Striving For Skinny

Fostering Grace

2013-01-20T06:26:00.000-08:00

This is Grace, currently she is at the Columbus GA animal control on the "urgent list." I am going Tuesday to get her out! I am trying to find a home for her, but in the meantime I need to buy her food, get her a bed and a kennel, toys, and other things that dogs enjoy. If you're able to help out, even the tiniest amount- I would be so grateful!

Asian Inspired Chicken Wings

2013-01-08T12:05:00.002-08:00

Ingredients

For the sauce
1 cup sweet chile sauce, such as Mae Ploy
2 tablespoons peanut butter
1 tablespoon sesame oil
2 teaspoon rice vinegar
2 teaspoon soy sauce
2 teaspoon chopped garlic
2 teaspoon chopped fresh ginger
2 tablespoons chili sriracha
1 chopped jalapeno
1 tablespoon cilantro
3 pounds chicken wings, preferably free-range
2 cup flour
1 teaspoon salt
1 teaspoon paprika
1 teaspoon cayenne
Peanut oil, for frying
Finely chopped fresh cilantro
1 scallion, thinly sliced

Directions:

Combine flour, salt, paprika, and cayenne in a bowl.

Toss chicken in dry ingredients, ensuring chicken is coated.
- Refrigerate for 60 minutes.
- Place peanut oil in pan, high enough to cover chicken almost entirely.
- Put chicken in oil and fry for 10-15 minutes, or until done.
- At the same time, blend together chili sauce, peanut butter, sesame oil, rice vinegar, soy sauce, garlic, ginger, chili sriracha, jalapenos and cilantro.
- After the chicken is done cooking, coat the chicken in the sauce.
- Garnish with cilantro and scallion.

Thai Peanut Noodles

2012-08-21T17:37:00.002-07:00

Ingredients:

2 boneless, skinless chicken breasts

OPTIONAL CHICKEN MARINADE: This is where it gets sort of complicated because we just play with the marinade until it tastes right. But here are the ingredients that we use:

Brown sugar
Honey
Soy sauce
Hoisin
Sriracha
Basil
Sesame Oil
Rice Vinegar
Garlic
Ginger

1 tbsp coconut oil (can use olive oil if that's what you have in your house)
1 lb whole wheat linguine noodles
2 bell peppers, sliced. I used red and yellow
1/2 cup of peanuts, crushed
4 Green onions, chopped
Garnish with lime wedges
Sauce:
- 1 cup of water
- 4 tbsp of lime juice
- 6 tbsp of creamy peanut butter
- 2 tbsp of Sriracha hot sauce
- 3 tbsp honey
- 4 tbsp low-sodium soy sauce
- 3 tsp ground ginger
- 3 tsp minced garlic

Directions:

Let chicken marinade for 1-2 hours in the refrigerator.
Take chicken out of the marinade and cook until finished (either on the grill or in a pan)
Start a pot for the pasta and cook pasta until al dente.
Sautee the bell peppers in the coconut oil.
While you are waiting for these three things to be finished, make the sauce.
Combine water, lime juice, creamy peanut butter, Sriracha, honey, soy sauce, ground ginger and garlic in a bowl and whisk until the peanut butter is no longer clumpy.
Chop up the chicken when it is finished cooking.
Strain the pasta, and add it back into the pot.
Add the sauteed bell peppers and chicken to the pot with the pasta.
Pour the sauce over the pasta, chicken and bell peppers.
Cook for 5 minutes and allow sauce to coat all ingredients.
Garnish with crushed peanuts, green onions and lime wedges.
Delicious with more Sriracha added!

Recipe adapted from: Once A Month Mom

Enjoy!

Garlic Pesto Chicken with Tomato Cream Penne

2012-08-21T17:18:00.002-07:00

Ingredients:

1 Bottle of Lawry's Garlic and Herb Marinade
4 chicken breasts, pounded thin
4 tbsp of pesto
1 lb of Penne pasta
4 tsp olive oil
2 shallots, diced
4 cloves of garlic, minced
1 cup of chicken broth
1 14 oz can of tomato sauce (whatever the normal size can at the store is)
2 cups of half and half
2 tsp of flour
Salt and pepper to taste
Basil, for garnish
Parmesan, to taste
Red pepper flakes, to taste.

