The cook book

Tuck into these healthy and speedy meals

Serves 2

Salmon poke bowl

Ingredients

● 150g sushi (sticky) or jasmine rice, rinsed under cold water in a sieve until the water runs clear

● 1 tbsp rice/rice wine vinegar

● 75g frozen edamame beans

● 150g sushi-grade salmon fillet, skinned and cut into 1.5cm cubes (must have been frozen)

● 1 small carrot, peeled and shredded or grated

● Pickled cucumber or pickled red cabbage

● 1 ripe avocado, halved, stoned and thinly sliced within its skin

● 2 spring onions, trimmed and thinly sliced diagonally

● Mixed black and white sesame seeds, toasted

For the marinade

● 1 tbsp dark soy sauce

● ½ tbsp rice/rice wine vinegar

● ½ tbsp toasted sesame oil

● small pinch of dried chilli flakes

For the sauce

● 2 tbs thick mayonnaise

● ½ tsp dark soy sauce

● ¼ tsp sesame oil sriracha sauce, to taste

Method

1 Put the rice into a small pan with 180ml of cold water, put the lid on and bring to the boil. Lower the heat, simmer gently for 13 minutes. Remove from heat, leave to steam for 10 minutes with the lid on.

Remove the lid and stir in the rice/rice wine vinegar. Divide between two bowls.

2 Meanwhile, cook the edamame beans in a separate small pan of boiling well-salted water for 3 minutes, then drain and cool.

3 Mix the marinade ingredients together in a small mixing bowl and stir in the salmon. Set aside. Mix the sauce ingredients together in a separate small bowl and set aside.

4 Arrange the carrot, edamame beans and pickled cucumber (or other pickles), with a little of its juice, in groups over the rice around the edge of the bowls. Then add the salmon, with its marinade, in the same way. Remove the avocado halves from their skin with a large spoon, fan out the slices and arrange on the rice.

5 Drizzle the sauce in lines over the top of the bowls, or spoon it into the bowls. Scatter with the spring onions and some toasted sesame seeds. Serve.

Serves 4

Tomato and coconut dhal

Ingredients

● 250g dried red split lentils

● 1 onion, thinly sliced

● 1 tsp ground turmeric

● 1½ tsp medium curry powder

● ¼ tsp ground cinnamon

● tsp medium chilli powder

● a small handful of dried curry leaves, roughly crushed

● 1 x 28g vegetable stock pot or 1 vegetable stock cube

● 1 x 400g tin coconut milk

● 400g tomatoes, half of one reserved for garnish, the remainder chunkily chopped

● salt and freshly ground black pepper

To serve (optional)

● soft-boiled eggs (lowered into boiling water for 6½ minutes, then into cold water and peeled when just cool enough to handle)

● nigella or onion seeds

● roughly chopped coriander

● natural yoghurt (dairy-free, such as coconut yoghurt, for a vegan dhal)

Method

1 Put all the dhal ingredients, except the tomatoes and salt and pepper, into a large pan. Fill the empty coconut milk tin with water and add that, then bring the mixture to the boil, stirring from time to time. Simmer on a low heat, stirring occasionally, for 10 minutes.

2 Add the tomatoes and simmer gently for a further 15 minutes, stirring occasionally. If necessary, thin with a little more water to your preferred consistency (bearing in mind the dhal will thicken up if not eating it immediately). Season with salt and pepper.

The recipe can be completed to the end of step 2 up to 3 days in advance, then cooled, covered and chilled, or it can be frozen (defrost before reheating). For both options, reheat gently in a pan until hot and bubbling.

3 Divide the dhal between four bowls, thinly slice the reserved tomato and arrange on top with any, or all, of the serving suggestions (if using), and serve

Serves 4

Pearl Barley

Ratatouille ‘Risotto’

Ingredients

● good glug of olive oil, plus extra to serve

● 1 onion, finely chopped

● 1 medium aubergine, sliced lengthways and cut into roughly 1cm dice

● salt and freshly ground black pepper

● 2 garlic cloves, crushed

● ½ tsp dried oregano

● 1 red pepper, halved, de-seeded and cut into roughly 1cm dice

● 150g pearl barley

● 1 x 400g tin chopped or plum tomatoes

● 400ml vegetable stock

● 1 medium courgette, cut into roughly 1cm dice

● 12 pitted black olives, halved

● 4 knobs of butter

To serve (optional)

● Basil leaves

● a small bowl of grated Italian-style hard cheese

Method

1 Heat the olive oil in a lidded sauté pan (around 24 x 6cm), add the onion, aubergine and some seasoning and cook on a low heat for 10 minutes, stirring occasionally, until softened. Add a little more olive oil if necessary as they cook, but the aubergine will soak up as much as you give it, so don’t be tempted to add too much. Add the garlic, oregano, red pepper and pearl barley and stir over the heat for a minute or two.

