Yes, it makes a difference. Fakers increase the risk that people who really do have life threatening allergies won't be believed. This danger is especially great for the ten percent of food allergy sufferers whose immune systems react to unusual allergens.
Friday, August 19, 2016
You Wouldn't Fake a Service Dog
Obviously some people do fake service dogs, but this is for the decent sort who wouldn't misuse a handicapped parking space either.
Yes, it makes a difference. Fakers increase the risk that people who really do have life threatening allergies won't be believed. This danger is especially great for the ten percent of food allergy sufferers whose immune systems react to unusual allergens.
Yes, it makes a difference. Fakers increase the risk that people who really do have life threatening allergies won't be believed. This danger is especially great for the ten percent of food allergy sufferers whose immune systems react to unusual allergens.
Tuesday, August 9, 2016
"You'll Meet People Like that Everywhere."
One of the strange elements about group dynamics is how when a relationship sours in a mixture of personal conflict and safety issues, people who attempt to be peacemakers often ignore the safety problem to focus on the personal conflict.
Historic reenactment is among my hobbies, which is not easy to do with OAS anaphylaxis. Imagine spending four days on a remote campsite forty minutes from the nearest emergency room while sharing a kitchen with ten people. You have to really trust your group.
About five years ago it became obvious that there was a problem. Someone who was camping with us needed a medical airlift and had stopped breathing. That in itself is a serious problem, but another member of the group interfered with the rescue.
"You don't understand!" That person interjected, attempting to persuade the first responders that the real problem was a relationship issue.
This behavior had red flags all over it.
The individual who needed the rescue did not have anaphylaxis--their underlying medical problem was different and, thankfully, that person survived without serious harm. Yet as anyone who does live with anaphylaxis can understand, the thought in my head was how in the worst case scenario that could be me.
Maybe if the person who interfered with the airlift were extremely young it would have been feasible to sit them down for a talk. This individual was over forty and had an underdeveloped sense of personal boundaries.
Not every event is a four day camping trip. I distanced myself afterward, but noticed that this person started to corner me and tried to start relationship discussions when my own health was shaky.
At a later event--and yes it was a bad idea to try the cole slaw without getting a complete rundown of the ingredients but who puts apple into cole slaw? I mistook the slivers for radishes and spat out the first bite, rinsing my mouth with water repeatedly and leaving the table. From there it was a waiting game: self-medicate, monitor the symptoms, stay calm, and hope this does not end in a trip down winding mountain roads to a hospital.
At that juncture this person decided to block my path and start a discussion about why I had been avoiding her.
Nope.
Really the last thing I wanted to hear at that moment is how much she cared. She had no healthcare background at all, not even a first aid certificate, and I had zero desire to bond with someone who had a track record of getting in the way when a patient stopped breathing. My response to her by no means encapsulated all of these thoughts yet it was more blunt than diplomatic.
Although I apologized for the bad manners within the hour and she said she accepted the apology, the inter-group political gears started turning pretty soon afterward. I wanted to stop camping with that group but my better half did did not see the problem himself and disagreed. This led to friction. Frankly I wanted to drop it and cut ties, but several people took me aside to express support. The same individual who was causing my problems had done similar things to other people before.
Frankly, none of these were conversations I wanted to have. I would have stopped camping with that group immediately after the incident with the medevac except for very strong pressure from the better half. I really do not want anyone who thinks relationship issues are more urgent than airway obstruction if I go into anaphylactic shock.
A former Navy Corpsman understood and agreed with those priorities; others did not. I was not going around raising complaints, yet when someone took me aside and started the conversation I responded truthfully. I still do historic reenactments--just not in close contact with that group.
One refrain was, "You'll meet people like that everywhere." This comes to mind today because the same words were recently directed at a friend with different medical problems who contemplated leaving a similar social group that had stopped being a safe environment. On both occasions those words were well-intentioned.
You'll meet people like that everywhere backfires in this context.
Conflicts are inevitable; many conflicts can be resolved, some cannot. If there had been any chance of talking me out of that departure the safety issue would have been central, which could probably be worked out for day events but not for extended camping trips. You'll meet people like that everywhere is beside the point: I do not spend the rest of life separated from the nearest hospital by forty minutes of winding mountain roads. That other patient was lucky to get her breathing passage reopened before brain damage set in. I choose to avoid that risk. If you insinuate that this decision is on par with an adolescent who runs away from conflict out of ignorance about what the world is like, you are missing the point. That does not reassure me; the effect is quite the opposite.
