EMS NEWS

I was listening to an NPR piece earlier today out of boredom. (I saw it linked from another site which I got from Stumble Upon. It’s an article about something called Miracle Fruit, and I was intrigued, so I purchased a small amount of it to see if it actually works.

Apparently, when this fruit is chewed, it tricks your tastebuds for about an hour, making bitter things taste sweet. This sounds better than top diet pills.

I am notorious for not eating vegetables. They all taste bitter and nasty to me. The NPR story had the hosts drinking black coffee and eating lemons and talking about how delicious it was. So I’m gonna try some brocolli once I get my order and wolf it down in front of Corrie and see if she faints.

I don’t know if it was the Venti Frap or the medium cookie dough blizzard that made me realize that I need to lose some weight today. Oh, and the pizza for breakfast and lunch.

I would really like to get some phentermine and start exercising at work and on my off days, but it’s just so daunting, knowing that I’ll have to do it for months to see any appreciable results. I guess at it’s core it is a willpower problem.

I’m a big believer in popping pills though, even if they are natural weight loss pills and not the glorius phentermine.

Believe it or not, I used to be quite the little athlete. I was a champ at little league in the 3rd grade. I was one of the younger players, and was much smaller than the other kids, so I quit after my winning year.

I was also quite into golf. I had my own clubs and golf bags and played every Sunday for about 6 years. My problem is that they never let the kids use golf carts, and I hate walking. More than that, I hated carrying that damn bag of clubs.

My physical activity nowadays is limited to walking the dog and carrying fat people down the stairs.

I have successfully passed my fireman’s agility test.  My time wasn’t that great but I had never done one before so I didn’t want to pass out halfway through.  I was told that times only matter if there is a ‘tie’ between candidates. 

From what I could tell, I was the youngest candidate there at 28, so that give me an advantage, I think.  The test was based on the CPAT test.  It’s been 3 days and I’m still sore.

We had REAL stairs.  Sissies.

We see it all the time on the ambulance.  Drug seeking.  Drug seeking in and of itself isn’t such a bad thing.  You may really need a narcotic and you may really be in pain.  However, as this doctor says, nothing is worse than someone who is lying to get narcotics.  A drug-seeking act won’t fool very many health professionals.  We just aren’t that stupid, and you aren’t that smart. 

Advice from an ER doctor to drug seekers

Date: 2007-03-27, 9:56AM PDT
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 doctor

I have gained mucho weight this year, mostly my fault, but also working 24 hours shifts at a base with no refrigerator has done it’s fair share.  How am I supposed to store breakfast lunch and dinner at room temp and not have it be nasty? 

I brought Corrin’s elliptical to my apartment but Ican get into a regular routine with it right now.  I think I’m gonna try and get serious about it after our big move.

When we first moved into this base we went to a garage sale and they had 2 pieces of fitness equipment for $25 each.  One was a NordicTrack, and the other was a bike.  We opted for the bike, and it actually sees use on day we dont get slammed.

Anyhow, my plan is to shed some weight in 2008.  Who is with me?

I am getting fat again.  The last year of school has made me so stressed and constantly away from home, so eating out happens a lot more than it should.  I don’t want to admit how much I’ve gained, but I lost a lot of weight last year and managed to gain it all back.  I need something like a hoodia patch to constantly release hunger-controlling chemicals directly into my bloodstream.  I’m almost done though and so hopefully I can get back on the right track.

I’m gonna talk about Freeze It again!  Freeze It Gel sent me a bunch of free samples a few weeks ago because they know my pain.  Working as a paramedic is murder on your back, shoulders, and legs.  Lots of the dispatchers in our company are former EMTs and paramedics who hurt themselves and cant lift people anymore.  (Or they became chronic alcoholics, but that is neither here nor there.)  While I like most of my dispatchers, I can’t ever see myself stuck behind a desk talking to people on the phone all day.  So I use Freeze It whenever I get sore!

Last night we had a monster.  It is the 4th HUGE patient we have had this week.  If you were to add up the weight of each of these patients, and then you figure that I have to lift each one of them 3 times (Once off the ground, once into the ambulance, and once out of the ambulance)  you can estimate that my poor body has lifted close to 2 tons in the past week. 

