Wednesday, December 28, 2005
Recently I had a MUGA scan done. This was because my most recent echo,a month ago, showed my EF as having fallen back down into the 15-20% range. Doc says that at low numbers like that, the echo isn't very accurate or precise; the MUGA is. I haven't heard the results yet - he's on vacation; I meet with him the day he gets back, Jan 9. Anyway, some of you have heard about MUGAs, and if you haven't, you can read more about them here:
http://heartdisease.about.com/cs/cardiactests/a/muga.htm
http://www.chfpatients.com/tests/muga.htm
Although those sites describe the test, they don't really. What they don't tell you is the "sit and wait" aspects. So here's what it's really like:
Arrive at lab in basement of building at 9 a.m., still 90% asleep. Sign in, sit and wait. After about 10 minutes, a tech gets around to you, and draws some blood, making jokes that you don't get since you're not really awake yet. Then you go back and sit in the waiting room for another 20 minutes, while they add the radioactive stuff to your blood. The stuff's called technetium, which they pronounce tek-NEE-shem. The waiting room has small chairs, cheap, with not much padding, and fewer and older magazines than a doctor's waiting room. So if you didn't bring your own reading material or knitting, you are in for more boredom than usual. They do, however, offer juice or coffee - in most cases, there is no reason why you cannot eat or drink before a MUGA, unlike many other lab tests and scans. So, if you don't have to fast, then one way to pass the waiting time is to bring your own coffee and donuts, or tea and toast, or whatever, for breakfast.
Then you go back in the blood-drawing room to have your blood re-injected into you. Then you go back out to the waiting room, and wait for another 20-25 minutes, for the radioactive blood to circulate enough. Pull out the knitting again, or the crossword puzzle, or your PDA. During this wait, the staff will probably also use the time to give you your "radioactive letter" - a note that says you've had this test done, so that if you have to go into a high-security area, you can explain why you happen to be radioactive. They recommend keeping it with you for 30 days.
Finally you get to go back to the machine. If you are wearing thin clothing, you probably get to keep it on; if you are wearing heavy clothing or clothing with metal on it - women's bras, shirts with snaps or metal buttons - you will probably be asked to undress to the waist. Then you lie down. The description at the web sites above says "you will be asked to hold very still." Actually, they don't count on you for that - what they do is stretch a thin rubber sheet over your thorax (chest) and right arm (your left arm rests above your head) and fasten it down, so that you are held firmly in place. It would take quite an effort to twitch, let alone move much, under there. Then the machine hums and the technician mutters at her computer and the background music plays, for about 15-20 minutes. (I dozed off, so I don't know the exact amount of time; it was at least 4 Christmas carols, though.) And that's it - when they let you up, you get to just leave, and wait to talk to your doctor about the results.
I was pushy enough to ask to see the technician's computer screen, and she ran a bit of the view for me. One can see one's heart clearly; what's surprising is how large and bright one's spleen is!!
Well, results when I get them will be posted here. Till then, Happy New Year!
keywords: MUGA, scan, EF
http://heartdisease.about.com/cs/cardiactests/a/muga.htm
http://www.chfpatients.com/tests/muga.htm
Although those sites describe the test, they don't really. What they don't tell you is the "sit and wait" aspects. So here's what it's really like:
Arrive at lab in basement of building at 9 a.m., still 90% asleep. Sign in, sit and wait. After about 10 minutes, a tech gets around to you, and draws some blood, making jokes that you don't get since you're not really awake yet. Then you go back and sit in the waiting room for another 20 minutes, while they add the radioactive stuff to your blood. The stuff's called technetium, which they pronounce tek-NEE-shem. The waiting room has small chairs, cheap, with not much padding, and fewer and older magazines than a doctor's waiting room. So if you didn't bring your own reading material or knitting, you are in for more boredom than usual. They do, however, offer juice or coffee - in most cases, there is no reason why you cannot eat or drink before a MUGA, unlike many other lab tests and scans. So, if you don't have to fast, then one way to pass the waiting time is to bring your own coffee and donuts, or tea and toast, or whatever, for breakfast.
