Miami!

I'll post pictures when I get home and can upload them, this is just a quick update.

I got mildly sunburned, but it is quickly turning into tan (YAY!)

Because of said sunburn I took the day off from the pool yesterday and actually snuck into a few of the conference sessions....so cool! I love learning. AND there are a few things about eating disorder treatment that specifically applies to Emergency Departments and ambulance rides so not everything was "extraneous" to my job.

I have eaten more food than I thought possible and far from developing anorexia I think I'd be more likely to turn into a binge eater if I stayed down here!

I've almost finished a fascinating book about sociopaths (my poolside reading). Th

I can't wait to go home because I miss Brian and Remus immensely. I wish both of them could've come with (though I would've had to shave Remus).

Thats all for now!

Happy Easter!

I hope everyone had a wonderful Easter weekend, it's the first time in a looong time that I've missed an Easter Sunday service. I love sunrise service! Instead, I had a very busy, very stressful weekend at work. (Fri, Sat and Sun night) I was in the "slowest" zone of our rotation Saturday night and ended up having a Cardiac Arrest first thing Easter Sunday morning. Mad props to my partner and to the FD already on scene doing CPR. This is only the second cardiac arrest I've "run" officially, the rest of them there was always another paramedic on scene who got there first. And, very apropos for Easter, this was the first Cardiac Arrest I've ever been a part of where we got a pulse back. Oy.

Let me explain a little something about working a cardiac arrest. You know on TV, besides the LOUSY rendition of CPR (you don't bend your elbows to do chest compressios), everyone is all busy and shouting orders and looking important with their scrubs and white coats and snarky terse comments. A real cardic arrest can be frustratingly boring and a lot of physically hard work. CPR, done correctly, is no joke. Try doing CPR for two minutes, take a 20 second break, and repeat.  Now imagine you're trying to do it while wheeling a stretcher down a hallway, now try while going 90mph in the back of an ambulance down the interstate, now down country roads, now wheeling the stretcher into the hospital. Imagine doing this for 40 minutes. Let me tell you something, you're arms will give out, your legs will give out, and tomorrow your abs will feel like someone repeatedly punched you in the gut. Cardiac Arrests are dang hard work and I truly thank God that the Fire Department has a bunch of adreniline junkie guys who will do CPR till they drop.

Only one person can do CPR at a time, however, so this is how Cardiac Arrests work from my perspective. Game plan, I handle drugs, my partner does airway. We get on scene, FD is already doing CPR and have airway managed. The first 2-3minutes of a cardiac arrest is where it is pure chaos. The AED pads needs to be switched over to our monitor and the four leads put on, airway assessed and additional airway management done if necessary, plus capnography and rescue pod need to be added to the BVM, an IV needs to be established-if no IV get the bone drill and ZZZZZZZZZttt! IO them (bone needle through the tibia under the knee). All this needs to happen pretty much at the same time. The rhythm needs to be assessed once a 2 min cycle of CPR is done and then the first drug needs to be given. After that, you stand around....2 minutes of CPR....rhythm check! YAY get to shock and/or push another drug! Flush w/NS aaaand back to waiting.....2 minutes....oh goodie finally another rhythm check!... as a paramedic, I feel absolutely useless during those 2 minute waits and two minutes seem like an awful long time. Your adreniline is on overload, too, especially after those first few hectic minutes. I'm still fairly new at this, so I haven't perfected the calm, almost bored look some medics have acquired while working a code, I am pretty fidgety. I get the next drug I think I'll need to use prepped and make sure I have all the alternatives within reach, I'll check lung sounds to make sure my airway guy is doing ok, I'll get a bag of fluid hanging, I'll...sit...and...try to ....find someting....BAH! It's really annoying.

To make matters worse-from that perspective- but better for the patient- is when they regain a pulse. Oof. So we get a Blood Pressure, keep double checking the pulse, push Sodium BiCarb ready, cover pt with a blanket... H's and T's...Pt loses a pulse? Restart CPR. Push  Epi after rhythm check, another cycle CPR, another drug, another cycle CPR... Pulse again?! Fudge. Now I REALLY feel useless. Another BP done, monitor the airway (again)....theres not much else for me to do. If an antiarrhythmic was used I can hang a drip...keep checking airway...pulse...BP...rhythm...tidy the ambulance...remember to breathe...


So the cardiac arrest was my Easter morning wake up.


