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June 30, 2008

I Can Has Cheezburger
Posted by Jim Macdonald at 10:42 AM * 108 comments

This being the summer, and therefore the Hamburger Grilling Months, I present the recipe that we’re using here to Great Applause.

We follow the Alton Brown school of hamburgering: “For medium-rare burgers, cook the patties for 4 minutes on each side. For medium burgers, cook the patties for 5 minutes on each side. Flip the burgers only once during cooking.”

The important statement there is “flip the burgers only once.” Also, do not (no matter how sorely tempted) press on the burgers with your spatula. After the flip, put on a slice of cheese (provolone is very nice).

For the patties we take normal store-bought hamburger meat and mix in an envelope of dry onion-soup mix.

Serve with sliced onion, tomato, lettuce, etc. The local custom in northern New England is to use mayonnaise as a spread.

[Recipe Index]

Comments on I Can Has Cheezburger:
#1 ::: John L ::: (view all by) ::: June 30, 2008, 11:32 AM:

Heh. I always flatten my hamburgers with the spatula, and turn them more than once. But, I want them done more than "medium rare" too.

Also, mayonnaise on a hamburger is an abomination; only mustard and ketchup should be allowed, along with cheese/pickles/lettuce/tomatoes and onions, of course.

#2 ::: Tom Barclay ::: (view all by) ::: June 30, 2008, 11:38 AM:

"The local custom in northern New England is to use mayonnaise as a spread."

It's also the custom in Livingston, TX, deep in the piney woods, at Nell's. Nell's makes the best hamburgers I have ever eaten.

If you're not wearing your burger down your arms half-way to your elbow, you haven't been to Nell's.

But your method looks promising, Jim. We'll give it a try.

#3 ::: joelfinkle ::: (view all by) ::: June 30, 2008, 11:50 AM:

I'm with john @ 1 regarding Mayo. Growing up, mayo was used only for tartar sauce and cole slaw, and I never cared for tartar sauce.

According to Alton, part of the purpose of the mayo is to prevent meat juices from creating a soggy bun. An alternative to that is butter (e.g. Steak and Shake, and Culver's "Butterburgers"), but growing up Jewish made that something you'd shudder about, even though we weren't keeping Kosher (I can has cheezburger too).

Lightly toasting the buns helps, as does stacking up the sandwich just before cooking.

The "mayo" thing has stuck with me pretty strongly: If a restaurant offers a burger with "chipotle sauce" I'm fine, but I can't even order it if it's called "chipotle mayo." Don't get me started on chipotle-flavoring, though: I make a sauce from a Rick Bayless recipe that one cup probably could flavor all of McDonald's chipotle use for a year.

#4 ::: ebear ::: (view all by) ::: June 30, 2008, 11:50 AM:

Spatula-flattening makes for dry burgers. Just saying.

#5 ::: punkrockhockeymom ::: (view all by) ::: June 30, 2008, 12:11 PM:

Lordy be, I'm starving. And I think I'm making Puppy burgers for dinner tonight. THESE burgers.

#6 ::: Caroline ::: (view all by) ::: June 30, 2008, 12:27 PM:

Helpful hint and tip: If you are using a charcoal grill, use enough charcoal.

Last time I tried to make burgers, after 45 minutes they were still quite raw on the interior. I'm surprised we didn't die.

#7 ::: Mark C. Chu-Carroll ::: (view all by) ::: June 30, 2008, 12:37 PM:

Personally, after getting some advice from a chef named Susannah Foo (she's a friend of my wife's family), I *never* buy pre-ground meat at the store. The store-ground stuff is ground too fine, which makes it much more prone to drying out.

Just buy a nice fatty steak, like chuck. Cut it into cubes, and then throw it into a food processor, and pulse until it's ground to your desired texture.

It takes under a minute from fridge to ready to cook, it costs less, and it tastes better. And the food processor can be thrown into the dishwasher, so it's not even more work to clean up!

#8 ::: Madeline F ::: (view all by) ::: June 30, 2008, 01:23 PM:

At the Berkeley Hang Gliding club food fests (remarkable number of foodies in that club) I found a couple interesting hamburger variations... Like, form the patty so it has a concavity in the center and put a little dollop of olive oil in that (or maybe just leave it to cook more evenly). Mix in finely chopped garlic to the raw hamburger... Or sweet corn kernels cut off the cob... Or various herbs to try out... Or red wine.

Adds to the experience, IMO. I like having burgers that don't need the typical ketchup/yellow mustard/tomato treatment.

#9 ::: Alan Braggins ::: (view all by) ::: June 30, 2008, 01:24 PM:

> still quite raw on the interior. I'm surprised we didn't die.

Eating decent beef raw shouldn't be a problem. Compare with the steak tartare recipe.

Leaving it to warm but not really cook for 45 minutes on a grill that was possibly also used for other meat first might mean that a undercooked burger has a higher risk than steak tartare, but it would still be more surprising if it did kill you.

#10 ::: Bruce Cohen (SpeakerToManagers) ::: (view all by) ::: June 30, 2008, 01:24 PM:

I've been grilling cheeseburgers just this way (including the mayo) for many years, and I've been very satisfied with the results. For some reason, I fell out of the habit of using onion soup mix, and instead mix in dried onion flakes, worcestershire, garlic, salt, pepper, and a bit of red wine. One additional point about grilling: don't make the patties thin like FastFoodHockeyPucks™ unless you really like them very well done and dry.

#11 ::: Xopher ::: (view all by) ::: June 30, 2008, 01:36 PM:

prhm 5: I think I'm making Puppy burgers for dinner tonight.

That's so meeeeeeen. Poor puppies!

OK, I haven't had an actual meat burger, cheez or otherwise, in three decades. But I will say this to people who flatten the burger with the turner (which I REFUSE to call a spatula): ur doin it rong.

#12 ::: Kate Y. ::: (view all by) ::: June 30, 2008, 01:36 PM:

I get the bit about (not) pressing with the spatula. But why, O Hive Mind, is flipping more than once a Bad Thing?

#13 ::: John L ::: (view all by) ::: June 30, 2008, 01:46 PM:

I'll only say that if you start with a thick patty of hamburger, flattening them with the spatula while on the grill is not a problem. When done my burgers are still at least 1/2" thick and juicy, although done throughout.

I also flip them several times until I'm happy with the result. Maybe I just like flipping them...

We also add worcestershire sauce to the meat before forming them into patties.

#14 ::: P J Evans ::: (view all by) ::: June 30, 2008, 01:51 PM:


I've seen one recipe where you make two thinner patties and sandwich them with a bit of cream in the center (not to the edge). Seal the edge and grill. YMMV.

#15 ::: G. Jules ::: (view all by) ::: June 30, 2008, 01:55 PM:

I am a strong partisan of cheddar, Worcestershire sauce, sauteed onions or shallots, and toasted buns. And if there's a Whole Paycheck Foods in the offing, they've got excellent ground beef.

#16 ::: Caroline ::: (view all by) ::: June 30, 2008, 02:07 PM:

Alan Braggins @9, well, it was ground beef from Costco, probably originating at a factory farm. Not something I would ordinarily choose to eat raw. Had it been locally raised, small-operation beef that I'd ground myself, it would have been a different story.

#18 ::: julia ::: (view all by) ::: June 30, 2008, 02:20 PM:

Caroline, they keep it in a separate section, but our CostCo has organic ground beef.

#19 ::: Ursula L ::: (view all by) ::: June 30, 2008, 02:23 PM:

Kate Y. @ #12 wrote: I get the bit about (not) pressing with the spatula. But why, O Hive Mind, is flipping more than once a Bad Thing?

