Dear Nurse Miss Kelly

If you aren't in the mood to read a rant, than I suggest you file this post under "to be read at a later date."

I work in healthcare. I'm going to graduate school for public health. I understand the healthcare crisis. I have money taken out of my paycheck every cycle to pay for my health insurance. I don't have complex medical issues. SO WHY CAN'T I GET A DOCTORS APPOINTMENT?!?!?!?!

Last year I found a GREAT internist/gynecologist. I also found a great dermatologist. After much angst I did find a dentist, but after my visit, I decided that I wouldn't be going back there ever again. In December, amongst holiday cards and holiday bills, I get a letter from the dermatologist:

Dear Nurse Miss Kelly,

It is with deep regret that we tell you that as of Jan. 1, 2009 Dr. N will no longer be with the practice. She has decided to relocate to Florida. Please call xxx-xxx-xxxx to book an appointment with the doctor who will be taking over her patient load.

Noted. Due for my annual checkup at the end of January, I called to book an appointment "with the doctor who will be taking over her patient load." What does the secretary tell me? Our conversation went something like this:

"Hi. This is Nurse Miss Kelly. I'm a patient of Dr. N's. I'm aware that she has left the practice, so I was hoping to book an appointment with whoever took over her patient load."

"Oh, well you see, you are going to have to wait. It's a four month wait to be seen as a new patient."

"But I'm not a new patient, I've been to the office before! I have records there. I just need to change doctors."

"Yes. But you are new to the replacement doctor and she will need to do a workup. What do you need an appointment for?"

"Just my annual skin check. I'm sorry, I'm confused. All patients of a doctor who left must now wait to be seen as new patients?"

"Correct. You can be seen in four months. How does April 29th sound?"

I concluded our call with, "Let me check my schedule and I'll call you back."


I was pissed. Not only did that not make any sense, but also this lady was clearly very misinformed. What did I do? First I looked to see the names of the other physicians in the practice to book an appointment with them. Then I called back, spoke with a muffled voice, what if the same wacko picked up, and booked an appointment with another doctor. Yes the wait was two months, but that was much more reasonable.

Crisis averted.

Not even two days later, I get another letter in the mail.

Dear Nurse Miss Kelly:

As of January 1, 2009, Dr. JW will be leaving WCIMA and joining a private practice. She will continue to admit her patients to xx hospital. Dr. PC will join WCIMA in February 2009 and will be responsible for your care. It is expected that she will participate in the same insurance plans that Dr. JW has participated in. Please contact us at xxx-xxx-xxxx to arrange to see our new physician.
If you wish to continue your care with Dr. JW here information is listed below..


Great, I'll call and book an appointment with her new practice. I mean, I never thought that she wouldn't take my insurance, after al it's expensive to be in private practice, so the more patients the merrier, right? WRONG.

Since I fractured my pelvis last summer, my lifestyle has been chaotic, at best. I broke up with a boyfriend, was studying for the GRE's, worked ALL the holidays, had a fight with my best friend, applied to grad school, etc. Through it all, I continue to work nights, sleeping less than four hours a night. My energy levels have bottomed out. It takes all my will power to get out of bed. I have no stamina and my workouts, once my sanity saver and favorite pastime, are awful and I hate the thought of the gym. My runs have dwindled down to nothing. I haven't run in over three weeks.

I've continued to eat my vegetarian, almost vegan diet and be very conscious of what and how much food I put in my body. So I was concerned that I started gaining weight and more and some more. I don't weigh myself, I go by how my clothes fit, but I'd estimate that I've gained 15 pounds since I graduated from college. And that freaks me the hell out!

Recently, I've began having some other symptoms:
-dry scalp and skin
-swelling of the hands and face
-gas and bloating
-thinning hair
-increased exhaustion

When I woke up the other morning and my hands were so swollen I couldn't get my rings off, and I also didn’t fit into any of my pants, I knew I had to go to the doctor. Something isn't right.


I pulled the letter out of my files and dialed the number of my old doctors new private practice. After explaining that I had been a former patient of Dr. JW's, I asked the secretary if she was taking my insurance plan.
"Um, No. I'm sorry. She's not accepting any managed care. But she will gladly see you for a physical. Would you like to come in today?"

"Hmm, well. How much is a physical? I would like to continue my care with her if possible."

"A physical would be $1000. And lab work is about $400."
I cough and scoop my jaw off the floor

"I think I'll pass. Thanks though."

No way in hell was I going to pay $1400 out-of-pocket when I have insurance! Guess I'll call the old office. After being hung up on twice, transferred twice, and then on hold for 15 minutes I finally managed to speak with someone. I told her that I needed to make an appointment with Dr. PC. And then, like something out of a sitcom, she tells me, "Well. Right now we don't have a doctor covering. Dr. PC's joining the practice has been delayed, twice. In the meantime you can be seen by a resident until we get an attending on staff."

A resident? A resident?!?! No way, lady. I get that this is a teaching hospital, and I'm all about higher learning, but this is serious. It's my health we are talking about and I want an attending!

Frustrated beyond belief, I agreed to see a resident at 2:30 that day; nevertheless, I did insist on the name of the resident's attending to have for reference.

Two hours and four vials of blood later, I walked out.

Hopefully they can figure out what's wrong with me.

Hopefully I can figure out what's wrong with our healthcare system.

Four Foods- Salty!

Another week of late posting. Bad me! Check out everyone else's timely posts here.

#1. Potato chips. Flavored? Regular, ridged or stacked?
Baked, anyway they come.

#2. Cheese doodles. Yellow or white? Puffed or crunchy?
Pirate Booty, so white and puffy.

#3. Pretzels? Your favorite shape? Favorite flavor?
Honey Wheat Rods

#4. Share a recipe for salsa or dip.

Chipotle Chickpea Dip

1 large clove garlic, peeled
15 ounces (1 1/2 cups) chickpeas, drained and liquid reserved
2 tbsp. lime juice
1/2-1 tbsp. chopped canned chipotle peppers (adjust according to how spicy you like it)
1 tbsp. chopped red onion
1 tbsp. tomato paste
1/4 tsp. chili powder
1/4 tsp. cumin
salt to taste
more red onion for garnish

With the food processor running, drop in the garlic and process until chopped. Add the chickpeas and lime juice and begin processing. If it's too dry, add 1-2 tablespoons of cooking liquid from chickpeas or, if you're using canned, just use water. Add the remaining ingredients and process until smooth. Adjust salt to taste. Serve garnished with chopped red onions.

