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…

Genital Photos, HIPAA and the Media

A surgery resident at the Mayo Clinic is under fire for taking a photo of his patient’s genitals during surgery for a gallbladder problem. A concerned surgical staff member took it upon themselves to contact the press about the incident, and so now the entire country knows what this poor guy has tatooed you- know- where.

It seems to me there’s a bigger problem here than the photo – and that’s the violation of this patient’s privacy by the staff member who took the story to the media. Since when is calling the local paper the appropriate way to handle a hospital incident involving a patient?

In fact, I’d argue that the “whistle blower” to the media committed an even bigger violation of the patient’s rights than did the resident who snapped the photo. What could have been a private matter between the patient and the Mayo Clinic (and the lawyers for both sides) has now become national news.

(Hat tip to Kevin, MD for the story, the latest addition to his “Doctors Gone Wild” post series.)

FDA Warnings on Nonoxynol-9 Re-Define Sponge Worthiness

Elaine’s date tries to convince her that he is “Sponge-Worthy”
The FDA has issued a new ruling requiring manufacturers of contraceptive and spermicidal products containing Nonoxynol-9 to warn users that Nonoxynol-9 does not protect against HIV or other STD’s. Labels must also warn that Nonoxynol-9 can irritate the vagina and rectum, which may increase the risk of contracting HIV/AIDS from an infected partner.

Nonoxyl-9 is the active ingredient in the contraceptive sponge. It’s also found in spermacidal jellies used with diaphragms and cervical caps, and in contraceptive inerts, foam and vaginal film.

Nonoxynol-9 is a surfactant, and acts to disrupt sperm membranes, thus preventing pregnancy. Contraceptive efficacy of N-9 containing spermicides ranges from 70% if used alone to 80-90% when used with a diaphragm. Advantages include absence of hormones and easy reversibility. The disadvantages are that they are less effective than hormonal methods, can cause irritation and can increase HIV transmission if your partner is HIV-infected.

So before you dip into your sponge stock or take out your diaphragm for a guy, better make sure he’s truly worthy and does not carry the HIV virus. If you’re not sure, forget the sponge or diaphragm and use a condom.

TBTAM’s Rules for Spermicide Use

  1. If you are at risk for HIV or if your partner’s HIV status is unknown to you, don’t use Nonoxynol-9 containing contraceptives. Use a non-spermicidal lubricated condom. If you want additional protection against pregnancy beyond that which condoms provide, look towards additional methods that don’t entail spermicide use, like the oral contraceptive.

  2. If you are at low risk for HIV infection, and especially if you know that your partner is HIV negative, go ahead and use whatever contraceptive works best for you, including spermicides, diaphragms and sponges.

  3. The best way to protect yourself against HIV infection is to limit your number of sexual partners, or as TBTAM has said again and again – Save sex for those you love. But since even someone you love could have HIV, both of you should get that HIV test before you stop using a condom or use spermicides.

The Road to the Ruing

We’ve known for some time that Nonoxynol-9 use can increase HIV transmission, from studies of sex-workers in Thailand and Africa, who were found to acquire HIV more often when they used Nonoxynol-9 spermacides along with condoms, compared to their counterparts who used just condoms.

In 2002, the CDC issued a warning against the use of Nonoxynol-9 for HIV or STD prevention, and advised against using spermicidal lubricated condoms for HIV prevention. In response, over a dozen condom manufacturers, including Planned Parenthood, stopped adding spermicides to their products, as did makers of personal lubricants.

But at the FDA, the issue became politicized, since it involved labeling on condoms.

Right-wing advocates of abstinence wanted the label to say that condoms don’t protect against AIDS. AIDS Advocacy Groups wanted to be sure that the labeling did not discourage condom use. Women’s groups were concerned that the warning against spermicides might be applied too broadly, causing women who were at low to no risk of HIV to turn away from effective contraception. Also at the table were the condom manufacturers, some of whom continued to manufacture spermicide-lubricated condoms on the grounds that these condoms are appropriate for couples without HIV. And, I suspect, the instability of the FDA leadership over recent years didn’t help the matter…

In 2003, the GAO, under pressure from the right wing lobbyists, issued a statement against the FDA, urging them to move forward on the labeling change. Four years later, the ruling is finally final.

The FDA warning goes beyond the 2000 CDC message to address the widespread use of Nonoxyl-9 in contraceptives, and to correct any remaining mis-perception that these spermicides protect against HIV.

The ruling also contains wording for condom labels that states that their consistent use greatly reduces, but does not eliminate, the risk of catching or spreading HIV. A nice compromise, I think, on that issue.
_____________________________________________
The full FDA Ruling is posted on the FDA Website
Great info on Nonoxynol-9 from IBIS Reproductive Health

XO Laptop – First Impressions

My daughter’s XO Laptop arrived today – just one day late for her birthday, not bad delivery timing.

