Fresh Recipe: Warm Spinach and Artichoke Dip

Tuesday, November 25, 2014 3:41 PM comments (0)

thanksgivingDon’t let your Thanksgiving favorites leave you feeling guilty the next day. Start things off right with veggie-packed appetizers that are sure to please even holiday food traditionalists. 

Katrina Herrejon, Registered Dietitian and Certified Diabetes Educator, Adult Endocrinology Group, shares one of her favorite Thanksgiving starters:  

Recipe makes 6 servings
Serving size 2/3 cup

Ingredients: 
2 cans artichoke hearts, rinsed and drained (16 oz.)
1/2 cup reduced fat mayonnaise (4 oz.)
2/3 cup cooked spinach or frozen spinach that has been thawed (4 oz.)
2/3 cup white extra sharp cheddar cheese, shredded (3 oz.)

Instructions:

  • Preheat oven to 350 degrees.  
  • Place 1/2 of the artichoke hearts and the mayonnaise in a food processor and blend until smooth.
  • Chop the remaining artichoke hearts and the spinach into small pieces.
  • Fold the chopped spinach and artichoke hearts into the pureed artichoke and mayonnaise mixture.
  • Mix 1/2 of the shredded cheese into the dip.
  • Transfer dip into an oven safe 9-inch glass pie plate.
  • Sprinkle the top of the dip with the remaining cheese.
  • Bake for approximately 20 minutes or until the top of the dip is golden brown.
  • Serve dip warm with high fiber crackers and/or raw vegetables.

Nutrition Information (per 2/3c serving):

Calories: 149
Total Fat: 10
Total Carbohydrate: 8
Fiber: 2
Protein: 6

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Simple Tips to Avoid Overindulging on Thanksgiving Day

Monday, November 24, 2014 1:18 PM comments (0)

thanksgivingCounting calories isn’t at the top of many to-do lists on Thanksgiving Day, and it still doesn’t have to be. With a little planning and a few substitutions, your Thanksgiving can be a little healthier and every bit as delicious. 

Katrina Herrejon, Registered Dietitian and Certified Diabetes Educator at NorthShore, breaks down this decadent day, sharing health tips for before and during the big meal:

Before the Dinner

  • Create a calorie deficit. Add an extra 20-30 minutes to your weekly exercise routine before and after the big day. That’s enough to create a calorie deficit and give you a little leeway at the dinner table. 
  • Eat breakfast! While you may think you should try to save up calories for the big meal, eating breakfast will save you from snacking beforehand and gorging come mealtime.
  • Prioritize. What would you regret not eating on Thanksgiving? What can you do without? The day is filled with rich, delicious foods, but you don’t have to eat them all. Determine what dishes are most important to you and then pass on the rest. 
  • Avoid snacking beforehand. Crackers, nuts and cheese spreads are unnecessary calories compared to the Thanksgiving classics you’ll be served during your meal.

When Cooking

  • Cut back on butter. A little butter goes a long way, and it’s also not the only way to boost flavors. Citrus fruits, like lemon, lime and orange, can add a burst of flavor to gravies and veggies with a fraction of the calories. 
  • Replace cream with milk. In the same vein, avoid using cream if you don’t have to. For creamed onions or mashed potatoes, use low-fat milk. The calories saved will far outweigh the subtle change in flavor.
  • Sweet potatoes are sweet enough. The natural sweetness of sweet potatoes is more than enough to sustain a yam-based dish. Bake them instead of mashing with butter, sugar and cream. 
  • Start from scratch. Making stuffing from scratch is much healthier than prepackaged stuffing mix because it cuts back on sodium and additives. It also means you have control over what goes in, including cutting back on butter and oil as well as swapping wheat bread for white to up fiber content.
  • Keep sampling to a minimum. It can be tempting to keep taste-testing your food, but try to avoid consuming those extra calories before the meal itself.