Oops

I must admit, I enjoyed a glorious four days/nights off. I did laundry, polished china, cleaned out my closet, filed for financial aid for grad school, caught up on t.v. (oh how I <3 DVR!), and slept. However, yesterday was a blah weather day. Gray skies, cold and windy, with bouts of sleetish (sleetesque?) precipitation and I had a headache. I took a power nap before leaving for work, but my head was still a pounding.

I'm not one to take much medicine, so my "medicine" cabinet is mostly hairproducts, toothpaste, and only two bottles of pills-Tylenol and Tylenol PM. After my powernap, I rushed into the bathroom to grab something to kick my headache before what was sure to be a busy night at work.

I popped open the bottle, grabbed two pills and swallowed them with my water. As I was putting the bottle back in the cabinet I froze... "Tylenol PM". Uh, oh.
Not really sure what to do (I've never been very good at making myself throw up), I sighed, walked out of my apartment, and walked into the first coffee shop I passed on my way to work

6:45 pm......triple shot of espresso
I'm going to tell you all something now, a valuable lesson if you will, espresso does not negate the effects of Tylenol PM.

8:30pm.....cup of coffee from the overpriced starbucks in the hospital lobby

9:30pm.....2 cups of green tea

10:30pm....bottle of diet pepsi (uck, I haven't drank soda in over 2 years!)

11:30pm....diet red bull (man, that stuff is gross)

12:30pm....at this point in the night, my bladder is ready to explode, my heart is racing, and my eyes are so heavy that I need life preservers to keep them open!

With each hour that passed at work, my eyes got heavier and heavier. Thank God my patient was sick and VERY busy becuse if I had one moment to sit down, I would have been out cold.

Waiting on His Steps

A moment.
A bad accident.
A very tragic injury.
A young life changed forever.
A broken family grasping for hope.

But what can we do for them?
Will faith conquer impending death?
Does modern medicine prevail?
Believe in God?
They do.

To trust.
They must believe.
We will try everything.
It is a long road.
One that many do not survive.

But they sit at bedside vigil.
And sing against the tune
Of the musical alarms.
She will live.
They pray.

We hope.
Our actions suffice
And instincts are wrong
But fear lingers ever present.
Each day brings a new change.

But no more can be done.
We join in their prayer.
Medicine is not God.
We know this.
Trust him.

-KS 2009
I'm not an overly religious person, but lately I've been rocked back into my faith. Life is precious.

Four Foods on Friday 65

Here are this week’s four questions. Check out the FFoF meme for yourself.
Let’s talk about foods that sound funny.

#1. What’s the funniest sounding food or ingredient you know of?
Maybe I'm immature, but I still chuckle when people order the "Pu Pu Platter"

#2. How do you pronounce “cavatelli”?
(cah)-(va)-(tel)-(lee)

#3. How do you pronounce “gnocchi”?
(know) (key)

#4. Share a recipe that calls for mozzarella cheese.
Mozzarella Salad
Ingredients
4 ears sweet corn, in the husk
1/4 cup extra virgin olive oil
2 tablespoons sherry vinegar
1 teaspoon Dijon mustard
1 clove garlic, finely chopped
2 tablespoons finely chopped fresh chives
Sea salt, to taste
Freshly ground pepper, to taste
1/2 pound fresh mozzarella, cut into 1/4-inch cubes
2 ripe avocados, halved, peeled and cut into 1/4-inch cubes
1/2 pint grape tomatoes, halved
1/2 cup cooked black beans
10 large fresh basil leaves cut into thin strips
5 cups baby arugula, spinach or romaine lettuce for serving

Method
Preheat oven to 400°F. Soak corn in the sink or a bowl filled with cold water for 10 to 15 minutes.

Meanwhile, prepare vinaigrette by whisking together oil, vinegar, mustard, garlic, chives, salt and pepper. Set aside.

Once corn has soaked, place on a rimmed baking sheet lined with parchment paper. Roast for 25 minutes, until kernels are tender. Cool to room temperature, then discard husks and silks. Cut the kernels off the cobs and put them in a large bowl. Add mozzarella, avocados, tomatoes, black beans and basil.

Drizzle the dressing over the salad. Toss gently to combine. Season with salt and pepper and serve over a bed of greens.

I've worked the last six nights straight.
i had to stay 5 hours late on my last morning becuase a nurse didn't show.
two nights with sickest patient on the unit, four nights as charge nurse
bed census: full! (40 patients)
toal work hours = 82
total sleep hours =24
work to sleep ratio: > 3:1


my eyes are puffy
my ankles are swollen
i have no clean underwear
my refrigerator contents: ketchup, soy sauce, applesauce, soymilk, beer
number of unanswered emails: 35
number of times I've seen my roomate in the last week: 1
my neighbors upon seeing me in the elevator: "Ouh, rough night?"

what I want to do most? sleep
what am I going to do? sleep
why am I still typing this? who knows, goodnight!

ZzZZzzZZZzzzZZZZzzzzZZZZZzzzzzZZZZzzzzZZZzzzZZzzZz

"I got no strings to hold me down"

Two weeks ago I got an email from Columbia…

Dear Kelly,

Happy New Year. I hope this email finds you well. The admissions committee is in the process of reviewing your application file and I was asked to see if you would be willing to take the biostatistics placement exam. It will help the committee in their decision-making process…

I nearly shat myself. My heart started racing. Biostatistics? Test? Now? Are you kidding me? It didn’t help that I read this email at 8 in the morning after a four night stretch at work. As tempted as I was to just shoot back and email saying, “NO!.” I knew that was essentially writing my own rejection letter. I did the next best thing and called the woman who sent me this email. Of course she wasn’t in the office, so I left a voicemail. Boy do I wish that she had the option to delete and re-record because I rambled and babbled and stumbled. I managed to leave her my number and the best times to reach me, but I hung up with a pit in my stomach.

Thankfully, I managed to fall asleep for a few hours that morning. I got up and went about my day (gym, grocery shopping, post office, shower, date with the firefighter). After a late night, I didn’t wake up until the 11 the next day. What’s waiting for me? A voicemail from the admissions woman. I had only missed her by twenty minutes; I quickly called her back. She picked right up. She sounded so happy and perky; I, on the other hand, sounded like a hoarse, stuffy nosed sick person. I apologized for my rambling message and she said, “ Well after reading your application it sounds like you have a very intense and exhausting job. No excuses necessary.” Phew! That made me feel better. I told her that I was glad we were able to speak in person. I had a few questions and felt that speaking was much more personal than email (bonus points?)