What followed in my case was an offer of mediation. I declined. Experience had taught me that what follows takes the shape of a hostile negotiation in which my health needs get treated as an opening bid. That becomes a no win situation: if I make concessions I accept an unsafe environment, if I stand firm by my needs the negotiation fails and I get branded as stubborn. Theoretically I could exaggerate my needs in order to make meaningless concessions, but that would undercut my credibility--which becomes a foolish choice in the long run if new allergies develop or if the existing ones become more severe. Even if we somehow achieved detente, the other person could extract new concessions at any time in the future by reopening the negotiation. I have to give in; my health depends on it.
That isn't mediation. It's blackmail.
Historic reenactment is among my hobbies, which is not easy to do with OAS anaphylaxis. Imagine spending four days on a remote campsite forty minutes from the nearest emergency room while sharing a kitchen with ten people. You have to really trust your group.
About five years ago it became obvious that there was a problem. Someone who was camping with us needed a medical airlift and had stopped breathing. That in itself is a serious problem, but another member of the group interfered with the rescue.
"You don't understand!" That person interjected, attempting to persuade the first responders that the real problem was a relationship issue.
This behavior had red flags all over it.
The individual who needed the rescue did not have anaphylaxis--their underlying medical problem was different and, thankfully, that person survived without serious harm. Yet as anyone who does live with anaphylaxis can understand, the thought in my head was how in the worst case scenario that could be me.
Maybe if the person who interfered with the airlift were extremely young it would have been feasible to sit them down for a talk. This individual was over forty and had an underdeveloped sense of personal boundaries.
Not every event is a four day camping trip. I distanced myself afterward, but noticed that this person started to corner me and tried to start relationship discussions when my own health was shaky.
At a later event--and yes it was a bad idea to try the cole slaw without getting a complete rundown of the ingredients but who puts apple into cole slaw? I mistook the slivers for radishes and spat out the first bite, rinsing my mouth with water repeatedly and leaving the table. From there it was a waiting game: self-medicate, monitor the symptoms, stay calm, and hope this does not end in a trip down winding mountain roads to a hospital.
At that juncture this person decided to block my path and start a discussion about why I had been avoiding her.
Nope.
Really the last thing I wanted to hear at that moment is how much she cared. She had no healthcare background at all, not even a first aid certificate, and I had zero desire to bond with someone who had a track record of getting in the way when a patient stopped breathing. My response to her by no means encapsulated all of these thoughts yet it was more blunt than diplomatic.
Although I apologized for the bad manners within the hour and she said she accepted the apology, the inter-group political gears started turning pretty soon afterward. I wanted to stop camping with that group but my better half did did not see the problem himself and disagreed. This led to friction. Frankly I wanted to drop it and cut ties, but several people took me aside to express support. The same individual who was causing my problems had done similar things to other people before.
Frankly, none of these were conversations I wanted to have. I would have stopped camping with that group immediately after the incident with the medevac except for very strong pressure from the better half. I really do not want anyone who thinks relationship issues are more urgent than airway obstruction if I go into anaphylactic shock.
A former Navy Corpsman understood and agreed with those priorities; others did not. I was not going around raising complaints, yet when someone took me aside and started the conversation I responded truthfully. I still do historic reenactments--just not in close contact with that group.
One refrain was, "You'll meet people like that everywhere." This comes to mind today because the same words were recently directed at a friend with different medical problems who contemplated leaving a similar social group that had stopped being a safe environment. On both occasions those words were well-intentioned.
You'll meet people like that everywhere backfires in this context.
Conflicts are inevitable; many conflicts can be resolved, some cannot. If there had been any chance of talking me out of that departure the safety issue would have been central, which could probably be worked out for day events but not for extended camping trips. You'll meet people like that everywhere is beside the point: I do not spend the rest of life separated from the nearest hospital by forty minutes of winding mountain roads. That other patient was lucky to get her breathing passage reopened before brain damage set in. I choose to avoid that risk. If you insinuate that this decision is on par with an adolescent who runs away from conflict out of ignorance about what the world is like, you are missing the point. That does not reassure me; the effect is quite the opposite.
