The FDA Takes on the Compounded Hormone Industry

The FDA has finally taken on the compounding pharmacy industy for misleading and unsubstantiated claims made in marketing so-called “bioidentical” or natural hormone therapy.

In warning letters to seven such pharmacies, the FDA cited them for making unsubstantiated claims that their hormonal formulations are safer than FDA-approved formulations. They’ve also challenging the use of estriol, an estrogen formulation never approved for use by the FDA for hormone replacement.

Estriol is a form of estrogen found in the body, along with estrone and estradiol. Estriol is a weaker estrogen than estradiol, leading its proponents to claim it is safer than estradiol, the most commonly used bioidentical estrogen, and the one found in many FDA approved products such as patches, creams and pills. There is no data to prove that claim. Estriol binds to estrogen receptors, can stimulate both uterine lining and breast cancer cells, and if used in high enough doses, probably has the same risks as conventional estrogen replacement.

I am disappointed that the FDA stopped short of assuming regulatory power over these pharmacies and is not requiring them to include standard patient information and warnings for estrogens when these drugs are compounded.

What still upsets me is that it took a so-called “citizen’s petition” from Wyeth Pharmaceuticals to get the FDA to take action. Wyeth manufactures Prempro, the HRT formulation studies in the Women’s Health Intitiative, the study that put the nail in the coffin for HRT’s use for heart disease prevention.

I’ve said it before and I’ll say it again – Wyeth’s involvement in the battle allows the multi-billion dollar anti-aging industry to frame the battle as the little guy (them) against Big Pharma. This is not a battle for Wyeth – it is about informing women.

The seven companies targeted by the FDA are –

Panorama Compounding Pharmacy
Saint John’s Medical Plaza Pharmacy
Murray Avenue Apothecary
Village Compounding Pharmacy
Pharmacy Compounding Specialties
Reed’s Compounding Pharmacy
Pacifica Pharmacy

These pharmacies appear to be taking the warning seriously – When I checked their websites tonight, all but one was either offline or had taken down their information on hormone replacement.
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FDA information on compounded hormones

BRCA Mutations and Familial Breast Cancer Risks

A study published this week in JAMA examines the risk for breast cancer in the families of women with breast cancer.

The researchers studied 2000 women with breast cancer diagnosed before age 55. Of these, about 5% of the women with unilateral breast cancer were found to have either the BRCA 1 or BRCA 2 gene mutation, while 15% of women with bilateral breast cancers were gene mutation carriers.

Overall, 75% of women with breast cancer were the only person in their immediate family to have had the disease. Among BRCA mutation carriers, 58% were the only member of the immediate family with breast cancer.

The risk for breast cancer in family members varied widely, from 30-90%, and was highest in families of women with cancers at an early age and with bilateral breast cancers.

Significant weaknesses of this study, in my opinion, were that family history of second and third degree relatives was not assessed, cancers up to age 55 (and not the usual age 50 cut off) were considered, and data on family history of ovarian cancer was not included. Family members were not assessed for the prevalence of the gene mutation, and their histories were taken second hand from the breast cancer subjects. This, the penetrance of the BRCA gene in these families was only presumed, not measured.

What To Do with this Info

The take home messages for me from this study were these –

1. BRCA testing is still uncommon, even in women who have had breast cancer. The younger your age at diagnosis, the higher the odds you will have a BRCA mutation. I believe testing is worthwhile in women who have had pre-menopausal breast cancer. But even in this group, most will test negative.

2. If your Mom or sister had breast cancer under age 55, odds are still that it was not a BRCA-related cancer. The more family members and the younger the age, the higher the risk. The best way to find out is for that person to get tested. If that person is positive, the next best step would be to get yourself tested.

But before doing this, talk to your doctor, and think hard about what you would do differently if your test was positive.

3. Even if you are a BRCA carrier, we really can’t reliably quantify your risk of breast cancer other than to say it is somewhere between 30 and 90% by age 70. That’s not very helpful, is it? The variability in risk is probably due to other genetic factors that interact with BRCA.

Family history itself may be your best indicator of your own risks. If your relative had breast cancer at a young age or had bilateral breast cancer, your risk is higher than if their cancer was at an older age and unilateral.

But how high is too high? What’s your personal risk tolerance? Does it vary with age? At what point would you take a medication (Tamoxifen or Evista) to reduce that risk? At what point would you have your ovaries removed? Not easy questions. Here’s the story of one woman who had to deal with these issues.