2 Add the tomatoes and stock, or, if using a cube, fill the empty tomato tin with water, add it to the pan and crumble over the stock cube. Bring to the boil, while stirring, then add generous seasoning. Cover and simmer very gently for 30 minutes, giving it the odd stir and adding a little more water if all the liquid has been absorbed.

Step 1 can be completed up to a day in advance. Cool, cover and chill. Reheat gently in the pan until hot throughout, then continue the recipe.

3 Stir in the courgette and black olives, bring back to a simmer, and simmer, uncovered, for a further 10 minutes, until the barley is plumped and tender but still chewy and the courgette retains a little bite. You may need to loosen the mixture with a little water – it should be just on the sloppy side, rather than dry or runny. Check the seasoning.

4 Serve in bowls with a knob of butter nestled into the middle of each serving, a scattering of basil leaves (if using) and an extra swirl of olive oil. Hand around the cheese separately (if using).

Extracted from Deliciously

Simple by Jane Lovett (Headline Home, £26)

QI have an overactive bladder for which treatment using the drug Oxybutynin and general bladder training therapies have had limited success. My MS nurse has suggested percutaneous posterior tibial nerve stimulation (PTNS) could be a possible solution. Can you tell me more about this treatment, its safety and effectiveness?

APTNS is a therapy that is relatively new to the NHS and is used to counteract the symptoms of an overactive bladder. The procedure involves inserting a needle close to a nerve which is situated just above the ankle, with an electrode being placed on the foot. Once these are in place a mild electric current is passed through the needle and is then directed to the nerves that are responsible for controlling bladder function. These nerves are situated in the lower back. This treatment is administered via 12 outpatient sessions, once per week, with each session lasting approximately 30 minutes.

The National Institute for Clinical Excellence’s (NICE) patient guide for PTNS confirms that is a reasonably safe and effective way to treat an overactive bladder, particularly if first line treatments such as medication, bladder training and pelvic muscle training have not had the desired effect. Moreover, studies have shown that PTNS treatment is effective in treating people with MS who are affected by overactive bladder issues.

Given that this treatment is relatively new, more evidence is being gathered regarding its effectiveness in the long-term. It may follow that one day, PTNS treatment becomes part of the first line solutions offered to counter bladder symptoms. What we do know so far is that for many, it has provided a welcome relief from the discomfort that accompanies an overactive bladder.

To find out more about the PTNS procedure, including evidence of its efficacy and safety, go to the NICE website – nice.org.uk/guidance/ipg362

QMy condition has affected my speech and ability to communicate confidently. I’m OK with my family and people that I know well, but communicating with others can be challenging at times and it’s started to make me anxious. Sometimes I type things out on my tablet or phone for people, but it takes so long! Is there any help I can get or anything that you can suggest?

ASome people with advanced multiple sclerosis (MS) may find that their speech becomes difficult, and you may need to find new and creative ways to communicate with confidence. This may be to either clarify what you’re saying, or as a whole alternative to speech. Finding the most suitable communication support depends on your overall situation and solutions really need to be tailored to you. When it comes to communicating, it is not just down to how speech is affected, but there may be other issues involved too. Cognition, memory, reading and visual symptoms should also be taken into account.

There is support with a number of communication aids available. This can range from simple but effective communication boards (with symbols and words) through to more technologically advanced voice output communication aids.

When getting support from professionals, this would be managed by a multi-disciplinary approach, meaning that professional from a range of backgrounds can help. It would be a good idea to contact your MS nurse. The MS nurse and their neuro-rehabilitation colleagues (speech and language therapists and occupational therapists) are normally involved in assessing and supporting you.

You may also want to connect with the Ace Centre. This is a charity providing support with assistive technology and augmentative and alternative communication services for people with complex communication needs. They offer assessment, training and information services. They have a freephone helpline and a range of online information as well as provide services from their regional offices. Visit www.acecentre.org.uk/contact

You can also get in touch by emailing info@ms-uk.org or visiting ms-uk.org/helpline