Then you go back in the blood-drawing room to have your blood re-injected into you. Then you go back out to the waiting room, and wait for another 20-25 minutes, for the radioactive blood to circulate enough. Pull out the knitting again, or the crossword puzzle, or your PDA. During this wait, the staff will probably also use the time to give you your "radioactive letter" - a note that says you've had this test done, so that if you have to go into a high-security area, you can explain why you happen to be radioactive. They recommend keeping it with you for 30 days.
Finally you get to go back to the machine. If you are wearing thin clothing, you probably get to keep it on; if you are wearing heavy clothing or clothing with metal on it - women's bras, shirts with snaps or metal buttons - you will probably be asked to undress to the waist. Then you lie down. The description at the web sites above says "you will be asked to hold very still." Actually, they don't count on you for that - what they do is stretch a thin rubber sheet over your thorax (chest) and right arm (your left arm rests above your head) and fasten it down, so that you are held firmly in place. It would take quite an effort to twitch, let alone move much, under there. Then the machine hums and the technician mutters at her computer and the background music plays, for about 15-20 minutes. (I dozed off, so I don't know the exact amount of time; it was at least 4 Christmas carols, though.) And that's it - when they let you up, you get to just leave, and wait to talk to your doctor about the results.
I was pushy enough to ask to see the technician's computer screen, and she ran a bit of the view for me. One can see one's heart clearly; what's surprising is how large and bright one's spleen is!!
Well, results when I get them will be posted here. Till then, Happy New Year!
keywords: MUGA, scan, EF
A couple of articles about Guidant ICDs
Three new deaths associated with Guidant devices
Dec 15 (Reuters) - Guidant Corp has filed reports with the US Food and Drug Administration about three new deaths associated with short circuits in its heart devices, the New York Times reported on Wednesday.
Citing FDA records, the newspaper said the deaths occurred after Guidant recalled the heart devices in June.
Guidant has faced intense scrutiny in recent months over its failure to inform doctors about potential defects in some of its implantable devices used to manage abnormal heartbeats.
It eventually recalled some of its most lucrative implantable heart devices because of concerns about their safety. Sales have since resumed.
Including the new reports, number of deaths associated with the flaws has reached seven, the Times said. It said doctors and families of heart patients may be more likely to have the units checked for problems after a death because of the increased scrutiny on Guidant.
According to the report, Guidant said it "regularly communicates information about product performance to various stakeholders including physicians and regulatory bodies," and has recently been releasing more detailed information about product malfunctions.
In October, Guidant said it had received a Justice Department subpoena concerning some of those recalled heart devices, which regulate abnormal heart rhythm and protect against heart failure. Two other makers of heart devices also got subpoenas.
Guidant, which is the target of competing takeover offers from Johnson & Johnson and Boston Scientific Corp., was not immediately available for comment.
Publish Date: December 15, 2005
Heart Device's Export Blocked - FDA Questions Rhythm Stabilizers From One
Guidant Plant
By Marc Kaufman
Washington Post Staff Writer
Wednesday, December 28, 2005; A02
The Food and Drug Administration has told Guidant Corp., a maker of medical
devices, that it will not approve new contracts to export heart-rhythm
stabilizers made in its Minnesota plant until the company can prove that its
products are being properly made.
In a warning letter from the agency, the troubled company was also informed
that it had to make significant improvements in its manufacturing practices
before any additional company devices could be approved for sale.
Guidant acknowledged in a statement on its Web site that it received the
formal FDA warning Dec. 23, and that it outlined quality-control issues at
its St. Paul plant. The warning letter covered a broad range of
still-uncorrected problems first identified by the FDA during a September
inspection.
