Combative Patients

I'm tired, so I'm not going to be saying much, but the other night we had an ambulance and rescue truck called to a location about an hour and a half away. The call literally came right as I stepped in the door and said hello to my hostess. So much for dinner. /sigh

It was raining and none of us wanted to be outside breaking open a car. Luckily for us, the EMS group up in that area managed to extract the patient from his car and transferred him to us when we met up with them (about an hour out from the clinic). This patient... Where do I begin? He would not answer questions, ripped out his IV before we could stop him, was belligerent, threatened to break out of his spider straps (hah, good luck with that one...) numerous times, called our provider some very unbecoming names once we got back to the clinic, and was generally just a nightmare to deal with. Eventually he settled down and became more cooperative (mostly after our provider threatened to keep him bound in the spider straps and just send him to Little City ^_^).

Anyways, we were all glad once we finished dealing with him and could go home. Cheesecake made the night so much better. I only wish I had made a red velvet instead of a generic New York Style. Mmm, chocolaty velvet.

Patience and cheesecake

No, I'm not using cheesecake as a reward for patience. The process of making it, however, takes quite a bit. At least with the kitchen I have available. Seriously. No rubber spatula. No spring-form pan (I realized this after I had made the filling already T_T). An oven which can't realistically go above 400F (and even that temp takes about an hour to get to). And amidst a myriad of other minor issues, the only sugar in the house was in sugar packets. You know, those dinky little things with less than a teaspoon of sugar in them... Yeah, there went a good half hour of my life. Scraping down the sides of the bowl with a spoon between additions took another decent chunk, but if you are going to do something, you might as well do it as best you can with what you have.

And now I'm sitting here, waiting... waiting for the cheesecake to cool down so I can actually try a piece. Oh, and I'm actually waiting on two to cool. Turns out the recipe made a LOT of cheesecake... That or I'm using tiny little cake pans. Either way, they look good, but I'm a little worried they might not be cooked all the way through.

In addition to the trials and tribulations of today's baking spree (the cheesecakes, several loaves of bread with only one bread pan, pitas [they puffed up perfectly this time, btw], and home made hot pockets for someone's lunch), the three little girls were unbelievably energetic and loud. The youngest would not stop screaming, the middle child made a horrific mess, and the eldest's new favorite phrase is a toss up between "COME BACK HERE AND APOLOGIZE!" and "no!" The lot of them were ushered outside for a little while before it started raining (still raining, twelve hours later), but that only seemed to give them more energy. Normally in such circumstances I'd seek solace on a nice LONG bike ride, or at the very least hide away from all the chaos, but being shackled to that demonic oven (I actually managed to burn myself on it while adjusting the time) kept me in the middle of it all.

Since I'm talking about baking, the other day I made yet another black forest cake (I can't remember if I posted about the first one, though technically it was only a BFC in spirit, it was still good and made the perfect sentimental anniversary gift). This one was amazing. Since this was a rather special occasion, I decided to have my brother pick up a bottle of kirsch, and even the small amount I used really did add to/bring out the cherry flavor. I had a bit of an issue with the cherries I used for the filling though, and the bottom layer was a touch soggy, but meh. Chocolate + cherries = happiness, however brief. And whipped cream. That helps too.

I think next weekend my hostess is going to request croissants, which I love, but amg it's a lengthy process. Layering in all that butter, letting it chill between folds, eating them all in about two seconds flat... *Ahem*

Week summary

Such a miserable week. Monday I couldn't drag myself out of bed until 11am, and then I was only up long enough to talk a little with my hostess, say 'hi' to the girls, eat something, and then pass out on the couch. I ended up officially waking up at 4pm. So for me, Monday didn't actually happen. Tuesday and Wednesday I went in to work about the clinic, but I was pretty much a zombie the entire time. Learned about clotting and the various ways medication affect it. Thursday there was a call to pick up a patient with a blood pressure of 215/199. Not even joking, and he was about an hour away. Also on Thursday my depressed immune system decided to pay me back by letting me catch some nasty little GI bug. I could barely keep anything down, and had crazy stomach pain. Thankfully, it cleared up in a couple of days.