She called me screaming in excitement, and when I arrived home about a half hour later, she opened the door holding the laptop up, with the words “Hi Mom!” written on the screen. She had already made a video, taken a few pictures and figured out where our wireless network was. All I had to do was explain that our network password was in hexadecimal, and she had her Internet up and running.

User friendly start up – Check.

We’re still exploring it, figuring out the tricks to this new interface. Found a writing program, but haven’t figured out where the files get saved to. Fortunately, there is support info on the web, and a community of users is growing.

The only downside so far is that I don’t think the XO will run I-Tunes. There’s a USB port, so the I-Pod should be able to connect. I think a program called Banshee should do the job, but I’ll have to do little learning about Linux to download it and get it working for her. One more job for IT Support-Mom…

I wish we could find out who the kid was that got the laptop we donated – it would have been fun to connect with him/her wherever they are (?Africa maybe).

Make Sperm, Not War

The Civil War in Lebanon caused a decrease in sperm count, according to a study published this week in Fertility and Sterility.

Researchers at the American Hospital in Beiruit retrospectively reviewed records of couples receiving fertility treatment between 1985 and 1995, and compared the results of semen anlyses performed on samples collected during the war (1985-89) and after the war (1991-95).

Sperm concentrations were significantly lower during the war compared with the post war period, although sperm volume and motility remained the same. Sperm morphology was actually more abnormal after the war. (Whether this latter result was due to toxic exposure during the war or a change in how semen anlayses are reported is unclear, but the latter seems more likely.)

The authors suggest that the stress of war leads to a decline in sperm production, possibily through a depression of testosterone levels via the effect of stress hormones on the hypothalamic-pituitary-gonadal axis.

Although a longitudinal study of men before, during and after war would have made a better case, these results are interesting to say the least, and give us one more reason to make love and not war.

More on Ghostwriting

For a brilliant analysis of the art of ghostwriting by Big Pharma, read this post at Dr Carlat’s blog. And while you’re at it, put him on your blogroll. This is an important blog.

Medicare and the Annual Gyn Exam

This post is for all you baby boomers out there who are enrolling into Medicare after having seen your gyn every year since college for an annual exam, and for all you Medicare veterans coming to my practice for the first time since your previous doctor retired. There’s something you need to know –

Medicare only pays for routine breast and pelvic exams and pap smears every 2 years.

It’s true. Here it is, from Medicare’s web site –

Medicare helps pay for a Pap test, pelvic exam, and clinical breast exam once every 24 months.

Most women don’t need a routine pap smear every year. So I’m happy to have you forgo that testing on an annual basis. In fact, if your paps have always been normal, we can even go 3 years between paps.

But I still recommend you have a breast exam every year, and a pelvic if you still have all those parts.

What if I’m high risk?

If you are high risk for cervical cancer (see below for the definition of high risk), you get a pap every year.

But if your paps have always been normal, and you see me for only a routine check up less than 2 years since your last routine check up, Medicare just won’t pay.

What About Problem Visits?

Now, if you a medical problem, Medicare will almost always pay for your visit. So don’t be afraid to come in if, for example, you have a urinary tract infection. Or a yeast infection. Or have a pessary, osteoporosis, breast cancer, abnormal paps, abnormal bleeding or are on hormone replacement and you need to come in more often than once every two years. We have a diagnosis code to support the medical necessity of those visits, and we’ll all be fine.

In fact, if you come to see me for a “check-up”, but also have other problems that we deal with on that visit, I can “carve out” the portion of the visit that medicare will pay from the preventive part they won’t – so you won’t get stuck with the whole bill.

The ABN (Advance Beneficiary Notice)

If you’re here for preventive services, my staff will ask you to sign a form called an ABN, or Advanced Benificiary Notice. This is to prove to Medicare that we informed you which services were not covered and that you agreed to pay for them if Medicare won’t.

If we don’t have the signed ABN in your chart, we can’t bill you, so please understand when we ask you to fill one out. Every single year.

If, after reading the ABN, you decide to forgo the preventive services, that is absolutely your choice. We’ll happily see you next year for these services.

What about your secondary insurance?

Good question. You may have a secondary insurance that will pick up what Medicare pays. On the other hand, your secondary may not pick up the uncovered portion of your visit. Since everyone’s plan is different, that part is up to you to figure out.

Apologies

I’m really sorry about this, but there is absolutely nothing I can do. I can’t make up a code to get your visit covered if it is not.