You want the outside of the burger to brown and crisp up. If you keep flipping the burger over repeatedly, you take the any given side off the heat, over and over, and interrupt the browning process, leaving you with a blander, greyer burger.

#20 ::: -dsr- ::: (view all by) ::: June 30, 2008, 02:26 PM:

Please consider your cheese carefully. If the package has qualifiers near the word cheese, such as "food", "pasteurized process", or "product", you have been deceived. It is not cheese.

I think a slice of Cheddar and a slice of Muenster go together well. Some like it Blue.

#21 ::: Larry Brennan ::: (view all by) ::: June 30, 2008, 02:32 PM:

Cook's Illustrated recently had a piece on making slider-style burgers at home that included a method for grinding your own beef using a food processor. If you're going to eat raw beef and want to be safer, this is the way to go about it.

I only buy the costco burgers for large-scale cookouts and then insist on taking them at least to medium-well. I didn't know they had organic. It's still industrial, but probably better than the non-organic.

For myself at home, I buy a local brand (Oregon Natural or something like that) and feel free to grill to medium rare. Mayo, however, is not welcome at the party unless it's been converted into homemade 1,000 Island Dressing. As for mustard, blasphemy!

#22 ::: Linkmeister ::: (view all by) ::: June 30, 2008, 02:34 PM:

Ursula @ #19 has it right: you sear each side to seal the juices inside.

Bruce (STM) @ #10 does something close to me. I use fresh chopped onions rather than flakes. That's another reason to sear the outside; unless you add bread crumbs or some other binder, the burgers want to fall away from the onions.

I used to flatten burgers until I absorbed the "you'll lose the juices" idea, probably from The Food Network early on in its tenure.

#23 ::: B. Durbin ::: (view all by) ::: June 30, 2008, 02:49 PM:

-dsr-: "Please consider your cheese carefully. If the package has qualifiers near the word cheese, such as "food", "pasteurized process", or "product", you have been deceived. It is not cheese."

Evil Rob has a story about a cookout where they ran out of cheese and somebody went to the store and purchased the cheapest thing there: FMV, also known as the generic of generics.

Apparently, when they put them on the grill, they didn't even melt.

Suggested uses for FMV "cheese" include shuttle tiles.

#24 ::: Theophylact ::: (view all by) ::: June 30, 2008, 02:53 PM:

Mayonnaise is fine; but it should be homemade garlic mayonnaise, a.k.a. aïoli. Otherwise, use ketchup -- or better yet, Dat'l Do-It Hot Sauce (not very hot, in my estimation, and fully fungible with ketchup for those who like a little zip in their lives).

#25 ::: Lance Weber ::: (view all by) ::: June 30, 2008, 03:07 PM:

Kate Y @ 12: But why, O Hive Mind, is flipping more than once a Bad Thing?

Everytime you move/flip/press a cooking burger you'll cause more of the juices to run out eventually leaving you with a dry burger. It's certainly okay to do an initial press as you place the patty if you want more pronounced sear marks. As with most meats, once you remove the burgers from the grill, you can cover and let them sit for a few minutes before serving to let the juices re-distribute.

Acceptable toppings also include large strips of Hatch green chiles grilled along side the burgers.

#26 ::: punkrockhockeymom ::: (view all by) ::: June 30, 2008, 03:26 PM:

Xopher@ #11:

First I saw your comment and laughed and laughed!

And then, just now, I had a phone conversation with said Pupster about the chores, and the dishes, and the ice rink...and now I'm thinking Puppy Burgers are JUST what the dietitian ordered for my headaches!

And the cure for adolescence. *wink*

Puppy Burgers are People!!!

#27 ::: Earl Cooley III ::: (view all by) ::: June 30, 2008, 03:40 PM:

One of these days, I'd like to try a Krabby Patty in the style in which master frycook SpongeBob SquarePants has made so famous.

#28 ::: Bruce Cohen (SpeakerToManagers) ::: (view all by) ::: June 30, 2008, 04:00 PM:

Odd as it may sound, a nice smelly Stilton or Gloucester works well on a burger. -dsr- @ 20 is correct; if it says "Food" on the package, it isn't.

#29 ::: Skwid ::: (view all by) ::: June 30, 2008, 04:06 PM:

My burgers always receive rave reviews, but their preparation takes a bit longer than the standard "dump an onion soup packet in" method. I start with extra-lean ground beef, then mix in Guinness (not much...say 1/4 cup per 2 pounds of beef? I eyeball it...). Cook the patties now, and they'll fall apart, so I add whole eggs as an emollient (again, at about an egg per 2 pounds). Then, the spices. Garlic powder, onion powder, chili powder, ground cardamom, red pepper sauce, and whatever else strikes my fancy. Cooking is as Jim describes, though I find that the meat needs to be shaped into a thin, broad patty to avoid looking like big beef pills.

For cheese, I prefer Swiss or Muenster, but usually I eat mine with just mayo (sometimes chipotle mayo), lettuce, and pickles.

I remember one time I was grilling and had forgotten to pick up cheese, so had a guest who hadn't yet arrived stop for cheese on the way. They brought me "American" "cheese," and completely failed to understand why myself and several other guests were clearly taken aback.

#30 ::: Debra Fran Baker ::: (view all by) ::: June 30, 2008, 04:09 PM:

Linkmeister @#22:

Ursula @ #19 has it right: you sear each side to seal the juices inside.

You sear the meat because it tastes better that way. It does NOT seal the juices inside. Harold McGee proved this - it actually opens the pores more.

Because I like my meat well-done, and so keep them on the heat longer, I can turn them more often and not lose the browning. (It's a texture thing. Non-well-done meat feels raw and unpleasant in my mouth.)

#31 ::: lightning ::: (view all by) ::: June 30, 2008, 04:48 PM:

#23 B. Durbin:

Suggested uses for FMV "cheese" include shuttle tiles.

Can't. 'Way too heavy.

As to the burgers, just about all the above recipes sound inedible. When you mix "stuff" into your burger (or anything else, for that matter), please keep in mind that many of us have food sensitivities. With me, for example, chopped onion in a burger would put me flat on my arse for about 12 hours. Whether I tasted it or not.

#32 ::: Lance Weber ::: (view all by) ::: June 30, 2008, 04:53 PM:

Debra Fran Baker @ 30:
What I do for folks who like theirs well-done when I grill: 5 minutes per side, one flip then a gentle spatula (Klatu Verata SPATULA!!!! So there Xopher!) move to the lower heat zone for 3 minutes. YMMV depending on burger size, lower heat setting, etc.

#33 ::: R. M. Koske ::: (view all by) ::: June 30, 2008, 05:00 PM:

#31, lightning -

Yeah, I was kinda thinking about that, too. I'm good with onions, it sounds yummy. But worchestershire sauce or Guinness? I can't go there, and even someone who knows about my intolerance could very likely not even think about those as problem items.

To make matters worse, I probably wouldn't have thought of a burger as a potential problem because my mother used ground beef, salt and pepper in her burgers. If she made a change, it was by building a whattaburger which was two thin patties and the filling of your choice (mushrooms or a variety of cheeses) sealed between them.

I hope no one here feels I'm scolding them, that's not it. It's more of a realization for me. If there's a chance it has something other than the obvious in it, I *have* to ask. Dammit.

#34 ::: Elyse ::: (view all by) ::: June 30, 2008, 05:27 PM:

Many of these recipes sound delicious.

Unfortunately, a couple of weeks ago I was diagnosed with allergies to milk, eggs, and malt. (It's amazing how hard it is to find commercial baked goods that don't include one or more of those three ingredients.)

Also stringbeans (but not kidney beans) and shellfish, but at least stringbeans and shellfish aren't in EVERYTHING.