I'll leave you with two of my new favorite "Chief Complaints" from pts showing up at the ED.
"I cut my mouth on a taco and it hurts."
"I'm cold, hold me."

Hope everyone had a glorious Easter celebrating the glory of our risen Saviour and our subsequent salvation and freedom in Christ!

Baby Mama Drama...

In honor of my visit to see my adorable niece Emma, I figured I'd take a moment to post two of my favorite ridiculous "baby" calls from work. Recently, we've had a rash of children from 6 months to 2 yrs falling off of couches, but my favorite calls are usually from new moms.

3am, call goes out to our unit for  "severe respiratory distress" of a 2 month old baby. We arrive, are told by the VERY young mother that the baby is sleeping and has been for an hour. The GRANDmother pipes up, yeah the baby is sleeping but earlier during the day and evening she's been "frothing at the mouth". ....really? So we walk up this perfectly healthy rather cute baby girl, who is thankfully not too cranky for being woken up out of a sound sleep at 3 in the morning. There is nothing wrong whatsoever with this child, she's smiling and making agreeable baby noises and then, to the immediate distress of the surrounding family members she...wait for it...blows a spit bubble! The grandmom flies into a panic searching for something to wipe the kids mouth while gesturing "see?!?! She's been doing that off an on all day!" We are completely nonplussed. This is the severe respiratory distress? Thankfully, we were able to convince both mom and grandmom that this was completely normal and obtained a refusal.

Another call at 4 am, a few days ago, thankfully another unit jumped it for us. "26A1 (sick person), 3 week old female, pt is crying, mom doesn't know why." Yup. If your baby cries, it is now a medical emergency.

Oh, and just an FYI, if you give your toddler RED colored Children's Liquid Tylenol and then the child vomits, that red color is from the tylenol, it is not blood. Vomited blood does not look cherry flavored delicious.

**Disclaimer. I am by NO means underestimating the stress of having a baby, but a modicum of common sense is probably a good idea to obtain before procreating. Some things should be understood before embarking in the glories of motherhood, like the fact that babies cry (sometimes for no other reason than crankiness) and that they also blow spit bubbles. Three cheers to all those moms (including my sister) who don't immediately panic and call 911 when their diminutive charges make funny noises or, in Emma's case, snores. ** Additional disclaimer, if that baby had been crying non-stop for awhile (I don't know the full story because another unit took the call) I'd rather the mom call someone-including 911-rather than shake the baby to get it to be quiet.

Also, my niece has the cutest ears. :P

Favorites

I'm taking a leaf out of Sara Pierce's blog and putting in a recipe. Theres no way I'll be able to post them as frequently as she does since my culinary creativity comes in fits and bursts dictated by how tired I am from my nutsy work schedule, but this particular recipe is one of my absolute favorites.

I have another confession to make, it isn't exactly a recipe, I don't have measurements for any of it, it's kind of just a "add to taste" kinda thing. SO here goes, my version of Beef Stroganoff.

Ingredients:
1 Steak (You don't want a lot of fat marbling in the meat, cheap is fine since you aren't eating it like a usual steak)
1 onion
2-4 cloves garlic
2 ish qts heavy cream
A lot of sour cream
Some milk
A little bit of butter
Worcestershire sauce to taste
A cereal bowl of flour
Assorted spices (rosemary, thyme, savory, ground black pepper)
Extra Virgen Olive Oil
Egg Noodles

 Chop your onions and garlic cloves. I usually slice the onion in medium width long strips, but Brian doesn't like "big pieces" in his food, so I coursely chopped the onions a little smaller to see if I could get him to eat a few more veggies. I put the garlic in the same bowl, it's all ending up in one pan.

 Rinse your steak, then wrap in seran wrap. Use a meat tenderizer if you have one, or resort to a can of your favorite Campbell's soup. Spaghetti sauce jars also work well. Commence in pounding the snot out of your steak. The steak will be sliced  into thin strips later so this step helps keep your meat from turning into tough shoe leather. After pounding (on both sides) remove seran wrap and cut meat into thin strips.

After slicing the meat it's time to prep it for the frying pan

Mix equal parts of your spices in a bowl. Put flour in another bowl and then have a plate ready for your floured meat. Take a strip and place it in the spice bowl and then use your fingers to rub in the spices. Too much spice can make gritty meat so don't layer it on too thick. Put the spiced meat in the flour bowl and thoroughly cover the meat in flour. Put your finished floured meat on the plate to get ready for frying. Once you have a substantial amount of floured meat ready, put some EVO in your pan and place burner on medium-high.

