Thursday, February 24, 2011

"Spiritual Wheelchair."

Today, I got called to your run of the mill, sub-standard, smelly, group living facility... We got called out for priority 1 (serious sounding) CVA or Stroke. We get on scene, and no one knows anything about our arrival.  We find out that the room that we are looking for is not only upstairs, but that they don't have an elevator. 

We grab our stuff and head up stairs, and down the hall to find a 44y/o F (y/o= year old) laying in bed, in a seemingly clean-ish looking room. When we knock on the door and state that the ambulance is here, she raises her left hand and starts shaking it as if she is doing some one handed jazz hands routine.  I walk up and ask her what the problem seems to be. She states that I be having a stroke.  I quickly administer our field stroke exam, and find nothing abnormal.... I ask her why she thinks that she is having a stroke.  She says that she has a history of "TI's."  Hmm, thats a new one on me... I thought they were TIA's, but I've been wrong before.  (TIA is generally referred to as a "mini" stroke.  The symptoms generally resolve themselves with in about 48-72 hrs.) There is a couple in the room and they look like they may be some kind of zoo keepers for this establishment.  I look at the male and ask if he knows her history, and if she really does have a history of TIA's.  He looks at me blankly. Excellent, the blind leading the blind....

I attach the monitor and find that this pt's vital signs are extremely stable and look nothing like that of someone having an actual stroke.  I ask her again what are the exact symptoms that make her think that she is having a stroke, she says, the leff side of my mouth is numb.   I say ok, are you hurting anywhere? She denies... I ask her if she thinks she can walk to the cot, then tell her it's down stairs.  She says, No, my legs are no good.  My partner looks around, seeing no wheelchair or transport devices, asks how she gets around.  The pt raises her arms and says, I got me a spiritual wheelchair.  Resisting the undeniable urge to smile, I tell her that we don't have room in the ambulance for a spiritual wheelchair and that she will have to walk, she says ok, I disconnect the monitor.  I'm fairly certain that I will go to hell if I re-enact a scene from an Evangelical healing when they smack them in the head and the paralyzed walk and the dead rise...

I reach for the pt's hand and say, Let's go.  She is actively trying to stay completely flat in bed.  I give her hand a little squeeze and repeat myself.  She springs up and takes off at a brisk pace.  One of the firefighter's near the door grabs her and and she drags him down the hall, down the stairs and to the cot.  When she gets close to the cot, she instinctively let's go of the fire fighter's wrist, then jumps on the cot.  I'm a few steps behind, and trying to compose myself.  My partner and I get to the business of buckling her up and she start's to have another "stroke."  She raised her hand and starts the jazz hand's routine again and I grab her wrist and tell her to "STOP. NO MORE. You are not having a stroke."  She puts her hands down and they stayed there for the rest of the trip, and into the ER. 

While giving the hospital a quick head's up about the interesting pt that they had coming their way, I state that pt doesn't have any symptoms of a stroke nor a history, pt yells out, I don't know where you went to school, but you better check yo self. 

Oh, Awesome, Crazy and an attitude...   Transport uneventful... Upon arrival, care turned over to RN staff and verbal report given to accepting RN.  Signed, printed and back in service.  Whoops, there goes my auto-pilot.

Wednesday, February 23, 2011

Peach Kuchen

Peach Kuchen

If you are German, you know exactly what I'm talking about... My grandmother used to make this for us all the time.  It has all the things that German cooking should have; Heavy Cream, butter and recipe components that use "pinch of, dash of" ect...  Hope you enjoy. :)

Crust:
3/4 c Heavy Cream
2 tbsp Sugar
1 tsp baking powder
pinch of salt
1 1/4 c flour

Filling:
2 eggs, slightly beaten
1 cup heavy cream
3/4 c sugar
1 tsp vanilla
2 large cans of peaches, (cut into bite size pieces)

Topping:
1/3 c flour
2/3 c sugar
1/4 c butter, softened, NOT melted... but if you do, add a little extra flour