Myriad, the company that makes the test, has begun aggressively marketing the BRCA screening test, a step that I believe is premature. What we know about BRCA was largely learned from testing Ashkenazi Jews, a group known to be at increased risk. But we still don’t know the true prevalence or penetrance of this gene in the general population, and what it really means to be a carrier. Before we start mass screening and mass mastectomies and oophorectomies, we better know what the risks truly are for having this gene.

Studies such as this one are helpful in better defining that risk, but we have a long way to go before mainstreaming this genetic screening test.
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Birthday Party for a 12-Year Old Girl

“And to think we’re having another party in just 3 days!”

These were my daughter’s words to me as we were cleaning up after our New Year’s Day Open House Party. I almost died, because she was right. I had promised her she could have a belated birthday party in January, since her birthday had fallen on the weekend before Christmas when all her friends’ families were heading out of town for the holidays.

The good news was that she had planned this whole party herself, and it was minimal work for the adults in her life.

Birthday Party for a 12 Year Old Girl

The menu uses homemade chicken, but the rest can be store bought, and the kids will love it all. I must say I felt a bit guilty using bought cupcakes for this party, but it made things so easy….

Kids walk home from school Friday afternoon together to your apartment, where they drop off backpacks and such, make popcorn, then head to movie theater to see “PS I Love You“, or some other perfect chick flick. Bring along popcorn from home and supplement with drinks from the theater. One adult leaves halfway through to go to the store for food for dinner and then home to prepare it.

Walk home to our apartment for snacks and Improv games while adults finish preparing dinner.

Improv Games

Snacks

  • Cheese, grapes and crackers
  • Clementines
  • Gertie’s Artichoke Dip with crackers
  • Dried cranberries
  • Martinelli’s apple cider

Dinner

  • Baked Chicken Winglets with Paul’s Barbecue Sauce – Cut chicken wings in half into winglets, then bake as described in this recipe and serve with barbecue sauce.
  • French Fries (Ore Ida frozen fries cook up deliciously, and kids love them)
  • Caesar Salad (We used Dole bagged salad mix. Again, easy and the kids love it.

Open Gifts

Spit Tournament

Every kid gets a pack of cards. (Buy a big box of playing cards at Costco) Line up in two lines of face to face on the floor. Winner of each game plays winner of game next to you, losers play each other. And so on, until there is one winner of the winners. Everyone keeps on playing – the one with the most wins is the winner, the most losses the loser, and all the rest in between. There are no prizes, just the thrill of victory and the agony of defeat.

Snaps

“Snaps is the name of the game. The name of the game is Snaps.” This is the game they played in PS I Love you.

Birthday Cupcakes
From Crumbs. Make Cupcake Sandwiches. Here, I’ll let Natalie show you how –

Main Party over.

Sleepover for the inner circle (4 kids + Birthday girl). Watch The Breakfast Club and stay up till 3 am talking. Sleep till 11 am, then get up, have bagels and cream cheese and orange juice. Then all go home.

Except of course, the birthday girl, who declares this was the best birthday party. Ever.

Family Meal Time Protects Against Eating Disorders

Eating together as a family 5 or more times a week reduces eating disorders in adolescent girls. So says a study published this month in Archives of Pediatrics & Adolescent Medicine.

In this 5-year longitudinal study of more than 2500 adolescents, Neumark-Sztainer and colleagues found that extreme weight control behaviors, such as using diet pills or laxatives or vomiting, were 3-fold more common among females than males. Having at least 5 family meals together per week lowered this risk by 30% among females. However, among males, regular family meals were associated with skipping meals and eating little.

I wonder what percent of families today actually eat together at least 5 times a week?

I think we hit the 5 mark most weeks, mostly thanks to Mr TBTAM, who is firmly convinced that shared meal time is critical for us as a family, and god bless him, cooks dinner most weeknights to be sure that happens. I, on the other hand, would skip dinner or eat on the run if it were up to me. And I’m the one with the over-eating disorder. (By the way, my family ate together pretty much every night growing up. But there were nine of us, and some foods were in limited supply, so I think that led to us all gorging when food was around as opposed to just eating when we were really hungry. Just my own little psychoanalysis….)

How about your family? Take the survey over there on the sidebar for an informal poll of TBTAM readers’ family eating habits.