I'm still trying to figure out what I can still eat and jonesing for cheese like you wouldn't believe. I go back to the doctor next week and I'm going to insist on separate tests for goat and sheeps' milk

#35 ::: T.W ::: (view all by) ::: June 30, 2008, 05:28 PM:

Our ground beef comes off the family farm and is often too lean but bacon drippings mixed in takes care of that.

#36 ::: Linkmeister ::: (view all by) ::: June 30, 2008, 05:58 PM:

My chopped onion insertion occurs only when I'm cooking for the two of us; if there's company I just make 'em straight up. Meat, s&p and that's it.

#37 ::: R. M. Koske ::: (view all by) ::: June 30, 2008, 06:27 PM:

#34, Elyse -

Malt generally contains gluten, so it is avoided by people who have Celiac and/or are gluten-intolerant. You can start checking out the products labeled gluten-free and surfing the gluten-free recipe sites. Karina at Gluten-free goddess is also allergic to milk, and she posts a fair number of vegan recipes, so you'll definitely find some things that are malt-free, egg-free and dairy-free there. Avoiding dairy is pretty common among people avoiding gluten, for some reason.

I've got my fingers crossed for you that you'll be able to tolerate sheep's or goat's milk.

#38 ::: Lee ::: (view all by) ::: June 30, 2008, 08:01 PM:

Alan, #9: I'll see your steak tartare and raise you kitfo. Had some at an Ethiopian restaurant in Dallas last year, and it was outstanding. They offered it in raw, rare, or well-done versions, and with mild, medium, or hot spicing. I keep meaning to try making my own version, but it hasn't happened yet.

#39 ::: pcomeau ::: (view all by) ::: June 30, 2008, 09:12 PM:

2 more cents:
James Beard American Cookery has been my bible for burgers.

Nothing fancy, just add some shaved onion and 1 tablespoon of heavy cream to each pound of ground meat.

Works great for lamb burgers too.

#40 ::: Debra Fran Baker ::: (view all by) ::: June 30, 2008, 09:52 PM:

Lance @ 32:

That sounds about right for making meat well-done. With patience, I can get juicy meat. I use tongs to do my turning - very gently.

And I mix fattier and leaner ground beef for my burgers, adding a fair amount of freshly ground pepper. I don't add salt because kosher meat gets thoroughly salted during processing. We prefer them absolutely plain, to be eaten with a knife and fork.

#41 ::: Laurie Ashton ::: (view all by) ::: July 01, 2008, 01:03 AM:
Evil Rob has a story about a cookout where they ran out of cheese and somebody went to the store and purchased the cheapest thing there: FMV, also known as the generic of generics.

Apparently, when they put them on the grill, they didn't even melt.

Sounds like the only kind of locally-made "cheese" we can get here in Sri Lanka... Just for kicks, I took a bit of "cheese" and put it in a frying pan on the highest flame because, well, I'm just that curious. Evidently, re-entry into the Earth's atmosphere wouldn't be enough to melt it since it turned black without even a hint of melting.

The last time I had decent cheese (note the lack of quotation marks) was on a trip to Dubai or Singapore.

#42 ::: Marilee ::: (view all by) ::: July 01, 2008, 01:27 AM:

I was in my early twenties when I first had hamburgers at someone else's house and they just made them of meat! I was shocked! In our family, we added bread crumbs, almost the same volume as the meat, and that was when I realized we did it to save money. I'd done plenty of other things to save money, I just hadn't realized the bread crumbs in hamburgers were for that.

#43 ::: Mikael Vejdemo Johansson ::: (view all by) ::: July 01, 2008, 03:25 AM:

At one, legendary, fast food shack in the general Stockholm area, there used to be an extremely innovative special menu available. With entries such as the half and full cheese burger (7 or 14 slices of cheese), and the chocolate burger:

Mashed potatoes
Chocolate square
Meat patty

Tasted a lot better than you'd expect. Really.

#44 ::: James D. Macdonald ::: (view all by) ::: July 01, 2008, 05:51 AM:

#31 please keep in mind that many of us have food sensitivities.

It's up to the cook to be aware of the guests' food sensitivities, and it's up to the guests to make the cook aware of their food sensitivities.

When you're cooking for yourself and your family, well, you cook for yourself and your family.

#45 ::: tom ::: (view all by) ::: July 01, 2008, 06:02 AM:

My girlfriend likes the idea of an egg added to burgers. And onion and all sorts of spices. And to be perfectly fair, I have made and enjoyed burgers with all sorts of things added to the meat. These days, though, I live in West Africa, and ground beef of decent quality is not easy to come by. When I do get it, all I want is salt and pepper.

I have always felt that a burger that requires pressing needed better shaping to begin with. The flip side of that is that a well shaped burger is quite thin in comparison to its diameter (This still means 3/4 of an inch thick for me, but I use more than half a pound of meat per burger) and is thus fragile. Flipping more than once is not a mortal sin, but flipping too early is, because everything will fall apart. And it just so happens that flipping as soon as the burger is cooked enough to hold together, and then letting it cook that long again on the other side, results in a perfect medium rare, so why flip more?

The most important thing I have found when cooking burgers is coals hot enough to get good brown color on the outside in just a few minutes.

#46 ::: R. M. Koske ::: (view all by) ::: July 01, 2008, 09:20 AM:

#44, James D. Macdonald

It's up to the cook to be aware of the guests' food sensitivities, and it's up to the guests to make the cook aware of their food sensitivities.

I agree with that 100%. That is the hardest part of my food sensitivities for me. It feels like I'm being difficult or ungrateful when I need to ask any host what *exactly* they put into the food. That feels wrong, to "distrust" a friend (who is making me food!) like that. At the same time, it is absolutely wrong to make them responsible for knowing what I can and can't eat. I haven't found the mental balance that makes it okay to do what I need to do.

And I'll repeat myself from earlier - I don't want anyone to feel scolded. You're right. For your family, make it taste good! I'm sure the bits I can't eat (breadcrumbs, worchestershire, Guinness) make for a really good burger. I'm a grownup and need to take care of myself.

I'm grateful for the conversation and for lightning's post, because I never would have thought of additives to hamburgers as a possible issue. As a matter of fact, I'm invited to a cookout this weekend, and I need to contact my host to check on that and see what I should bring.

#47 ::: James D. Macdonald ::: (view all by) ::: July 01, 2008, 09:34 AM:

I once ran into a case of anaphylaxis where the patient (who was allergic to seafood) had eaten french fries that had been cooked in the same oil that had been used to cook fried clams.

You have to know and ask and watch out, and you can still get surprised.

#48 ::: R. M. Koske ::: (view all by) ::: July 01, 2008, 10:01 AM:

#47, James D. Macdonald -

Ain't that the truth. The potential avenues for exposure are so much greater than you expect when you first learn of an allergy/intolerance. I keep finding them, dammit. I'm very lucky that mine is an intolerance and not a true allergy. Anaphylaxis is scary.

#49 ::: Rikibeth ::: (view all by) ::: July 01, 2008, 10:46 AM:

Elyse, there's a terrific book called "Vegan Cupcakes Take Over The World" that might be useful for you. I've found the cupcakes very simple to make and the chai ones are especially tasty.

#50 ::: Debra Fran Baker ::: (view all by) ::: July 01, 2008, 10:57 AM:

It really depends on the food issues and the person. I'm type II diabetic, for example, and under decent control with my meds and diet. This means that, while I'll tell a host this if they ask, it's okay if they don't. I can determine what I can and cannot eat and I'm perfectly happy to skip dessert or steal a bite of someone else's. A mistake isn't going to kill me, or even hurt me. My husband needs to control his salt intake, and he's perfectly happy to skip the soup or let me taste it first.