But onto the real issue at hand. What I wanted to know was if they wanted me to take the test because of a shortcoming on my transcript/performance, or if it was something they were asking all candidates to take? She quickly summarized why she had contacted me. She was a member of the admissions committee and they were in the middle of reviewing my application. They were very impressed with my undergraduate transcript (Ivy League, Magna Cum Laude), my letters of recommendation (two PhD’s well known researchers & the worlds best nurse- BSN, CCRN, MSW, NC, Reverend –I forget all of his other credentials), and my personal statement. However, what they were rather concerned about was my quantitative GRE score. My scores just didn’t match up with my other credentials. That being the case, they felt that they needed me to take a placement test to determine my quantitative (math) capabilities.

I took in a deep breath and said, “Sure. When would you like me to take the exam.” She said, “Great! Here’s the name of the woman you need to contact about the test. Best of luck, Kelly.”

I hung up and sat motionless in my bed. I hadn’t taken a statistics class since my sophomore year of college, but I did get an (A). When I contacted the exam woman in the afternoon, she said that the sooner the better. I looked at my calendar. This was a Wednesday, that Friday I was beginning a 5 night stretch. I told her that due to my work schedule the earliest I could take the exam was the following Thursday. And that was that. Thursday at 10am. I no sooner hung up from her and ran out to the store to buy a review book.

Over the next week I did nothing but work (and study), work-out (and study. I’m sure the other gym members were like who’s the nut on the treadmill reading a statistics book?), and “sleep”/have nightmares of linear regression models, T-scores, and Z-scores.

Before I knew it, Thursday had arrived. I got up early that morning and was at the gym by 5 (sans review book). After a good sweat and steamy shower I set out for 168th and Riverside Drive. Oh yeah, WAYYYY up there across town. Knowing that public transportation would take almost an hour, I opted for the cab (gasp!). What I didn’t account for was morning rush hour traffic. I left my apartment at 8:50. I caught a cab at 9:20. Absurd! My stomach was in knots, my heart racing. The cab driver asked me if I was okay- I guess my voice was shaking as I told him where I needed to go. He was sweet and dropped me off right at the door, wishing me good luck as pulled away. I made my way to the sixth floor, knocked on the door, and then- test time!

The woman’s chipper personality made me more at ease. She led me to a barren room, I said a quick Our Father and Hail Mary and began. Forty minutes later I emerged and handed in my exam. She asked me to sit outside as she graded it. I could hear her turning the pages, it seemed like an eternity. She emerged from her office, paused, then said, “Congratulations, Kelly! 20 out of 21.” My stomach flopped, my head buzzed, I felt all warm and tingly. It may have been just a test, but it was a sweet victory for me.

And now all I have to do is wait for their decision….

Four Foods on Friday 64

Here are this week’s four questions.
Let’s talk about things that might not be quite the usual fare.

#1. What’s the oddest thing you’ve ever made with bread?
A gingerbread house. We didn't have any graham cracker, nor molds to make gingerbread so I improvised. I toasted it, then sprayed it with shilack (did I spell that right?)

#2. What’s the oddest thing you’ve ever done with mac and cheese or pasta?
Dried Pasta Jewelry. Go here for instructions

#3. Is there a food you eat other then it is intended?
Sometimes I take boxed cake mix and add it to some canned pumpkin, stir and eat. It's (almost) guilt free. May I suggest you try it with Namaste brand spice variety


#4. What’s the weirdest food you’ve ever seen?
It's not weird, but my phobia is. You know those "eyes" on overripe potaotes- they freak me out.

(photo credit Food Boom)


Do you want to play? Check out Valmg's FFoF blog feature!

Four Foods on Friday 63

Here are this week’s four questions.

Let’s talk about Chinese food.

#1. Do you prefer to eat Chinese food in the restaurant or to have it delivered?
Delivered. Chinese restaunratns scare me. Cat foo yong.. any one?

#2. Do you prefer wonton or egg drop soup?
Neither, too much salt.

#3. What flavor fried rice is your favorite?
I'd say vegetable.

#4. Describe your favorite item on the Chinese food menu.
This is so lame, but my favorite is steamed veggies. Since I don't eat meat and the tofu isn't recognizable in most dishes, I stick to the green stuff (and the occasional carrot). =)

What about you? Go and check ou Valmg's FFoF blog feature.

One Final Prayer

My last two shifts were non stop, but they are two shifts that I will never forgot.

X was accepted as in international transfer five weeks post burn. Although I've seen many patients with his % burn survive, the fact that at five weeks out none of his wounds were closed was not favorable. When X finally arrived in New York at the beginning of December, he was in renal failure, maxed on dopamine and norepinepherine for his blood pressure, thrombocytopenic, in respiratory failure and ventilator dependent, and in septic shock. Additionally a MRI of his brain revealed an acute cerebellar infarct. He had six surgeries for debridment and skin grafting but none of them took as his body was invaded with fungus and bacteria. I took care of him the better half of the last two weeks and grew to know his family well. They halted their lives abroad and moved here to keep vigil at his side. They waited and prayed and waited and prayed and waited and waited and waited and prayed.

In the last two weeks, X grew sicker and sicker. He had showed some signs of improvement early on (return of some kidney function with oliguric output, improved ABG's, improved coagulation, fewer bacteria invading his wounds) but he took a turn for the worst...

Pseudomonas in the sputum, blood, and urine.
Acetinobacter in the sputum.
Candida on the skin and in the blood.
Thrombocytopenia
ARDS
Pulmonary Edema
Acute Renal Failure
Collapsed Lung
Sepsis
Acidosis
20 kilos of fluid overload with edema making him unrecognizable

In those 25 hours of work I administered 8 units of blood, 8 units of FFP, 10 units of platelets but he remained thrombocytopenic.
The ventilator was on 100%FiO2 and he was still lethally acidotic.
He required continuous deep lavage suctioning that involved removing him from the ventilator and breaking PEEP causing his blood pressure to plummet.
He was so unstable we couldn't turn him to put him on dry sheets, yet he was putting out 11 liters a day in bed drainage (yes, we suction and measure this).
He was two days overdue for day #5 post-operative dressing (POD) change.
His eyes were dilated and minimally responsive.
He was maxed out on Dopamine, Levophed, Neosenepherine, and Epinephrine.

I arrived at work on Monday and was partially surprised to find X still alive. The three hours prior to my arrival his blood pressure was resting around 68/40, his heart rate tachycardic in the 110's, and his O2 sat around 73%. The attending physicians held a discussion with the family during the day and I thought they were leading in favor of DNR, but in a desperate twist of fate the father disagreed and said he wanted "every thing possible" to be done.