Also, at some point during the week (well before the GI issue) I tried soy milk for the first time. Vanilla flavored. Not bad actually, and it's supposedly healthier too. Not to mention it's $2 cheaper up here than the same volume of regular milk. The local grocery store is making a killing because they are basically the only place to shop for this town, and many of the northern towns. I mean, who sells bread at $5.05 a loaf? and milk at $5.00 a HALF gallon. So glad I make my own bread and only rarely drink milk. >.< I actually pretty much just use milk for baking, and unfortunately you can't substitute in soy milk. The consistency is different, and it does have a very distinct taste. Oh, and whilst I'm ranting about prices, how much is your gas? Mine is $4.29-$4.39. I praise my lucky stars the crazy little dodge neon I'm driving gets 33-38 mpg.

Hands on experience

Nothing beats it. I'm good at learning by reading, but actually going in and pulling the staples out of someone's leg, or stitching up someone's head will always be better. Marginally. >.> And that's one of the things I love about helping out at the clinic and working with the EMS up here. The vast majority of the patients in the clinic are more than willing to let me, uh, 'work' on them (perhaps because they don't know I've never done it before...) And with EMS patients, they usually can't even say no. Oh implied consent, you are wonderful. Of course, everything I'm doing is supervised, I HAVE read about it before, and it is all for the patient's good.

Speaking of getting experience, I'll soon be taking a two day class on swift water rescue. Day one will be all the class room stuff, day two will be practical experience. It should be fun. ^_^

Mornings

Normally, I like mornings. No really, I do. They are quiet and peaceful. Cooler than midday and not as bright. I work well when I first wake up and above all else I am usually alone.

Well this morning was not like most mornings. I woke up with bright sunlight shining right on my face, then I was surrounded by small children (one of whom still only communicates by screaming), and it was a little *too* cool. The heat was off at night and my shampoo turned into a very, very thick gel. Not to mention it was still ice cold going into my hair because I was too impatient to wait for it to warm. I couldn't even get my face wash out of the tube, it was so stiff. Then, to top it all off, I opened my deodorant and watched as it went sailing through a perfect ark before shattering on the floor. It never occurred to me that deodorant could shatter. /facepalm

And pita bread. I thought "Oh! It's flat. It doesn't need to rise, I can make it quick and then go to sleep early." Yeah... I'm still waiting. But the dough did feel amazingly silky and it was fun to knead.

Fun in the Little City

I decided to pull a LONG weekend. I left Home late Thursday night (originally I was going to leave before dinner, but I got pulled into making that chocolate cake), got to FHB just after 10pm, played some games with my cousins and then crashed. I'd been running on borrowed time ever since that last medevac to the Big City. I ended up sleeping right through until 11am... My excuse was that my phone died so I didn't have any way to tell the time, but really, I needed the sleep.

Anyways, even with that annoyingly late start to the day, I managed to fit in many games of badminton, more video games (I'm getting better with the darned 360 controllers), and was still able to drive two hours to the Little City and meet up with my brother right as he got off of work. We went out to dinner at a restaurant called Vallata. It was expensive, and supposedly an upscale establishment, but being Far Far Away the facilities were a little shoddy and there were people in t-shirts. *rolls eyes*

The food was also... meh. I could make better for a fraction of the cost. At the very least, it was a good opportunity to catch up with my brother, cE, and get to know V a little better. She's an amusing lady to be sure. Dinner also took close to two hours. Not even joking. I think at one point our waitress forgot about us. I mean, she even asked "have I asked you this already?"

Anyways, after dinner my brother and I tied up a few loose ends in the Little City and then stopped by his new residence. I didn't really get a chance to see more than the living room area as my attention became occupied by a very energetic little dog who was desperately trying everything to be noticed. I did, however, manage to convince him to drive back FHB with me, in spite of the hour (we ended up getting in at 12:30am >.>). Now, he could have just as easily come up in the morning, but I wanted to ride in his car. It has lumbar support. I don't know how, but I managed to put my back out driving from Home to FHB.

I'm not old enough to drink legally (I'll be honest, first draft of this I split that infinitive, clearly I was exposed to Star Trek at too young an age and it has permanently scarred my language skills) and I'm already experiencing back problems. FROM DRIVING. I'm in for a wonderful life. /sigh And yeah, badminton with lower back pain probably wasn't the smartest thing, but it was fun. And my team won every match. Also, coming down in the same car meant I got to spend four more hours (two on the drive down, and two on the drive back to pick up my car) with my brother. Always a plus.

Potentially, it could let me spend more time with him, but at the rate things are going it doesn't look like it. He's good at the whole sleeping in thing. I'm generally not. As proven by the fact that I'm up, all alone, typing this out at 7am even though I went to sleep around 3am last night.