I also keep kosher, and I can't expect anyone who doesn't to provide anything but, say, fresh fruit. Or I'll take my own steps - there's a reason I run con suites.

However, I do ask my guests about food issues, and I've provided vegan/vegetarian food for seders, nightshade-free meals for a friend allergic to them, and adapted a recipe so a child in a family could avoid the nitrites that give her migraines.

#51 ::: Lance Weber ::: (view all by) ::: July 01, 2008, 11:19 AM:

The rise in awareness for food-specific intolerances (in addition to lifestyle and allergy dietary restrictions) has really complicated party planning. Earlier this spring my wife invited a dozen+ girlfriends over for a "girls only" party - which meant of course that I had to provide all the food/drink and then disappear like good hired help should. About half the attendees had some kind of dietary restriction:

* Vegetarian
* Vegan
* Wheat/gluten-free
* Lactose Intolerant
* Onion Intolerant (light okay)
* Severe Celery Allergy (no traces!)
* Low Carb/South Beach Diet
* No Red Meat

My first reaction was to throw up my hands and tell her I'd be serving two dishes: water or water with lemon. But of course the challenge began to intrigue me: What would be the minimum number of dishes I could make that would still allow everyone to enjoy 2-3 items. It about doubled my upfront planning effort, but I was able to pull it off pretty successfully.

I'd be interested in what you other foodies and super-hosts do though, is that just going to be the new norm? Should I invest in a startup that'd be a cross between a recipe indexer and social network for everyone's dietary restrictions??

#52 ::: Debbie ::: (view all by) ::: July 01, 2008, 11:58 AM:

Lance Weber @51, a network or searchable database or something would be nice sometimes. In my fairly immediate family there is someone with gluten intolerance, a diabetic, and someone with cholesterol issues (not to mention the spectrum of likes and dislikes -- no lamb! broccoli, yuck!). When we all get together it's usually for something kind of special, so of course you want everyone to be included. I very, very, very much appreciate knowing people's sensitivies ahead of time.

I have been playing around with the idea of trying to collect ML recipes into some sort of database. Step 1: Learn how to use database software*. In my ideas about how to organize it I've always considered dietary restriction search terms.

*not too far behind the times, am I? Looking at this positively, it's like killing two birds with one stone -- I get the recipe collection and learn a new skill.

#53 ::: ethan ::: (view all by) ::: July 01, 2008, 12:04 PM:

Does anyone know how much of it is increased awareness of food-related health problems, and how much of it is, well, The Sheep Look Up? By which I mean, does anyone know?

#54 ::: James D. Macdonald ::: (view all by) ::: July 01, 2008, 12:10 PM:

#48: Anaphylaxis is scary.

Tell me about it. Anaphylaxis is a true medical emergency; people die from it. Signs and symptoms develop within twenty minutes of exposure. Of those who die the majority of deaths occur within the first hour.

#55 ::: Lance Weber ::: (view all by) ::: July 01, 2008, 12:23 PM:

The person with the severe celery allergy I mentioned above? She'll experience life threatening shock with even the slightest exposure. She carries epi-pens at all times, because it's such a ubiquitous/hidden ingredient it can show up quite unexpectedly.

#56 ::: Lance Weber ::: (view all by) ::: July 01, 2008, 12:34 PM:

Ethan @53:
I'll be honest, I think quite a few folks who ascribe some of their health issues to specific food intolerances are really suffering from poor dietary choices in general rather than anything specific. I think the science is pretty clear now that eating overly processed, nutritionally empty, glycemic bombs whose calories exceed what you burn by 2-4 times is a Bad Idea.

#57 ::: James D. Macdonald ::: (view all by) ::: July 01, 2008, 12:51 PM:

A really good anaphylaxis article.

If you see anaphylaxis:

Call your friends from 9-1-1.

If the patient has epinephrine, get it into him/her.

Treat for shock.

Stand by to do CPR if necessary.

#58 ::: debcha ::: (view all by) ::: July 01, 2008, 12:56 PM:

#51: Lance

I've definitely done similar meals, albeit nothing quite so elaborate (I think the most complex I've done was vegetarian, lactose-intolerant, and celiac disease at one meal). My solution is normally is to crib shamelessly from other cultures and do mezze, tapas, Indian food or the like - something that consists of lots of dishes. It works great. I highly recommend Mark Bittman's The Best Recipes in the World if you want straightforward but yummy foods from non-European cultures.

Of course, left to my own devices, I'm happy to eat a non-kosher, red-meat-containing, lactose-rich, wheat-containing cheeseburger. With mayo.

#59 ::: Andrew Plotkin ::: (view all by) ::: July 01, 2008, 01:04 PM:


That article is useful (I was not sufficiently educated on the
subject). However, I tripped over this line on the first page:

"An explosive reaction involving the skin, lungs, nose, throat, and
gastrointestinal tract can then result."

Classic case of "You weren't writing this for SF fans, were you?"

#60 ::: R. M. Koske ::: (view all by) ::: July 01, 2008, 01:07 PM:

#53, ethan -

Gluten intolerance/celiac is an autoimmune disorder, so there's some chance that it's on the increase due to increased environmental stresses on the immune system. I do believe autoimmune disorders in general are on the rise. I don't know how many other food issues fit that model, though.

There's also a definite increase in awareness of it - until just recently it was thought of as something that occurred only in children and was outgrown by most people who had it.

#61 ::: James D. Macdonald ::: (view all by) ::: July 01, 2008, 01:49 PM:

Classic case of "You weren't writing this for SF fans, were you?"

When you see a full-blown rapid-onset case ... it's closer to what SF fans would imagine than you probably want to get.

There's a photo here (Teresa don't look). Note that the patient has been trached. (That is to say, he's lost his upper airway so a surgical opening had to be made in his throat.)

#62 ::: Lee ::: (view all by) ::: July 01, 2008, 03:42 PM:

A few years ago, I read two mystery novels in close succession which revolved around nut allergies. One of them handled the topic very plausibly; the other... didn't, and it bounced me right out of the story. (In brief: guy who knows he has a bad nut allergy, goes into something he knows is a high-risk situation, why the HELL didn't he have an epi-pen on him?)

#63 ::: Marilee ::: (view all by) ::: July 01, 2008, 07:31 PM:

The other problem with autoimmune diseases is that once you have one, others tend to develop. I'm up to eight now.

#64 ::: BSD ::: (view all by) ::: July 01, 2008, 08:16 PM:

My current preferred hamburger technique goes like this (this is a grill or grill-pan recipe. Flat skillet or broiler needs to be done entirely differently):

Mix chopmeat with sufficient Worcestershire to season (make salty enough).
Thinly slice pickles.

Scoop up about a handful, press to about 1.5" thick between hands. I prefer a slightly bulging middle to a true disc. Just before cooking, coarsely grind pepper and put a VERY small amount of salt on ONE side.

Heat grill very hot, oil well. Place burger, seasoned-side down. This should be noisy.
Immediately season top side of burger as previous. Cook until bottom is crusty, generally about 2-3 minutes depending on grill, flip, do not press, cook for 1.5-2 minutes more, until second side is crusty. The burger should be barely warm at center, but have some texture outside, should retain shape well.

Suggested condiments include tomato and pickle. As it is perfectly seasoned, ketchup is not recommended, and either pan dripping (if a grill pan was used) or mayo should be used if a wet condiment is desired.

#65 ::: Michael Roberts ::: (view all by) ::: July 01, 2008, 08:40 PM:

Elyse @34 - the distinction between goat and cow milk is not always too clear. Narrow it down to caseine vs. whey proteins, though -- you might be OK on cheese. (Or might not -- stay off it a couple of weeks, then try some cheese. Better yet, try cheese on a three-day periodic schedule and log all your symptoms, for a couple of weeks. If you get correlation, start thinking about cheese alternatives.)