During the day, the family had kept vigil at the bedside, never more than three visitors at a time. In the middle of report from the day nurse, Xs alarms sounded, his O2 sat was 65%, he needed to suctioned. The day nurse (J) and I went in and prepared to suction. We no sooner finished when his heart rate began to plummet: 110-90-80-75-70-60-55......

J yelled to get some atropine began bagging the patient. I hopped up to begin compressions. In rolled the code cart and so began the code. His venous access lines ( a right internal jugular TLC, a left femoral TLC, and left femoral Aline) were a mass of "spaghetti" coming from the 13 pumps running on either side of his bed; however, when the atropine arrived J started pushing meds, I continued compressions ,and the fellow took over bagging. I felt ribs snap, I saw my artificial compression "V-tach" heart rate on the monitor, my triceps and deltoids tightening with every blow. And then it happened. The mother came running down the hall, stopped in the doorway, and yelled, "Stop! NO More! I'm his mother." We all looked up- all hands off the patient. At this point the attending physician was also in the doorway and he and the fellow clarified with the mother what stopping CPR would mean and verified that this indeed was her wish. With tears streaming down her face, she sobbed, "Yes. Yes." And with that we turned off the pumps and stepped back. I stood there holding the mother as we watched the agonal heart rhythm on the monitor...28, 23, 10, asystole. We checked- no pulse. And he was gone.

The monitor no sooner read asystole and the sister came running back in. She threw herself over her brother and let out a blood curdling scream. The crowds started to dissipate from the room and the fellow, J, and I began to comfort the family. After turning off the monitors and stocking the room with tissues, we all left and let the family grieve. I called the priest. It broke my heart as I watched the father pace frantically outside the room, refusing to set foot inside. After the priest left, I heard a noise coming from the room. I looked up from my paperwork and started walking towards the room...

Oh Dios de quién Único Hijo nos ha otorgado los beneficios de la vida eterna, concédenos la gracia que te pedimos mientras meditamos los Misterios del Mas Santo Rosario de la Bienaventurada Virgen María, debemos imitar lo que contienen y obtener lo que prometen, a través del mismo Cristo Nuestro Señor. Amen.

Over the last two weeks I'd listened to X's family chant prayers at his bedside, but suddenly I was moved. Not overly religious, but still connected to my Catholic roots, I stopped to think about what they were saying.

Let us pray. O God, whose only begotten Son, by His life, death, and resurrection, has purchased for us the rewards of eternal life, grant, we beseech Thee, that meditating upon these mysteries of the Most Holy Rosary of the Blessed Virgin Mary, we may imitate what they contain and obtain what they promise, through the same Christ Our Lord. Amen.

Jesus died at 33, their son didn't even make it to 30.

The post mortem care that followed was grueling. It took over 3 hours. Removing the dressings churned my stomach. X's skin was green with infection and textured with fungus. When all was said and done, I called the family in one last time to say good bye. As they kissed him their final goodbyes, I stopped the mother in the doorway and took her hand. I opened her clenched fist and placed something in it. She brought her hand closer to her face and opened her fingers--an ID band. She threw her hands up around my neck and sobbed, "Thank You. Thank You." I may not have been able to save her son, but I sure hope I can preserve his memory.

WEEK 62: Four Foods On Friday

And I've been out of the loop for over a month. Life has been quite busy and work, well, overwhelminng. But it's a new year and I'm trying to get back on track. Valmg's been in a funk too, so hop ov over to here meme, check it out, and leave her some love.

Here are this week’s four questions.
#1. Waffles. Do you usually eat frozen or homemade?
What do you consider waffles made at a restaurant? I guess they are "restauarnt" made- but those are the only times I eat waffles

#2. Eggs. Do you buy brown, white, or it doesn’t matter?
Whatever is on sale, but I always buy organic, cage free eggs.

#3. Oatmeal. Do you usually make instant or cooked?
Cooked. Call me a snob, but I'll forgo the oatmeal if I dont have time to cook it. Cooking tip- Old Fashioned Cooking oats are MUCH Better in cookies.

#4. Bacon. Share instructions or a recipe that you use bacon in.
PASTA WITH SPINACH, BACON AND MUSHROOMS
1/2 lb. thick sliced bacon
2 tbsp. butter
1 c. onion, chopped
1/2 c. sweet red pepper, diced
1 c. sliced fresh mushrooms
1 bouillon cube in 1 cup hot water
Salt and pepper to taste
1 lb. pasta
10 oz. fresh, washed spinach (about 4 c.)
1 c. grated fresh Parmesan cheese
Cook bacon until crisp in skillet. Discard fat. Place bacon on paper towels. Add butter to same skillet (do not wash). Saute onions and peppers for 2 to 3 minutes. Add mushrooms, saute for 1 minute.
Over high heat, stir in broth. Bring to a boil. Lower heat and simmer for 2 minutes. Taste and add salt and pepper. In a large pot, cook, then drain pasta well. Return pasta to pasta pot.

Add the vegetable sauce and spinach. Toss over medium heat until spinach is wilted and most of the sauce is absorbed. Divide onto 6 plates. Top with crumbled bacon and Parmesan cheese.

2k9 MEME

I got this MEME from O, who got it from All & Sundry. It's my last day off for the next five, so I figured what the hell-let's waste some time on the computer.

1. What did you do in 2008 that you’d never done before?
took the GRE's

2. Did you keep your new year’s resolutions, and will you make more for next year?
Is it a bad sign that I can't remember if I made one last year?

3. Did anyone close to you give birth?
two of the nurses that I work with, two of the girls I went to highschool with, and Anjali

4. Did anyone close to you die?
yes, one of my coworkers. RIP Tara. Miss you.

5. What countries did you visit?
St. Martin, St. Barts

6. What would you like to have in 2009 that you lacked in 2008?
Sleep and a social life; weird combination I know.

7. What dates from 2008 will remain etched upon your memory, and why?
December 19th- best Christmas party ever!
December 1st- I dischared the first pediatric trauma that I ever admitted
June 14th- I fractured my pelvis

8. What was your biggest achievement of the year?
Staying healthy

9. What was your biggest failure?
Not staying in touch with my friends becuase of my crazy schedule

10. Did you suffer illness or injury?
Fractured Pelvis

11. What was the best thing you bought?
My blackberry

12. Whose behavior merited celebration?
Amy: new job as a VP= all grown up

13. Whose behavior made you appalled and depressed?
The parents of my patient who pressed their child's face against the radiator. It made my blood boil.