Place floured strips of meat in hot oil in pan, flipping until both sides are browned. If you do a few slices at a time you can flip them faster and keep your meat more tender. Too many pieces and your steak will be very cooked through. I like my steaks medium rare, so I try to flip the pieces pretty fast. Continue to add oil as needed as you fry the meat strips. Let the pan cool a little and wipe it down when the meat is all finished.

Sautee Onions and Garlic

When onions are nice and golden, add meat back to pan and we start the sauce process. YUM! I think the sauce is the best part. While you make the sauce, go ahead and throw on water to boil for the noodles.


SAUCE! Pour some milk into your sauce pan with your

 onions and meat, keep the burner on medium-low. Add a LOT of sour cream. A medium sized container is a good start. Add a little less than 2 qts heavy whipping cream. Stir very frequently to get everything to blend smoothly together. Maybe add a tablespoon or so of butter if you feel so inclined. Continue to stir, bring the burner up to medium. Add dashes of worcestershire sauce to taste, I'm guessing I put at least 1/8th cup in my sauce, hard to tell since I don't ever measure. Stir, stir, stir, graudally bringing up the heat. Trick is you want the sauce to warm through thoroughly and thicken, but you don't want the dairy products to break down. Medium high is as hot as I'll bring the sauce and I'll usually bring the heat back down fairly quickly once the sauce bubbles to avoid breaking up the sauce. TIPS: Less milk, more cream, especially if you use 1%milk or less, the fat is the key to this rich sauce. Too much milk and it'll take forever to thicken. Use plenty of sour cream. Stir in the worcestershire thoroughly and taste after each addition so you don't put in too much. Use pepper to season if you want.

VOILA! Finished sauce.

Now just let sauce cool and thicken for a minute or two, pour over cooked egg noodles and your beef stroganoff is complete! I forgot to take a "finished product" picture of our bowls of noodles and sauce, it was just too yummy smelling and I was too hungry! I took my bowl straight to the couch and tucked in. This is one meal on which I overstuff myself every time I make it. My stomach hurt for the rest of the night, but it was so good!

This is the only type of Beef Stroganoff I've ever had. I've never had the "Hamburger Helper" version with ground beef which my husband apparently detested. I was pleased and he was pleasently surprised when I first made this rendition for him. Take that Hamburger Helper!

Next on the list is to make a good Borscht. :)

Yoga....24 hours without sleep

Me: "ADD people do yoga all the time. I can instantly forget my surroundings, even mid conversation."

Me: "Does it count if I'm thinking about what my organs are doing? I think my gallbladder is cute, it's all snuggly underneath my liver. It's like Beauty and the Beast."

My breathing was not fluid or equal, I kept yawning, and I can't really say I feel much difference in my circulation though Brian laughed so hard at one point I think he started wheezing. Perhaps Yoga is best done seperately...or when fully awake...

It was marginally better than me sniping at the weather man on the news, but not much. And now? It's after 8 so I almost feel awake because my body feels like I should be at work. My body feels slightly awake, my brain feels heavy and light at the same time. Like it could fly away at any moment but if I wanted it to fly it wouldn't budge.

Annoyance> Brian discovered an excellent fantasy series 4 years ago, but only the first book was out. The second came out last November. The third will probably take another 4 years till publishing. I just finished the second and I am annoyed that I read it. It was engaging, earthy, not silly fantastical, and following a different pattern of storytelling that makes it enjoyable and complex while not being confusing just for the sake of confusion. I should have waited. Now I will just have to read both of them again in four years and hope the story wraps up in the Third (which I doubt).

BIG post.

I have three things to discuss in this post, I shall try and make it brief.

A. A chapter in exorcism does not exist in any paramedic text book, it is not part of the required curriculem, or even recommended. In fact, it was never mentioned. However, it is in not entirely infrequent demand in the EMS world. Please, call a pastor or a priest, I can not get rid of that evil spirit trying to evict you from your apartment. I can, however, get you somewhere safe until you're no longer high on bath salts. Take your pick.

B. Remus at the dog park. We were by ourselves for the first 20min or so so I took pictures :)

 

Plenty of room to roam

Isn't he cute? :)

He sniffed all the benches.