And I really don’t know how your last doctor got Medicare to pay for you to see him every 6 months for the past 10 years when you don’t have any gyn problems.

I only know that these are the rules, and I have to play by them.
______________________________________________________
Read Medicare’s Information Booklet for Women

High Risk Definition: You are at increased risk for cervical cancer, according to Medicare’s guidelines, if you have not had a pap for 7 years or have not had 3 normal paps in a row. Also, if you started having sex before age 16, have had more than 5 lifetime sexual partners or an STD, or are a DES-daughter, you get a pap every year.

Apple Torte

Thanks for Bureka Boy for a marvelous recipe, and as usual, a great how-to that makes baking gorgeous desserts like this a snap.I brought the torte to a Hanukkah dinner party tonight, and it was a huge hit with all ages. (Hint- keep the sides on the springform pan for risk-free transport.)

Go ahead, try it. It’s not hard to make at all….

European Apple Torte 

I strongly encourage you to read the recipe at Bureka Boy’s site – it’s complete with beautiful prep photos and hand holding instructions. I’m putting an abbreviated version here for easy printing. 

Crust Ingredients

  •  1/2 c butter, soft
  • 1/3 c sugar
  • 1 pkg vanilla sugar, optional
  • 1/2 tsp vanilla
  • 1/8 tsp salt
  • 1 c all purpose flour

Cheese layer ingredients:

  • 1 pkg (8 oz/25o g) cream cheese, room temp.
  • 1 tbsp lemon juice
  • 1 tsp vanilla
  • 1/4 c sugar
  • 1 egg

Apple layer ingredients:

  • 2 large baking apples* (plus 1 extra, just in case)
  • 1/3 c sugar
  • 1/2 – 3/4 tsp cinnamon
  • 1/4 c sliced almonds

Crust: In a large mixing bowel using the paddle, together the butter, vanilla, sugar and salt. Mix until well blended.  Add the flour and mix only until blended. Place the dough in an ungreased 8 1/2″ springform pan. Pat and press the dough evenly across the bottom of the pan and up the sides about 1 1/2 inches. make sure it is even. And not too thick between the bottom of the crust and the walls of it. You will think you don’t have enough dough, but trust me, you do. Just keep working it and thin it out to cover.  Set aside.

Cheese filling : Mix everything together in a medium sized bowl using the paddle for 2 or 3 minutes. It needs to be perfectly smooth and not grainy.  Place the cheese filling in the unbaked crust, smoothing it using a rubber spatula. Set aside.

Preheat the oven to 450F at this point.

Apple layer: Peel and slice the apples 1/8 inch think. Layer the apples around the outer perimeter, carefully overlapping them. When you get to the first apple you layered, lift it to add the last one. Repeat a second layer just inside the first. Arrange the few apple slices in the innermost layer nicely. Mix the sugar and cinnamon together and with a spoon, distribute the mixture evenly all over the apples.. It will look like too much – don’t worry it is not. Finally, sprinkle the almonds evenly over the apples.

Bake for 10 minutes only @ 450 F and then reduce the heat right away to 400 F and cook for another 25 minutes.  Remove from the oven to a baking rack and let cool completely. Gently run a knife around the cooled torte and release the spring siding. Let the torte sit several hours in the fridge for it to firm up properly before eating it. It is best served slightly cold or at room temperature.  Dust with confectioners sugar if you like or serve with whipped cream dollops. I serve mine plain.

A Latke by Any Other Name…

Tonight is the first night of Hanukkah, and of course that means latkes.

Hanukkah is one Jewish holiday where I feel right at home food-wise, since I grew up eating latkes. Of course we didn’t call them latkes – we called them potato pancakes, and they are a standard in the Slovak kitchen. My Grandma used to come up and make them for us in our kitchen sometimes on Saturday nights. We were so anxious to eat them, I don’t think we even waited to all sit down at the table together – we just lined up next to the electric fry pan with our plates and practically grabbed them from the spatula as Grandma was laying them onto paper towels to drain!

My Grandma grated her potatoes by hand using the small holes of the grater and never drained the liquid. This meant she needed a fair amount of flour to sop things up, and ended up with a rather thick, dense, floppy and wonderfully delicious pancake.

The potato pancakes I make now are a bit different than the ones I grew up with. They are based on my mother-in-law Irene’s recipe, and they are pretty perfect if you ask me. Actually, Irene didn’t really give me a recipe, just approximate amounts and a gestalt. But I decided to try and nail down the amounts tonight as I made them.