14. Where did most of your money go?
Rent, rent, rent. Did I say rent?

15. What did you get really, really, really excited about?
The prospect of getting a permenant day position (too bad it was only a prospect).

16. What song will always remind you of 2008?
I don't know.

17. Compared to this time last year, are you:

a) happier or sadder? neither, I'm content
b) thinner or fatter? fatter and it's really stressing me out
c) richer or poorer?Richer. That's what happens when all you do is work and have no time to play!

18. What do you wish you’d done more of?
Stayed in touch with my friends, gone to church, slept (in no particular order)

19. What do you wish you’d done less of?
Stressing over the future

20. How did you spend Christmas?
At work. Hospitals never close.

21. Did you fall in love in 2008?
Someone won my heart over, but then broke it.

22. What was your favorite TV program?
The Biggest Looser (a guilty pleasure, I know).

23. Do you hate anyone now that you didn’t hate this time last year?
No.

24. What was the best book you read?
Quantum Wellness

25. What was your greatest musical discovery?
Our tiny little bathroom has great acoustics for shower singining

26. What did you want and get?
a complement

27. What did you want and not get?
a permenant day position

28. What was your favorite film of this year?
Rachel at the Wedding

29. What did you do on your birthday, and how old were you?
I worked, but at least Dr. MAtt was there *cue the dreamy music*! I turned 24.

30. What one thing would have made your year immeasurably more satisfying?
Working days so I could see more of my friends and family, sleep more, and make dating easier

31. How would you describe your personal fashion concept in 2008?
Hospital issued 50/50 Cotton, Poly scrubs; gym clothes; a conglommerate of J.Crew, Gap, and Bloomingdales

32. What kept you sane?
Escapes to the suburbs to see the L's or my family, late night talks with Natasha or AMy, and Wednesday Night Dinner Club

33. Which celebrity/public figure did you fancy the most?
I can't decide if the numerous adoptions and procreations of Jolie-Pitts is admirable or insane

34. What political issue stirred you the most?
The shit show otherwise known as our health care system

35. Who did you miss?
My family, my sorority sisters, Sarah, Memegrl and family, Shestartedit and family

36. Who was the best new person you met?
Cheryl. I'd be lost without her friendship

37. Tell us a valuable life lesson you learned in 2008.
Life is best lived with a little spontaneity.

38. Quote a song lyric that sums up your year.
Don't get all worried but if you remember this post, I'd say these lyrics just about sum it up:

What's wrong with me?
Why do I feel like this?
I'm going crazy now

No more gas, in the red, can't even get it started
Nothing heard, nothing said, can't even speak about it
On my life, on my head, don't wanna think about it
Feels like I'm going insane, yeah
-Rihanna, Disturbia

9 things About Me for 2009

1. I like green grapes but red wine
2. I can't fall asleep with dirty dishes in the sink
3. I can wiggle my ears
4. I don't play any musical instruments
5. I haven't eaten meat in 8 1/2 years
6. When applying to college I was torn between architecture and nursing
7. I floss after I brush
8. I prefer flats to heels
9. I'd rather go to bed at 10pm and be up at 5am, than go to bed at 1am and sleep till noon.

the final countdown

Christmas is in less than four days It's three days, fourteen hours, and two minutes to be exact, but who's counting, right?

Per usual, there has been no rest for the weary. I worked four days this past week and they were no less exciting than my previous post. Also, I made a mad dash from work on Thursday night to get across town to babysit. That was fun in rushhour, not! Thankfully the R's were home before midnight, so getting up at 4:44a.m. for the gym and work on Friday wasn't impossible. Friday night was our Christmas party. Now it's a well known fact that us nurses love to party and have a good time...sometimes just a wee bit too much. That's what happens your life is more work than play -the play is way overdone.

Our party was nothing fancy, nor was it free. It was at a local bar that many of us go to frequently. For $30 we had 4 hours of open bar from 8-12. I was determined to get there early this year because last year I missed most of the party while waiting for N to dilly dally getting ready. Too bad my plan wasn't quite in line with the hospital gods. I had to work Friday day but I figured I'd be out by 7:50ish. Or not!?!?. Brief recap of what happened between 4:30 p.m. and 8:45 p.m. when I finally left work.

-Four patients came back from the OR
-One patient got discharged
-Two patients arrived from outside hospitals as transfers that were so not necessary
-A patient needed to be transferred to the pediatric floor but had no family at the bedside to travel with them
-A patient was extremely hypotensive and had a critically low Hemoglobin and Hematocrit (5.5, 15.5!!!). Said patient needed to be transferred from a stepdown room into an ICU room and get two units of blood rapidly transfused. But first needed to have a type and screen sent because the initial one expired. The type and screen was sent but one line of the sheet wasn't signed so the lab rejected and threw out the sample and another one had to be sent (have you ever tried to get blood from an exceptionally hypovolumic person?) I'm still in shock that I go an IV into their arm. Additionally the cardiac monitor was not working in the patients room so they had to be on a portable monitor.
And the most exciting, although rather traumatic...
-A patient blew their anatomises and ruptured their carotid artery. You know those scenes on TV where blood is squirting out everywhere? Real life is way more intense! After that patient got rushed to the OR, and I settled the patient with the low H&H into the room, and I transferred the patient to the pediatric floor, and I did the admission history and assessment on one of my new admissions, and gave report to the night staff on my other patients, I rushed home, took a 49 second shower, put on my new party dress, straightened my hair, and hopped in a cab to my party. I arrived at 9:20 p.m. Now that people is a speedy party prep!

I was barely in the door and someone put a drink in my hand, followed by another and another and another. I'm a two drink drunk on a good day, so four drinks on an empty stomach meant the super chatty, quick witted,flirty, confident Kelly was out in full force. I don't know where the night went. Before I knew it, the party was coming to a close and it was close to 2am. As I left, I think I hugged and kissed on the cheek every firefighter that was there, plus all my coworkers-even the ones who I only sorta like, haha. Two, very nice, older, as in could be my father old, firefighters walked me out and got me a cab home. My party dress was barely off (that sounds so dirty) and I passed out. I didn't wake up until 10:30 Saturday morning and, to be quite honest, I wished I had just kept sleeping. My head was pounding, my throat was killing me, and my eyes were crusty with Friday night's makeup.

I managed to rally after a multivitamin and two cups of tea. And by rally I mean go to the gym for a jog, shower, and attempt to Christmas shop;however, he latter was a huge failure because with every store I walked into and saw a line, I turned on my heels and walked out. Which brings us to the present.. T-minus three days, fourteen hours, and two minutes until Christmas.