Lance @51 - that's a fantastic idea! I'll write it when my current work glut subsides. Or I'll plan to, then get distracted by something shinier. sigh.

Also, Lance @56 - you ain't kidding about that. Also, we're doing a candida cure for most of the family (not me; I can't live without Coca-Cola, in a "looks like I picked the wrong day to give up heroin" sense.) It is hard to eliminate carbohydrates in earnest.

Marilee @63 (whose name I am working hard on pronouncing correctly in my head) - have you tried any dietary changes? Just curious, actually. Autoimmune diseases suck. My family collects them, too.

#66 ::: Rikibeth ::: (view all by) ::: July 01, 2008, 09:31 PM:

Lee, I've got a nut allergy, and it's severe enough to make an epi-pen a good idea, yet I don't carry one around as a matter of course.


No health insurance. And I keep forgetting to ask for a new prescription on my infrequent doctor visits. I had one once, you see, and it expired without me ever using it (hallelujah).

It's true, the only nuts that trigger the reaction are Brazil nuts, and those are uncommon enough that they're usually called out on a menu description, let alone on an ingredient listing. And I avoid unspecified "mixed nuts" just in case -- I once ordered a Chinese dish that called out "almonds, peanuts, and cashews" on the menu, and when it arrived, they'd clearly used mixed-nuts-from-a-can, 'cause there was a Brazil nut sitting on top of the dish, large as life. Good thing it was on top! Sent it right back, explaining that I'd like to substitute another dish entirely, because that one? Could have killed me.

The other thing I have to watch out for? Cosmetics. I've learned to check ingredients on hippie organic skin creams, and I don't let anyone put unfamiliar product on my hair before I check the label. I'm not SURE that Brazil nut oil sprayed on my hair would provoke a reaction, but I don't want to find out.

But with all of that... I still don't carry the epi-pen. I find it easier to be cautious.

#67 ::: James D. Macdonald ::: (view all by) ::: July 01, 2008, 09:37 PM:

You can get a neat belt holster for your Epi-pen by buying a Mini-Mag flashlight and using its belt holster. And you get a great flashlight out of the deal too!

#68 ::: P J Evans ::: (view all by) ::: July 01, 2008, 09:58 PM:

I have to admit that going anaphylactic from antibiotics is a lot easier to deal with. (You can sure end up with a short list of 'this seems to be safe' drugs.)

Marilee, I was reading in Science News some time back about a Swiss study, where they were getting correlations of some kind between autoimmune disorders (diabetes was specifically mentioned) and things like bipolar/unipolar disorder. They're thinking some kind of inflammation is involved, but it's still way too early to say what's going on. Also the study was a fairly small group, a few hundred people.

#69 ::: Sandra Cormier ::: (view all by) ::: July 01, 2008, 11:23 PM:

Please, please please don't buy into the notion that a medium rare hamburger is the way to go. The burger MUST be cooked all the way through or you run the risk of contracting E-coli bacteria.

Steak tartare is not a true example of rare beef. Because steak is all in one piece, the e-coli bacteria is cooked off on the outside surface, therefore safe to eat.

Hamburger has the e-coli ground up and distributed throughout the meat, increasing the risk of the bacteria surviving on the inside of the patty.

The daughter of a friend of mine ate an undercooked hamburger and her kidneys shut down. She was close to death for several weeks.

Spice 'em up any way you want. Flip them, squeeze them and love them, but cook them thoroughly.

#70 ::: Lee ::: (view all by) ::: July 01, 2008, 11:29 PM:

Rikibeth, #66: Oh, I understand that sort of thing happening in real life, but fiction has to make sense. :-) The guy in the book was clearly shown as not being in denial about his allergy, and he was prosperous, so the "no insurance" reason wouldn't seem to apply. But the largest problem was that none of the characters seemed to be aware that such a thing as an epi-pen existed! I'd have been okay with a 2-sentence exchange just showing that somebody was curious about it, even if the response had been, "I have no idea why he didn't."

#71 ::: Rikibeth ::: (view all by) ::: July 01, 2008, 11:42 PM:

Lee, #70: definitely! You'd expect the medical examiner at LEAST to have raised the question, even if his friends were oblivious about it.

I hate those logic lapses. Like the one in Minority Report where all I could think of was "Wouldn't HR have deleted his biometrics from the security system as soon as he was canned?" and so the complex and icky plot device failed to work for me.

#72 ::: Mez ::: (view all by) ::: July 02, 2008, 05:55 AM:

IIRC, one of the major functions proposed for personal computers, way back when the idea of them was just being seriously discussed, was "organizing your recipes".

#73 ::: Ingvar M ::: (view all by) ::: July 02, 2008, 11:12 AM:

Mikael Vejdemo Johansson @ #43

If you haven't tried the burgers at Stångebro Gatukök (Linköping, can't recall the exact address, but it's past S:t Lars, down to the river, across the bridge and then another 50-100 metres, near the fire station), it's almost worth a train journey from Stockholm in order to do so.

The "House burger" is a 150 g lump of meat that's fried (OK, OK, not grilled, but charcoal grills indoors is nasty), with a weight on top to flatten it from spherical. Flipped once, served in a bun with fresh veg, burger sauce made in the kitchen (optional), ketchup made in the kitchen (optional) and mustard made in the kitchen (also optional). Make sure to order the fries, they're thickly cut and fried to perfection (deep-fried, that is). It's also worth shelling out for some sauce bearnaise to dip them in (made fresh daily in the kitchen).

There's also several different expressions of the "house burger" (to wit, "slice of cheese", "thiick slice of garlic cream cheese", "blue cheese", two or three spicy versions and by now probably more).

#74 ::: P J evans ::: (view all by) ::: July 02, 2008, 11:23 AM:

Mez @ 72
The best version I've heard of 'using the computer to organize recipes' was to create a database of favorite recipes, and which cookbook they were in - so they could be found more easily.
(Somehow I don't think that's the kind of 'organizing recipes' that was intended.)

#75 ::: Ginger ::: (view all by) ::: July 02, 2008, 12:22 PM:

Sandra Cormier @ 69: I appreciate your concerns about cooking or eating rare to raw hamburger, but you've got a few errors floating in your post.

The appearance of the meat (medium to rare) does not correlate to temperature, so if you want to protect yourself, get a meat thermometer that's accurate and use it. 160 degrees is considered appropriate for ground beef.

Steak tartare is not cooked. It is still at the same risk for bacterial contamination as hamburger or kitfo or anything else. It's not the consumer handling that puts the meat at risk, it's the slaughterhouse and butchers. If the carcass is contaminated, the meat is contaminated. Proper handling of the entire carcass throughout the process makes the meat safe to eat.

E. coli is actually a common bacteria in our gut, so the presence of E. coli in your food is not the danger -- it's the presence of specific strains of E. coli -- O157:H7 in particular -- that are dangerous. This strain causes serious illness and renal damage.

The vast majority of meat processed in this country (and Canada) is from a healthy animal, is processed properly, and is brought to the consumer in a safe-to-eat package. The odds are, you'll be fine as long as you monitor the temperature of your meat as it cooks.

#76 ::: Janet Croft ::: (view all by) ::: July 02, 2008, 01:05 PM:

Organizing recipes? I use a program called MasterCook (widely available, including on Amazon). It's got a pretty good search function you can use to include or exclude certain ingredients, or on a more sophisticated level, search for a specific nutrient above or below a certain threshold, for example. If you added a descriptor like "lactose-intolerant" or "high fiber" to your recipes as you entered them, you could apply some Boolean logic to come up with a menu to suit a group of folks with different special needs. It comes with a pretty big recipe file, and it looks like the newest version can import recipes from the internet (WANT!). The thing I really like about it is the nutritional analysis. I can input a recipe and see exactly how many carbs are in a serving. I recommend it!