At the Table

  • Serve up a colorful plate. Vegetables add the color, so try to craft a plate that is packed with veggies, approximately half the plate and then divide the rest evenly between turkey and stuffing or rolls. 
  • Downsize dinnerware. Studies show that people serve themselves portions on scale with the size of the plate they’re given. In other words, smaller plates mean small portions. 
  • Slow down. It can take around 20 minutes for your brain to recognize that your body is full. Before you serve up seconds, take a breather and drink a little water to make sure your body isn’t confusing thirst for hunger. Or, have a basic salad on hand—dark lettuce leaves and a light dressing—and eat that to see if your hunger holds out. 
  • Less can look like more. If it’s too difficult to stick to ‘just a sliver’ of all your favorite pies, ditch the standard 9-inch diameter pie pan for something smaller. The piece will look big but be significantly smaller.

What do you do to keep holiday eating in check? 

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Safety Check: Do You Have a Carbon Monoxide Detector?

Friday, November 21, 2014 12:23 PM comments (0)

Carbon-Monoxide

We’re all busy and keeping tabs on the safety of our homes often falls by the wayside when calendars fill up quickly with day-to-day activities like getting the kids to school on time and shuttling them back and forth to practices and events. But, it’s incredibly important to make time to ensure the safety of your home.

Some household risks are easy to spot but there are some you can’t see at all. Carbon monoxide is very dangerous and because the gas is odorless and colorless, it's hard to detect without proper monitoring. Now that frigid temperatures have settled in for the winter and furnaces are working overtime, it’s even more important to make sure your family is well-protected from carbon monoxide poisoning.  

Jerrold Leikin, MD, Medical Toxicologist, shares five household safety requirements:

  • Get a UL-approved carbon monoxide detector. First and foremost, if you don’t already have a carbon monoxide monitor installed in your home, do so immediately. If you do have one, be sure to check and change the batteries frequently. You should also plan to test it on a regular basis.
  • Install your detector properly. Detectors should be placed away from windows and drafty areas. Outside air can offset readings and reduce effectiveness. You should also avoid installing a detector in your bathroom, over your oven range or any another high-humidity area.
  • Place all detectors within several feet of sleeping areas. It is recommended to have a detector on every level of your home. A basement detector should be installed at the top of the stairs.
  • Get your furnace and other gas appliances checked out annually. Having an expert evaluate your appliances can help identify leaks and other health hazards. Make sure you’re using appliances correctly; outdoor grills should never be used inside your home.
  • Know the symptoms and act fast if you suspect you may have poisoning. Some of these symptoms include dizziness, headache, nausea and confusion. Symptoms may not always be present and/or may not be distinguishable. If several members of the household notice similar symptoms, seek medical attention immediately.

Do you have a carbon monoxide detector in your home? How frequently do you check it?

 

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Q&A: Dr. Alexandru Barboi Discusses NorthShore’s New Diagnostic Powerhouse

Friday, November 14, 2014 4:48 PM comments (0)

Dr BarboiThe NorthShore Neurological Institute recently opened a new autonomics laboratory with the assistance of Mayo Clinic experts. This emerging area of medicine identifies a rare nervous system disorder that can greatly impact the daily lives of patients. The lab comines the latest technology and a multidisciplinary team to offer patients comprehensive care for complex autonomics disorders.

Alexandru Barboi, MD, Director of the Neuromuscular and Peripheral Neurophysiology Program, answered questions on autonomic disorders and the new laboratory in Connections and continues his Q&A here:

What is the autonomic nervous system?
The autonomic nervous system controls subconscious and visceral functions, such as heart rate, digestion, respiratory rate, salivation, perspiration, swallowing and more. 

What are some common symptoms of autonomic disorders?
Patients may have difficultly standing for longer periods of time, excessive dizziness, lightheadedness, exercise intolerance, gastrointestinal symptoms, bladder and sexual dysfunction and chronic pain. Because symptoms can occur in so many different regions of the body, autonomic disorders are often very challenging to diagnose. 

What does NorthShore’s autonomics lab offer?
Our lab provides state-of-the-art, noninvasive diagnostic testing. It’s one of the most comprehensive in the region. In addition to having sophisticated technology, the lab is staffed with specially trained technicians and a team of experts working together to diagnose and develop individualized treatment plans for adults and children ages seven and older.