You will also need a 9x13 baking pan, bowl, spatula, cooling rack.
  1. Preheat oven to 350 degrees.
  2. Mix the crust ingredients thoroughly and press into the bottom of the baking pan
  3. Mix the filling together, (Hint: add eggs first, beat, then other ingredients in the order they are listed, makes mixing easier.) Pour the mixture over your crust.
  4. Blend your topping together, crumble and sprinkle over the top of your dessert, 
  5. Bake at 350 for 45 minutes.  
Even if you aren't German, I'm fairly certain that you will enjoy this recipe.  My poor boyfriend has endured countless recipes that I grew up with and still eats what I cook, and sticks around.    Lucky me or lucky him?
Let me know what you think. :)

Pork Tenderloin in the Crockpot

Pork Tenderloin in the Crock pot

I found this recipe while looking online.  By far, the BEST, and easiest pork tenderloin in the WORLD.  Make sure to make bread to soak up the au jus.  I couldn't get enough.  I'm sure it would even be amazing if thickened as a gravy.

1 (2 pound) pork tenderloin
1 (1 ounce) envelope dry onion soup mix
1 cup water
3/4 cup red wine
3 tablespoons minced garlic
3 tablespoons soy sauce
freshly ground black pepper to taste
 
You will also need a crock pot.  
  1. Place pork tenderloin in a slow cooker with the contents of the soup packet. 
  2. Pour water, wine, and soy sauce over the top, turning the pork to coat. 
  3. Carefully spread garlic over the pork, leaving as much on top of the roast during cooking as possible. 
  4. Sprinkle with pepper, cover, and cook on low setting for 4 hours. 
  5. Serve with cooking liquid on the side as au jus. 
 I made rosemary roasted potatoes and a veggie mix.  I also served a Parmesan ciabatta bread. If you would like to thicken the sauce into a gravy, the easiest way that I have found is to....
 How to Thicken Au Jus into Gravy:
3 tbsp Cornstarch
1/3 c COLD water
you will need a Whisk, bowl, fork, and a sauce pan.
  1. Mix them together in a small bowl with the fork. 
  2. Bring the Au Jus to a boil in a sauce pan.  
  3. Give the mixture a quick stir, then slowly pour part of the mixture into the boiling Au Jus.  (*!*!*  If you want a thinner gravy, don't add all of the cornstarch mixture.  If you need to thicken more liquid, you may need to double the initial ingredients.)
  4. WHISK!!
  5. Continue to stir until the mixture until it is blended, and serve hot.
 
Enjoy, and let me know how it turns out! 

Night Shift and popping "Bu's"

Chris and I picked up a night shift together and it was nice. 

We started out the shift with an emergency transfer.  A lady had a sub-arachnoid hemorrhage (fancy talk for a bleed inside the head) and an AMI (Acute Myocardial Infarction, fancy talk for a heart attack.)  She was a bit of a nag... "I want this, I want that, give me this, what's with all the bumps, can't you drive?"  Sometimes, holding your tounge is the hardest thing...

Then, we went to an after hour's clinic, 12 minutes before they were set to close.... suspicious, yes, very suspicious. She was an anxiety case, wowza.  She has a history of ulcers and says it feels like another ulcer.  Pretty Straight forward.  The part that bugs me is, "I've been out of my ativan for a week and my prilosec for a 3 weeks."  (I'm having a hard time with people who choose not to manage their conditions, then call the ambulance when the flare up's happen due to their ill management of those conditions, but I'm sure I will probably rant about this another day, but anyway.) Well... you say your tummy hurts, ok.  You are saying you are vomiting, ok.  Now show me.  Most people with ABD pain, present in a certain way.  She wasn't, and I didn't see any vomiting or evidence of vomiting either.  But... the blessing here, is that as soon as she was on our cot, she her anxiety was mostly resolved... At least I could do that for her.