A New Year’s Day Open House

This year will mark our 15th year living in New York City. That meant it was time for a party -a BIG party for all the wonderful friends we’ve made over the past 15 years. And what better day than New Year’s Day?

Now, any normal person planning such a thing would make a guest list and send out invitations with RSVP’s, plan the menu at least two weeks ahead, and start cooking a week ahead and freeze the make-ahead stuff…You know, the right way to have a big party.

Let’s just say we didn’t do it that way.

Two days before Christmas, when I still hadn’t sent out invitations, Mr TBTAM just started e-mailing his tennis buddies that we were having a party. That meant I’d better get a move or none of my friends would be there. So two days after Christmas, while we were driving back from Philly, I went through the contact list on my phone and began calling my friends. I had no idea who was in or out of town, but no one was home so I just left messages everywhere. The connection was probably terrible, because one friends called me back saying “I think you are inviting me to something, but I couldn’t understand a word you were saying”.

Then I got sick. Really sick for the rest of the week. On New Year’s Eve morning, I awoke with a whopping headache, but we finalized the menu and headed out to shop. Somewhere between Costco and Fairway, I realized I was feeling better. Really good, actually. Either the Imitrex had kicked in or the cold had run its course. Praising Big Pharma, I headed into the kitchen where we spent the remainder of the day, only stopping briefly at midnight to run up to the roof with the kids to scream Happy New Year and have some sparkling cider. By 1 am, we were all in bed, only to rise at 9 to start cooking again.

The party was to start at 12 pm. My friend Mark arrived shortly thereafter, having just come off the morning shift at his deli. He helped my glaze the ham and arranged the salmon tartare and egg salad platters as only a real foodie can, then left. By 1 pm, when no one else had arrived and the girls were sure our party would like the one Michael threw at the Convention in “The Ofiice”.

But they were wrong – by 1:30pm, we were in full swing.

Overall about 60 folks came, and from the post party calls and emails, I think they all had a good time. I know we did. So many wonderful people, such dear friends. What was so great was seeing folks from the disparate parts of our lives talking and getting to know one another. I can’t think of any better way to start the New Year.

Of course, not everyone could make it with such short notice, and I had accidentally missed inviting a few wonderful people since their numbers were out of date in my phone. That’s the price I paid for not doing this thing so last minute.

Next year I’ll do it right.

Menu for a New Year’s Day Open House (Feeds 60 guests)

This menu will work for a mixed vegetarian-carnivore crowd, and has some healthy choices for folks trying to keep New Year’s Resolutions. Unfortunately, it has nothing for the Jewish meat eaters, as noted my friend Andy with the comment that “Grammie Hall would have loved the ham”. So next year I’m doing a beef tenderloin instead of a ham.

Guests will need to supplement this menu with desserts, as did ours, and thank goodness – most everything went!

You’ll need to do some cooking, reheating and restocking during the party to keep the food supplies fresh, but making the streudel and quiches ahead makes this easy, and you get some nice time in the kitchen with good friends who offer to help.

I’ll be posting the recipes for some of these things in the days to come, and will insert the links then.

  • 1 glazed Spiral-Cut Ham served with rolls, mustard and mayo. We got the ham at Costco. Heat and serve the day of party
  • 8 Mushroom Strudels – Double the recipe that will follow this post – Can be made ahead and frozen, then baked as needed for the party
  • 3 leek-red pepper quiches – Omit the sausages. Make and freeze unbaked crusts ahead, prepare filling the night before and refrigerate, then prebake crusts, fill and bake the morning of the party. Can be refigerated after baking and reheated as needed during the party.
  • Marinated Asparagus -This is incredibly delicious! Double the recipe. Make a day ahead and serve at room temp.
  • Salmon tartare with dill sour cream and baked pumpernickel toast points – Tartare and sour cream can be made ahead and refrigerated. Recipe will follow
  • Egg Mold with crackers -Make a day ahead. Recipe will follow. Toast points is more proper, this was easier.
  • Veggie Crudites with Spinach Dip – We got the dip at Costco. I prefer homemade.
  • Vegetable Pate -From Fairway, but next year I’m going to try to make my own pates.
  • Cheese Platter with grapes and a fig cake.
  • Gerties’ Artichoke Dip with Milton’s Multi-Grain Crackers -Thanks, again, Costco!
  • A bowl of Clementimes for peeling and eating
  • Dates stuffed with cream cheese and an almond – That’s the recipe
  • Spiced Pecans (any recipe you like for this will do) and Dried Apricots
  • Apricot Squares – Thanks, Martha & Mary!
  • Lemon Tart – Recipe will follow
  • Pineapple and Strawberries
  • Apple Torte
  • Assorted desserts brought by friends
  • Drinks – Champagne, Wine, Beer, non-alcohol grape bubbly and Martinelli’s Sparkling Cider, sodas and Pellegrino

    Happy New Year!