Directions:

Marinate chicken in Lawry's Garlic and Herb marinade and 4 tbsp of pesto. Best if done overnight, but a few hours is fine.
Grill until done.
Cook pasta until al dente in a pot of salted water.
Heat olive oil in skillet over medium heat.
Sautee shallots and garlic until shallots are tender.
Add cup of chicken broth and cook until the chicken broth reduces by half.
Stir in tomato sauce.
Add half and half and flour, stir well. *Make sure that the flour clumps are out, I had trouble with this*
Season with salt and pepper.
Toss pasta in sauce.
Plate pasta in bowl and top with chicken.
Garnish with basil, Parmesan cheese and red pepper flakes.

Enjoy!

How to Restart Your Diet

2012-08-21T05:49:00.001-07:00

I feel like I need to post this just for myself.

Thai Red Curry with Bell Peppers and Mushrooms

2012-07-23T16:32:00.002-07:00

Ingredients:

5 tbsp Red Curry Paste
2 tbsp cooking oil
1 13 oz package of angel hair pasta
4 cups coconut milk (I used 1 can of light and 1 can of regular)
1 lb ground turkey
2 tbsp brown sugar
3 tbsp fish sauce
2 tbsp grated lime zest
2 lime quarters
2 red bell peppers, diced
1 container of fresh sliced mushrooms
2 Fresh serrano peppers
Basil leaves

Directions:

Add cooking oil and red curry paste to pan and fry until fragrant.
Stir in coconut milk.
Boil salted water in a separate pot and add angel hair pasta, and cook accordingly.
Wait until coconut milk boils, and then add turkey.
Let the turkey cook through (about 15 minutes) and then add brown sugar, fish sauce, lime zest, and squeeze the lime juice from the quarters in the sauce.
Add red bell peppers and mushrooms.
Let simmer for 5-10 more minutes.
Plate pasta and then place sauce on top.
Garnish with sliced serrano peppers and basil leaves.

Enjoy!

Advice From an ER Doctor to Drug Seekers

2012-07-22T17:53:00.000-07:00

OK, I am not going to lecture you about the dangers of narcotic pain medicines. We both know how addictive they are: you because you know how it feels when you don't have your vicodin, me because I've seen many many many people just like you. However, there are a few things I can tell you that would make us both much happier. By following a few simple rules our little clinical transaction can go more smoothly and we'll both be happier because you get out of the ER quicker.

The first rule is be nice to the nurses. They are underpaid, overworked, and have a lot more influence over your stay in the ER than you think. When you are tempted to treat them like shit because they are not the ones who write the rx, remember: I might write for you to get a shot of 2mg of dilaudid, but your behavior toward the nurses determines what percent of that dilaudid is squirted onto the floor before you get your shot.

The second rule is pick a simple, non-dangerous, (non-verifiable) painful condition which doesn't require me to do a four thousand dollar work-up in order to get you out of the ER. If you tell me that you headache started suddenly and is the 'worst headache of your life' you will either end up with a spinal tap or signing out against medical advice without an rx for pain medicine. The parts of the story that you think make you sound pitiful and worthy of extra narcotics make me worry that you have a bleeding aneurysm. And while I am 99% sure its not, I'm not willing to lay my license and my families future on the line for your ass. I also don't want to miss the poor bastard who really has a bleed, so everyone with that history gets a needle in the back. Just stick to a history of your 'typical pain that is totally the same as I usually get' and we will both be much happier.

The third rule (related to #2) is never rate your pain a 10/10. 10/10 means the worst pain you could possibly imagine. I've seen people in a 10/10 pain and you sitting there playing tetris on your cell phone are not in 10/10 pain. 10/10 pain is an open fracture dangling in the wind, a 50% body surface deep partial thickness burn, or the pain of a real cerebral aneurysm. Even when I passed a kidney stone, the worst pain I had was probably a 7. And that was when I was projectile vomiting and crying for my mother. So stick with a nice 7 or even an 8. That means to me you are hurting by you might not be lying. (See below.)

The fourth rule is never ever ever lie to me about who you are or your history. If you come to the ER and give us a fake name so we can't get your old records I will assume you are a worse douchetard than you really are. More importantly though it will really really piss me the fuck off. Pissing off the guy who writes the rx you want does not work to your advantage.