On a random note, it occurs to me that I tend to put in rather long parentheticals which really do break up my sentences. I blame Ancient Greek. I remember one particular sentence that essentially went 'The farmer, *page and a half of various dependent and independent clauses*, went to the market.' By the time I got to the end of it I had almost forgotten who 'he' was referring to...

Burning the Midnight Oil

Literally. That midnight, I was in a Navajo, flying to the Big City with a patient who had jumped out of a moving vehicle. We got to the hospital around 1am, got a slice of pie from Village Inn after situating the patient with the hospital (it was terrible, the Graham cracker crust was too thick and masked the flavor of the key lime filling, the whipped cream layer on top was thicker than the filling and judging from the density had been sitting around for a while. I can't really complain though, I didn't have to pay for it. >.>), and then ended up flying back with the patient because his injuries weren't as severe as we thought. He was incredibly lucky, didn't even break any bones or suffer a concussion despite a rather nasty blow to the head. Well, lucky depending on how you look at it... Medevacs are rather expensive.

Anyways, when all was said and done, I was crawling into bed at 5am with the prospect of waking up early and heading to the clinic. Fun, fun, fun. Thankfully, I've discovered the perfect task to work on while in a zombie like state. Dictations. At some point after meeting with a patient, our provider records all the important S.O.A.P.(E.) information and then someone (in this case me) comes along and actually writes it into the chart. It doesn't require a lot of thought, and I still learn a great deal.

Then the next night, there was a call just after midnight for two ambulance crews. I was already asleep and was awakened by my radio, but at the time I wasn't sure if it was really happening or if I was dreaming it. It didn't help that my hostess had just been telling me about a situation very similar to that being described over the radio. Needless to say, I did not respond to this one... I heard later that it took them about three hours to resolve this one, and they didn't need to transport anyone from the clinic.

Lemon muffins and chocolate cake

Shortly before coming up here, I discovered a recipe for lemon poppy seed muffins over at Annie's Eats. Unfortunately, poppy seeds are prohibitively expensive at Home. So I decided to give the muffins a go without them. After all, the seeds would really only add a little, barely noticeable crunch. As far as I can tell, they really don't have much of a taste.

Halfway into making them, I realized we didn't have any yogurt in the house. The recipe calls for a cup. The closest thing I had on hand was 1/3 cup of sour cream, so I used that, diluted with about a tablespoon of lemon juice. And you know what? They came out amazing. Light, puffy, and perfectly flavored. Or so I'm told... I didn't actually get to try one. I had to run out of the house so I wouldn't be late for my CPR/First Aid class whilst the muffins were still cooling, and they were all gone by the time I got back. They certainly looked and felt light and airy when I slid them out of the muffin sheet, but alas, I only got to smell that tantalizing lemon fragrance. I'll definitely be making them again as we now have a bag full of lemons just sitting in the refrigerator. Calling to me...

As for the chocolate cake, I can say without a shadow of a doubt that it was fantastic. I patched my Oma's recipe together as best I could from memory (quite a feat, seeing how I never actually saw her make it) and cobbled together a black forest cake. It had to be the fastest cake I've ever made and decorated. Right before I set out to FHB, my hostess decided to ask me if I could bake a cake for her anniversary. Of course, I couldn't say no. I mean, 1) it's baking a cake, 2) she's family 3) she pulled out the good cocoa for it. It smelled unbelievable, and was so rich and dark. /drool

Anyways, I was worried the cake would come out as a brick, because as a sponge cake, it basically starts life as a meringue and then has the flour + cocoa folded into it. I didn't fold. I whisked. I was crunched for time, and the best implement I could find to fold the dry ingredients in was completely useless. The moment I turned the blender on, I could see my batter deflate as all the air I had whisked in previously came rushing out. A little disheartening, but meh. The consistency still came out just right and the higher quality cocoa was definitely noticeable.

After stuffing the cake in the refrigerator so it would cool down faster, I applied a whipped cream frosting. With a bread knife. When I first set the bowl of frosting down next to the cake, I looked back and forth between the two thinking "Oh snap. I don't have a cake icing spatula, I don't even have a normal spatula..." Then I notice the knife stand. *Light bulb* (I've now seen Despicable Me, oh, a good seven or eight times now.) The bread knife actually worked out pretty well all things considered. Having a regular dinner plate for a cake platter didn't exactly make it easy to frost the lower edges, but I managed. And then piping from a Ziploc bag with no tips limited the amount of finesse I could bring to bear on the finishing touches, but all in all it still looked delectable.

