weigh in #1

Ok, its been 2 weeks since I started this new healthy lifestyle eating plan. I am weiging in today at 295. Thats a 5 pound loss. Not too shabby if I do say so myself..... I have been doing pretty good on this plan, only had one or two occasions where my will power lost, but I didn't go crazy with it. Now if I can just motivate myself to get more exercise in this new lifestyle...I need an exercise buddy that will call me out and make me accountable, Id be happy with just a walking buddy 3 days a week....I simply need to get off my lazy butt.....

frustration

Sorry its been so long.

My roommate/best friend has been sick for the last 5-6 weeks, something to do with her GI system, they are thinking gastroparesis. Meanwhile since she has been sick she has been unable to work. We have been dealing but its getting to the point that Im not sure what we are going to do. She has not worked in a month. She knew that no working=no income. She is working on getting a temporary disability which will include rent assistance and such. I talked to her tonight and asked what our landlord said when she talked to them. Guess what...she hasnt yet! Rent is due in 4 days. I knew she had been waiting to hear from the assistance office, but our landlord is expecting rent, paid in full on the 1st. I am not mad that she is sick and can not work. I am mad that she hasnt taken the initiative to straighten things like this out. It leaves a lot of pressure on me. I have been working a lot of hours in hopes of putting some funds away in savings for emergencies and for vacation. She is my best friend, she is like a sister to me. I know she is frustrated, but this doesnt affect only her. I am trying to be as supportive as I can, trying to keep her from getting depressed, but I cant do it anymore. Im too tired. Physically tired, emotionally drained....I dont know what to do...

no regrets

"Eat that damn chocolate cake, get your hair wet, love someone, dance in those muddy puddles, tell someone off, draw a picture with crayons like you’re still 6 years old and then give it to someone who is very important to you. Take a nap, go on vacation, do a cartwheel, make your own recipe, dance like no one sees you, paint each nail a different color, take a bubble bath, laugh at a corny joke. Get on that table and dance, pick strawberries, take a jog, plant a garden, make an ugly shirt and wear it all day, learn a new language, write a song, date someone you wouldn’t usually go for, make a scrap book, go on a picnic, relax in the sun, make your own home video, kiss the un-kissed, hug the un-hugged, love the unloved, and live your life to the fullest. So when you’re standing in front of heaven’s gate that chosen day, you’ll have no regrets, no sorrows, no disappointments."


THIS (found this at "and it's love" tumblr)

oxygen, harmful or not?

Im pretty sure oxygen is a good thing, in the majority of cases anyways. In the last 24 hours I have had 2 encounters where I thought a bit more O2 would definitely be a good thing, but was contradicted by providers with more schooling than me.

event #1:  severe asthmatic comes in to the ER and we take them straight to a bed, I pull out a duoneb treatment (cause it takes respiratory a few min to get downstairs after someone calls them) and give the pt a neb via mask on oxygen when the RN tells me "no, use the medical air"...what?? When she sees my confused look she says they normally use medical air, and I inform her we (the medics) use oxygen, pt got the neb via oxygen in the end....

event #2: 20 something y/o male, intoxicated, took a swan dive head first 6-7 feet into a cement trench. Pt unconscious and unresponsive, lac to right temporal, no active bleeding, pupils round, equal, but non reactive to light, pt breathing 12 times a min but shallow with snoring resps, lung sounds clear and equal, O2 sats at 02%, pt resps assisted via BVM, when OPA was attempted pt clenched down. 2 large bore IVs established,  24 min from on scene time to completing extrication of pt from the trench via stokes basket. Upon arrival of flight crew I asked if they wanted to RSI and they replied "no, he's breathing on his own".

I dont know if they were concerned with increasing the ICP, but found it interesting they opted not to intubate. Follow up of the pt was pt had an open fx to right temporal area, several closed fx, an epidural bleed to right temporal lobe and a parenchymal hemorrhage.  Pt was intubated at trauma center upon arrival. Pt was extubated approx 8-10 hrs later and is now alert and oriented but still in ICU at trauma center.

What do you all think?

new life plan

So I know I haven't written in a while, things have gotten a bit stressful in my life with working my fulltime job and fulltime hours at my part time job and a very ill roommate I have been trying to take care of. The theme of my posts are going to be changing a bit, while I am going to keep up my blogs about work and EMS, I am going to start writing about the healthier lifestyle I am struggling to obtain in attempt to not struggle so much. Your thoughts and advice are welcome, but please refrain from any nagging or negative comments on weight loss, etc., I have enough of those running in my head already....

Last week I found and ordered what I hope to be the start of a new, healthier lifestyle for me. I did some research and found Rob Nevins' Skinny Switch Secret.  It has a lot of things I like, it has 24/7 community help via chat rooms, it gives you an easy to follow meal plan, personalized for even the pickiest eater (like me). It also gives you workout tips. It sounds like a simple but effective healthy lifestyle plan, having one "load up" day focusing on some extra carb intake followed by 2 "lean" days and the cyle repeats itself. On your "load up" days it even allows you to treat yourself for one meal or snack to include any takeout favorite or sweetening snack. I guess it works so that your body doesnt get used to one thing. I am going to refer to this not as a diet, but as my new lifestyle change.