Anyhow, last night we get called for a patient with trouble breeathing.  The house had stairs at a wierd angle and the wife had no idea how we were supposed to get the stretcher into the house.  We eventually used a side door, but leading up to the side door were even MORE stairs.  When we finally met our patient, we noticed that he was in the area between 400lbs and “Jabba”.  He also hada trach to breathe through, so that further complcated things.  We didn’t have time to wait for another crew to help us, so we strapped this guy to a chair and fought our way out of the house, with my lumbar vertebrae and arms screaming at me the whole time. 

Keep in mind this happens at least once a week.  People just can’t seem to lose that last 300 pounds these days.

Luckily I have my Freeze It handy this morning!  Please bear in mind I just worked a 24 hours shift.  It’s not the prettiest thing in the world.  Please note the Freeze It and the totally awesome heart lamp.

(And the blanket because I fully intend on taking a nap.  Naps + Freeze it = bliss.)

I’m really hoping that my tale of woe will be heard by the people at Freeze It.  Did you know the average paramedic makes less than $35,000 a year?  All this life-saving and people-moving and no one ever takes pity on our back muscles!

When I was a young buck, I loved me some ice cream.  Well, I still do, but even more so then.  It was all well and good until I started getting my adult teeth in around 6 or 7 years old.  It might be a normal thing, but when my new grown up teeth came in, they were really sensitive to cold, so my ice cream and popsicle parade was cut back a lot.  I don’t think I ever really told anyone my teeth hurt, I just dealt with it.  I didn’t know about sensitive toothpaste back then so I just stuck with whatever my mom brought home. 

Biotene can help with sensitive teeth.  I was lucky enough to receive a sample in the mail a few days ago and it really makes a difference.  Even though it isn’t as bad, my teeth still twang every once in a while.  Since I got the Biotene sample I don’t feel anything.  It actually fixed the problem rather than just covering it up.

And just to be clear, I’m not brushing my upper lip in that picture.  I was bringing the toothbrush to my mouth and Corrin just happened to snap at that particular moment.  The Biotene tastes pretty good too, just in case you were wondering.

The best present we got for our wedding was a Eclectrics® Mixer to replace the old olive green one that was my grandma’s. Hamilton Beach makes the Hamilton Beach® Stand Mixer that can stand up to pizza dough, breads, and my favorite, cheesecake. The mixers also come in a range of colors to match any kitchen, and our Moroccan red mixer gives a punch of color.

Our Hamilton Beach® Mixer is so much better than our old mixer because it is deadly quiet, has 12 settings, a 4.5 qt. stainless steel bowl, and can mix anything you throw in the bowl.

I don’t cook much, but I have mastered the art of cheesecake baking with the help of our electric mixer. Below is the recipe that I learned from my favorite Food Network chef, Alton Brown.

Crust:
1 cup graham cracker crumbs
1/4 cup unsalted butter, melted
1 tablespoon sugar

Filling:
16 ounces cream cheese, at room temperature
2/3 cup sugar
1 cup sour cream
5 large eggs, room temperature
1 tablespoon vanilla extract
1/2 cup heavy cream

Preheat oven to 350 degrees and position rank in the middle of the oven.

To make the crust mix the graham cracker crumbs with the melted sugar and butter in a small bowl, then press the crumb mixture into the bottom of a springform pan. Bake the crust until golden brown, about 10 to 12 minutes, then let cool.

Now, lower the oven temperature to 325 degrees.

In the Hamilton Beach steel mixing bowl fitted with the paddle attachment, cream the cream cheese on medium speed until smooth. Gradually add the sugar and let the mixer have its way with the mixture until it is light and fluffy. Then beat in the sour cream and eggs, one at a time, until it’s fluffy. Stir in the vanilla and cream by hand, and pour the batter into the graham cracker crust pan. Back the cheesecake until slightly browned, about forty five minutes, then cool.