But, Guidant said in its statement that it has "taken a broad, thorough and
systemic review of its quality system and has made substantial steps toward
addressing all" of the FDA's concerns. The company has fulfilled 90 percent
of its upgrade commitments, the statement said.
The intensive FDA inspection followed a series of recalls and warnings
issued for Guidant's heart defibrillators and pacemakers because of reported
malfunctions, some of them fatal. Federal and state officials are
investigating the company, which faces dozens of lawsuits over its recalls.
After the inspection, FDA officials said that the company did not properly
warn doctors about software problems that caused some pacemakers to
malfunction, that company quality control was ineffective at several levels,
and that record-keeping was poor.
FDA spokesman Jason Brodsky said that while Guidant remains out of
compliance with good manufacturing practices at the St. Paul plant, the
agency had no additional product warnings yesterday for patients and their
doctors.
"We're working with the company now to bring them into compliance," Brodsky
said. "There are significant manufacturing concerns, but we have no new
recommendations for use of the products."
Brodsky said that the FDA's refusal to issue new export certificates for the
plant or to approve new device applications is not a new regulatory action
but rather a consequence of the plant remaining out of good manufacturing
compliance.
In the warning letter to Guidant, Minneapolis District Director W. Charles
Becoat said that the company had submitted five letters since early
September outlining its plans to improve the St. Paul plant. Nonetheless, he
wrote, "You have failed to address all of the significant violations . . .
and will receive additional correspondence detailing the inadequacy of your
response."
The company's devices are implanted in cardiac patients and use electric
shocks to correct faltering heartbeats. While the problems of some implanted
defibrillators and pacemakers have tarnished the industry, agency and
industry officials say that failure rates remain low and the devices are
often lifesaving.
Guidant's manufacturing problems have emerged as two larger companies --
Johnson & Johnson Co. and Boston Scientific Corp. -- have negotiated to buy
the company. Johnson & Johnson reduced its offer by almost 20 percent after
the problems arose, and then Boston Scientific countered with an offer
similar to the initial one from Johnson & Johnson.
Guidant stock dropped by almost 3.5 percent yesterday on the New York Stock
Exchange. The decline was the biggest since the price fell almost 5 percent
last month after New York Attorney General Eliot L. Spitzer accused the
company of misleading doctors about a design flaw in its defibrillators.
© 2005 The Washington Post Company
(keywords: Guidant, ICD, defibrillator, pacemaker)
Three new deaths associated with Guidant devices
Dec 15 (Reuters) - Guidant Corp has filed reports with the US Food and Drug Administration about three new deaths associated with short circuits in its heart devices, the New York Times reported on Wednesday.
Citing FDA records, the newspaper said the deaths occurred after Guidant recalled the heart devices in June.
Guidant has faced intense scrutiny in recent months over its failure to inform doctors about potential defects in some of its implantable devices used to manage abnormal heartbeats.
It eventually recalled some of its most lucrative implantable heart devices because of concerns about their safety. Sales have since resumed.
Including the new reports, number of deaths associated with the flaws has reached seven, the Times said. It said doctors and families of heart patients may be more likely to have the units checked for problems after a death because of the increased scrutiny on Guidant.
According to the report, Guidant said it "regularly communicates information about product performance to various stakeholders including physicians and regulatory bodies," and has recently been releasing more detailed information about product malfunctions.
In October, Guidant said it had received a Justice Department subpoena concerning some of those recalled heart devices, which regulate abnormal heart rhythm and protect against heart failure. Two other makers of heart devices also got subpoenas.
Guidant, which is the target of competing takeover offers from Johnson & Johnson and Boston Scientific Corp., was not immediately available for comment.
Publish Date: December 15, 2005
Heart Device's Export Blocked - FDA Questions Rhythm Stabilizers From One
Guidant Plant
By Marc Kaufman
Washington Post Staff Writer
Wednesday, December 28, 2005; A02
The Food and Drug Administration has told Guidant Corp., a maker of medical
devices, that it will not approve new contracts to export heart-rhythm
stabilizers made in its Minnesota plant until the company can prove that its
products are being properly made.