#77 ::: R. M. Koske ::: (view all by) ::: July 02, 2008, 01:20 PM:

#75, Ginger -

E. coli is actually a common bacteria in our gut, so the presence of E. coli in your food is not the danger -- it's the presence of specific strains of E. coli -- O157:H7 in particular -- that are dangerous. This strain causes serious illness and renal damage.

I might have already known this and forgotten. I did know that E. Coli was present in our gut, but not that it wasn't the dangerous strain.

This is of particular interest because the microbiologist who first drew public attention to germs and their relationship to safe food handling in the kitchen* has turned his attention to laundry. He has discovered that common laundering doesn't kill germs, and every single washing machine he's tested had E. Coli in it.

I think there was some twitter in the place I learned about this, but my main reaction was, "So what? It obviously isn't hurting us." And now I know why not.

*I can't recall his name and I can't look it up now. I'm stealing time for the post. I can look it up later if there's interest.

#78 ::: JESR ::: (view all by) ::: July 02, 2008, 02:47 PM:

Note: I don't eat ground meat from cows (or pigs or turkeys, for that matter) I haven't met personally.

There are way too many places in the commercial ground meat stream where the living animal or meat could be exposed to disease pathogens or chemical contaminants. And thorough cooking doesn't take care of other points of contamination after the uncooked meat comes into the house and before it is cooked which can come back at us through other foods.

#79 ::: Mikael Vejdemo Johansson ::: (view all by) ::: July 02, 2008, 03:06 PM:

I once played a cook at a LARP where the group's in-game leader handed me a single paper sheet.

Containing the list of things she could eat. Nothing not on that list was to come even close to her digestion.

The list contained things like:
* Salt
* Red meat
* Overcooked potatoes or pasta
* Mushrooms

and not really much at all in the way of seasoning.

I managed, in the end, to pull off an enjoyable 6-course banquet for the group, with only very few extra motions to accomodate her.

#80 ::: Ginger ::: (view all by) ::: July 02, 2008, 04:02 PM:

RM@ 77: There's always some one ready to point out that germs OMG! exist on nearly every single surface in our daily lives. My reaction is always "Yes? Your point is..?". We live in a soup of microorganisms (said the former microbiologist). Nothing we do will remove them from our lives, and besides, who wants life without apple cider or wine? Or cheese?

Our immune systems evolved inside this stew, and I think we're pretty well capable of handling the majority of microbes that come our way. In fact, our gastrointestinal tract has been described as a "tube of outside going through the inside", which is really a good way to look at it.

Then again, a human being is just a genome's way of making a new genome.

#81 ::: Michael Roberts ::: (view all by) ::: July 02, 2008, 04:20 PM:

Ginger @80 - even more than that, I'm finding; a good case can be made that the bacteria in our GI tracts are part of us. Certainly a healthy ecology in the gut really contributes to immune resistance. And there are more bacterial cells in a human being than human ones, anyway. (Even if you don't count mitochondria...) (Augh! There are bacteria in my cells!)

#82 ::: James D. Macdonald ::: (view all by) ::: July 02, 2008, 06:08 PM:

It's been suggested that the purpose of the appendix is to provide a safe haven for intestinal flora.

#83 ::: Madeline F ::: (view all by) ::: July 02, 2008, 06:32 PM:

#82 James D. Macdonald: I was just thinking about mentioning that! The way I heard it, the hypothesis is that back in the day when we were small roving bands, it was harder to come by good bacteria, and if you lost yours in some illness there were fewer other humans to pick up new ones from. So you needed an appendix as a long-tern storage vault for bacteria, but these days removing the appendix has no apparent effect because there's plenty of other sources of necessary bacteria.

The other cool thing I heard, when I told this hypothesis to some of my friends, was that people were studying the specific bacteria that live on humans in happy symbiotic relationships, and had found 6 different ones that lived only the in crook of the elbow and nowhere else on the body, that were shared amongst humans... Here's the article that probably came from.

I've certainly noticed that some oral antibiotics cause constant burping and attributed that to imbalances in gut flora. Ulcers, too: I suspect the heliobacter pylori that cause them grow better in the chemical conditions that occur when a person is stressed and eating poorly.

This reminds me of a previous suggestion of mine in the handwashing thread, that doctors wash their hands and then spray them with an innocuous bacterial culture to crowd bad bacteria out of the possible environmental niches...

I got that idea from a presentation given in the Plant Genetic Engineering class I took in college... A presentation given by perhaps the bitterest most broken man I've ever seen. He had been part of a team that did way early bioengineering of bacteria. The story is, frost damage causes a ton of crop loss. They figured out that there are bacteria living everywhere with a brilliant dispersion technique: the bacteria have a setup on their outside that holds 6 water molecules in a hexagon in the right position to make an ice crystal. When the temperature hits the freezing point, water can bumble around for a long time not freezing, but not with these bacteria there to help: it starts forming ice crystals right around them, and goes from there once the initial order is imposed, and these bacteria end up at the center of a snowflake, which is whipped up into the atmosphere by breezes and carried all over the world. Unfortunately, if the bacteria was sitting on a potato plant, that plant is scarred by frost.

So these guys adapted the icing bacteria to have a cockeyed water-holder, so they didn't make ice crystals. They sprayed the ice-minus bacteria on a potato patch, and saw that the frost damage there was hugely lessened, because the ice-minus bacteria lived in the exact same niche as the ice-plus bacteria. They were planning to save potatoes all over Washington state when anti-GMO activists started a campaign against them; and this was a long time ago, back when those guys were actually smashing things. The farmers backed out and I don't think the idea has ever been revived.

#84 ::: Lee ::: (view all by) ::: July 02, 2008, 07:20 PM:

Ginger, #80:
They're all over me!
They're inside of me!
Can't get 'em off of me!
I'm covered with...(microscopic bacteria)
What do they want from me?
What'll they do to me?
There's no escape for me!
I'm crawling with...(microscopic bacteria)

- "Germs", Weird Al Yankovic

#85 ::: Bruce Cohen (SpeakerToManagers) ::: (view all by) ::: July 02, 2008, 07:24 PM:

Madeline F @ 83

had found 6 different ones that lived only the in crook of the elbow and nowhere else on the body, that were shared amongst humans

That's not surprising. Commensal and symbiotic organisms co-evolve with their hosts, and so the niches they fill become very specific (pun intended). There's a species of mite, Demodex follicularum, which IIRC is found only in human eyebrows. We've made a home for it.

I agree with Michael Roberts @ 81, though I might phrase it a little differently: a human being is a collection of organisms of various species, including homo sapiens, in a commensal relationship. You can't really say which organisms are "part of" which are "separate from" the human organism; many of them can't live away from a human body, and many of them are necessary for correct operation of the human body.

"I can be cheezburger", as the LOLcat said to the Buddha.

#86 ::: Earl Cooley III ::: (view all by) ::: July 02, 2008, 07:59 PM:

Ah, cheese. The best tasting cheese I ever had was U.S. government surplus cheese, which, as far as I know, was one of the few perks Reaganomics provided for the non-wealthy (at least the best one fueled by taste-driven nostalgia).

#87 ::: Clifton Royston ::: (view all by) ::: July 02, 2008, 08:26 PM:

Bruce Cohen @ 85

Madeline F @ 83
had found 6 different ones that lived only the in crook of the elbow and nowhere else on the body, that were shared amongst humans

That's not surprising. Commensal and symbiotic organisms co-evolve with their hosts, and so the niches they fill become very specific (pun intended). There's a species of mite, Demodex follicularum, which IIRC is found only in human eyebrows.