I never follow the directions that say to let the cheesecake set overnight in the fridge and I never add any fruity berries or sauces. As soon as the cake is cool, grab a fork, and dig in. Then profusely thank your Hamilton Beach mixer for helping you make the best cheesecake ever.

 Most of you probably have never thought of an air ambulance service.  If you ever need one though, you’ll be thankful they exist.  I have run many calls to and from the airport for people who need long distance trips for treatment.  It’s a really cool feeling to be a part of something like that.  AeroCare is the leading air ambulance company in the US.

If you or someone you know gets hurt or is sick and you want them to be seen by a specialist, you can arrange for air evac flight ambulance service from most airports by calling AeroCare.  You can also ask your physician if AeroCare is an option for you.  you’ll get a flight nurse and a flight paramedic to take care of you during your trip, far exceeding the level of care on a ground ambulance.  Look them up if you ever need long distance medical transportation. 

Its no secret that I have put on a lot of weight this year.  I lost almost 40 pounds last year on my own, and gained it right back and then some when school started.  It’s been a really stressful year all around, and I have no one to blame but myself.  I have hope that next year will be less agonizing and I’ll be able to eat better and exercise on a regular basis.

Some people want to bypass the eating right and exercising part of this by getting a tummy tuck or other cosmetic surgery done.  Of course, it’s your right to do this is you want to and you can afford it.  However, a tummy tuck is a major surgical procedure and many people don’t properly weigh the risks involved.  Make Yourself Amazing is a UK-based company that is all about educating it’s clients and suggesting alternatives before performing surgery after other options have been explored.

Getting a proper UK Tummy Tuck can be difficult, because there are many surgeons out there who simply want your money.  They may even produce great results, but when a person’s motivation is in taking your money rather than your health, that’s a set up for problems.  Make Yourself Amazing was featured in the UK Times as the only company that recommended against surgery to correct a (slender) woman’s body.  If you are considering surgery to improve your appearance, make sure you visit at least 2 surgeons, and if you’re in the UK, make sure you visit MYA to get an honest opinion and get connected to a surgeon who isn’t trying to make the most profit.

MRSA.  Everyone is talkingabout it on the news, and I’m pretty tired of it.  MRSA has been around since the sixties, yet everyone is running around yammering on about the SUPERBUG and how it’s going to kill us all. 

MRSA is not a big deal to me. 

Ho do you prevent MRSA?  Wash your hands after each patient.  Clean your cot with alcohol after each patient.  Use reverse isolation on patients with respiratory MRSA.  Wear gloves on each call.

There’s nothing more to it.  If you’re an athlete, don’t be freakin disgusting and store sweaty clothes in a dark locker in a duffel bag and then wear them again.

Wash your damn clothes.  Problem solved.

In doing the research for my cardiology paper, I’ve found several studies that chest-compression-only CPR (i.e. no mouth-to-mouth) may be more beneficial than traditional CPR.  So if you’ve ever been in a situation that requires CPR and been squeamish about locking lips with a dead person, just bang on that chest.

Here is an article that goes in depth on the subject:

Linky Link

 

Performing chest compressions on people experiencing cardiac arrest may be just as good as, and possibly better than, combining chest compressions with mouth-to-mouth ventilation, the director of the University of Arizona Sarver Heart Center writes in tomorrow’s New England Journal of Medicine.

“Authorities in CPR have come to realize that our now standard method of performing basic CPR is very difficult for the average lay person to learn, retain and perform,” Gordon A. Ewy, M.D., writes in an editorial.

 

Read the rest of the article at the link above.

Some day I hope to be driving a nice big ambulance that I don’t have to refuel twice a shift.  Most ambulances are based off big vans and SUVs and get somewhere around 8-10mpg.

I get around 40mpg in my little Toyota, but a little car isn’t an option for a big family.  So if you need size and good fuel economy, (not to mention feeling a little greener), look for a new SUV Hybrid at a source for information on EVERY hybrid SUV available today. There are resources for new and current owners of green SUVs, including forums, reviews, videos, and pictures. 

Make the right choice, don’t settle for under 20 mpg!