The fifth rule is don't assume I am an idiot. I went to medical school. That is certainly no guarantee that I am a rocket scientist I know (hell, I went to school with a few people who were a couple of french fries short of a happy meal.) However, I also got an ER residency spot which means I was in the top quarter or so of my class. This means it is a fair guess I am a reasonably smart guy. So if I read your triage note and 1) you list allergies to every non-narcotic pain medicine ever made, 2) you have a history of migraines, fibromyalgia, and lumbar disk disease, and 3) your doctor is on vacation, only has clinic on alternate Tuesdays, or is dead, I am smart enough to read that as: you are scamming for some vicodin. That in and of itself won't necessarily mean you don't get any pain medicine. Hell, the fucktards who list and allergy to tylenol but who can take vicodin (which contains tylenol) are at least good for a few laughs at the nurses station. However, if you give that history everyone in the ER from me to the guy who mops the floor will know you are a lying douchetard who is scamming for vicodin. (See rule # 4 about lying.)

The sixth and final rule is wait your fucking turn. If the nurse triages you to the waiting room but brings patients who arrived after you back to be treated first, that is because this is an EMERGENCY room and they are sicker than you are. You getting a fix of vicodin is not more important than the 6 year old with a severe asthma attack. Telling the nurse at triage that now your migraine is giving you chest pain since you have been sitting a half hour in the waiting area to try to force her into taking you back sooner is a recipe for making all of us hate you. Even if you end up coming back immediately, I will make it my mission that night to torment you. You will not get the pain medicine you want under any circumstances. And I firmly believe that if you manipulate your way to the back and make a 19 year old young woman with an ectopic pregnancy that might kill her in a few hours wait even a moment longer to be seen, I should be able to piss in a glass and make you drink it before you leave the ER.

So if you keep these few simple rules in mind, our interaction will go much more smoothly. I don't really give a shit if I give 20 vicodins to a drug-seeker. Before I was burnt out in the ER I was a hippy and I would honestly rather give that to ten of you guys than make one person in real pain (unrelated to withdrawal) suffer. However, if you insist on waving a flourescent orange flag that says 'I am a drug seeker' and pissing me and the nurses off with your behavior, I am less likely to give you that rx. You don't want that. I don't want that. So lets keep this simple, easy, and we'll all be much happier.

Sincerely,
Your friendly neighborhood ER doc.

Source

Bara Chirashi Bowl from RA Sushi

2012-07-22T16:48:00.001-07:00

This seriously is my favorite thing in the whole world. Every time we go to Atlanta or I go home, we go to RA sushi and I order this. It's a sushi bowl, and beneath that mountain of fresh and delicious fish is a heap of rice. After eating one of these, I am absolutely stuffed. It has tuna, salmon, yellowtail, shrimp, avocado, cucumber and it is topped with poki sauce.

I really wish that Alabama had better sushi. I am SUCH a foodie, and I honestly will go out of my way just to go to this restaurant. Sad, right? I am so lucky to have awesome friends and an amazing boyfriend that support my ridiculousness. I mean, who drives two hours for a sushi bowl?!

IT'S THAT GOOD.

RA Sushi - Atlanta
Melissa And Doug Sushi Slicing Playset

Seafood Pasta in a Tomato Cream Sauce

2012-07-21T13:04:00.002-07:00

Ingredients:

1 lb (16 oz) Calamari or Shrimp
1 tbsp olive oil
3 tbsp garlic
1 medium onion
Red pepper flakes to taste
13 oz pack of linguine (we used Barilla whole wheat)
28 oz can of crushed tomatoes
2 tbsp brown sugar
3 heaping tbsp of capers (I LOVE CAPERS, so I use them in a lot of my pasta sauces)
1 cup of heavy whipping cream
1 cup of Parmesan cheese
Salt and Pepper to taste

Directions

1. Heat olive oil over medium high heat.
2. Add garlic, cook until fragrant.
3. Add onions and cook until translucent.
4. Add 16 oz of seafood (calamari or shrimp)
5. Begin to boil water for the pasta.
6. Once the water is boiling, add the pasta and cook until tender.
7. When the calamari is about 3/4 cooked through, add 28 oz can of tomatoes, 2 tbsp brown sugar and 3 heaping tbsp of capers.
8. Let simmer for about 20 minutes- to marry all of the flavors.
9. Right before you're about to be finished with the sauce, add 1 cup of heavy whipping cream.
10. Fold in 1 cup of Parmesan cheese.
11. Add salt and pepper to taste, top with basil for an attractive presentation.