Who is generally affected by autonomic disorders? Does it happen more often at a certain age or to someone with an already existing disorder?
Any age group can be affected. Both sexes, but it seems that women are more frequently affected early in life. It can happen in someone who is perfectly healthy but also in people that have an underlying medical condition like diabetes mellitus or Parkinson’s disease.

Do autonomic disorders get worse over time? Is there a range, mild to severe?
Yes they can get worse over time, ranging from mild to severe. They can be completely disabling.

At what point should a patient consider the possibility they might have an autonomic disorder? When should they consider testing?
Any combination of thermoregulation, sweating, cardiac, gut, bladder, sexual dysfunction and chronic neuropathic pain should be considered for an autonomic disorder. Testing always helps define the diagnosis, aids in planning treatment and establishes severity.

What causes an autonomic disorder?
Generally it can be caused by inherited or acquired disorders. The latter can be metabolic, inflammatory, traumatic, autoimmune and degenerative.

What sparked your interest in such a unique field?
My background in internal medicine and neurology and the interplay between both fields. 

What do you find most challenging about your work?
The most challenging part is understanding how an autonomic disorder affects each individual and also understanding how this disorder affects their emotional health too. It’s about harnessing the whole person to actively manage their condition.

What do you find most rewarding?
Definitely seeing patients improve, when they experience a return to having the “best day in my life that I can possibly have.”  As a doctor, when you see that moment in a patient, you never, never give up.

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Breaking Down the Carbohydrate: Good Carbs, Bad Carbs and Everything in Between [Infographic]

Wednesday, November 12, 2014 10:55 AM comments (0)

Don't just cut carbs! They are the primary source of energy for the human body, which means you can't do without them! When it comes to healthy diet that includes carbs, it's important to think in terms of quality over quantity.

The experts at NorthShore University HealthSystem break down the carbohydrate--the good, the bad and the necessary--in our latest infographic. Click on the image below to view our full infographic on the importance of the carbohydrate in your diet.

carb infographic

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Sick Days: What Are Hand, Foot and Mouth Disease and Herpangina?

Tuesday, November 11, 2014 12:56 PM comments (0)

hand foot and mouthHand, foot and mouth disease (HFMD) is a typically mild but highly contagious viral infection most common in children under seven years of age. The illness is characterized by mouth or throat pain (due to sores), fever and a rash (typically involving the hands, feet, buttocks, arms and legs). The infection is caused by enteroviruses—most often coxsackie virus A16—which are transmitted from person-to-person by oral contact with stool, saliva, fluid from skin lesions or respiratory fluids via coughs or sneezes. Herpangina, also caused by enteroviruses, is a cluster of symptoms characterized by fever and mouth lesions (but no rash).  These illnesses are particularly common in child-care settings because of the frequency of contact and germ sharing between children and inadequate handwashing—especially after diaper changes or toilet use. The viruses can also be transmitted by contact with contaminated surfaces or objects, like toys.

Outbreaks occur most often in summer and fall but can happen anytime, especially if your child is in daycare. Kenneth Fox, MD, Pediatrician at NorthShore, shares symptoms parents should watch for and outlines ways you can make your child more comfortable while the virus runs its course: 

Symptoms of Hand, Foot and Mouth Disease:

  • Small, painful sores in the throat or mouth, including cheeks, tongue and gums 
  • These lesions cause pain and difficulty swallowing
  • Small blisters or red spots classically located on hands, soles of the feet and between fingers and toes 
  • Fever
  • Decreased energy and appetite
  • Diarrhea and vomiting
  • Respiratory symptoms like congestion, cough and “pink eye” (conjunctivitis)

Symptoms of Herpangina:

  • Fever
  • Painful red sores in mouth/throat (as above)
  • Vomiting
  • Abdominal pain
  • Headache

Fever and mouth/throat pain usually last three to five days. Other symptoms, like mouth sores and rash (with HFMD) can last up to seven to ten days. The virus is shed orally for one to three weeks and in stool for two to three months after infection. While there are no cures for HFMD or herpangina, there are things you can do to make your child more comfortable during those first few days, as well as reduce the risk for dehydration which can occur because of pain and difficulty swallowing. 

What can parents do?

Keep little ones hydrated. Try Pedialyte or Gatorade to keep their electrolytes up. Also popsicles, ice chips and other frozen treats can replenish fluids while also helping with pain. 