What do I have to do before then?
1. Buy gifts for: my cousin, one of our fellows, my roommate, my dad, my mom, my trainer, my grandfather, my cleaning lady, my water delivery man.

2. Mail the already stamped and addressed holiday cards (hey, the post office is 2 blocks away)

3. Bake Christmas cookies

4. Wrap the few gifts that I have purchased

5. Do laundry so I have clothes to bring home

6. Find a Christmas Eve mass AFTER I get out of work, but BEFORE midnight

7. Get in touch with the L's so I can finally give them their Christmas AND Birthday
presents

8. Book a train ticket home for the day after Christmas

9. Work Tuesday, Wednesday, and Thursday


Wow, I've got a lot to do and not much time. On that note, I'm out. Wishing you all a happy, healthy holiday and new year!

Exhausted

Holy Moly, I’ve been MIA and I have lots of catch you all up on. First, the entire month of November I was feeling really down. Some days it took all the energy I had just to get out of bed. I wasn’t excited about anything, nor did I want to do anything. I even hated going to the gym or running (yes, you read that correctly). I was rather concerned. I knew it wasn’t normal to feel that way; however, I didn’t care much about anything.

When my family saw me at Thanksgiving, they thought I looked bad. My schedule wasn’t helping my case. I was working 5 nights a week, 12+ hours a night, and not sleeping more than 3 or 4 hours in between shifts. I don’t care what you say, sleeping during the day does not even compare to sleeping at night. Plus, all this exhaustion was wreaking havoc on my body.

I’m very conscientious about what I eat, how my clothes fit, my weight etc. So when my pants started getting tighter ,and I knew I hadn’t changed my eating habits or how much I exercised, my stress only increased. I finally reached my breaking point when N called, asking me to dinner, and I broke down and cried. I told her that I’m just miserable. I hate working nights. It’s lonely. It’s isolating. I can go an entire week without seeing my roommate. I don’t do that much for myself and the few things that I do (i.e. working out, running, cooking) I no longer enjoy. After an hour of her listening to me sob and sob and sob, she convinced me to go out for sushi in the Village. It was freezing cold outside, but I needed the fresh air. After another restless night’s sleep (that’s the other problem, now that I’m used to staying up at night, I can’t sleep on my days off) I called my doctor. Not being one who EVER takes medication, I now have lovely prescription for some @mbien. Magic.Little.Pill.

Even better than the fake sleep that I’ve been getting is the fact that I’m doing a month long rotation on days. It’s heaven. They’ve also been giving me a lot more responsibility at work. In addition to acting as charge nurse, I’m also precepting some of our new nurses. It’s extremely flattering to be given so much responsibility after only working in the BICU for 16 months.

My transition from nights to days was a little hairy. I worked Thursday and Friday nights, had Saturday off, then worked Sunday, Monday, Tuesday days. Despite the fact that I hadn’t worked a day shift in a year, I was in charge on Sunday, Monday, and Tuesday. Let the games begin!

I won’t bore you with the details but we were slammed with boarder patients from the PACU, two of which were extremely unstable and ended up getting emergently intubated and rushed back to the OR. One patient died. One patient coded six times over 48 hours. The repeat coder also ended up swanned (twice, after the first one was defective), had a transvenous pacer placed by cardiology, then had a GI bleed, then stopped oxygenating his body as indicated by his PO2 of 45 from his ABG.

On top of all this activity, we had another patient who came in intubated with an unknown medical history; she was found down in a house fire after smoking and drinking in bed. Turns out this lady had quite a history with IV drug use and alcohol abuse, so she was damn near impossible to sedate due to her high tolerance of narcotics. Her magic cocktail turned out to be 150mcg of Fentanyl and 50mcg of Propofol.

The above situations kept all of us doctors and nurses very busy, but I had a very emotional experience on Monday. I can’t remember if I ever posted about this patient, but back in July I admitted a five year-old boy started a house fire and ended up with 65% total body surface area full thickness burns. He was intaubted and sedated, teetering the line between life and death.

The night I admitted him, I thought-on more than one occasion- that we were going to loose him. His mother was the first parent I had to address regarding life and death. I took off all my surgical garb, took her by the hand, and walked her into her son’s hospital room. I explained, in lay man’s terms, the physiology of burns. My knees knocked, but my voice never faltered, as I told her that the first 72 hours were the most critical. I caught her in my arms as she broke down; she wept on my shoulder like baby.

I took care of this boy four nights in a row and countless times over the next few months. His hospital stay was complicated by infections, sloughed graphs, respiratory and neurological issues, but every time I took care of him I felt a sense of pride and hope. I was there the afternoon they extuabted him; I watched him take his first non- ventilator assisted breath; I teared up.

This little guy became a fixture on our unit. Everyone knew him, and he knew everyone. Two weeks ago he celebrated his 6th birthday, it was a 24-hour, non-stop party. Everyone from the attending physicians to the house keeping staff joined in the celebration. I knew he was getting better, but the idea of him leaving never crossed my mind. So when I found out that he would be discharged to rehab on Monday, my stomach knotted.

Monday morning I went into his room and had a long talk with him. I told him that although I was very sad to see him go, it was a very special day for us both. For him it marked astounding progress, for me it was a happy ending to a six month journey. I can’t begin to express how meaningful it was for me to discharge the very patient who I thought I would loose.

As I reviewed the mounds of paperwork with his mother, she looked up at me and started to cry. Much like the first night I met her, I caught her in my arms and she wept on my shoulder. However, this time her tears were that of joy not fear. She looked at me, as I wiped away her tears, and mouthed “thank you.” And it was that moment that reminded me why I do what I do. It makes the long hours, the back-breaking work, the stress, and the frustration all worth it. I must have some angels up in heaven, because this reminder couldn’t have come at a better time. Once again, I feel at peace, ready to take on whatever comes my way.

Week 58: Four Foods on Friday

I'm back this week. Check out everyone else's meme entry here.

#1. Does your family usually eat meals in the kitchen or somewhere else?
Well, we eat in the living room around the coffee table. Hey, it's city apartment living!

#2. Who usually does the dishes in your house?
Me, I'm OCD about dirty dishes in the sink.