After a short nap... Chris's pt was a man who was drinking all night, met the fire department at the door with a gun, and said he was having a "really fast heart rate."  Mmmk, well, let's hook you up to the monitor and take a look.... So, we did. Whoa! Sinus at 230.  Sucks for you bud, but awesome for us that we finally have a pt who actually need's an ambulance.  Started a line on scene, and his rate went to 130 and maintained there.... got him to the cot, then off to the hospital.

After another little nap, we got another call... En route, we were bumping along and all of a sudden, we hear a big POP!  and the Bu (amBUlance) coasted to a halt.  We called dispatch and let them know we weren't going to make it.  They sent another unit, and we called Sup for answer's.  We turned the truck and power off, then restarted, it went well... Now we could manage speeds of 30mph!  Yahoo!!  We limped back to 41 and ended our shift.

Now, I'm sure if you have never met me, or don't know anything about EMS, this post will probably have some upsetting points.  Now let me explain.....
  • Pt #1 - If you are still nagging about every detail, you are not very sick. Think about it.  (Yes, I understand that this lady was very sick, but have some humility.  I can't fix the bumps in the road, and there are too many to avoid them all, still upset?  Contact your local government to fix the roads, and be prepared for a tax hike.)
  • Next Pt... Doctor's write you prescriptions and send you home for a reason.  They can't manage every detail of your life, so they give you the tools to manage your chronic (long term) conditions at home, so that you can still live your life.  Now, doc did his job getting you the prescription, now it's your turn to be an adult and take care of yourself.  An ambulance ride to the hospital is not an acceptable way of getting your prescriptions refilled.
  • Fast heart rate man... Please don't call 911, then pull a gun when you have a knock at your door.  You called for help, remember? 
In closing, when I was in Paramedic School, a very wise man told me that, "Everyone has their limits, thing's that aren't an emergency for you or I, might be an event that throws these people into a state of emergency."  Well, Mr. Lee Thomas, I haven't forgotten, and I'm trying to keep all of the things that you taught me in mind... So, to the public:  I understand, however, there are some things that aren't emergencies to anyone.  So, please, think for a moment. 

Epidural Steroid Injections

Ok, I know, I've been bad at keeping up my posting.  When I got back from San Diego, I started some drafts and was going to fine tune and publish them a little later, but I ended up having a Epidural Steroid Injection (ESI) of Methylprednisone (80mg.)  It put me on my ass. 

I went in and everything went according to plan, I suppose. When I went in, they asked me if I've had any trauma, and I told them that I haven't been kind to my body through out my life.  I've played hockey for so long that I can't remember when it started, I've got 7 years in the Army.  They started asking about car accidents, and that type of thing.  I was in a fairly decent accident a month after I finished Basic. This last fall, I was in a 5 car pile up at work.  I didn't think anything of it, but they told me that little things like that, can speed up the disease process. Then the doc came in and asked me if I had any questions about anything and how I felt about all this. I told the anesthesiologist, that unfortunately being in my line of work, I can't play ignorant.  So... On top of the versed, I got Ativan.  I've never been more anxious, and just like Tabetha said so many years ago, Ativan is awesome.  (Tabetha was a classmate in Paramedic School.) 

Jodi went with me to the procedure, and she drove me home.  On the way, we stopped at Little Ceaser's and got some pizza, then went home and played Wii for hours.  When she went home I went to bed and slept like a rock.

The next day, I woke up and felt good, no better, no worse, so I went to work.  It was ok, towards the end of the day, it felt like I was having more of the sharp, shooting pains than I normally was.  When I went home, I went right to bed, I've been sleeping on a hot pad for so long now, I can't sleep without it.  I woke up the next morning, and felt a little more sore than normal, but nothing that made me think that I couldn't work through it. 

I went to work, made it just over half way through the day, then I had to call out on FMLA.  I hate doing it.  I'm stubborn and I know it.  I don't feel like I'm dead yet, so I don't think that I should have to change the way I live for this.  I spent the next two days home, rationing out my time standing, sitting and laying down, so that the pain would stop or lessen.

