on Beet Buns with a Goat Blue Cheese Aioli , but you could serve them alone with toothpicks and have the dip on the side as a delicious Hors d'oeuvre at your next back yard bbq.


The recipe is easy to follow and the prep/cook time is minimal.  It took me a total of 45mins from prep to plate but I move Fast!  I am super organized and can multitask well.  For some it may take closer to 1 hour.  That is why making the meatballs in advance and freezing or refrigerating works wonders.


Ingredients:

2lbs pasture chicken thigh meat
1 egg
1 cup almond meal (ground almonds)
3 organic green onions sliced thin
2 garlic cloves minced
1/4 cup chopped fresh Dill
1 tsp kosher salt
1/2 cup franks Red Hot Sauce plus 1/4 cup in a separate small bowl
2 organic Jalapeno peppers diced (Optional, we like it hot!)
2 large organic beets
EVOO
1tbsp grassfed butter

Find my Goat Blue Cheese Aioli Recipe


Instructions:

Preheat the oven to 350 degrees

For the Beet Buns:

• Wash and slice your beets, you want each slice to be about 1/8 inch thick.  If they are too thin they will crumble and if they are too thick they will take too long to cook.
• Place the beet slices on a non-stick baking sheet or use a non-stick cooking spray
• Brush each beet slice on both sides with EVOO and sprinkle each side with Kosher Salt.  Kosher Salt is important because it gives the beets a nice crust that sea salt does not.  And it has a wonderful flavor!
• Bake in the oven turning once for approx 35 minutes.  you want them to be firm and just starting to brown.  I leave my beet slices in the oven the entire time that my meatballs are cooking.  The timing seems to be perfect!

For the Meatballs:

• Trim all visible fat from your chicken thigh meat
• Using your food processor, grind the chicken thighs (You could use store bought ground chicken meat but I find the meat balls a little dry this way.  You may want to add another egg and cut back on the almond meal if you choose to use the store bought ground chicken)
• In a large bowl using your hands, mix together the ground chicken thighs with all other ingredients except the Jalapeno peppers and the Franks Red Hot.

•  This is where I modified some meatballs slightly for my 7 year old daughter who doesn't like anything spicy.  At this point I separated enough of the chicken mixture to make her 4 large meatballs without the Jalapenos and Hot Sauce.  If you Dont want to make a few meatballs that are not spicy skip this step!

• Then add your Jalapeno peppers and Franks Redhot Sauce and mix well using your hands.
• You will notice that this chicken mixture is gooier and stickier than your typical meatball mixture that contains bread crumbs.  This is perfectly fine, its just a little trickier to form perfect round balls, so I don't stress out about it.  They still look fabulous.
• Wash hands well with antibacterial soap, and use hands to form round meatballs about the size of a small plum.  I find it helps to keep my hands moistened with a little water during this process to help keep the chicken mixture from sticking.
• Place the meatballs on a non-stick baking sheet or you may want to use some non-stick cooking spray.  There isn't a lot of fat in these meatballs so they will stick to the pan if you don't.
• Bake the meatballs for 30 minutes turning them a couple of times.
• In a small bowl combine 1/4 cup of franks redhot with 1 tbsp melted grassfed butter and drizzle some of this buffalo sauce over each meatball

Serve the meatballs between the beet buns topped with my Goat Blue Cheese Aioli along with a side of Fiddleheads !

To please my munchkins, I served the meatballs on fresh slider buns and topped them with shredded cheddar cheese instead of the Goat Blue Cheese Aioli.  They were a huge hit!

GOAT BLUE CHEESE AIOLI!

This is a very simple easy recipe for a Goat Blue Cheese Aioli.  

I am aware that some do not consider dairy to be paleo.  However, I follow a paleo lifestyle for health reasons not because I am following a trend or fad.  I am casein and lactose intolerant.  I can tolerate goat milk cheese in moderation and therefore choose to include this as a part of my paleo lifestyle.

I was going through the effort of making my own paleo dairy free mayo, until I came across this product which is vegan, dairy-free, gluten-free, soy-free and non-GMO. Follow Your Heart Veganaise .  I use this in many of my dips and dressings.

Ingredients:

2 tbsp Creamy Goat Milk Blue Cheese 
1/2 cup of Follow Your Heart Veganaise or Homemade Paleo Mayo
1/4 tsp sea salt
1 clove minced garlic
2 tbsp chopped parsley

Instructions:

• Mix everything together in a bowl and refrigerate until ready to use.

Serve this aioli over my Paleo ish Buffalo Meatball Sliders

vegan, gluten-free, dairy-free, non-gmo, soy-free

(vegan, gluten-free, dairy-free, non-gmo, soy-free) - See more at: http://followyourheart.com/products/soy-free-3#sthash.GDa4GeR4.dpuf

(vegan, gluten-free, dairy-free, non-gmo, soy-free) - See more at: http://followyourheart.com/products/soy-free-3#sthash.GDa4GeR4.dpuf