Reduce pain or fever. Use Acetaminophen or Ibuprofen but check age-appropriate dosages before administering. 

Make swallowing easier. Eliminate salty, spicy or acidic foods to avoid further irritating mouth sores. Consider providing a variety of soft foods, like yogurt, pudding and rice. And always rinse mouth after meals. 

While it is not always possible to prevent your child from contracting hand, foot and mouth disease, you can reduce his or her risk, and your own. Here are some ways to keep your kids healthy and prevent the spread of HFMD in your home:

  • Wash hands with soap and water for 15-30 seconds and dry with disposable towel after using the toilet, changing diapers; after touching another child, the floor or contaminated surfaces; before eating meals or snacks; after coming in from outdoor play; after sneezing, coughing or wiping nose or eyes 
  • Clean and disinfect contaminated surfaces and toys more than once a day
  • Avoid or prevent close contact like kissing, hugging, sharing utensils or cups 

If your child does get hand, foot and mouth disease, watch for these signs of complications:

  • Dehydration (dry mouth, pale skin and nails, no tears or urine, lethargy)
  • Breathing difficulty
  • Chest pain
  • Stiff neck
  • Mental status changes (inconsolable crying, confusion, poor balance, difficulty walking)

Have questions about hand, foot and mouth disease or any other pediatric illness? NorthShore's new online community, The Parent 'Hood, has answers. Join today to connect with other parents in the community as well as our expert physicans.  Click here to start now

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Recognizing the Signs of Domestic Violence

Friday, November 07, 2014 3:32 PM comments (0)

stop domestic violenceDomestic abuse is a pattern of violent behavior used to control a partner—spouse, boyfriend, girlfriend—and it can happen to anyone at any age and at any point in the relationship.

For many men and women who experience abuse at the hands of a partner, leaving isn’t easy.  Domestic abuse is a form of control and it can be extremely difficult for a victim to break free. There are many reasons why a victim might stay in an abusive relationship, from a fear of heightened violence to a belief that they, the victim, are to blame. 

Often support and encouragement from a friend may help the victim find the strength to seek help.  Do you think you might have a loved one, friend or coworker who might be suffering abuse at the hands of a partner?  The Domestic Violence Committee at NorthShore shares the signs of abuse you shouldn’t ignore: 

  • Withdrawing from friends and family or having few close friends.
  • Having to seek permission for meetings with friends or events with other people.
  • Limited access to money or resources.
  • Symptoms of depression or even suicidal thoughts.
  • Low self-esteem or appearing extremely apologetic. 
  • Bruises and injuries that look like they were not the result of an accident, particularly bruises or discolorations around the neck or wrists. Attempts to hide bruises with makeup or clothing.  

There is help available for victims of domestic violence. If you believe someone you know might be suffering in silence, help them find the information they need. Click on the sites listed to be directed to their pages: 

Apna Ghar is a Chicago-area agency for immigrants from East India. 

A Safe Place is a Lake County-area agency that offers counseling/shelter. 

Evanston YWCA offers counseling/shelter.

Between Friends is a Chicago-area agency.  

Lifespan is a Chicago and Des Plaines-area agency.

Shalva is a Chicago-area agency for Jewish families. 

IL Coalition Against Domestic Violence offers resources statewide. 

 

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The Harmful Effects of Smoking and the Health Benefits of Quitting [Infographic]

Wednesday, November 05, 2014 3:52 PM comments (0)

Smoking is more than just a bad habit; it’s the leading cause of preventative death worldwide. Each year, close to 400,000 people in the U.S. will die from smoking-related diseases like lung cancer, heart disease and stroke. 

As part of National Lung Cancer Awareness Month and the American Cancer Society’s Great American Smokeout, NorthShore University HealthSystem has created an infographic that explores the harmful effects of smoking and the big health benefits of quitting. Make today the day you break a deadly habit and begin to look forward to many healthier years ahead. 