    • How He Does It

    Jon Armstrong, hubby to Heather, the author of Dooce.com, has written the most amazing blog post called “How I do” about living and loving a woman who battles chronic depression.

    One of the biggest and most detrimental side effects to being a partner of someone with a mental illness is that there is the impulse to not share the hard stuff with them for fear they can’t handle it. Likely corollary to that is that the disease is a part of our relationship, meaning it needs its own space. The meds and therapy continue to help, but the disease is always there. I have to be aware of those times where nearly every exchange, every gesture and every non-verbal cue is related to the illness in some way. This adds a burden to any relationship and ours is no different.

    I’m no shrink, but if you live with someone who is depressed, that this post is packed with great advice and strategies for taking care of yourself, your partner and your relationship. The post already has 315 comments, which I think speaks to just how important this topic is.

    If someone you know is depressed or has a loved one who is, share this post with them.

    Bravo, Jon!

    Blog 365 – Pure Heroin for Blog Addicts

    For those of you who, like me, tried to post every day during National Blog Posting Month (NaBloPoMo) and failed, a new addictive blog challenge has arisen – Blog 365.

    That’s right – some sicko blog-pusher has posted a challenge to blog every day for a year, starting New Year’s Day 2008.

    The rules for Blog 365 are a bit looser than those for NaBloPoMo. You don’t have to actually write the post on the day you post it, so that you can pile up pre-written posts and feed them out one at a time. Posts can be anything – a photo or video link are fair game.

    For a blog addict like myself, Blog 365 is pure heroin. I think I should stay away from it.

    But don’t let that stop you from joining the already 465 bloggers who have signed on to the challenge. (It’s always nice to know there are others whose addiction is worse than mine… )
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    Heroin photo used with permission from the DEA Multimedia Library

    XO Laptop – Second Impressions

    As I wrote last week, we got an XO laptop for our 12 year old daughter as part of OLPC’s Give a Laptop, Get a Laptop program.

    Our first impression of the XO Laptop was that this was a really cool little laptop.

    And it is. A computer that has built in video, audio, internet browsing and file sharing for just about $200? That’s amazing.

    The XO is a big hit among the populations for which it was designed – kids in the third world. Read how the XO is transforming life in a Peruvian Village.

    But after almost a week of fiddling with it here in America, we’ve decided the XO just doesn’t completely fit the my kid’s computing needs. Which is totally fine – it was never meant to. So what follows is not complaining and is not meant to be a negative review. It’s just the facts of our little experiment to see if the XO could be my daughter’s personal computer.

    Our XO Experience

    After fiddling around with the video camera and the internet, it was time to get down to work. Truth be told, we had little use for most of the games and actvities loaded on the XO – activities meant for a learning environment. The games my daughter did access were fun and easy to use. But we focused mostly on the activities she uses most – internet, writing and music.

    While the XO multi-tasks, programs load slowly. Web based email worked fine, but we still cannot figure out how to save attachments. Some web pages load smaller versions, and it’s a bit like web browsing using your cell phone. Other pages load fully, but you have to scroll to see the whole page n the small screen.

    The XO really saves activities, not files, in something called Journal. Naming a doc requires opening the journal entry for the activity that generated it. Journal entries pile up quickly, and it’s a bit slow scrolling through them to find a file, especially for someone like myself used to a folder tree system.

    The word processor is just fine, but there is no printing (yet) and not a smooth interface with Microsoft Word or Publisher, making document sharing difficult for my daughter, who edits her school newspaper. File sharing with the XO is meant to happen among groups of XO users, but we’re the only users in our laptop’s range.

    There is no way to play Itunes on the XO, so a kid who has her music stored there will be unable to use the XO for this. I gave up trying to figure out if I could use some other Linux-based program for this, as it is pretty much beyond my tech skills.

    I tried to chat online with other XO users in my neighborhood, but no one accepted my invitation to chat. Maybe they don’t know how to use this feature.

    And finally, the pointer is jumpy, a source of continuing frustration. (A fix is due soon.)