My only regret is that I only had a chance to savor one piece before I flew out the door.


Edit: I suppose I should mention that a week ago I made a red velvet cake. Or rather a deep forest green velvet cake because we didn't have any red food coloring. Then because the little people I stay with would enjoy it I made a pink frosting. It looked abominable, but they loved it and I relish the taste of velvet cakes. As a side note, always remember to use powdered sugar in frostings. It saves the effort of having to go back and degranulate it. I realized my mistake right as I added the last of the sugar. Not wanting to waste it, but also not wanting to serve a grainy frosting, I worked some magic and smoothed it out.

Week summary

All in all it was a pretty uneventful week. I had another medvac down to the Big City, this time with a lifetime EtOH abuser who was paying for his mistakes. That's not me being judgmental, just an apt assessment. Then there was someone who had absolutely nothing wrong with him (that we could find), but was complaining of chest pains. After hours too. Other than that, the biggest thing is that I'm now sitting in with our provider when she deals with patients, so I get to see how she works.

A true taste of vacation

Sort of. This memorial day weekend I had another long weekend and planned to spend all of it (starting on Friday) at Familial Home Base with a large chunk of my extended family. Of course, this didn't go quite as I had planned. I found out earlier in the week *coughWednesdaycough* that there was a CPR and first aid class early Saturday morning, and that the second half of extrication training was that afternoon. Whatever, I could just leave at like 4pm on Saturday and still spend two nights at FHB. Oh was I disappointed. The CPR class was amazing, our teachers knew what they were doing and moved at a brisk pace so we actually finished an hour early.

The extrication training was supposed to be cutting up three cars (one on its wheels, one of its side, and one completely flipped) in order to remove our 'patients'. Three cars... in the field we need to do a car in under 30 minutes tops. Preferably like 10 minutes. It took FOUR HOURS. The car on its wheels took two hours on its own. It was ridiculous. Nothing against our instructor, but boy he can go on. 'And this tool does this, and this one does the same thing, and then there's this one, and this one, and blah blah blah let me show you how they all work even though it's pretty much exactly the same.'

When we had finally finished, instead of packing up and heading back to the clinic quickly, people decided to sit around and talk. Telling the exact same stories they had been telling the entire day, just in a slightly different way. Urgh, old men. So I finally got back home at about 6:30, and ended up leaving Home for FHB at around 7pm. I realize that the training is important, but I hate having my time wasted. The class could have been done in a much more efficient manner, and we would have learned just as much.

I will admit that I did enjoy breaking car windows with the spring loaded center punch. Just stick it in the corner of the window, apply a little pressure, and POP! Entire window shatters. >.> Perhaps I enjoyed it a little too much...


Once I got to FHB, I enjoyed myself. I helped uE fix up the car I am borrowing so it runs much smoother now, and once again he went above and beyond what was necessary. For sleeping arrangements I was originally on a cot. Now, I don't have any problems sleeping on cots, goodness knows I've spent months on one before. This particular cot, however, squeaks whenever you move on it. Roll over? Squeak. Scratch your nose? Squeak. Twitch in a dream? Squeak. Anyways, I think you get the point. All this squeaking would keep me awake and wake me up when I finally managed to fall asleep, so I migrated to a very comfortable armchair. This armchair and I go way back. Way, way back. I've also spent numerous nights sleeping soundly on it, so I spent the rest of the night in comfort. Of course, when uE saw me sleeping in a chair, he decided that he needed to set up a bed for me. Never mind that it needs to be pulled out of storage, that there is very little space for it, and that I'm perfectly happy to sleep in the chair. The bed is coming out. /sigh I do appreciate it, really. But I hate creating such a fuss.

During the days, I played DotA with my cousins, actually beat them in Halo Reach (still not sure if they let me win or not... I will always doubt my abilities when it comes to xbox. I'm a computer gamer through and through), and mostly cleaned house in Super Smash Brother's Melee. I got my bottom handed to me so many times in high school by a friend that I've actually become proficient in the game. We also did some skeet shooting (or rather, they did and I watched for a little while), and had a mini barbecue. I'm slowly refining my Oma's potato salad, and I've learned of another possible ingredient from my Opa. Speaking of which, that man is full of surprises.