#3. What’s your favorite small appliance or tool in the kitchen?
Blender. With limied space, I use it to chop, puree, mix, and of course blend

#4. This one’s for my son. Share a recipe for chili.
Can't take credit for this one, it's from 28cooks

Tempeh Chili

1 (8 oz) pkg tempeh

Marinade
2 tbsp soy sauce
2 tbsp water
1 tbsp Lousiana-style hot sauce
1/4 tsp garlic powder
1/4 tsp onion powder
1 tbsp sesame oil

4 tbsp oil
4 cloves garlic
1 cup onion, chopped
1 tsp Italian seasoning
1 tsp mustard powder
1 tsp cumin
1 tbsp chili powder
1 tsp salt
1/4 tsp freshly cracked pepper
2 (14.5 oz) cans diced tomatoes with green chilies
1 (15 oz) can black beans
1/2 c water

In large ziploc bag, combine all marinade ingredients. Add tempeh, seal bag, and refrigerate for 1-8 hours (or longer). Grate tempeh with large grater and place into medium bowl with remaining marinade. Heat olive oil over medium-high in large pot. Add garlic and onion, and saute until almost tender, about 5 minutes. Add Italian seasoning, mustard, cumin, chili powder, salt, and pepper, and stir for 30 seconds. Add tomatoes, beans, tempeh, and water. Stir well, bring to a boil, then lower heat. Simmer, uncovered, stirring frequently, for 30-45 minutes, until chili is thickened. Serve and enjoy!

In Which I Try Something New

Hold your breath. I actually had a holiday off! Yes, you read that correctly. Nurse Kelly was nowhere near New York's big medical center. When I found out that I didn't have to work, I immediately phoned my family. Instead of my mother fussing over what my travel arrangements, she laid a shocker on me. She announced that her, my father, and my sister would be traveling to New York. My first thought was "Sweet!", my next thought was, "Holy Shit. HOWAMIGOINGTOCOOKATHANKSGIVINGDINNERINMYTINYTINYAPARTMENTKICHEN???? I think my mom sensed my apprehension because she quickly said, "and how about we go out to dinner? That would be lovely."

Shocked at my mothers suggestion, I agreed an quickly set out to find a reasonably priced Thanksgiving dinner. My search took about a week. Apparently, some people New Yorker's don't bat an eyelash at $109/per person prixe fix holiday dinners that do not include alcohol. I finally found a place with a varied menu costing only $55/per person for a three course meal. I made a 4:30pm dinner reservation, sat back, and then thought.....what am I going to do with my family all.day.long?

This issue continued to stress me out. Did I mention that my family was going to be staying in my apartment? Yes, my roommate was going home, but at $725 a night for a hotel, I was not about to kick my family out. My stress was exaggerated because preceding thanksgiving I worked 11 out of 15 days (uh, hunh not kidding).

Before I knew it, it was last Sunday and my mom was giving me all the details (sometimes I love having a mother who's as type A as me!) They would be arriving Wednesday afternoon, probably late because my sister was playing in the powder puff football game and they couldn't leave Boston until 11 and they were anticipating mucho traffic. My mom then suggested that we go see the balloons be blown up for the parade. So touristy, she and my dad both wanted to check out the Macy's Day Parade on Thanksgiving morning. We'd wing the rest of their visit. In my state of exhaustion, I just agreed and went about the week.

Before I knew it, it was Wednesday at 2pm and my family was buzzing my apartment. Wow! They made it in record time. I went down to help them bring in their stuff. My jaw almost hit the floor when they showed up: two jumbo suitcases, pillows, tools (I needed my dad's drill), gift bags, garment bags, etc. You would have though they were traveling overseas. I soon learned that one entire suitcase, plus one of the duffel bags was full of my sister’s clothes (oh to be 16). They came up and settled in. I must admit, I was having a mild anxiety attacked with their stuff everywhere, but I played it cool.

After catching up, we humored my mothered and headed off through the park to the west side to see the balloon inflation. Direction said to check them out between 77th-81st on Central Park West. Umm, so weren’t we surprised when we were looped up to 81st, across CPW to Columbus, across Columbus, down Columbus to 78th, back across Columbus, down to 77th only to realize that if we wanted to see the balloons we would essentially have to walk that same route AGAIN, except in the opposite direction on Central Park West. Oh the crowds! It was insane. Umm, at that point, we threw in the towel and decided to get something to eat. We were right at Isabella's so I tired to go in and check out the wait time. But I couldn’t get past the cop who told me the restaurant was booked until 10pm. And off we went down to 72nd so we could go back acorss the park. And we walked and walked and walked. My mom said a few times, “Kelly, where are we going? We are going in circles."

I really hadn't been paying attention, as we were talking all the way. Suddenly I noticed this LARGE, long building. And then I stopped, dead in my tracks, and laughed. We walked to the street corner "85th and 5th." Whoops. We had accidentally walked diagonally through the park up to 85th! At least we were back on the East Side!

Famished, we headed to a big Italian family style restaurant. We were seated promptly. We all needed a drink, so we ordered a pitcher of Sangria. Doesn't the waitress come back to the table, with our huge pitcher of yummy sangria, and say, "Four glasses, right?" My mom tried to prevent her jaw from hitting the floor. The waitress poured the four glasses and walked away. That's when Colleen, picked dup her glass and said, "Cheers!" She's sixteen! Not wanting to make a big deal my parents let her drink it, after all it was in a controlled environment, but it was just comical.

At this point it was time to order out food. Being the only vegetarian in my family, and this was a family style restaurant, I pretty much stayed out of the conversation and said all I wanted was some linguini and steamed broccoli. My family all agreed on chicken parmesan but for some reason my sister was putting up a fight over the veal. She lost the battle and my parents ordered a half size portion.

When the food came, there were lots of plates on the table. After some rearranging the veal parmesan ended up in front of my sister. I jokingly offered her some and she looked at me, dead serious and sad, "You know I don't like fish!"

My parents and I burst into laughter. My sister, the child prodigy seriously thought that veal was fish. After a good chuckle, we ate our meal and drank our sangria-all four of us.

It had been a long day, so we came home, put on our pajamas and lounged around. Sleeping arrangements were interesting. My sister and I slept on my roommates bed, my mom slept in my bed, my dad slept on the blow up aero bed. None of us slept well. It seemed like had just gone to bed when my dad pops his head in at 6:40 a.m. and announced that it was time to get up. We threw on clothes and headed off to the West Side to see the parade. We were at 72nd and CPW by 7:15 and the parade didn't begin until 9.