Enjoy!

Asian Style "Spaghetti and Meatballs"

2012-07-20T17:08:00.000-07:00

1/4 cup panko bread crumbs
1-1/4 lbs 93% lean ground turkey
1 egg
1 tbsp ginger, minced
1 clove garlic, minced
1/2 tsp salt
1/4 cup chopped fresh cilantro
3 scallions, chopped
1 tbsp low sodium soy sauce
2 tsp sesame oil
Red pepper flakes to taste
1 chopped jalapeno
1 package of Maifun rice noodles

Sauce

8 tbsp low sodium soy sauce
4 tsp sesame oil
4 tbsp fresh lime juice
6 tbsp water
1 tbsp rice wine vinegar
2 tbsp chopped fresh scallion
2 tbsp of cilantro
2 tbsp of sugar (we use Splenda but any kind is fine)
Sriracha to taste

Directions

1. Preheat oven to 500°F.
2. Mix ground turkey, panko, egg, salt, scallions, ginger, cilantro, 1 tbsp soy sauce, and 2 tsp oil and mix with your hands until combined well. Shape 1/4 cup meat mixture into a ball and transfer to a baking dish. Repeat with remaining mixture.
3. Bake until cooked through, about 15 minutes.
4. Boil salted water and add rice noodles to pot until cooked through.
5. Strain noodles.
6. In a separate bowl, mix together lime juice, water, soy sauce, sesame oil, water, rice wine vinegar, scallions, cilantro, sugar and Sriracha.
5. Place noodles in a bowl, top with meatballs and drizzle with sauce.

Adapted from SkinnyTaste

Enjoy!

The Nub Tail Best Friends

2012-07-18T07:52:00.003-07:00

This is Oliver, he's a rescued boxer mix.

This is Dwight, a Manx cat that I found starving near a trash can.

When we found Dwight, he was very young and very thin.

The first day we had him, he attached to Oliver like he was his mother.

Oliver loves cat food, so Dwight figured he'd try a little of his food that day. Oliver obliged.

Neither of them have tails, they understand each other.

They love bothering me while I'm studying.

Dwight apparently makes a nice pillow

Pictures from Loachapoka, Alabama

2012-07-17T17:15:00.001-07:00

Loachapoka, Alabama

We had to do a nursing project for school about a rural community surrounding Auburn. Our group got assigned Loachapoka. I have always been fascinated with rural communities but more so with abandoned buildings. I really would like a hobby, and photography would be an interesting one to say the least. Not that I really have a lot to take pictures of, but just capturing certain moments would be so rad. Anyways, here are the pictures.

Camera of Choice: Canon EOS Rebel T3i 18 Megapixel Body Only Digital SLR 5169B001

Poblano Chicken Fajitas

2012-07-17T15:22:00.001-07:00

Poblano Chicken Fajitas

Ingredients:

1 lb boneless skinless chicken breasts
2 bell peppers, cut into strips (we used yellow)
1 poblano chile, cut into strips
1 red onion, cut into strips
3 tbsp lime juice
1 tsp ground cumin
1 tsp garlic powder
Ancho Chile Powder to taste
Salt and pepper to taste
2 tsp olive oil
Cotija cheese (you usually can find this in the Mexican section of the dairy items)
Jalapenos - optional. We love spicy food so there are always jalapenos in our food.
1 whole avocado- sliced or diced
Fat-free/reduced fat sour cream
Whole grain tortillas

Directions:

1. Marinate the chicken in lime juice, chile powder, salt, pepper, cumin and garlic powder. Refrigerate for 30 minutes-1 hour.
2. Throw the bell peppers, the chile, and the red onion into a large freezer bag and throw in salt, pepper, and olive oil. Shake the bag to coat the vegetables.
3. After taking the chicken out of the refrigerator, slice it into thin strips.
4. Over medium-high heat, place the chicken in a pan and cook most of the way through.
5. Transfer the chicken to a plate.
6. Put the vegetables in that same pan and cook until tender.
5. Add the chicken to the pan and cook chicken through.
6. Heat up tortillas to your preference (microwave, stove, grill)
7. Add cotija cheese, jalapenos, avocado and sour cream at your will.