... and a different species of mite which lives only an inch or so away in the pores on the forehead.

#88 ::: R. M. Koske ::: (view all by) ::: July 02, 2008, 09:24 PM:

Here's the article I read about the laundry and E. Coli. I was misremembering about how many washers had E. Coli - it was one-fifth, not all of them. (I'm not sure where I got that from!)

While digging out the link, I also found two interesting pages about spices killing E. coli O157:H7. One is about cinnamon killing it in apple juice, the other is about cinnamon, garlic, clove, oregano and sage killing it on hamburger meat. (They did test the spices individually. Clove was most effective.)

#89 ::: Marilee ::: (view all by) ::: July 02, 2008, 09:46 PM:

Michael Roberts, #65, the doctors don't care what I eat as long as it's not more than 60gr protein a day and at least 1000 calories a day. I don't get hungry anymore, so I have to prompt myself to eat. As you may have guessed, I have focal glomerulosclerosis, which is a renal autoimmune disease. We think it may have come because I had an earlier renal failure (ibuprofen poisoning -- not too much, I'm just sensitive) and during the last surgery on my ankle, the anesthesia triggered an autoimmune lung disease, which is a lot like asthma. I haven't shown any symptoms to any food, and the doctors think the additional autoimmune diseases are just my immune system continuing to try to kill me.

PJ, #68, I saw that, too, but I see a psychiatrist every few months to make sure the SSRI is working and neither of us think I have any indication of anything more complicated than depression (largely due to lots of dead brain).

#90 ::: Michael Roberts ::: (view all by) ::: July 02, 2008, 10:48 PM:

Marilee - my son has minimal change disease, but it's not in a nephrotic range. And has been pretty stable, within certain limits, for four years now. When his allergies are stimulated, his proteinuria gets worse.

When he's given steroids, his proteinuria gets much worse. This is really idiosyncratic.

Our current theory -- and his nephrologist has no opinion yet -- is that this is because the steroids upset the intestinal microflora balance, that this degrades the condition of the gut wall, that that in turn allows more poorly-digested peptides access to the bloodstream, and that the resulting stimulus to food allergy exacerbate the inflammation in the kidney.

We're using the "specific carbohydrate diet" -- which helped our daughter get entirely asymptomatic with her Crohn's Disease last year (yes, it's all been very informative) -- to address the health of the intestinal wall. Results have been mixed; there have been some reasons to believe that the dietary change is having the effect we want, but as he's not actually in remission (yet!), it's not at all conclusive. On the other hand, his proteinuria was at the lowest level we've ever measured, last time we measured it (a month ago). So that's a good thing.

I was just curious whether you'd heard of any low-carbohydrate approach or probiotic approach or not. Apparently not. It's certainly not the diet for everybody, but I really think some aspect of it will be the future of auto-immune treatment.

#91 ::: P J Evans ::: (view all by) ::: July 02, 2008, 11:25 PM:

Marilee, that one was interesting to me because my most-senior-aunt has bipolar and rheumatoid. We're playing with a not-quite-standard deck, I think.

#92 ::: Paula Helm Murray ::: (view all by) ::: July 03, 2008, 12:24 AM:

I came kind of late to the party but;
#23; one useful thing one can do with that kind of cheese is to put the unwrapped packets on the grill and see which person's cheese slice blows up first. I believe this started in the U.K.

#30: Alton Brown did that with steak on one of his programs. It did not fundamentally change the weight (he seared one before broiling, left another one plain, then put into oven until both reached 140 Degrees).

Anaphylaxis--I've had it, once. After cleaning in our basement. Never got it again, though IV Benedryl is, urm, interesting.

Right now I'm fighting the battle of making sure Margene does not eat rare burgers or raw eggs. She's going to have the third of four doses of the rougher chemo tomorrow, and it's been a thrill (I'm chief cook here, esp. since I became unemployed). I have to hope beyond hope that the white cell booster they are giving her helps.

#93 ::: jere7my ::: (view all by) ::: July 03, 2008, 01:41 AM:

Also coming late, but: You want the secret to savory burgers? I stumbled upon it through experimentation. In addition to the aforementioned Alton Brown method (no-press, flip once), mix half a teaspoon of dry mustard in with the hamburger. Maybe some basil and black pepper, and possibly a tablespoon or two of A-1, but all of that is secondary to the mustard powder, which will unlock the awesome flavor of delicious burger. Add no salt to the interior, but apply it liberally to the outside. Win.

#94 ::: sherrold ::: (view all by) ::: July 03, 2008, 10:23 AM:

Ginger @75 said: The vast majority of meat processed in this country (and Canada) is from a healthy animal, is processed properly, and is brought to the consumer in a safe-to-eat package.

And of course, that's true. And I routinely eat raw hamburger, without taking care to grind it myself.

Nevertheless, meat safety in this country is a ongoing problem. The USDA is completely pwned by the meat packing industry, downer cows are a constant issue, we recalled 143 MILLION pounds of hamburger just a few months ago, and much of that meat proved to be untraceable, already put into consumer goods. (After the 2002 e coli out breakout, again after the 2003 Mad Cow scare, the USDA promised better tracking procedures. Nothing happened.) And most beautiful of all, when a Kansas producer wanted to test ALL of its cows, rather than the USDA required 1%, the USDA forbid them.

Having said all that, I admit to being amused at myself. Like I said, I routinely test the flavoring in my burger mix by tasting the raw meat and poo-poo any concerns onlookers share with me. But I had a strong gut reaction to Ginger's post. Maybe it's just a desire for a more informed group of raw meat eaters?

#95 ::: Soon Lee ::: (view all by) ::: July 03, 2008, 04:20 PM:

Paula Helm Murray #92
Anaphylaxis--I've had it, once.

Twice here if anyone's keeping score. Wasp sting. Fortunately I have no food allergies.

My standard meat pattie recipe (the rare occasions I make it) involves mince beef, onions, salt & pepper. I'm on the flip-once-only team.

I've been told that NZ beef tastes qualitatively different from American beef; grass-fed vs grain. In general, our cows are left out on pasture to feed on grass.

#96 ::: Marilee ::: (view all by) ::: July 04, 2008, 02:51 AM:

Michael, #90, I was on long-term high-dose steroids for the lung disease before the newer better drugs came about and I became Cushingoid. I still have some of the effects, so we do dose-paks only when I really have trouble breathing. My proteinurea is pretty low these days, about 7, but when the second renal failure was diagnosed, I had 57 grams in a 24-hour urine. If I eat too much protein, my kidney labs get worse, but I don't normally eat that much protein anyway. In fact, I just went 25 hours without eating or drinking again (partly due to having to take narcotics for pain and sleeping a lot) so am now having rehydration fluid before I go to bed. I don't think what I eat makes a big difference, since I'm a large person and in the past, many doctors tried many diets and none of them made me lose weight (or changed my labs).

PJ, #91, it's hard to know. My grandmother has rheumatoid (that's what I thought the first gout tophus was), and although she's senile, she's not bipolar. You'd think if I was going to have three types of arthritis that deal with my hands and feet, I'd get rheumatoid, too, but I haven't.

I've had respiratory arrest twice, when I was near horses. At the time, I was allergic to all furry critters and since my father insisted on dogs and cats, took gigantic amounts of benedryl every day. When we went to a place with horses, it was assumed the benedryl would handle that, too. It didn't. And the second horse was a surprise -- a horse in a parade that came over to make me stop breathing. My allergies went away when I was about 19 and I don't have problems with little furry critters anymore, but I haven't gone to see horses.