SJ and Josh were in town, and they were champs about just hanging out around the house and putting up with me.  Oklahoma City is kinda the half way point for this married couple.  They are physically separated due to the Air Force and schooling, but still very much in love and married.  When SJ is done with her schooling, they should be back in the same duty station, so this is just a temporary evil for them.  Even though I was super lame and didn't get to do anything with them, we were kinda planning it since I couldn't find anyone to work for me.   I just wish I was actually feeling better than I was, I spent my weekend all "hopped-up" on hydrocodone.

Tater-Tot Hotdish

This was one of the staples we had in my home, growing up. 

Tater-Tot Hotdish

1 lb of ground hamburger
1 can of cream of mushroom soup
1 can of corn (I like frozen better)
salt and pepper to taste, you can add garlic and onion powder too, if you like
tater-tots!
cheddar cheese or maybe some seasoning salt, if you like. :)

You will also need a 9x9 baking dish, and tinfoil

Brown the hamburger, and then mix in the cream of mushroom soup with the spices. 

Put the hamburger mixture in the bottom of the baking dish.  Drain the corn and put on top.  (If you love cheese, you can put a layer of cheese here too.)  Then put the tot's on top, cover with tin foil and bake until hot and bubbly, (about 20-25min at 350 degrees)  Take the hotdish out, remove the tin foil, then sprinkle the cheese or seasoning salt... Enjoy.

It's awesome on cold days, and reheat's well.  Thanks Mom. :)

San Diego

Chris and I went to San Diego this last week.  It was fun.  We went out a few days earlier than my parents, and we stayed in Old Town.  We went to the Old Town Mexican Cafe, it was awesome.  We stumbled on it by accident.  We decided to go look for dinner and found the little Old Town area.  We were walking along the sidewalk, and found this little cafe, where Mexican ladies were making tortilla's in the window.  We had to go, and the food was awesome!!!

The next day, we went to LegoLand.  It was also, SO MUCH FUN!  It was expensive up front, but it had all of the ride's included, which was nice.  We were the only couple there without kids, I told Chris that I couldn't wait until we could blame all of this on kids... :P  It was fun.

That night, we were  exploring another part of town and found Little Italy.  We wanted to park and walk the sidewalks to see what we could find again.  We saw a little parking area, and decided to pull in.  When we pulled in, a man stopped us and asked us and asked, "You going to Filippi's?" We said yes and parked, then realized that we had no idea what he said or where it was... We walked back out to him and asked him where to go, and he pointed to the Italian Deli behind him.  We decided that he was very serious, and you don't mess with someone who looks like he might be related to the godfather.  So, we went in.  It looked like a butcher's shop with alot of canned and dry goods.  We walked past the crowded shelves and went to the counter.  The lady there, brought us to a little table, with a view of the kitchen, and the front counter.  Over head, small and large chiani bottle's are hanging, they are scribed with love notes, and memoirs, funny pictures and dates.

The server brought us our menu and we asked about the bottles, we decided, well... When in Rome... (Or Little Italy.)  So, we ordered a small bottle, because neither of us particularly like red wine.  Well... It was delicious.  We loved that they didn't bring wine glasses, but the little glasses, almost like shot glasses. We asked the server what to order and she said Pizza or Lasagna.  Well.. Chris ordered the pizza, and I ordered the Chicken Primavera. The Soup and salad came first, then the Garlic bread, and then the meal.  Chris decided to order anchovies on his pizza, then decided he didn't like them, and took them all off.  My chicken came out, with cheese ravioli and lots of homemade sauce.  OMG!  It was so wonderful. :)

The next day, we had planned on going to the wildlife park, but we felt lazy, and didn't go.  We went to the Coronado bay area and Chris went the the Crown Barber shop.  He said it was the best hair cut ever.  While we were there, the barber was telling us about all the places that you have to go, including 2 wonderful resturants, that we had just happened to stumble upon the days before.  I thought we were so lucky!  I guess the Barber shop has been open since the 1930's. It was very cool.  all of the chairs were brought over the years, some of them had alot of character.  Then we met my parents at the awesome Loew's Coronado Bay Resort....  It was beyond beautiful!