    My daughter, God bless her, was willing to stick with the XO and work between it and the family computer till upgrades later next year. But it felt to me as though this gift, given with such love and received after much anticipation, was becoming more of a burden for her than a joy.

    So, yesterday we bought her a laptop at the local tech superstore for a great price. It was a model that is being discontinued, but what do we care? It’s already 10 times better than my 4 year old laptop…. Of course, she’s flying with it. Listening to tunes while writing articles for the paper, checking email and planning on uploading and editing the videos that she and her friends have made. I’ve only had to get involved to help her set up E-mail and update her antivirus software, both tasks I can do without having to read a manual.

    Other Families’ XO experiences

    Read another family’s entirely different experience giving an XO to their kid – He’s younger and clearly more tech-minded than my kid or me.

    This Dad clearly spent a bit more time with his kid on the XO than I did with mine, and it shows.

    Both these kids were under age 10, which may be why they picked up on this system faster than my 12 year old, who already was used to current operating systems and had her own idea of what a computer should be able to do.

    Bottom Line

    The XO is a great laptop for the price. In fact, it is an amazing laptop for the price, especially since for every one you buy, one gets given.

    If you don’t need to rely on the XO for all your computing needs, are interested in playing around with Linux and are willing to wait for the upgrades that will make it a bit more user-friendly here in the second world, then it is a fabulous laptop for your kid. Printing should be available by mid 2008, and there are even rumors of a change to a Windows platform.

    But if your kid is like mine, namely not too tech-savvy and already used to the computing environments offered by Apple or Microsoft, the XO alone will likely not serve his/her computing needs.

    And that’s okay – After all, the XO was not built for my kid. It was built for kids whose families cannot afford even one computer, let alone our family, where the one laptop, one cellphone, one digital camera per person program is in full swing.

    My question now, of course, is what to do with the XO we have. There is not yet a program for donating it back, which was my first thought. On second thought, I hear they are going for up to $600 on E-Bay…

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    More XO Reviews

    Aaron Landry – has two articles on the XO, and great discussion in the comments section
    Ubuntu tutorials – Nice sum up of specs
    NY Times review by David Pogue
    Notebookreview.com – very complete review
    David Seah – First Impressions

    A Healthcare Wish List for Santa

    I wrote a little song for all of you for Christmas.

    Won’t you sing along with me? (Click on the song title for music – I apologize for the crappy sound quality, but it’s the best my 13 year old nephew producer and I could create at 10 pm on Christmas night.)

    Happy Holidays to all!

    Santa Baby

    Santa baby, if you can fit it under the tree, for me
    We need a national healthcare policy
    Santa baby, so hurry down the chimney tonight

    Santa baby, Universal coverage costs a lot, but why not?
    While you’re at it keep the premiums low,
    Santa baby, so hurry down the chimney tonight

    Pay whenever we are ill
    Pay for every shot and every pill
    Next year it could be twice as much
    But I know that you can foot the bill

    Santa Baby, our healthcare outcomes should be the best, the rest
    Of the world should learn from us, not us from them,
    Santa baby, So hurry down the chimney tonight.

    Santa honey, one little thing we really need for sure, a cure
    For cancer and for chronic disease
    Santa honey, so hurry down the chimney tonight

    Santa cutie, if you decide to keep Medicare, No fair
    Unless you pay the doctors what they’re worth,
    Santa Cutie, so hurry down the chimney tonight.

    One more task you can perform
    Malpractice is in need of a major reform
    I know you want it even if we don’t
    And you can make it better even if we won’t.

    Santa baby, forgot to mention one little thing, please bring,
    A President who’ll listen to science
    Santa baby, so hurry down the chimney tonight

    Hurry down the chimney tonight
    Hurry, down the chimney tonight!

    Chicken Country Style

    Tonight at Irene’s we made yet another recipe from her Archives – those great old recipe files she has culled together over the years. This one’s from the NY Times and is at least 30 years old. A few modifications have perfected it – for example, whole wheat flour is used instead of regular flour (makes a better crust), olive oil replaces most of the butter in the original recipe, and tarragon is added for flavor. Feel comfortable making it for company the first time. You won’t be sorry.