What followed in my case was an offer of mediation. I declined. Experience had taught me that what follows takes the shape of a hostile negotiation in which my health needs get treated as an opening bid. That becomes a no win situation: if I make concessions I accept an unsafe environment, if I stand firm by my needs the negotiation fails and I get branded as stubborn. Theoretically I could exaggerate my needs in order to make meaningless concessions, but that would undercut my credibility--which becomes a foolish choice in the long run if new allergies develop or if the existing ones become more severe. Even if we somehow achieved detente, the other person could extract new concessions at any time in the future by reopening the negotiation. I have to give in; my health depends on it.
That isn't mediation. It's blackmail.
Monday, August 8, 2016
Doesn't Everyone Lie about Allergies?
Early in the afternoon before a gathering, the hostess was running down the changes in her menu she had made to accommodate the guests. It came as a surprise to hear myself grouped among the picky eaters especially because the hostess was a retired nurse. She had seen my food allergies act up on two occasions, one of which had nearly needed an ER visit.
If anyone would understand the difference between a food preference and a medical need, wouldn't she comprehend?
Moments later it became clear that for several years she thought I exaggerated my list of dietary restrictions, adding in with the real allergies various foods she assumed I only disliked.
On seeing my reaction she added, "Doesn't everyone?"
That needed an immediate response. Nobody coaches anaphylaxis sufferers what to say in this situation so I searched for words to express the truth: I never lie about a food allergy. It would be foolish to gamble my credibility on something as frivolous as a food preference.
I hate very few foods. I detest ketchup, but the way I communicate that is, "I don't like ketchup."
In fact I wish other people wouldn't fib about food allergies. That makes it harder for people like myself who actually have the real thing to be believed.
She had always accommodated my requests because she was a sweet person and a gracious hostess. Her food was excellent. I later confirmed when another RN was among her guests that neither of them had been taught about OAS anaphylaxis in nursing school.
If anyone would understand the difference between a food preference and a medical need, wouldn't she comprehend?
Moments later it became clear that for several years she thought I exaggerated my list of dietary restrictions, adding in with the real allergies various foods she assumed I only disliked.
On seeing my reaction she added, "Doesn't everyone?"
That needed an immediate response. Nobody coaches anaphylaxis sufferers what to say in this situation so I searched for words to express the truth: I never lie about a food allergy. It would be foolish to gamble my credibility on something as frivolous as a food preference.
I hate very few foods. I detest ketchup, but the way I communicate that is, "I don't like ketchup."
In fact I wish other people wouldn't fib about food allergies. That makes it harder for people like myself who actually have the real thing to be believed.
She had always accommodated my requests because she was a sweet person and a gracious hostess. Her food was excellent. I later confirmed when another RN was among her guests that neither of them had been taught about OAS anaphylaxis in nursing school.
Pickling: Additional Notes and Sources
If you want a continuous supply of pickles then keep two or three jars, staggering the start of the process every week or ten days.
To make sauerkraut, get a mandolin slicer and make thin slices. Then use your favorite pickling recipe minus the dill. Cabbage gets much less dense once sliced so choose the smallest head in the bin unless you really adore sauerkraut. Red cabbage can also be pickled, then braised in wine and served with roasts and sausages; this is a version of what Germans call either rotkraut or rotkohl (the name of the dish varies regionally).
Pretty much any type of root vegetable, tuber, or bulb can be pickled. I find this useful to speed up everyday cooking because a pickled shallot, for instance, is ready to serve after five minutes on the stove. Pickling also speeds preparation of potatoes, carrots, onions, etc. Since these ingredients would otherwise be the slowest parts to cook in many dishes, a pickling hobby can mean a net savings in kitchen time.
Pickling also reduces waste by preserving vegetables that would be difficult to consume before they go bad. If you can only realistically eat half a bunch of fresh asparagus, then divide it the day you bring it home and pickle the other half. The same goes for mushrooms, pearl onions, and other veggies that grocery stores like to sell in premeasured units. Gourmet aisles charge an arm and a leg for pickled versions of these vegetables; when you pickle at home it costs less and tastes better. Most people are intimidated against trying because they don't know how to pickle things and they overestimate how much effort this takes, but if you have a gallon of vinegar lying around and an extra pint jar with the usual spices the preparation is done in a jiffy. Porous mushrooms will be pickled in five days. Bell peppers are ready in ten days. Asparagus takes about two weeks depending on how thick the stalks are.