Head to Toe Assessment Tool

2012-07-16T15:13:00.004-07:00

Head-to-Toe Assessment

Initial Survey: Check ABC’s

LOC (Awake, alert/lethargic/unresponsive)
Orientation (to person, place and time)
Neuro check (PERRLA/Glasgow Coma Scale if appropriate)

Skin color (pale/pink/ruddy/cyanotic/dusky)
Skin temp (cool/cold/warm/hot)
Skin texture (dry/diaphoretic)
Skin lesions/pressure or statis ulcers/ecchymoses: color, drainage, odors, LxWxD in cm

VS – T (include route), P, R, BP/5th VS = PAIN
Apical-rate

Rhythm (regular/irregular/regularly irregular)
Intensity (loud/distant)
O2 and Pulse Ox
Effort (easy/unlabored)
Depth (deep/shallow/blowing)/Auscultation-ant/lat/post
* Chest tubes/need for suctioning/advanced skills, i.e. tactile fremitus/diaphragmatic excursion if applicable

Upper extremities – if IV present note: gauge, solution, rate and infusion pump/controller. Assess IV site for: warmth, redness, edema, drainage or tenderness.

Abdomen – inspect (round/flat/obese/distended)
* Any PEG, G-tube, NG-tube, Dobhoff tube?
Auscultate (bowel sounds present x 4 quads? rhythm of BS – normal/hyper/hypoactive and the intensity – high/low-pitched)
Palpate (soft/firm/hard/tender to light and deep palpation?)
Abdomen (continued)
Bowel: Last BM (size/color/consistency/odor)
Postop flatus?
Incontinence – urinary or fecal or both?

GU: Void/ Foley/ Suprapubic/Fr and balloon size, amount, color, presence of mucus/sediment, odor. Note patency and describe urine in dependent drainage bag tubing.

Ostomy? (note condition of stoma and skin surrounding stoma/contents of ostomy bag-phalange or bag change/client’s adaptation to ostomy)

Lower extremities –
Homan’s sign (negative/positive) - with positive being a bad sign possibly indicative of DVT.
Pedal pulses (Dorsalis Pedis/Posterior tibial, compare bilaterally, Grading (0 - +4)/check for edema) – pitting (+1 - +4)/nonpitting?
Capillary refill (brisk/sluggish-how long, >3 seconds)
ROM, Gait

Dressings, drains or wounds should be assessed and documented in the order they appear in the assessment – i.e. RUE ā RLE. If a circulation check is done, place that information in the order it was assessed.

Circulation Assessment, include: color/warmth/pulse/ capillary refill/movement and always compare bilaterally.

Client Education: Include how client learns best, teaching done and client response.

Southwestern Stuffed Bell Peppers

2012-07-16T13:39:00.003-07:00

Southwestern Stuffed Bell Peppers

Ingredients:

1 lb lean ground beef
2/3 cup chopped onion
1.5 (1 1/4 ounce) package taco seasoning mix
1 egg, beaten
1 can black beans
1 can corn kernels
5 red bell peppers
1 (19 ounce) can diced tomatoes
1 (15 -16 ounce) jar salsa
shredded low-fat cheddar cheese
fat-free sour cream
Green onions
Jalapenos

Directions:

Combine beef, onion, seasoning mix and egg in a large bowl.

Add uncooked corn and black beans and mix well.

Cut peppers in half lengthwise; remove seeds and membrane.

Spread tomatoes on the bottom of an ovenproof 12 X 9 inch baking dish. The liquid from the tomatoes will reduce during cooking so if (like me) you like lots of sauce, add about a cup of water. This also helps make the peppers softer.

Place peppers, cut side up, on top of the tomatoes.

Spoon beef mixture into peppers, mounding as necessary.

Top each pepper with salsa.

Bake in preheated 375°F oven for 40-45 minutes or until beef is cooked thoroughly and peppers are soft.

Cover each pepper with cheese and return to oven, under the broiler, until the cheese melts- less than a minute, so watch carefully!

Serve with sour cream and additional salsa. May top with green onions and jalapenos as a garnish.

Portion Control

2012-07-16T13:12:00.000-07:00

Meal MeasureThis is the meal measure. I find that I often have a hard time controlling my portions, or getting exactly the amount I need to. I absolutely LOVE carbs and everything about them, so I really find it difficult to stop when I should.