1) He's playing croquet... I'm pretty sure he's mocked the game on numerous occasions and it just seems so out of character.
2) I've heard rumor that he has been walking outside barefoot.
3) He's gardening. Like, actually tilling the earth, planting seeds, and watering them gardening. He's set up a tomato (or potato, I never quite heard properly what was being said) patch. To me, that was always and ever, now and forever Oma's domain. Speaking of Oma... My god I'm almost afraid she's going to come back and haunt us. Well, haunt certain people first and then us for doing nothing.

AND speaking of doing nothing. I feel like I have to say this. There are certain situations where doing nothing at all can be just as harmful as actually doing something. Certain situations where doing almost anything would be better. I know that there are many, many ways to take that statement. Feel free to see what you will in it. Maybe in a later post I'll talk about it more.

To the Big City!

The view for about the first fifteen minutes was beyond amazing... The river was snaking back and forth below us, swathed by luscious dark and bright green trees. The mountains in the distance were beautifully white capped, and there were patches of snow beneath us too. Then we hit the clouds. After enduring the dull gray for a few minutes we burst forth into... more gray. Which at the time was rather boring, but it got worse. Once we got through the next layer of clouds there was nothing between me and the bright, blistering sun. Just lots of white fluff reflecting it back. I did manage to get a minor sunburn on the way down.

Flying to the Big City, we go higher than when we just go to Little City, so we were at 14k feet instead of 8k. Now, I didn't realize it, but I probably should have been on oxygen flying down (I certainly was on the way back up). I got a headache and kept falling asleep, but the EMT in the plane seemed perfectly fine, so I thought it was just because I hadn't really slept well the night before. Oops. On a related note, nasal canula are kind of uncomfortable. It basically blows oxygen right up your nose, so exhaling feels weird and of course you have two short tubes going up your nostrils.


BEWARE THE DANGERS OF SMALL CHILDREN. Seriously. Our patient got kneed in the eye by a four year old. I don't know how it happened, and frankly, I don't want to know how it happened. What I do know is that she's probably lost the eye by now. I saw it for about two seconds (I was looking over the provider's shoulder when she took a quick peek) and the orb looked deflated. Also, lots of blood, but that wasn't the important part. Not fun. Of course, with eye injuries, you need to cover both eyes. If you just cover the injured eye, the patient will continue to look around, and the eyes track together, even if one is closed. This is bad. So the poor patient was blinded for most of the time in our ER, the entire transport, and presumably she will remain that way in the Big City's ER/hospital until this is all resolved.

All things considered though, the patient was really nice. Polite and quiet. The only thing which wasn't agreeable was that I had to hold the patient's hand whenever the flight became turbulent. Part of this whole 'compassion' thing, and making the patient as comfortable as possible. I understand why she wanted the contact though. Going from a sighted world to suddenly not being able to see anything, being brought into a strange environment, and then feeling like the plane is going to shake apart can be a little unnerving.


I've decided to play it even safer, just to avoid any HIPAA related complications, so I'm removing all locations from the blog. From here on out (and in previous posts) you'll now just be seeing Home, Little City, and Big City whenever patients are involved. (And since all patients are coming from Home, I'll be taking the name completely off the blog.)

Unruly patients

Usually, the patients we get in the clinic, or deal with on the EMS end are nice, generally well behaved, and accept the fact that we are there to help and that they need our help. Every so often, however, we get someone who refuses to cooperate. Heart problems and chest pains? LET US GIVE YOU YOUR DARNED NITRO. You complain that your chest hurts, struggle, yell, moan, and do everything else, but the moment that little pill gets close to your mouth, bam. Closed tight. /sigh Then, you decide not to let us put a catheter in. No, no, don't take our word for it. Feel for yourself how uncomfortable you are going to be when that other medication kicks in and starts flushing fluids out of your system. Don't make all of our lives easier by letting the catheter drain you. URGH.

And then the medvac flight. Wonderful view of the mountains, we have your vitals stable, and then you decide you need to flail around and almost pull the emergency exit release. At least I'm faster, by the grace of god... (See what I did there? eh? eh?) Anyways, I did manage to slam my hand against it before the patient's fingers got around it, but it was still one of those wide-eyed, did that really almost happen moments.

Oh, remember how we didn't get a catheter in? We had to bring portable urinals and he was strapped to a gurney... 2 + 2 = SCARRED. FOR. LIFE.

Anyways, that's that rant out of the way. On the bright side, there is a pretty good burger place in the Little City which we go to after getting the patient set up at the hospital. Jalapeno Burger ftw. It's amazing and I actually find is spicy!



I have a backlog of posts that I just haven't had a chance to put up. So I've set it up to post them, one a day, for the next few days.