Day one of adult trauma clinical: So I stay up until 1:15 a.m. working on the pathophysiology, drugs, nursing care plan, nursing diagnosis and plan of action for my patient and get to the hospital and am told that they discharged him. Which means that I get to try to find a patient to play with for the day. The night nurse decides that I can share a patient w/ my classmate because she’s “difficult” meaning that her O2 stats were in the 50’s all night long (we like to aim for 98-100% saturation in healthy adults). Came in from a fall as a result of a CVA (cerebral vascular accident - fancy talk for stroke) with a broken hip. The nurse who was responsible for her was too busy to come give us a status report (don’t even know if she had seen her at all) and the pt kept us busy enough trying to get her to respond to our voice, checking LOC, and doing a.m. care (pesky O2 masks…. the amount of oxygen needed to just keep her stats above 80 was so high that it dries out the mucous membranes and tongue - she had kept trying to take it off all night - if someone had just given her some good oral care consistently they could have improved her comfort) The first time we pass meds always takes the longest because you need to look up all the drugs, rates of administration, check for drug to drug interactions, etc. About 30 min after her meds got pushed the patient began sweating and her eyes rolled back in her head. I went out to track down her nurse and she came in and decided to call the doctors. She had heart sensors in place, connected to monitors at the nurses station (not in her room) and when we looked back we saw that she had flat lined for about 30-45 seconds before her heart started beating again. She did that 2 times. The daughter arrived at about that time, requested the discontinuation of any measures other than comfort. The doctor asked us if we had ever seen anyone die before, and that this is what it looked like. So we took off all the stockings, braces, blood pressure cuffs off of her and left her oxygen mask on, discontinued any medication besides morphine and left her with her daughter and son.

Tomorrow I’ll see if she’s still with us…..

It’s almost the end of October! Which I am told, means that after the students desperately claw their way up this pile of books, papers, classes and clinicals is where we finally reach the top and can see down to the other side. I can’t say that I quite believe them, because even though it’s supposed to getting easier from here on out all I see are the “to dos” that I have to get done to stay on top. I still have an enormous amount of papers, journals, care plans, tests, a proposal for a community project, and a pile of reading that keeps on growing. I just went through a final in one class and midterms in the others. I have finished Lifespan II and will begin Lifespan III Monday. My friends and I look around to see who’s missing and I am just thankful that as we come back in after that week of test after test after test after test that I’m still occupying a seat.

P.S. I start my adult trauma clinical @ St. Louis University Hospital this Tuesday and Wednesday for 6 weeks. My clinical instructor, Bobbi said that we’ll see everything we’ve imagined and a lot that we would have never thought of. I’ll try to post all the interesting stuff, which means the gross stuff of course….

If you aren’t aware, Tom Cook and I are currently en route from Sacramento to St. Louis for a major road trip. I set up a separate blog for it…

roadtrip.melnickzoo.com

Well, much to my dismay and sorry, I have received my very last issue of Cook’s Illustrated magazine. After over 5 years of receiving a subscription to their magazine, I have cancelled my subscription.

No longer will I receive the colorful and informational magazine that is so dear to my heart. It makes me sad to think that I won’t be getting a present in the mail every other month for me to eagerly page through.

… but wait …

There, a flicker of hope! In just one year I will receive a reminder from the good folks at Cook’s Illustrated! They will entice me with the whole year’s collection of their magazines, hard bound and indexed! With great pleasure, I will dole out my credit card number and like a fiery beast rising from the ashes, Cook’s Illustrated will return!

OK, any of you that know me, know that I love to cook. And being Male, I love tools. It’s not too much of an exercise in logic to asume that I love kitchen tools. I still remember the day that I opened a package from my mom, and there was my first REAL kitchen tool, an 8″ Wusthöf Classic Chef’s knife. I was and still am in love with that knife. It is perhaps a perfect example of a simple tool that is ultimately useful. I’ve had that knife now for seven years, and it is every bit as useful today as it was that first day. Since then, I’ve accumulated a wonderful collection of Wusthöf knives: paring, vegetable, sandwich, serrated utility, bread, santoku, carving; sharpening steel and fork. My next real kitchen tool after my chef’s knife was a KitchenAid stand mixer, followed by a set of Calphalon sauce and saute pans. I’m the guy that will spend $12 on a bottle of vanilla, cause it’s the best. I drooled over Williams Sonoma and all their awesome stuff. I like the best, and the best has got to cost the most, right?