We spent a few days just hanging out, We went and walked on Mission Beach one morning, and it was a good time.  Then we went to the Zoo and I freaked when I saw the giraffe's.  Here is when you might think that I'm lame, but I love Giraffes... :) 

The flight's home were bumpy, but I was glad to be home and so thankful to the Koenig's and Andy and Natasha for house and puppy sitting.

Wednesday, February 2, 2011

Are you Diabetic?

Got called to a Taco Bell for a possible diabetic emergency.  PD is on scene and states that she is a possible DUI, however he states that she is a diabetic, so they are concerned about pressing forward if it has nothing to do with ETOH.

me; “Are you diabetic?”
PT; ” Yes”
me: “Ok, Which type?”
PT; (sobbing) “I don’t know!”
me; “Bullshit.”  After checking her FSBS, talking to the officer “Her blood glucose is 86, Its good, You can give her the DUI.”
PT; “NO!  I have multiple scoliosis!!”
me; “Oh, wow… Is that like multiple sclerosis, or more like scoliosis?”
PT now has a dumb founded look on her face.
I walked back to the truck, laughing with Shannon about the stupidity we just saw...

Chicken Pot Pies:

Here is my recipe for Homemade Chicken Pot Pies:

Chicken Pot Pies

2 Large Chicken Breasts, cubed
1/2 c flour
1/2 tsp Ground Sage
1/2 TBSP Parsley
Salt and Pepper to taste
2 TBSP cooking oil, (I like Olive Oil)
2 c Frozen Mixed Veggies
1 1/2 c Chicken Broth (I use chicken stock)
2 c Heavy whipping Cream

Topping:
3 c Bisquick
1 c milk
1/2 TBSP Garlic Powder
1/2 TBSP Onion Powder
1 c Shredded Cheddar
Butter

Mmmk... So, you will also need a gallon sized ziplock bag, tin foil, baking sheets, a ladle, large pot, and 4 - 20 oz baking dishes.

Place the Flour, spices, and chicken into the Ziplock bag.  Toss to coat all of the chicken.   Put the oil and chicken mix into the large pot and cook on medium, until cooked completely.  Once the chicken is cooked, add the chicken broth, and veggies. Then add the cream, simmer the mixture for a few minutes. 

Prepare the Topping by mixing everything except the butter.

Ladle the chicken mixture into the baking dishes.  Cover the chicken mixture with the topping. Bake at 450 degrees for 7-10 minutes, the top should be golden brown.  (Word to the wise.... Place the baking dishes on a cookie sheet covered with tin foil, for easy clean up. The warm bubbly goodness is probable to boil over.)

Once the pot pies are warm and bubbly, put some butter on top, the butter will melt. :)

When you are done enjoying, let me know how you like the recipe, and any improvements that you would make.

In the beginning...

Ok, Well, Here goes nothing...
I'm 24, I've got 7 years in the Army, I've got an associate's degree in Paramedicine, I'm a Paramedic in Oklahoma City, OK.   I've got four-legged babies, a little fluffy named Cocoa, and a big wrinkle headed Boxer named Rylie.  I've played hockey most of my life, and "I can see Canada from my house." (Spoken in my best Sarah Palin voice.)  I was born and raised in a small town outside of Bismarck, ND. 

My daddy taught me all about cars, how to keep them running and how to run them.  My mom taught my how to cook, and bake.  My family taught me how to be stubborn, and "strong-willed" as my grandfather would say.  I've skated with some of the best, and those on their way to being the best.  I've enjoyed coaching the most, my dream is when one of my "kids" makes it big, they will say that I taught them something.  I'm a Paramedic, and every person that I've met has taught me some lesson, even if it is, "don't ever live like that."

I'm scared of large fish tanks, taxidermy, and birds.  I have a bad back and my career in the Army is dependent on just how bad it is...  I'm not the best at everything, and I'll be the first to say.  I have much to learn.