Click on the image below to be directed to the full infographic

smoking infographic

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Prostate Cancer: Knowing Your Risks and Options

Monday, November 03, 2014 11:14 AM comments (0)

prostate cancerProstate cancer is the second leading cause of cancer death in men. If detected and treated early, prostate cancer survival rates are high and associated with good functional outcomes. Brian Helfand, MD, PhD, Urologist at Northshore, answers questions about prostate cancer risk, PSA values, early signs and symptoms, recommended screening, as well as current treatment options for prostate cancer and recovery after treatment.  

What is a normal PSA?
I always tell my patients that you should compare your PSA to what is "normal" for your age group. Most men age 50 and younger have a PSA below 0.7ng/ml. For simplicity, you could use a cutoff of 1.0ng/ml. It’s important to point out that having a PSA value that is above your age group does not mean that you have prostate cancer. It does, however, mean that you are statistically at a slightly increased risk for being diagnosed with the disease. For that reason, you should continue to be screened with PSA on an annual basis at least. 

There are other factors that should go into the interpretation of PSA before deciding to perform a prostate biopsy and these include: PSA values that have been rising over time, family history of prostate cancer, African-American heritage and history of benign prostatic hyperplasia (BPH). Remember, PSA is not a perfect test but it has saved many lives and it’s still the best test for prostate cancer screening.

Guidelines for median PSA levels by age:

  • Age 40 to 49: 0.7 ng/mL median PSA
  • Age 50 to 59: 0.9 ng/mL median PSA
  • Age 60 to 69: 1.3 ng/mL median PSA
  • Age 70 to 79: 1.7 ng/mL median PSA

If there is a family history of the disease, does that increase your risk? When should someone with a family history of the disease begin screening?
Prostate cancer is one of the most inheritable of all cancers. As such, risk factors that are most associated with prostate cancer are first-degree family history (father, brother, uncle, etc.) and race (i.e. African-Americans). Based on statistics, a man with a first-degree connection to the disease is almost two times more likely to be diagnosed with prostate cancer than a man without a family history. Although there is some debate regarding the routine use of PSA screening, I’m a firm believer that if there is a family history, one should start undergoing annual PSA screening by the age of 40.

After treatment, how often should a patient return to their physician for further tests and screenings?
After surgery, patients should have an initial post-operative PSA in about four to six weeks and then every three to four months (based upon their urologist's preference). After two years of having an undetectable PSA, I suggest my patients get PSAs every six months.

Are there preventative measures that could potentially reduce one’s risk for developing the disease? 
It’s possible that a heart-healthy diet low in fats and simple sugars may help reduce one’s risk of developing prostate cancer. There is emerging evidence that obesity is a driving factor for benign growth of the prostate (referred to as BPH or benign prostatic hyperplasia) and that it could also contribute to one’s risk for prostate cancer. Extra weight may also make it harder to detect the disease until it is advanced. Obesity also is thought to contribute to prostate cancer recurrence. That’s why it’s important for men to realize that a heart-healthy diet can help keep their prostates healthy too!

How likely is a patient’s sexual function to be affected after treatment? What surgical options result in the best possible outcome as far as recovering sex life?
I tell my patients that your post-operative sexual function is significantly related to your age and pre-operative function. In general, treatment for prostate cancer (radiation or surgery) has never improved a man's erectile function. However, if a man is young, not diabetic or obese and had good erectile function prior to surgery, he has a very good chance of having normal erections post-op.

I believe that good, nerve-sparing surgery significantly helps with the recovery of erectile function. This can be done by a urologic surgeon who is trained in the technique and frequently performs the operation. In addition, I believe that all men should start (at minimum) a rehabilitation program before and immediately after surgery that helps to recover nerve function. This could involve taking drugs like Cialis before and after surgery.

If you do suffer from sexual dysfunction after prostate cancer treatment, what can you do to aid/improve recovery?
Unfortunately, there is no universal solution for every man but there are many different options that are available for treatment of sexual dysfunction after surgery. Prostate cancer patients should have an assessment of psychological function and desire for sexual activity following surgery. Many men get nervous about intimacy following surgery and an evaluation by a trained professional can help relieve a lot of this anxiety.  

If there are erectile issues after treatment, many men respond to simple medical therapies like Viagra and Cialis. This is often a starting point. If you fail to respond to these therapies, other interventions such as a vacuum erection device or injection therapies can be used to obtain an erection. As always, regular exercise and a heart-healthy diet help increases your chances of a successful recovery.