The streets were PACKED. People were pushing, shoving, yelling, moaning, and groaning. We ended up finding a spot behind a relatively open area, closed for CNN VIP's. We thought we hit the jackpot. Boy were we wrong. Turns out, this was also the spot to enter and exit the viewing stands for the porta-pottys. For the next two hours and all through the parade we were shoved, pushed, and untimely sandwiched in between two trash cans and six porta-pottys. We didn't even get to see Santa because they ushered us out of the area so they could clear the stands. We trekked home cold, but not defeated. Many of our friends texted us that they were looking for us on TV and asked us how the parade was live. We texted back to look for the porta-potty's and that the parade probably looked better in HDTV.

Walking home, we decided to stop and get breakfast and bring it back to my apartment. For most of the afternoon we lounged around. My sister napped and then we all showered and got ready for dinner. We decided to walk 30 blocks to the restaurant and worked up an appetite. Seated promptly, the meal was delicious from start to finish. We took a cab home. Then came what I dreaded most...a lull, with nothing to do.

We flipped back and forth on the television but nothing was appealing. It was only 6:45, but I put on my pajamas curled up on the couch and fell sound asleep. I woke up a few hours later and crawled into bed. The following morning I could smell fresh brewed coffee and freshly toasted bagels. I was quite impressed that my family finagled their way around my kitchen AND ventured outside to the bagel store. It was a bit comical when my dad opened the refrigerator to get cream for his coffee and all he saw was soymilk and opened up the sugar jar only to find splenda. Sorry dad. However, the best part of waking up was walking into my living room and seeing my little Christmas tree all decorated. It warmed my heart.

After my family showered, they packed up the car and left. I got a wee bit emotional but I know I’ll see them again in a month. Although this past Thanksgiving was different from any other holiday I've experienced, it was great to try something new.

Taste of Something New

Maybe it's because it's almost Thanksgiving, or maybe because it's chilly outside, or maybe because I've had two days off in a row (cue to choirs!!), but whatever the reason I've been playing with the foods inside my pantry food cabinet. I had a can of pumpkin, a bag of craisins, and some rice that I wanted to use.

Here's what I created...

Pumpkin Cranberry Risotto

1 onion. diced
1 tbsp olive oil
2 cups arborio rice
1 cup white wine
4 cups vegetable broth
1 1/2 cups canned pumpkin
1/4 cup real maple syrup
1 tbsp orange zest
1 tsp nutmeg
1 tbsp margarine
salt and pepper to taste
1 cup craisins

Mix pumpkin, orange zest, and maple syrup and place into 350 degree over for 20 minutes.
Sautee the onion in olive oil over medium heat until soft.
Add the rice. Allow to cook, stirring, for a minute or two. Slowly add the wine- CAREFUL when pouring alcohol onto heat.
Add the vegetable broth, 1/2 cup at a time, allow the moisture to cook off before adding the next 1/2 cup. Stir frequently. Add in salt and pepper.
Once all the liquid has been added, fold in pumpkin mixture, nutmeg, margarine, and craisins.

Enjoy!

Four Foods on Friday

I'm running late with this post again. I need a vacation! But nevertheless here are this week's questions

#1. What’s the worst tasting food you’ve ever eaten?
That would be Walden Farms fat free, calorie free peanut butter. Yes, you read that correctly It was metically tasting and sharp smelling....kind of tasted like fertilizer smells. I should have known that it sounded to good to be true.

#2. Share a funny or embarassing story about a meal you’re made.
Um, the huge bath of pumpkin bread that I made for the holidays two years ago. I accidentally grabbed the paprika instead of the cinnamon. You should have seen my grandfathers face when he took a bite.

#3. What food do you burn or have problems cooking most often?
I said it before, but I cannot make brownies. I've tried to make them from scratch and from the box but never had any luck. They are mushy in the center and charred on the edges. MAybe it's my pan??

#4. Name two foods you’ll be eating on this Thanksgiving.
We're trying something new this year. My family is coming into New York (yay!) and we are going out to eat. Here's our menu selection:

SOUP
Soup of butternut squash, hazelnut, apple and roasted seckel pear

SALAD
Organic baby mesclun mix, toasted walnut and fall squash vinaigrette

ENTREE
-Crisp skin long island duck breast, sweet potato and maple puree, garlic sauteed brussel sprouts
-Whole wheat rigatoni with fall vegetables, fresh red and yellow tomato sauce, roasted olives
-Roasted organic amish turkey, sweet potato puree, brussels sprouts, cranberry chutney, chestnut stuffing, mashed potatoes and giblet gravy
-Stuffed farfalle with sundried tomato pesto, grilled sweet italian sausage
-Slow braised beef short ribs with cheddar cheese mashed potatoes, roasted root vegetables
-Fennel crusted north atlantic salmon, scallion and celery root mashed potatoes, warmed grapes and caperberries
-16-oz ny strip steak with roasted garlic and herb butter, crispy french fries and belgian dipping sauce
DESSERT
-Machintoch apple, cinnamon raisin cobbler with cinnamon ice crem
-Individual pumpkin pie with fresh chantilly cream
-Flourless chocolate souffle with vanilla bean ice cream
-Italian blood orange sorbet

Want to join in? Check out the FFoF Meme HERE

4 Foods on Friday-Thanksgiving Edition

Hard to believe it's already mid-November and that Thanksgiving is 2 weeks away! See what everyone else is drooling over on their Thanksgiving menu....

#1. Stuffing. Boxed or from scratch?
Boxed, but all doctored up with apples, celery, craisins, and onions

#2. If you were served the perfect Thanksgiving dinner what would it be?
Well, mine would have no meat, but the ideal Thanksgiving meal that I would serve to all my carniverous friends and family would be....Roasted turkey with hickory maple rub, stuffing (see above), mashed sweet potaotes with crushed pineapple and cinnamon, steamed green beans, sauteed spinach with garlic, homemade chunky cranberry sauce with fresh grated orange zest, and warm fresh baked honey wheat bread

#3. What’s your favorite Thanksgiving leftover?
Sweet potatoes reheated in the oven with just a dab of maple syrup

#4. Share a recipe using turkey.

Turkey Gobble-Up

1 large ripe avocado, peeled, pitted
1 tablespoon lemon juice
2 tablespoons mayonnaise
2 tablespoons sour cream
1/4 teaspoon hot pepper sauce
12 slices cooked turkey breast meat
12 slices tomato
12 slices American or cheddar cheese
12 strip bacon, halved, cooked, crumbled
6 English muffins, split and toasted

In a small bowl, mash the avocado; add lemon juice, mayonnaise, sour cream and hot pepper sauce.

Spread over muffin halves; top with turkey, tomato, cheese and bacon.

Broil 6 inches from the heat for 3-4 minutes or until cheese begins to melt.

Yield: 6 servings.