#97 ::: Michael Roberts ::: (view all by) ::: July 04, 2008, 05:45 AM:

Marilee, even 7 makes my heart pound; our son's varies between 0.4 and 0.8 and only occasionally ventures above a single gram (four times: twice because of prednisone, once because of an experiment with a high-carb diet (not as reckless as it sounds, really) and once, we think, because of a very high mold count.) I don't even want to think about 57. I guess it puts it into perspective, really: he's still healthy. The idea is to keep him that way, and frankly it's exhausting worrying about it. But you do learn a lot.

Did you try any low-low-carb diets like Atkins? Did you try probiotics (e.g. VSL#3 or homemade yoghurt)? I'm guessing you probably did try Atkins, since Atkins is so popular, and probably didn't see much change. But in the last year or so we've gotten way into dietary management, so I'm a True Believer right now. A hungry True Believer, yes -- but it hasn't hurt me to lose this weight, either, and my IBS has cleared up.

Really, in all these years we've been fighting this thing, and since my father's generation of the family has started dying, the one thing that kills me -- the one thing that keeps coming back and coming back to it -- is how very primitive our medical knowledge is. If you get any further into disease than bacterial agents, it's absolutely frightening how often you run across "etiology unknown". "Mechanism unknown." There aren't even any debuggers available for this stuff. For instance, the only way to find out whether you're allergic for something is to test each individual thing you think you might be allergic to (RAST) -- there is literally no way to just look and see what proteins are in your blood. I find this astounding, actually. The field of protein identification is wide open, and it will utterly revolutionize medicine every time they manage to get a reliable improvement.

Once the kids are through college, I really am seriously considering med school. There's got to be some way I can help solve some of this stuff. Just have to find me a cheap med school; I'm thinking Mexico.

#98 ::: Melissa Mead ::: (view all by) ::: July 04, 2008, 06:43 AM:

Marilee @89

Thank you-I'd been wondering what constituted a "low protein diet." (I have autoimmune liver disease)

#99 ::: ajay ::: (view all by) ::: July 04, 2008, 07:03 AM:

had found 6 different ones that lived only the in crook of the elbow and nowhere else on the body, that were shared amongst humans

One does wonder how they are transmitted. I don't have elbow-to-elbow contact with that many people as a rule. (Folk dancing? Hornpipe-Transmitted Infections?)

#100 ::: ethan ::: (view all by) ::: July 04, 2008, 12:24 PM:

Maybe that's what the elbow sex in Rocky Horror is about.

#101 ::: ajay ::: (view all by) ::: July 04, 2008, 12:42 PM:

100: ?????

Don't remember that bit...

#102 ::: JESR ::: (view all by) ::: July 04, 2008, 07:41 PM:

sherrold, some day I'll have to bring you some of the (farm raised, dry aged, individually processed, flash frozen) hamburger I do eat- it's a revelation. And needs no added stuff to make it savory, although sometimes it needs oil to keep it from sticking to the pan.

#103 ::: TomB ::: (view all by) ::: July 04, 2008, 08:10 PM:

Michael Roberts @97 -- We can test for any protein (or peptide sequence) if (a) we know about it, (b) we can isolate or make enough of it to make antibodies for it, and (c) we think it's worth it enough to do (a) and (b) and provide a test. The cost per test is also an issue. Manufacturing antibodies is similar to making beer, but the up-front research and development costs are very high, and also you need very stringent ongoing quality controls. There are some great opportunities if one can figure out how to drive the cost down. However, I think whatever we'll be able to do over the next decade or two will be utterly cumbersome compared to the body's own immune system. Most of the antibodies we make aren't even designed, we just let an animal's immune system respond to the molecule of interest, and select the antibodies that seem to work best.

#104 ::: Marilee ::: (view all by) ::: July 04, 2008, 08:18 PM:

Michael, #97, yes, the doctors thought I'd die in 1993 and I'm 15 years beyond that now, and my kidney labs are getting better. I used to have a nephrologist who said I was too stubborn to die. I haven't tried probiotics, they're newer than the last batch of diets, but I've been losing literally three pounds a month with the better renal labs, which makes sense, since I gained all this weight while in the hospitals for the renal failures. I hope your kids stay as well as possible.

Melissa, #98, you should check with your doctors. I was on a 40gr protein per day diet for many years and was just advanced to 60gr this year, after my labs started getting better.

#105 ::: Ginger ::: (view all by) ::: July 04, 2008, 09:22 PM:

Michael Roberts @ 97: Keep in mind there's a lot of complexity in living systems; everything has to interact with (1) its neighbors, (2) centrally-directed signals, and (3) foreign invaders. The immune system is not easily quantifiable, and -- believe me -- we're working hard on figuring out what all these little bits and pieces do. Transgenic mice are key in that, as we can knock out or knock in genes, insert genes, and play around with the genome to find out what happens when we do [this].

The more we know, the more we know we don't know. ;-)

#106 ::: Melissa Mead ::: (view all by) ::: July 04, 2008, 09:46 PM:

Re: #104

For now, my labs are normal, but I have cirrhosis and esophageal varicies. So my doctor says I don't need to change anything yet, but I'd like to start getting mentally prepared ahead of time. (I've already cut way down on salt.)

#107 ::: Michael Roberts ::: (view all by) ::: July 04, 2008, 11:43 PM:

TomB @103 - Don't get me wrong! RAST is very cool -- essentially, you attach radioactives to proteins, then if the blood sample has antibodies to that protein, it ends up radioactive. So if you have, say, grass proteins, you can tell whether a person's immune system is sensitized to grass.

But you can only test for presence of a protein you know. It would be far, far cooler to sort out all the antibody-shaped proteins in the blood, and see what proteins they fit, then find out what in the environment has those proteins -- in other words, the exact causal inverse. And we all know that in n years for some value n < 200, it will be possible.

But it isn't yet. And that is frankly intolerable. Every time we interact with doctors, I see Dr. McCoy in the elevator, saying, "It's a goddamn Spanish Inquisition!" Phew, is that ever true. My uncle died three years ago, just 64 years old, I believe. Congestive heart failure. Nothing you couldn't deal with if you had cellular-level surgery -- you don't even have to know anything more than we do now about proteins, for instance, to fix a little extra water in the tissues.

I figure the technology most likely to make a personal difference in my son's life the soonest will be targeted localization of pharmaceuticals. If you could deliver prednisone just to the kidney and not affect the digestive tract, I'd be willing to bet his MCD would be under control next month. And that's not far off; they're actually doing that with arterial plaque (where they can figure out how to tell the capsules they're in position.)

Ginger @105 - yeah. I've got med school curricula, and I've been reading to the curriculum, off and on. Schaum's Immunology is about my speed; I'm not interested in more detail yet, just want to know what's what, as far as anybody else does. There's a vast amount of detail in the immune system; makes my head spin every time I reread a chapter, and I have to go sit down in the corner and cool off. Immunology is cool.

Marilee @104 - well I, for one, am quite happy the doctors continue to be wrong for you. As to our kids -- well, we try. And since our son's allergies force us to live on a tropical island, sometimes it's hard not to see that silver lining. Life has an odd way of working out when you least expect it.

I figure that even if we can't keep his kidneys under control, we essentially just have to extend them until stem cell research can grow him a new one in situ -- and there's some really encouraging work going on in Utah, where they just pass some stem cells through the kidney and their mere presence makes the kidney think it's growing again, and it heals. In mice, anyway. I just wish it were all moving faster.

#108 ::: Serge sees SPAM ::: (view all by) ::: March 15, 2011, 09:09 PM:

...and you can't spell.

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