In a warning letter from the agency, the troubled company was also informed
that it had to make significant improvements in its manufacturing practices
before any additional company devices could be approved for sale.
Guidant acknowledged in a statement on its Web site that it received the
formal FDA warning Dec. 23, and that it outlined quality-control issues at
its St. Paul plant. The warning letter covered a broad range of
still-uncorrected problems first identified by the FDA during a September
inspection.
But, Guidant said in its statement that it has "taken a broad, thorough and
systemic review of its quality system and has made substantial steps toward
addressing all" of the FDA's concerns. The company has fulfilled 90 percent
of its upgrade commitments, the statement said.
The intensive FDA inspection followed a series of recalls and warnings
issued for Guidant's heart defibrillators and pacemakers because of reported
malfunctions, some of them fatal. Federal and state officials are
investigating the company, which faces dozens of lawsuits over its recalls.
After the inspection, FDA officials said that the company did not properly
warn doctors about software problems that caused some pacemakers to
malfunction, that company quality control was ineffective at several levels,
and that record-keeping was poor.
FDA spokesman Jason Brodsky said that while Guidant remains out of
compliance with good manufacturing practices at the St. Paul plant, the
agency had no additional product warnings yesterday for patients and their
doctors.
"We're working with the company now to bring them into compliance," Brodsky
said. "There are significant manufacturing concerns, but we have no new
recommendations for use of the products."
Brodsky said that the FDA's refusal to issue new export certificates for the
plant or to approve new device applications is not a new regulatory action
but rather a consequence of the plant remaining out of good manufacturing
compliance.
In the warning letter to Guidant, Minneapolis District Director W. Charles
Becoat said that the company had submitted five letters since early
September outlining its plans to improve the St. Paul plant. Nonetheless, he
wrote, "You have failed to address all of the significant violations . . .
and will receive additional correspondence detailing the inadequacy of your
response."
The company's devices are implanted in cardiac patients and use electric
shocks to correct faltering heartbeats. While the problems of some implanted
defibrillators and pacemakers have tarnished the industry, agency and
industry officials say that failure rates remain low and the devices are
often lifesaving.
Guidant's manufacturing problems have emerged as two larger companies --
Johnson & Johnson Co. and Boston Scientific Corp. -- have negotiated to buy
the company. Johnson & Johnson reduced its offer by almost 20 percent after
the problems arose, and then Boston Scientific countered with an offer
similar to the initial one from Johnson & Johnson.
Guidant stock dropped by almost 3.5 percent yesterday on the New York Stock
Exchange. The decline was the biggest since the price fell almost 5 percent
last month after New York Attorney General Eliot L. Spitzer accused the
company of misleading doctors about a design flaw in its defibrillators.
© 2005 The Washington Post Company
(keywords: Guidant, ICD, defibrillator, pacemaker)
Tuesday, December 20, 2005
News:
Micronutrients helpful for heart failure patientsec 07 (Reuters Health) - Micronutrient supplementation improves heart function and quality-of-life in elderly patients with chronic heart failure, according to a report from investigators in Germany and the UK.
"The vitamin story has been confused with studies examining the response to single vitamin supplements in relatively low-risk patients," Dr. Klaus K. A. Witte from Castle Hill Hospital, Cottingham, told Reuters Health.
On the other hand, "CHF patients are at higher risk and might have multiple deficiencies. Replacing just one micronutrient might expose deficiency elsewhere (the vitamin E and C interaction, for example), so a combination is important," Witte explained.
He and his and colleagues investigated the effects of long-term multiple micronutrient supplementation in 32 patients older than age 70 years with stable heart failure.
After an average of 295 days, the patients who had been assigned to get micronutrient supplements experienced significant improvements in cardiac pumping ability, the team reports in the European Heart Journal.