(more…)

We took the puppies to an Off The Leash park today. It was pretty great…I think they thought that they were in heaven because as soon as they got out of the car, some lady dropped a bag of puppy treats so there was kibble raining down from heaven. We got the a little before some friends and their poodle, Buddy. The pups get into the OTL area, and pretty much instantly go crazy. They instantly get stormed by a different poodle, as well as a mob of other dogs. Charley and Sadie were a littel unsure of what to do with all the other dogs, but they did well anyway, for their first time. The only downside is that it is about a 30 minute drive to get there. Supposedly a park is supposed to be built in Saint Charles, but it’s not done yet. Since the new one will be about 2 miles from our house, it will be much more convenient.

Charley played a bunch of fetch, which was good. The pups got slobbered on quite a bit by huge dogs, which was funny but gross. They were pretty beat afterwards, although they did, of course, get plenty of energy later in the evening right before bed time. Check out the pictures for puppy madness.

Got my windscreen for my motorcycle today. I was pretty excited because it’s been pretty hard to find. Finally about two weeks ago, I found a used one on eBay that was from a totalled 919, but was supposedly in fine condition. Supposedly the windscreen has an MSRP value of $85.95 from Honda, and the one on eBay was about $40 when I found it. I figured it was a steal since I couldn’t find one anyway. I guess that everyone else was having as much difficulty finding one. So over the next two days the bid went up to $81!!! For a used one!!! So I figured I’d go back to good ol’ Google to do a little searching. After several pages of fruitless searching, Google AdSense, of all things found it for me. On the right side of the search results was a link for OEM accessories from Rick Roush motorsports.

Anyway, so thanks to Google AdSense, I was able to get a new OEM windscreen for $66 + S&H. That’s what I love about eBay…a sucker is born every minute that’s willing to pay more for a used item than a cheaper new one you can get for fifteen minutes of searching.

Check out pictures of the installation (below) (more…)

Yesterday, I embarked on what is “yet another” attempt to bake some bread. I have an affinity with bread making, yet it has always remained a somewhat elusive task. If success in bread baking is merely defined as getting the bread to rise, I have had perhaps 75% success rate. I’ve tried sandwich bread, sour dough, bagels, rye, whole wheat, et. al., ad nauseum. Although I have made plenty that are just OK, and definently not worth the day long effort that it takes. Forget about making some that is as good or better than what you could get in the bakery section of a supermarket or Panera/St. Louis Bread Co.

Let’s rewind a few months. I bought an incredible book called the Bread Bible by Rose Levy Beranbaum which is a beautiful book chock full of bread recipes and detailed explanations. I read all the instructional parts almost immediately, but got a bit overwhelmed by where to start. I wanted to make a hearth style, artisan, free form bread. Chewy, crusty, delicious bread. Nothing beats it. I’ve tried several recipes, some
have turned out just fine, and I have failed in others.

Anyway, so I decided to make something basic, rustic, hearth style. The recipe entitled “Basic Hearth Bread” sounded just about right. The basics are pretty easy. Make a sponge of white flour, whole wheat flour, honey, yeast, and water. Cover that with a “feed” of flour and yeast. This ferments for between one and four hours, which creates a sour taste, not nearly as sour as sourdough, but adds a lot of nice flavor (since the ingredients are pretty basic). I let mine go for four full hours, cause that’s how I roll. I then mixed the “feed” flour in by hand and kneaded it until it came together, then let rest for twenty minutes. This allows the moisture to become more evenly distributed and some of the glutens to develop. I followed this by ten more minutes of hand kneading. Then into my Cambro storage container which is perfect for rising dough. It’s much easier to see if the dough has doubled in a straight-sided container. Rise (1hr) , punch down, rise (1hr), punch down, shape into loaves, rise (1hr). Then mist with water, slash with razor, into the oven. You can see pictures of the whole process below. The results were the first bread that I’ve ever made that I can say is as good or better than bakery bread. The crumb was dense and chewy, with a rustic, slight sour flavor. The crust is not too hard or thick, and the interior soft. It was a labor, but the first time I felt very satisfed after finishing…it’s a great feeling.

Still studying. Final tomorrow, midterm tomorrow, 8 am - 6 pm stuck in classes tomorrow. Long day. Little sleep. Glad we have coffee shop right next to campus side walk. Will visit. (called the crave - like you crave coffee…so clever) Brain sleepy.

So I liked the idea of my brother-in-laws family blog so much that I thought I should set up one for Kelly and myself. So here it is, expect content soon. It’s a bit late tonight for creativity…

…enjoy our musings…