Garlic pickles wonderfully but it startles North Americans with its tendency to turn a glossy deep bluish green. This is safe to eat and is prized as a delicacy in northern China. The effect results from a few traits specific to this particular vegetable. I don't mind the color shift but if you want to minimize that effect then use distilled water, kosher salt, and store in a dark place.
Oak chips become their own particular rabbit hole among wine makers. If a supplier's selections bewilder you then copy my choice: medium toast French oak. I'll use a teaspoon per gallon--which is no more than a pinch in an average batch of pickles. Spent $2 on a small bag of oak chips six years ago and it's still half full; one of the best home brewing and pickling decisions I ever made.
Sometimes a pickling solution that is ready to retire smells too good to discard. Strain the liquid and give it one last hurrah as a marinade or as an addition to a soup, or else turn it into a sauce by simmering five minutes with a little flour or corn starch, stirring frequently.
-------------
Sources
Books:
The Art of Fermentation by Sandor Katz, Chapter 5.
The Lost Art of Real Cooking by Ken Albala and Rosanna Nafziger, Chapter 1.
The Lost Arts of Hearth and Home by Ken Albala and Rosanna Nafziger, pp. 28-33.
The Human Microbiota and Microbiome, ed. Julian R. Marchesi, p. 127.
Online:
http://www.cooksinfo.com/pickling
http://www.culturesforhealth.com/testing-acidity-strength-vinegar
http://www.motherearthnews.com/real-food/preserving-gourmet-garlic-pickling-zbcz1401.aspx
Suppliers:
(A spice supplier trusted by people with severe allergies) http://m.vitacost.com/categories/food-grocery-2?ISRC=mobile:home:foodandbeveragesicon
(A reasonably priced oak chip sold online--cannot guarantee against cross-contamination)
http://www.homebrewing.org/French-Oak-Chips-medium-Toast-4-oz_p_403.html
Home Pickling: Vinegar Method
This method allows great flexibility in your temperature range and gives you the option of a sterile controlled environment. Most of the preparation steps are the same as the brine method; this section outlines the differences.
When using vinegar the thing to control is starting acidity. You need at least 2 1/2% acid to keep away nasty microbes. In a brine solution your friendly local lactobacillae would produce that acid for you. Here you have to pay a little more attention to the chemistry.
Your first order of business is to select a vinegar. Vinegars normally state their percent acidity somewhere on the label. The simplest thing to select is a 5% or a 6% acid vinegar; either can be mixed with water at a 1:1 ratio. If your diet is very restricted then distilled vinegar is the safest choice, but a more complex vinegar yields a tastier pickle. My favorite is an Italian white wine vinegar that sells at a local ethnic market for $6.50 a gallon.
Apple cider vinegar deserves special discussion. This can make a delicious pickle but it is also the least acidic type of mass market vinegar. Read the label, run your calculations, and dilute with less water accordingly.
Be aware that a particular subtype of apple cider vinegar sold at health food stores is live culture vinegar. This can also make pickles if you want but it carries its own set of issues. Live culture vinegar contains acetobacter, which has different properties from the lactobacillae used in the brine method. Both of these classes of bacteria are harmless to humans; yet while lactobacillae can take residence in the gut and provide beneficial effects, the main thing acetobacter likes to do is turn low concentrations of alcohol into vinegar. A few acetobacter will float into the air if you open a bottle of live culture vinegar, which means they will also go to town if provided the opportunity. Acetobacter will happily turn half a bottle of recorked cabernet sauvignon into vinegar for you, and that will probably make an outstanding vinegar--but that was probably not your intention. Home brewers who work with live vinegar cultures usually keep their vinegars on the other end of the house from their brewing. If you are a teetotaller none of this matters but if you aren't then be forewarned: the few cider vinegars that are live will state so on the label. Other types of vinegar do not risk this problem.
Since a vinegar pickling does not need to feed microbes, distilled water is fine and iodized salt is OK. Use an airtight lid--a wide mouth half gallon mason jar is perfect. If you feel jittery about aging vinegar pickles at room temperature then keep them at the back of the refrigerator. Submerge the cucumbers if you age vinegar pickles at room temperature but with refrigerator aging you can skip the submersion.