Controlling Portions Tips:

1. Drink an 8 oz glass of water before you eat.
2. When you first sit down to eat, divide your plate in half. One half should be fruits and vegetables and the other half divide in half again and have one part protein and one part starch.
3. Eat slowly; set your fork down in between bites and wait for twenty minutes before you go back and get seconds. It takes that long for your body to register that you're full and you could be over stuffing yourself.
4. Eat foods that are high in bulk. Salads, broccoli, kale are all ways to trick your body into thinking that you're full while getting nutritious meals and less calories.
5. Don't watch the T.V. while you eat and avoid other distractions. You don't realize how much you're eating and it makes you eat faster and a lot more than you need to.
6. When you eat out, divide your portion in half and ask for a box. Put the other half in the box and bring it home for your next meal. Restaurants have HUGE portions and much more than you need for each meal.

ER Terms and Common Medications

2012-07-16T12:51:00.002-07:00

Routes of administration

IV
Intravenous administration is when the drug is given in liquid form directly into a vein. This is often done by placing a venous catheter to allow easy administration.

IM
Direct injection into the muscle. Often a painful mode of administration, and provides a slow route of absorption.

PO
By mouth (Per Orum). Typically intermediate between IM and IV in speed of absorption. (is this true?)

PR
Rectal administration (Per Rectum). The rectum is actually a very quick method of drug administration as the rectum is highly vascular. This route is often used in children.

ET
Certain drugs can be given down an endotracheal tube. The drugs are given at 2-2.5 times normal IV dose. Drugs are followed with a saline bolus of ~10ml. The acronym for drugs that can go down an ET tube is ALONE:
• A – Atropine
• L – Lidocaine
• O – Oxygen
• N – Naloxone (Narcan)
• E – Epinephrine

Drug List

Lidocaine
Lidocaine has 2 uses: It is a local anesthetic when injected subcutaneously (and it can be used for a nerve block). It is also an antidysrhythmic drug when injected IV (used to treat cardiac dysrhythmias). Anesthetic preparations come in 2 forms: with and without epinephrine. The epinephrine is added to reduce absorption and prolong the effect. A classic question by the resident/attending is: What is the toxic dose when used as a local anesthetic (Answer: 5mg/kg for lidocaine without epi, and 7mg/kg with epi.)

Epinephrine
Epinephrine is a natural substance produced by the adrenal gland (a.k.a. adrenaline). Epinephrine is used in emergencies to stimulate the heart or to dilate the bronchial tree. Its use is limited by cardiac side effects. It is also mixed with lidocaine to prolong lidocaine’s effect and to control bleeding.

Furosemide (Lasix)
Lasix is a diuretic, which is given IV or PO, which causes the patient to produce more urine. This is often given to reduce the fluid overload in patients with congestive heart failure (a.k.a. CHF) or hypertension.

Diazepam (Valium)
Diazepam is a benzodiazepine that is used both as a powerful sedative and as an anticonvulsant for patients with seizures. You will see it used for alcohol withdrawal, cocaine toxicity, and status epilepticus (i.e. uncontrolled seizures). Diazepam may produce respiratory depression.

Midazolam (Versed)
Versed is a very powerful short acting benzodiazepine type of sedative and is used to sedate patients for painful procedures. Excessive dosing may produce respiration depression (when given i.v.) or coma.

Haloperidol (Haldol)
Haldol is a antipsychotic with powerful sedative properties. It is often used for patients who are acting in a psychotic manner. It should not be used to treat alcohol withdrawal or cocaince toxicity. In sufficient quantities it will render the patient unconscious.

Succinylcholine
Often called “sux” (pronounced sucks), it is a paralytic, resulting in total muscular paralysis. It will most often be used for “rapid-sequence-intubation” to make tracheal intubation easier and to allow the patient to be mechanically ventilated. It has no analgesic properities and paralyzed patients see, hear and feel everything - like a zombie! - thus it is never used without sedation.

Atropine
Atropine is used for several purposes, including inducing the heart to beat faster (i.e. chronotropy) as well as an antidote for certain
organophosphate poisonings. It is sometimes used as a drug for patients with severe asthma. It can also be dripped into the eyes to produce
dilation of the pupil (although this is a different formulation). Can also be used to dry up respiratory secretions during procedures.