What are the differences between robotic laparoscopic surgery and conventional open prostatectomy in terms of recovery?
I think the answer is surgeon experience. There are many urologists who can perform open surgery with excellent outcomes (great cancer control, erectile function and continence). And there are many urologists who can perform robotic surgery with similar outcomes. It’s most important to be treated by an urologist who is comfortable and experienced with a radical prostatectomy. Having said that, robotic surgery has recently become the most commonly used surgical intervention for prostate cancer. When compared to open surgery, robotic surgery offers significantly less blood loss and a shorter hospital stay. Although not proven, it’s likely that the robotic surgery offers increased visualization of the area by the surgeon which provides an opportunity to spare more nerves and create a nice connection between the bladder and urethra. These are both associated with increased erectile function and increased continence.

What does active surveillance involve? Why would someone choose to do that instead of actively treat their cancer?
We have come to a "new era" of understanding prostate cancer and realized that many men have prostate tumors that may not harm them during their lifetime (benign-type prostate cancer). This is because many prostate tumors grow very slowly and other medical problems may ultimately harm a man before the prostate cancer spreads

Unfortunately, there is currently no diagnostic test that can tell whether one has a lethal prostate cancer or more benign-type tumor; therefore, we have developed a program of surveillance in which we avoid treating patients with prostate cancer until there is evidence that it has an aggressive component. This involves actively and regularly monitoring men through the use of PSA tests and prostate biopsies. While this does increase the number of times that a man is evaluated by an urologist, it avoids overtreatment, like unnecessary surgery or radiation that could cause erectile problems and/or incontinence. Currently, NorthShore University HealthSystem has the largest program in the Midwest.

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Fresh Recipe: Hearty Pumpkin Soup

Friday, October 31, 2014 9:00 AM comments (0)

pumpkin soupPumpkins aren’t just for decoration. They can and should be eaten too! Pumpkins are high in fiber and vitamin A, which can protect your vision, and full of flavor but still low in calories. So, when you head to the store or patch to grab one or two to meet your Halloween needs, don’t forget to snatch up one more for a healthy, tummy-warming fall recipe. 

Nothing says, "It's autumn!" quite like a warm, hearty bowl of soup. Katrina Herrejon, Registered Dietitian and Certified Diabetes Educator, Adult Endocrinology Group, shares her favorite recipe for pumpkin soup:

Recipe makes 4 servings
Serving size 1 cup

Ingredients:

  • 1 small pumpkin (pick a pumpkin that will yield 3 cups or 15 oz. of baked pumpkin “flesh”)*
  • 1 tablespoon canola oil
  • 1 large onion (9.4 oz.)
  • 1 medium red pepper (4.8 oz.)
  • 1 large carrot (4.8 oz.)
  • 4 cups vegetable broth (32 oz.)
  • 1/3 cup natural honey peanut butter
  • Salt and pepper to taste 
  • Roasted pumpkin seeds (optional)

Instructions:

  1. Preheat oven to 350 degrees.
  2. Remove the stem of the pumpkin, cut in half and remove the pulp and seeds.  
  3. Cut pumpkin into uniform pieces and bake for approximately 1 hour or until fork tender.
  4. When cool enough to handle, remove the skin from the pumpkin “flesh.” Set aside approximately 3 cups.
  5. Heat the oil in a large pot and cook the onion, pepper and carrot for about 5 minutes. 
  6. Add the pumpkin and broth to the pot and simmer for 5 more minutes.
  7. Puree the soup using an immersion blender.
  8. Add the peanut butter to the soup and stir until well incorporated.
  9. Add salt and pepper to taste.
  10. Garnish with roasted pumpkin seeds, if desired, and serve warm. 

*Store bought 100% pumpkin puree can be substituted if fresh pumpkin is unavailable.  If using pre-made pumpkin puree skip to step five on the instructions.

Nutrition Information (per serving): 
Calories: 266
Fat: 13g
Carbohydrate: 30g
Fiber: 7g
Protein: 7g

Do you have a healthy, yet delicious pumpkin recipe you traditionally make this time of year? 

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