    CHICKEN COUNTRY-STYLE

    2 ½ lbs. Chicken thighs
    1/2 cup flour (Whole wheat is best)
    2 tsp Irene’s Chicken Spice Rub
    Olive oil
    2 tbsp butter
    4 cups peeled and cubed Yukon Gold potatoes
    ¼ lb. mushrooms
    1 clove garlic, minced
    3 tbsp chopped fresh tarragon
    2 tbsps. finely chopped shallot
    ¼ cup dry white wine
    ¼ cup chicken broth
    Chopped parsley

    Preheat oven to 400 degrees. Peel and cube the potatoes,
    and parboil 2 minutes. Drain well and hold.

    Slice the mushrooms in half lengthwise. Trim off the stem and cut each half into thirds. Add to stems and hold.

    Mix the flour and spice rub on a plate, and dredge the chicken pieces lightly.

    Very lightly oil a large cast iron skillet, heat to a high heat and brown the chicken, skin side first.

    Remove the chicken and hold on a platter. Pour off excess fat from the skillet, and then melt the butter in the same pan.

    Roll the potatoes in the pan and season with salt and pepper.

    Remove the potatoes to a platter. Add the chicken back into the pan and cover with the potatoes.

     

    Bake about 30-40 minutes. (If the chicken finishes before the potatoes, remove the chicken and pop the potatoes under the broiler to brown.)

    While the chicken and potatoes are baking, heat a small amount of oil in another skillet. Add shallots and garlic, cook for a minute or two till aromatic. Add mushrooms, and cook for a few minutes until they give off most of their liquid,

    adding tarragon towards the end.

    Sprinkle with salt and pepper. Add the wine and broth,

    bring to a boil and cook off almost all of the liquid.

    To serve, pile chicken, potatoes and mushrooms onto a large platter and sprinkle with parsley.

    Serves 4.

    (Note – This is the two skillet method. If you only have one skillet, remove the chicken to a baking dish, then add the potatoes to that dish with the chicken to bake. Cook the mushrooms in the skillet while the chicken and potatoes cook in the baking dish in the oven.)

    Irene’s Chicken Spice Rub

    Just posting this for easy future reference.

    2 parts paprika
    3 parts kosher salt
    1 part Old Bay Seasoning
    ½ part lemon pepper mix (whatever brand you like)
    1 part garlic powder
    1 part sugar

    Mix all the ingredients together. Store in a shaker jar covered with plastic wrap to prevent it from becoming stale. Tape the recipe on the side of the jar for easy reference.

    Cranberry Beans the Greek Way

    So Schruggling, a frequent commenter and friend of my sister the OBS Housekeeper, e-mails me Thursday and lets it slip that he is heading to Ferry Street in Newark to buy fish on Saturday with his friend John Kaldes, fellow Big Pharma Guy and author of the cookbook Made in Greece (casual sip…). Schruggling’s wife is Greek, and they always make all this great Greek food, and John is going to help them make Greek octopus with tomatoes for Christmas Eve.

    Then, after all that, Schruggling does not invite me to come along with them.

    Ferry Street in Newark is like, what, 28.4 minutes away from me by MapQuest? And they’re going to be buying fish and talking food the whole time? And John is a real live, honest to goodness cookbook author ? And Schruggling’s not inviting Me???? Me, with the food blog? The food blog that the NY Times Online just linked to? That Me?

    Sure that there is some mistake, I email back suggesting that I could join them, we could do dueling octapus dishes, put it on the blog, won’t that be fun?

    And Schrugglin’ emails back something like – We’re not sure what time we’re leaving, it’s going to be a last-minute thing, blah, blah, blah. Maybe some other time.

    Okay, fine.

    It’s a Guy thing. Or a Greek thing. Or a Big Pharma thing. Actually, it’s not even a Big Pharma thing, since they both work for Generic Pharma, it’s a Big Pharma Copycat thing.

    What do I care? I don’t need them to hang Greek. Ferry Street isn’t even a Greek neighborhood – It’s Portuguese. I can go to Astoria, a real Greek neighborhood. Plus, I have these Greek friends across the street who have us over for these amazing lamb dinners and who give me olive oil from their family’s olive grove in Crete and who once left me a whole shopping bag filled with all this great Feta and stuff from Astoria, and they have promised to take me shopping with them in Astoria, we just haven’t found a mutual free Saturday morning…

    But who cares? I can out-Greek you anytime, Schruggling. I don’t need you and your friend. Your fellow-copycat Big-Pharma, so what if he wrote a Greek Cookbook friend…

    Then Schrugglin’ emails me Friday to tell me that he and John have firmed up their plans for Saturday and can I still meet them and how is 10am at the Popular Fish Market on Ferry Street?