The trick is to use the large grating blade of the food processor to shred the potatoes and onion, and thento drain away the liquid. Eggs hold the potatoes together and coarse motsa meal fills in the spaces without the heaviness of flour. Cook the latkes in an electric fry pan – it’s really so much easier and safer than doing it over the stove and you get a more consistent pancake as long as you don’t overload the pan. If you do it right, what you end up with is sort of a latke nest, with lots of crevices of crispiness on the outside and a few wonderful soft pockets of old time potato pancake in the middle.

Sour cream and homemade applesauce are the only other things you need. My kids, of course, also like ketchup.

Latkes (or Potato Pancakes)

For this batch, I used Yukon Gold potatoes and Streits Motsa meal that I borrowed from my friend Rachel down the hall. (Without Rachel I would never cook – she never runs out of anything…) I had never used that brand, and I like it – it is a coarser grind than Manichevitz, and so instead of just sopping up the egg and clumping together, the meal sort of stayed aloof on the outside of the shredded potatoes. This made for a less dense pancake. I also used canola oil because it is healthier, and noticed no difference from the traditional vegetable oil. You can vary the amount of onion depending on your tastes. Mr TBTAM likes his on the oniony side.

3 pounds potatoes (I used Yukon gold tonight)
2 eggs, lightly beaten
1 1/2 large onions
A little less than 1/4 cup Motsah Meal
salt
Pepper
Canola oil for frying

Peel potatoes. Shred using the food processor and remove to a large bowl. Shred the onion the same way and add to the bowl. Open out a large clean dishtowel onto the counter and dump the potato onion mixture on it. Top with a second clean towel and lightly roll to mop up the excess liquid (Don’t overdo it, you need a little of the potato starch and liquid for things to stick together.) Dump back into the bowl and add the eggs and the motsah meal. Season with salt and pepper.

Heat about a 1/2 inch of canola oil in electric frying pan at highest heat (mine goes to 400 degrees Fahrenheit). Scoop some of potato mixture into a large spoon, then put into the oil, flattening with the back of the spoon. Cook until the edges start to crisp and the underside is light brown, then gently flip and cook the other side.

Remove from pan to a cookie sheet lined with paper towels or newspaper. Keep warm in a low oven while cooking the rest of the potato pancakes.

Serve with sour cream and warm homemade applesauce.
_______________________________________________________

This of course, is not the only way to make latkes.

4Bureka Boy has a great round up of recipes and methods on his blog, as does Slashfood, whose latkes look suspiciously like mine.

4Epicurious does a nice job on technique, and uses a mixture of butter and oil to fry in their Classic Potato Pancake recipe.

4For healthier versions, see Got No Milk (no fat) and Diabetes Daily (lo-carb in the comments section).

4And, for a genuine latke making lesson from a genuine Jewish Mother, watch Feed Me Bubbie– Latkes.

Happy Hanukkah!

Cookies from an Angel

I’ve been invited to submit a recipe to Leonard Lopate’s Holiday Cookie Recipe Swap. I love Leonard’s radio program, so it was a thrill to get the email from his staff asking that I submit a recipe and help spread the word about the swap.

Picking a recipe was easy – Angel Fingers. When I was little, my Grandma made Angel Fingers at Christmas, along with shaped sugar cookies and a wonderful, crisp brown cookie she called a “Sand Tart”. I loved them all, but I only have the Angel Fingers recipe, handwritten by Grandma on an index card that is becoming increasingly yellowed with age.

My dad’s mom was a one of a kind. Never afraid to speak her mind, she was famous for such lines as “You have such lovely teeth! Are they your own?” and to her parish priest “If I’d known you when you were younger, you’d never have made it to the Cemetery.”(She of course meant to say Seminary.)

My Grandma loved her garden, her little bird, her crossword puzzles and the Phillies. And she could stand on her head even in her early 60’s, a skill she demonstrated to us during sleepovers at her house after we did her nightly calisthenics with her.

Grandma held a much less strict view on Catholicism than my parents, who insisted we attend church every single Sunday while I was growing up. And so I will never forget that Sunday morning when I came downstairs after spending the night and Grandma told me we were skipping Mass that day.

“God is in the birds, the trees and the flowers”, she said, spreading her arms out toward her garden. “We don’t need to go into a building to be with him.” So we sat on her porch that beautiful sunny morning looking at the garden, listening to the birds and reading the funnies.

I don’t go to church anymore now, having lost organized religion long ago. But I never lost my Grandma’s religion. I still believe that God is in the flowers, the trees and the birds.

And he’s also in these little cookies – cookies from my Grandma, who taught me to see holiness in the world around me.

Angel Fingers

Submit your favorite holiday cookie recipe by December 6, along with the reason why the recipe is special. Then tune in to WNYC on December 11 and listen to Leonard and Ruth Reichl talk cookies.