Drooly lips. He drools when he gets excited.

PAAAAASSED OUT on the way home. He takes up the whole car.

C. Figured I'd post some of the painting I've been doing, I was having fun, but I was getting a little bored by the tedium of the current stage of my project so I decided to create a "How To" guide to stave off the enuii.

These are the leaves I'm painting. It's going to take A LOT of leaves, I'm only on the first layer and each leaf is approx 5/16th of an inch, some smaller, some a tiny bit longer.

STEP ONE

Get you some Liquin! I paint in oils, usually I don't use a drying medium, but Liquin helps thin the paint to a good consistency as well as speed up the drying process since eventually I have to put three or four layers of leaves on top of each other.

STEP TWO

Mix your colors. I used French Ultramarine and Cadmium Yellow Pale Hue and made a light and dark tint. Thats also my detail brush of choice.

STEP THREE

Mix a tiny TINY bit of Liquin with a small portion of paint and load your brush. Start with one straight line for the middle of the leaf.

STEP FOUR

Connect two bottom lines for the base.

STEP FIVE

Add the top two lines, blending as needed with the rest of the leaf.

TA DA!

A leaf. I have A LOT of leaves left. Buh.

Sorry about the shadowy, blurry photography. My camera doesn't do well with close ups of small things, and it's hard to paint with one hand and photograph with the other. You get the gist :)

Thats all for now!

Singing in the car...

One of my favorite classes at Penn State was titled "The Rhetoric of Space" and dealt with various philosophies and theories on how people regarded space, how space changed people, and how to change spaces. Thats a very inadequate summary, but it's difficult to summarize a semester long reading intensive rhetoric course. To continue with the philosophical butchering, one of the ideas we studied was that about "private" and "public" space. (Private being inside your home for example, Public being businesses, schools, etc). Like most philosophy, grey areas are rampant, and in this case duly labled "Public-private spaces". For example, the pertinent part of this introduction, inside your car. Your car is, kind of, a private place. We view it mostly as such, people hold business in cars, have "private" conversations whether on the phone or with another occupant, and we "decorate" or maintain our cars as we choose. Their is a propietery ownership of the space inside your own car. However, your car has windows. For most people, these windows aren't tinted dark enough to warrant true "privacy" and all those other drivers can watch you put on your mascara one handed in the rearview mirrow, can see you get angry and gesticulate wildly in a heated conversation with whoever else is in the car, and they can watch as you sing a long to the radio. Sometimes, we are conscious of this voyerism. Sometimes, I definitely am not.

Last night was dreary and grey and rainy, like the past couple of nights, and I was headed off to work with an inadequate days sleep.  Remus had managed to trip over his chain and fall down the porch steps and I had kept him inside after that, letting him out as needed. Feeling antsy, tired and annoyed at the depressive weather, I chose a mixed CD Brian had made for me the year prior and loaded it into my car's CD player. Over half of my 40 minute commute is a two lane country highway, and last night the traffic was even sparser than usual. As my CD played I found myself caught up in the music and began exuberantly singing along. And I mean exuberantly. I repeated some songs, fine tuning the dance routines I made to match, belting out the lyrics at the top of my lungs because I was in my own car, my own private space, noone else could hear me. Well, this was all well and good on the two lane highway with no cars in sight, but I was so enthusiastic, I didn't realize until halfway up the traffic and stoplight dense portion of my drive that people were open mouthed staring at me. The truck next to me (the highway has turned to a five lane highway at this point) was pointedly making sure he's driving the same speed I am, even though his lane was moving faster, to take open glances at my bouncing musical renditions. To top it all off, I am in my neon reflective jacket, so I'm hardly inconspicuous. To stop now that I've noticed I had an audience seemed somehow shameful, so I sang lustier than ever and took every opportunity to speed up and lose the truck. Then, thankfully, a coworker called and I had a legitimate excuse to turn down the music and stop my theatrical  antics.

I shrugged away any embarrassment. I hadn't recognized the truck driver or his occupants and in the size of this city I convinced myself that noone I actually knew had seen my embarrassing performance. However, the fun of singing so ridiculously had me smiling and happy, dreary weather not withstanding, when I clocked in at work, and I even rebelliously sung a few bars in hearing range of coworkers when I walked into the bay to claim my ambulance.