I am really hoping that I can motivate myself to start this and stick to it (especially since I paid for it...lol). I am going to try and keep a weekly online recollection of this (Im going to pick a day and try to do a weigh in and update every week), but I will be keeping a more intimate, detailed handwritten journal as to not bore anyone on here. I am starting this weighing in at 300 lbs as of today (thats 18 pounds lighter than I was this past Christmas...). My first weight loss goal is to get to 275 by September 14th, my 26th birthday and long term I'd like to get under 200 pounds.  As I have stated before I have always had problems with motivation to start or continue any plan I have tried before. So if any of you are up for it, I would love to have someone challenge me or at least check in on me weekly to try and help me stay in line with this.

Originally my roommate had intended on trying this with me, but she has been pretty ill the last few weeks with no diagnosis at this time, so while she is simply trying to find foods she can keep in her stomach, I am going to start this full fledge on Friday May 14th. (That's pay day and there are a lot of grceries that need to be bought for this lifestyle change). I not only need to do this, but I want to do this, for me, for my health and to help me in all aspects of my life, physical and emotional. While I have seen the negative impact my lifestyle choices have had on my body for a while now, I have recently been experiencing more and more negative emotional impact, and I definitly do not like it. I frequently find that I don't feel like I have a very good support system (maybe I just choose not to tap into the people who could give me a lot of support due to fear of failure and disappointment), and so I am looking to the few people who graze through here from time to time...Thanks ahead of time and wish me the best of luck!

Skills Day

This week we had our yearly skills day. The highlight of skills day is airway familiarization, for me anyways. Our boss arranges to have multiple sets of pig lungs for us to practice on. We have the typical "fred the head" for run of the mill intubation practice and for King airway and for S.A.L.T. practice, but its hard to practice the surgical airway on Fred. Our medical director was present and dove right in with us. We practiced a needle crichothyrotomy and then surgical crichothyrotomy. We then ventilated the lungs. We were even fortunate enough for one pair of lungs to still have a large heart intact. Our medical director gently removed it and we passed it around, you could look right down the aorta and see and touch the aortic valve, we then disected th eheart, we could see and touch the chordae tendineae, and the bicuspid and trucuspid valves. It was an amazing experience and great refresher.  I will post some pictures of skills day soon...

new hopes, new aspirations

So I have begun to realize that this blog is a mess of sorts. I don't stick to any certain topics, and I honestly am ok with that. The idea of my blog was just a place where I could write stuff out to get it out of my head and off my chest. I have been selective in my personal life who has access to this blog but dont seem to care that any other bloggers might find it and read it. Today I reached a long time awaited goal of mine. I have been a "big" girl for a while. I reached my heaviest weight in the winter of 2008 at 318lbs. I had always promised myself I would never let myself reach 300, and I didnt stick to that. I have struggled with my weight sine I was approx 10 years old. In high school I began to get it under control by playing volleyball my freshman year. My sophomore year I didnt make the team, (major defeat #1)but I was still trying by running a mile a day, until I was chased down and tripped on purpose by a kid on roller blades with a hockey stick. That was major defeat #2 After that I quit trying. I used to sneak snacks and sodas at home, I'd go to fast food drive thrus between school and dinner time, Id go out with friends for food after dinner in the evenings. My parents tried several things to help me. They tried telling me the reason I didnt have many friends was because of my weight, they tried bribing me with a car if I lost weight. They tried to verbally remind me at meal times what I should be eating or drinking and how much and about not eating second helpings, all those things did was make me angry, angry at them, andgy at myself, and angry at the world. When it came time college I chose one far from home, to get away and have an excuse to not be there. I was suddenly in complete control of my actions. I ate and drank whatever I chose whenever I chose. I stayed on a plataeu for a while. 5 yrs of college came and went and I had slowly gained weight, throughout the next 3 years, during college I had made some friends and lost some friends. I joined the fire department early on in college and got involved in EMS. I tried several things to help control my weight and health and failed miserably on my own due to lack of motivation, lack of self respect, and lack of self discipline. I tried working out with some of the boys at the fire department but knew everytime I tried something and couldnt keep up or had difficulties they were making fun of me behind my back and that feeling of defeat washed over me again, just like back in high school. Then I met someone, someone who I would have done anything for, who I wanted to do everything for. He made me more happy than I ever could have imagined. We spent all ofour spare time together and became very close. We had several discussions about us and where we saw our relationship going and he expressed his concern for my health in several conversations. It felt like it became a game of "if you change, if you lose weight, then we can be together" I know he was conerned but he had poor ways of showing it. We constantly ate fast food instead of cooking in, instead of encouraging us to go  on a walk we stayed in, sitting in silence or watching a movie or studying. I am not blaming him for my problem but I place blame on him for leaving when I had not changed. I became depressed. I was alone, I was overweight, and I was putting on an act that I didnt care about either. The more I tried to hide it the worse my depression became. I began to notice myself becoming even less active, eating more junk, and taking worse care of myself physically. I was still capable of getting out of bed and showering and getting myself to work and school, but outside of that I holed myself up in my bedroom with whatever snack food I was craving and had gotten a hold of with my TV shows or my computer and I quit answering the phone, I would answer text messages but was in  no mood or condition to socialize with anyone.