    And I am so there….

    Since this post is getting way too long, I am going to have to save the whole fish market octopus thing for my next post, since it will involve picture of tenacles and suckers and stuff like that and I haven’t even made it yet.

    What I will tell you is that Schruggling (who I had never met till today) is really cute and nice and I feel like I’ve known him my whole life, probably because he knows everything about my whole family from OBS. And John is really gracious and nice, and very serious when it comes to this cooking stuff, and I learned a lot.

    Thanks, guys, it was really, really fun. And thanks John for putting up with us. And for the recipes. I even bought your cookbook, and can’t wait to try it out.

    And I didn’t mean that stuff I said about you guys, or that whole Big Pharma copycat thing…Well, technically, maybe you are copycats, but if you weren’t we’d all be paying thousands of dollars more for drugs.

    And of course, there’s a recipe…

    Cranberry Beans, Greek -Style

    While we were on Ferry Street, John bought some cranberry beans (he called them raspberry beans, isn’t that just so Greek?). So of course we bought some too. And while we were standing in line to pay, John told Mr TBTAM how to make them, and he made them for dinner tonight. I have a feeling we did not do them exactly right, but they were still delish.

    1 pound of Cranberry Beans, unshelled
    Tomato paste (we used 1 small can diced tomatoes)
    1-2 tbsp Olive oil
    1 medium onion, diced small
    We added chopped garlic and a bay leaf (We couldnt remember if John said to add them, but it semed right)
    Salt and pepper to taste

    Shell beans and place in saucepan with water to cover. Bring to a boil and boil for about 5 -10 minutes. Drain and discard the water. (This makes them less gas-producing.)

    Cook tomato paste or tomatoes in pot for a few minutes. Add the onion, garlic and olive oil and cook a few minutes longer. Add the beans and a bit of water, barely to cover.

    Simmer for 1-1 1/2 hours till soft. Serve on crusty bread as an appetizer, or as a side dish for dinner. We served it as a side dish along with grilled sausages, salad and a nice crusty bread.

    Tigo – Take your Tea and Leaf

    One of the fun things about being married to a school teacher is seeing what gifts he gets each year from students, families and colleagues. This year was no exception, but this gift was. Mr TBTAM just brought it home tonight, and already we’re all fighting over who gets to use it first. (I’m the Mom, so I won…)

    It’s called the Tigo Filter Cup and it’s an on-the-go tea brewing system, the first of it’s kind being sold in the USA.

    Unlike the other travel tea mugs I’ve seen with lots of parts, filters and presses, this is a simple, clean design that just makes sense. Here’s how it works – The stainless steel filter in the Tigo is built in –

    you rotate it open to add the tea,

    and close it to pour in the hot water. Cap it and go – it steeps and cools to the perfect drinkable temp while you travel. You drink it right from the cup, and the filter keeps the tea in its place.

    You can add hot water again and again, re-using the tea leaves the way the Chinese do to get every bit of flavor out of them before throwing them away. I’m already on the third brew of the wonderful Huangshan green/white tea we got with our Tigo, and I think I can still get another cup out of it. If you’re going to drink high quality green or white tea, this is a great way to get your money’s worth without making a lot of mess.

    The Tigo is so new that it’s not yet available in stores. But you can order it online from the Tigo Website. That’s a good thing, because I think we are going to need more than one in our family.

    In the meantime, I just have to figure out how to get the Tigo away from Emily, who swiped it from me before I could finish my cuppa’.

    Hey, there’s a slogan for you – “Leggo‘ my Tigo!”

    Genital Photos, HIPAA and the Media – Update

    Looks like the Mayo Clinic is recognizing the dual nature of the privacy violations in this case. From the Mayo Clinic Website today –

    Ultimately this episode reduces to two actions by two different individuals who violated our policies concerning respect and privacy. One was the inappropriate cell-phone photograph taken by a resident physician, subsequently displayed to others internally but to our knowledge not shared in any other fashion. The resident responsible for the photograph is receiving appropriate disciplinary action.

    The second breach by a different person was the reporting of the incident along with the actual patient’s name to the media. The identity of the person who disclosed the patient’s name is not yet known.

    I still fault the reporter who wrote that story as much as I fault the person who called the media. They could easily have written the story without revealing the patient’s name. The law may not require them too, but I think ethics do.

    Then again, perhaps I am just as much at fault for disseminating the story with my blog…