Heparin
Heparin is an anticoagulant used to prevent blood from clotting. It is used in patients suspected of having a myocardial infarction and to prep the syringe for an arterial-blood-gas for the same reason.

Valproic Acid
Valproic Acid is used as an anticonvulsant medication. It is not typically used in the emergency treatment of seizures, but toxicity can often be seen with seizure patients who have taken too much.

Phenobarbital
Phenobarbital is a barbiturate which is used either as a sedative and/or anticonvulsant medication.

Pentobarbital
Similar to phenobarbital but much faster acting and with a duration of effect. It is used as an anticonvulsant medication and to treat severe alcohol withdrawal. Often used in a continuous drip for patients who continue to seize.

Methylprednisolone (Solumedrol)
Solu-medrol is a long acting corticosteroid. It is often used to prevent the recurrence of anaphylaxis after the epinephrine has worn off and for patients with asthma. It has a half-life of around 6 hours.

Albuterol (Proventil)
Albuterol is a bronchodilator, used in a nebulizer for asthma patients. Typically a drop (0.5 mg) of albuterol is suspended in saline and nebulized with oxygen. Often referred to as “how many nebs the patient got”.

Ampicillin/Sulbactam (Unasyn)
This is an antibiotic (ampicillin) with the second compound added to prevent bacterial ßlactamases from working (which interfere with penicillins). This over comes the antibiotic resistance acquired by many bacteria.

Flouroscein
This is a fluorescent dye used to stain the cornea to look for scratches or ulcers. Scratches and ulcers will selectively retain the dye, making them glow under the cobalt-blue light of an
opthalmoscope.

Ketorolac (Toradol)
Ketorolac is a powerful NSAID, used for severe headaches, musculo-skeletal pain, kidney stones and inflammation.

Morphine Sulfate
Morphine is a powerful opiate (derived from opium and similar to heroin) that is used as a pain killer (i.e. analgesic). However, as a side effect it can suppress respirations.

Narcan is the antidote to opioids such as heroin or morphine. It is very rapidly acting and competes with the opioid for the opioid receptor. Be careful when administering this drug, as it may cause withdrawal in opioid tolerant patients.

Prednisone
Prednisone is a corticosteroid that is given for asthma and as an anti-inflammatory. A side effect of prolonged use is Cushing’s syndrome and often you may see tremors.

Rocuronium
Often called “rock”, it is a paralytic. Administration produces total muscular paralysis. It is most often used for “rapid-sequence-intubation” to make tracheal intubation easier and to allow the patient to be mechanically ventilated. It has no analgesic properities and paralyzed patients see, hear and feel everything and should never used without sedation.

Pilocarpine
Pilocarpine is dripped into the eyes to produce constriction of the pupil in patients with glaucoma.

Dopamine
Dopamine is a mild pressor agent, which is administered IV to produce vasoconstriction and raise a patient’s blood pressure.

Phenytoin (Dilantin)
Dilantin is an anticonvulsant. As a side effect, when administered too fast, it can induce
hypotension.

N-Acetylcysteine (Mucomyst)
Mucomyst is given in cases of acetaminophen toxicity (e.g. Tylenol).

tPA
Tissue plasminogen activator is a thrombolytic agent, used to lyse blood clots in patients with myocardial infarction (a.k.a. heart attacks), non-hemorrhagic CVA’s (a.k.a. strokes) and PE’s (a.k.a. pulmonary emboli). Thrombolytics can cause hemorrhage and should be used with care.

Streptokinase
Streptokinase is a thrombolytic (note: discovered here at NYU) made by Streptococcus bacteria which dissolves clots, similar to tPA (although through a different mechanism)

Diltiazem(Cardizem)
Diltiazem is a calcium channel blocker used to slow the heart down in patients with certain types of tachycardias such as atrial fibrillation.

Metoprolol is a beta-blocker which is used to slow down the heart and lower blood-pressure. These drugs are not typically used in asthmatics, as they can induce bronchoconstriction.

Atenolol
Atenolol is a beta-blocker similar to metoprolol.

Adenosine
Adenosine (the A of ATP fame) is used as an antidysrhythmic to break certain cardiac dysrhythmias; it is often used in patients with
supraventricular tachycardia. The half life of the drug is only a few seconds, and can often induce non-pathologic asystole (flat line on an EKG) for a few seconds.