Also, patients taking micronutrients had an increase in their quality-of-life score, whereas the participants who had been given placebo supplements had a decrease in their quality-of-life score.
The differences in overall quality-of-life score were mainly due to improvements in scores for breathlessness on exertion, quality of sleep, and daytime concentration among the patients taking micronutrients.
"At present there are few supplements that include the constituents we used," Witte said. "I would generally recommend a combined multivitamin supplement along with zinc, copper, and selenium. I also feel strongly that a high dose Coenzyme-Q10 is important. Most currently available supplements do not have enough Co-Q10."
SOURCE: European Heart Journal, November 2005.
Sunday, December 18, 2005
Top Ten List: Ten Reasons Why CHF is Not the Worst Thing That Could Happen
10. No chemotherapy, radiation, dialysis, or daily injections.
9. You get to use handicapped parking spaces at the mall.
8. Perfect excuse for getting out of parties you'd rather not go to in the first place.
7. Lots of chances to lecture people endlessly when they say "you don't LOOK disabled"
6. ICD support groups serve free dinner at quarterly meetings.
5. Get to take part in medical studies and maybe even get paid for them.
4. Take naps in mid-afternoon even if you're under 65.
3. Improve your on-line research skills hunting for low-sodium products.
2. Takes your mind off worrying about getting Alzheimer's when you get old.
And the number one reason why CHF INTWTTCH:
1. Cardiologists' waiting rooms have such great magazines!
10. No chemotherapy, radiation, dialysis, or daily injections.
9. You get to use handicapped parking spaces at the mall.
8. Perfect excuse for getting out of parties you'd rather not go to in the first place.
7. Lots of chances to lecture people endlessly when they say "you don't LOOK disabled"
6. ICD support groups serve free dinner at quarterly meetings.
5. Get to take part in medical studies and maybe even get paid for them.
4. Take naps in mid-afternoon even if you're under 65.
3. Improve your on-line research skills hunting for low-sodium products.
2. Takes your mind off worrying about getting Alzheimer's when you get old.
And the number one reason why CHF INTWTTCH:
1. Cardiologists' waiting rooms have such great magazines!
Thursday, December 01, 2005
It's the beginning of the holiday season!That means, for many people, FOOD.
And all those parties. Snacks and alcohol - what do we do about them?
First off, if you want to be sure there's something at a party that you can eat, bring something yourself; a bowl of my fruit salad with ginger dressing will work nicely. I can't seem to find the old post from a couple of years ago where I put this, so I'll re-print it below.
Eggnog is pretty much off limits. High in fat, higher in sodium than you'd think for a sweet beverage, and often has alcohol in it. A little alcohol will not hurt you, but eggnog can pack a surprising amount in it, with all the sugar disguising the alcohol content. So just say no to eggnog. You'll see "lite" varieties in the supermarket; these are lower in fat and cholesterol, but not any lower in sodium, and they tend to taste like vaguely rum-flavored thin milkshakes - worse, if they have artificial sweeteners in them. So they're not worth bothering with.
If you want to have a festive beverage that's very holidayish, consider mulled apple cider - there are thousands of recipes out there on the web. One way to make the making of mulled cider easier: instead of using cheesecloth balls to hold the spices (who even owns cheesecloth any more? How many of us would know where to find any if we wanted some? [The answer to that is: fabric stores.]}, use wire mesh tea balls. A large tea ball will hold the spices and brown sugar and allow the brown sugar to dissolve out into the cider just as cheesecloth would. And it's then washable and re-usable for your pot of tea.
Other beverages include sparkling cider - Martinelli's makes a non-alcoholic sparkling apple cider, as well as apple-cranberry and a couple other varieties. A chilled bottle or two of this with a festive bow is as welcome a hostess gift as wine, and drinkable by all. I served sparkling cider with Thanksgiving dinner, and everyone enjoyed it; we never even got around to opening the wine.