In January of 2009 I turned a new leaf. I had discovered I had exceeded my 300lb maximum. I had started a new job in the Paramedic field in September of 2008, in October 2008 I fell and completely tore a ligament in my ankle and fx it as well. It was during my time in physical therapy I began to think about what this injury could mean for my career and if it would have been less severe if I was not as obese. My physical therapy proved to be a challenge many times due to my ankle instability and my size. I realized during PT just how much I hate seeing myself in a mirror when I forced to practice some PT in front of one and in front of other pts. It was then that I decided I wanted to better, I needed to better myself, this time for me. Not for my parents, not for my best friend, but for me. So I started paying attention to what I was eating, when I was eating, and how much I was eating. It amazing how just doing that little bit can make a difference. After making a few residential moves I now live close enough to work that I can walk to work in 7-8 min. I have been trying to better myself and to not allow myself to make up any excuses, because God know I am way too good at that. In the last 6 months I have somehow slimmed down to 299 lbs, a number i had been waiting to see for a while now. Just last week I decided it was time to step up the game plan. I have decided to oust soft drinks....it has been tough, I need my caffeine that I am oh so addicted to. I am also trying to get into a routine of walking appprox 30 min hopefully 3 times a week. I would like to get down to 275 lbs by my next birthday, September 14th.  I am not sure I can do this, but I want to..... So here's to life, here's to living, and trying to right so many bad habits...

It's not my emergency!

Have you ever thought this? I have used that phrase myself, several times (and with more than one meaning at times). Steve Whitehead put it into a great post right here and I suggest you go check it out!

does (apparatus) color matter?

We are all taught from the beginning of our experiences that safety is number one in our professions. Personal safety, crew safety, patient safety, scene safety…you know it.
I was sitting at work the other day and it came up in discussion that one of the local fire departments was ordering a new fire engine and had decided to go with black as the main color. Yup BLACK. The first thing that came to my mind was how is anyone going to see them on a scene at night? While I understand that light reflecting tape is used on emergency units along with multiple lights for safety, I still didn’t think that black was a safe choice of color for a piece of equipment like a fire engine. This conversation got the mouse wheel in my mind going, and I couldn’t stop myself from doing a little online research on the subject. I found plenty of information to include a slideshow presentation and eventually stumbled upon this very detailed and informing document from FEMA.
The reading is a little dry but I learned a few things about the different kinds of reflective striping and how each works individually plus I learned about NFPA standards/recommendations.
The conclusion of my research is although a black engine may look sweet it definitely is not safe, no matter how much scotchlite or how many lights you put on it. The best bet is to stick to the red, orange, slime/ yellow, or even white for the best visibility and conspicuity on scene.

little work rant followed w/ needing your EMS advice...

I have always been a believer of "God doesn't give you anything you can't handle", "what doesn't kill you only makes you stronger", and "everything happens for a reason".  For whatever reason I have continued to carry these beliefs through all phases in my life, from growing up to college, to my professional life.  I know there are going to be times when I don't have a clue as to what I am supposed to do about a pt, but I am sure that most of the time I will fall back on my basic instincts. Tonight I had another one of those "oh sh*t" calls that when I look back on and talk with my co-workers (medics and doctors) that I know I did what I could with what I had in the amount of time I had. I just get really frustrated when I meet up with a BLS unit and they have nothing done for a critical pt, no history, no oxygen, no vitals. Oh wait, they had a grocery bag full of pill bottles for me. They were so concerned with this pts condition that they walked hin to the ambulance start towards the hospital that is opposit the direction I am coming from then realize Im 5 blocks behind them and cant catch up, so they stop and wait and then have none of the above mentioned done. But when you are called for a SOB and your pt is cyanotic from the nipples to the top of his head, i think any oxygen will help and walking him to the unit won't. Just saying...

I try not to get frustrated on these kind of calls. I try to use calls as teachings for these kind of EMTs who are new or just don't know what to do. During the critical calls I direct and after I try and teach, by explaining why I did or didnt do something or explaining why I did a 12-lead or why I didnt/did run lights and sirens to the hospital,, etc. I also take the time to answer any questions the EMTs may have which usually include "Did I do what i could/should have?" "or is there anything else I could/should have done?" and I answer them truthfully but without sounding like an egotistical jerk. I find that the next time I run a call with those EMTs they tend to be a little more comfortable with me and they have the things we talked about done, they have the pt on O2, they have a BP for me, or pt history for me.

I am sure Im not the only provider who runs into this. Any tips on how I can better this where I run? It happens with a lot of EMTs. Maybe some kind of "asisting the medic" class or something?