Digoxin
Digoxin (a derivative of the Foxglove plant) is a cardiac drug used to slow conduction through the heart, especially in cases of atrial-fibrillation. As a side effect it can produce various dysrhythmias including ventricular fibrillation and aystole.

Metronidazole (Flagyl)
Flagyl is an antibiotic used against anaerobic bacteria and certain parasites. As a side effect
patients can become violently ill to their stomachs from consuming alcohol with Flagyl (similar to Antabuse)

Vancomycin
Vancomycin is the “last ditch” antibiotic, used for highly resistant bacteria. It is fairly toxic to the patient, and often is a hobson’s choice to administer to a septic, shocky patient.

Trimethoprim/sulfamethoxazole (Bactrim)
Bactrim is a “sulfa” class antibiotic and is often used in urinary tract infections.

Ketamine
A sedative often used in conjuction with other sedatives (such as midazolam or diazepam).

Pepcid
Pepcid is a systemic antacid (H2 blocker) which takes 30-45 minutes to take effect, but lasts for several hours. Similar to ranitidine (Zantac) and cimetidine (Tagamet).

NS
NS stands for Normal Saline, which is 0.9% Sodium Chloride, and is the usual fluid given to a
patient who needs fluid due to dehydration. It is approximately isotonic.

LR
LR stands for Lactated Ringers, which is Normal Saline with other electrolytes. Due to the presence of the other electrolytes, there is a limit to how much can be administered within a specific period of time.

D5, D10, D25 and D50
The D stands for Dextrose, which is a stable form of glucose. This solution is given IV to give the patient glucose. This is never given IM, as high concentrations of glucose cause tissue death outside the vasculature.

Other useful terms

QD-Once per Day
BID-Twice per day
TID-Three times per day
QID-Four times per day
QHS-At the hour of sleep
NPO-Nothing by mouth

The Beginning

2012-07-16T12:49:00.002-07:00

This is my first week in my weight loss journey. I'm a strong believer that weight loss is about a lifestyle change rather than some fad-diet or a quick way to lose weight. I have about 30 lbs to lose in order to get to where I was (weight-wise) when I left California a year and a half ago.

I started to do weight watchers! I really love it because it gives me something to track and it is more realistic as far as the lifestyle change because while you are changing what you eat because you're confined to a certain amount of points each day, they don't ask you to cut out your favorite foods- but just eat them in moderation.

Crockpot Honey Sesame Chicken

2012-07-16T12:39:00.000-07:00

Ingredients:

2.5 pound boneless, skinless chicken breasts
Salt and pepper
1 cup honey
1/2 cup soy sauce
2 tablespoons ginger
4 tablespoons diced onion
4 tablespoons ketchup
2 tablespoon sesame oil
2 cloves garlic, minced
1/2 teaspoon red pepper flakes (optional)
2 Cups Broccoli
4 teaspoons cornstarch dissolved in 6 Tablespoons water
Sesame seeds
Green onions

Directions:

1. Cut chicken into small cubes.
2. Season both sides of chicken with lightly with salt and pepper, put into crock pot.
3. In a small bowl, combine honey, soy sauce, onion, ketchup, oil, garlic, ginger and pepper flakes.
4. Pour over chicken.
5. Cook on low for 3-4 hours or on high 1 1/2 – 2 1/2 hours, or just until chicken is cooked through. Add 2 cups of broccoli and let cook in Crockpot until tender (I usually put it in a half hour before the end)
6. Remove chicken from crock pot and place on a separate plate, leave sauce.
7. Dissolve 4 teaspoons of cornstarch in 6 tablespoons of water.
8. Pour remaining sauce into a sauce pan and add cornstarch and water mixture
9. Cook on medium heat until sauce is thickened (you may need to add more cornstarch and water, but always add the cornstarch into the water and mix it before adding it or it will clump in the sauce)
10. Return chicken and broccoli to crockpot
11. Once sauce is thickened, coat chicken and broccoli.
12. Sprinkle with sesame seeds and green onions
13. Serve over rice or noodles. (we used quinoa, which was awesome and more healthy than rice or noodles, but you can use whatever you'd like!)

Weekly exercise

2012-05-21T18:29:00.002-07:00

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The Beginning

Crockpot Honey Sesame Chicken

Ingredients:

Directions:

Weekly exercise