And then there's tea. Chai tea is a rich, spicy tea. It can be served sweetened or un; with milk or without. And there's decaf versions, if you are supposed to limit your caffeine intake. I also served chai at Thanksgiving - I made a huge pot of decaf chai, we sweetened it with Splenda, and drank it with dessert and afterward. One of my sisters-in-law is pregnant, so she really appreciated the non-alcoholic options. You can find decaf chais in various supermarket brands, such as Celestial Seasonings, or some good whole-leaf chais from on-line vendors, such as Plymouth Tea.
Finally, alcohol itself: a teeny tiny bit will not hurt most of us. I take 9 pills a day, including 5 that say on the label not to drink any alcohol. I have discovered, though, that I can handle 1/4 of a serving of alcohol without any ill effects. So I can allow myself a couple of gulps of beer or hard cider, or the bottom of a wine glass of white wine or champagne, or a bottle-cap-ful of Bailey's or other liquer poured over ice cream or into hot cocoa. I don't do it that often, but I can do it. Check with your doctor, and see if he or she goes into screaming fits at the idea, or instead says "yeah, you can have a sip of that as long as you don't drink a whole glass." Once you have that permission, though, don't overdo it!!
Festive Fruit Salad
suitable for bringing to parties or serving to company
1 banana
1 box of strawberries (more is OK- if you want to get a quart box instead of a pint box, that's fine)
1 large (quart) container of cubes of melon - most supermarkets have these, cubed honeydew and cantaloupe, sometimes watermelon too
1 can mandarin orange slices in juice
1 can pineapple chunks in juice
2 kiwi fruits (melon and kiwi are even higher in potassium than bananas!!)
several pieces of candied ginger
Use a bowl with a liquid-tight lid, such as Tupperware, to make this salad in.
1. Open the 2 cans and drain the juices into a separate bowl. Put the fruit in the bowl you're making the salad in.
2. Dice up the candied ginger into teeny pieces. Put it in the juices to steep. You can add a little bit of sugar to this if you want, but not too much!
3. Chop the banana into bite-sized chunks. Halve the strawberries. Cut the melon cubes, which are usually pretty large, into bite-size chunks. Put them in the salad bowl, and toss a couple of teaspoons of the fruit juice with them to keep everything fresh - the vitamin C (ascorbic acid) in the juice will do that.
4. Peel one kiwi, slice it in half, and then slice into thin slices to toss with the rest of the fruit. (You'll use the other kiwi at the end.)
5. Pour the rest of the fruit juice/ginger mix over the tossed fruit, and stir thoroughly. Cover, stick in the refrigerator, and let sit for at least 2 hours, and preferably more. At least once, more often if you think about it, tip the bowl around to stir up the ginger-juice so the fruit at the top gets to marinate in it.
6. Just before serving or setting off to the party, peel the other kiwi fruit and cut into thin circles. Toss the salad one last time, then place these kiwi circles decoratively on top - arrange them in a pattern, or cut snowflake shapes out of them first, or something decorative. Cover the bowl again until the minute you're ready to serve it or to put it on the buffet table at the party you're attending.
And all those parties. Snacks and alcohol - what do we do about them?
First off, if you want to be sure there's something at a party that you can eat, bring something yourself; a bowl of my fruit salad with ginger dressing will work nicely. I can't seem to find the old post from a couple of years ago where I put this, so I'll re-print it below.
Eggnog is pretty much off limits. High in fat, higher in sodium than you'd think for a sweet beverage, and often has alcohol in it. A little alcohol will not hurt you, but eggnog can pack a surprising amount in it, with all the sugar disguising the alcohol content. So just say no to eggnog. You'll see "lite" varieties in the supermarket; these are lower in fat and cholesterol, but not any lower in sodium, and they tend to taste like vaguely rum-flavored thin milkshakes - worse, if they have artificial sweeteners in them. So they're not worth bothering with.