An side benefit of vinegar pickling is that if you make a habit of removing pickles from the jar with a clean fork you can reuse the pickling solution several times. Just top off the ingredients as necessary, keeping the solution sufficiently acidic. The ease and savings of doing this was a main reason for offering to write this guide because when I want more dill pickles it rarely costs me more than a bag of cucumbers. Quite frankly, I can think of other spending priorities than $10 a jar on somebody else's recipe.
Tuesday, August 2, 2016
Brine Method Pickling
This is a probiotic environment that needs room temperature conditions below 80 F (26 C). If that suits your needs, read on. Otherwise use the vinegar method.
Start with a large jar or a crock. You will also need something to weight down the cucumbers and keep them below the water surface. Some people use a bag of marbles; others use a saucer. Sterilize your container with one of the following:
- Iodine sanitizer --also available from home brewing suppliers. Takes ten minutes if you aren't allergic to iodine.
- Hot water--a cycle in the dishwasher or else gentle immersion in simmering water in a large pot.
- Sulfite sanitizer--available from home brewing suppliers. Works instantly if you aren't sulfite sensitive.
Persian cucumbers work well--or any other small cucumber. Select ones that have smooth healthy skins. Rinse and trim the ends. Do not scrub them aggressively because the lactic acid bacteria already present on the surface is what initiates fermentation. Drop these into the fermentation vessel, allowing space at the top.
Next to make a brine: charcoal filtered tap water is fine. Spring water also works. Avoid distilled water because distillation removes trace nutrients that your lactobacillae need to thrive. Sea salt or Himalayan salt are good because either confers trace nutrients. Kosher salt is an acceptable alternative. Steer clear of iodized salt if possible. Use 2 tablespoons salt per quart of water (or if those units are foreign to you add enough salt to float an egg--you won't need the egg for any other purpose than to test salinity). Pour this brine over the cucumbers enough to cover the cukes completely.
Now to add your spices, weight the cucumbers so they stay below the water line, and label your container with the date of preparation. Cap loosely; this is a live culture and should remain open to air. Leave on a shelf in a pantry or cellar until ready.
Introduction to Home Pickling
If you get OAS then you may need a customized pickle recipe. Fortunately pickles are easy to make and almost any ingredient can be swapped out for something else. You'll have a different pickle but your pickles may be tastier than anything that comes from a store.
Home pickling can be probiotic--but doesn't have to be. Depending on what veggies you pickle it can save you time on cooking. It can also cut down on kitchen waste and save money.
Cucumbers - most of this guide will cover cucumbers because once you master that you can pickle almost anything else.
Time - it takes three weeks to turn a cucumber into a pickle. That's five minutes of actual effort followed by ignoring the thing on a shelf. Homemade pickles are good for three months.
Brine vs. Vinegar - these are two fundamentally different ways to make a pickle. Each has its advantages and disadvantages. This doc will discuss both.
Herbs and Spices - this part is very flexible. If you're allergic to one group just pick your favorites from another. Listing pickling spices by botanical family. Grape leaves and oak chips are added to lend tannins for crispness. Neither is intended to be eaten (nor is bay leaf, which is added for flavor).
Allium: garlic, chives, dried leeks
Apiaceae: dill, coriander, parsley
Piperaceae: peppercorns
Zingiberaceae: grains of paradise (substitute for peppercorns)
Cupressaceae: juniper berries
Brassicaceae: mustard seed
Lauraceae: bay leaf
Myrtaceae: allspice
Vitaceae: grape leaves
Fagaceae: oak chips
Monday, August 1, 2016
A Place at the Table
You have probably heard that 90% of potentially deadly food allergies are caused by 8 common foods.
What about the rest?
Rare Food Allergy Anaphylaxis is dedicated to the other ten percent of people whose food allergies are just as dangerous: anaphylaxis to fruits, to vegetables, to spices, to beef and pork--as well as a variety of other allergens.
We seek awareness and accommodation.
This blog is maintained in cooperation with the Facebook group Rare Food Allergy Anaphylaxis. Please join our community.
What about the rest?
Rare Food Allergy Anaphylaxis is dedicated to the other ten percent of people whose food allergies are just as dangerous: anaphylaxis to fruits, to vegetables, to spices, to beef and pork--as well as a variety of other allergens.
We seek awareness and accommodation.
This blog is maintained in cooperation with the Facebook group Rare Food Allergy Anaphylaxis. Please join our community.
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