If you want to have a festive beverage that's very holidayish, consider mulled apple cider - there are thousands of recipes out there on the web. One way to make the making of mulled cider easier: instead of using cheesecloth balls to hold the spices (who even owns cheesecloth any more? How many of us would know where to find any if we wanted some? [The answer to that is: fabric stores.]}, use wire mesh tea balls. A large tea ball will hold the spices and brown sugar and allow the brown sugar to dissolve out into the cider just as cheesecloth would. And it's then washable and re-usable for your pot of tea.
Other beverages include sparkling cider - Martinelli's makes a non-alcoholic sparkling apple cider, as well as apple-cranberry and a couple other varieties. A chilled bottle or two of this with a festive bow is as welcome a hostess gift as wine, and drinkable by all. I served sparkling cider with Thanksgiving dinner, and everyone enjoyed it; we never even got around to opening the wine.
And then there's tea. Chai tea is a rich, spicy tea. It can be served sweetened or un; with milk or without. And there's decaf versions, if you are supposed to limit your caffeine intake. I also served chai at Thanksgiving - I made a huge pot of decaf chai, we sweetened it with Splenda, and drank it with dessert and afterward. One of my sisters-in-law is pregnant, so she really appreciated the non-alcoholic options. You can find decaf chais in various supermarket brands, such as Celestial Seasonings, or some good whole-leaf chais from on-line vendors, such as Plymouth Tea.
Finally, alcohol itself: a teeny tiny bit will not hurt most of us. I take 9 pills a day, including 5 that say on the label not to drink any alcohol. I have discovered, though, that I can handle 1/4 of a serving of alcohol without any ill effects. So I can allow myself a couple of gulps of beer or hard cider, or the bottom of a wine glass of white wine or champagne, or a bottle-cap-ful of Bailey's or other liquer poured over ice cream or into hot cocoa. I don't do it that often, but I can do it. Check with your doctor, and see if he or she goes into screaming fits at the idea, or instead says "yeah, you can have a sip of that as long as you don't drink a whole glass." Once you have that permission, though, don't overdo it!!
Festive Fruit Salad
suitable for bringing to parties or serving to company
1 banana
1 box of strawberries (more is OK- if you want to get a quart box instead of a pint box, that's fine)
1 large (quart) container of cubes of melon - most supermarkets have these, cubed honeydew and cantaloupe, sometimes watermelon too
1 can mandarin orange slices in juice
1 can pineapple chunks in juice
2 kiwi fruits (melon and kiwi are even higher in potassium than bananas!!)
several pieces of candied ginger
Use a bowl with a liquid-tight lid, such as Tupperware, to make this salad in.
1. Open the 2 cans and drain the juices into a separate bowl. Put the fruit in the bowl you're making the salad in.
2. Dice up the candied ginger into teeny pieces. Put it in the juices to steep. You can add a little bit of sugar to this if you want, but not too much!
3. Chop the banana into bite-sized chunks. Halve the strawberries. Cut the melon cubes, which are usually pretty large, into bite-size chunks. Put them in the salad bowl, and toss a couple of teaspoons of the fruit juice with them to keep everything fresh - the vitamin C (ascorbic acid) in the juice will do that.
4. Peel one kiwi, slice it in half, and then slice into thin slices to toss with the rest of the fruit. (You'll use the other kiwi at the end.)
5. Pour the rest of the fruit juice/ginger mix over the tossed fruit, and stir thoroughly. Cover, stick in the refrigerator, and let sit for at least 2 hours, and preferably more. At least once, more often if you think about it, tip the bowl around to stir up the ginger-juice so the fruit at the top gets to marinate in it.
6. Just before serving or setting off to the party, peel the other kiwi fruit and cut into thin circles. Toss the salad one last time, then place these kiwi circles decoratively on top - arrange them in a pattern, or cut snowflake shapes out of them first, or something decorative. Cover the bowl again until the minute you're ready to serve it or to put it on the buffet table at the party you're attending.
