Sunday, October 14, 2012

What's for Dinner? Menu Planning

For those of you who know me, it's no surprise to you that I admit to being a planning freak.  Seriously, the farther in advance I can plan anything, the better.  It's a little neurotic, but I believe it's been a big part of getting me where I am.  I've extended this sentiment to our daily dinner schedule and gosh darnit, it's been a beautiful thing.

Throughout our crazy days of school, rotations, long hours, etc, I've made it a priority to cook decent dinners for Peter and I.  I learned quickly that if I planned to cook on lighter days, we'd still have nice dinners, just in the form of left-overs, on busier days.  I recently extended this philosophy to planning out a week's worth of dinners the week before.  Too much, you say?  Let me show you why this is brilliant, and will work for your family.

Once a week, usually Thursday or Friday night (how exciting!), I sit down (Peter contributes most of the time) and plan dinners for the coming week.  Simultaneously, I make the grocery list for said items since I grocery shop on the weekends.

It takes a bit of time to plan sometimes, but lets analyze this scientifically.  Without a plan, you go to the grocery store willy-nilly.  Then you spend time each day thinking about what you have and don't have at home, trying to pull something together for dinner.  That fresh produce you bought goes kinda icky for lack of inspiration and you're ordering Chinese because you're tired and don't want to think.  You then spend extra time running to the grocery store a few times a week, picking up things to make whatever you want for the evening, just to be short on supplies the next day.

Alternatively, you spend an hour or so making a plan and a list.  Magically, you're using the produce and other groceries you buy for actual recipes, you have leftovers to serve on busy nights and even to take to lunch, and the week goes off without a hitch.  I think it makes sense.

This has worked beautifully for us, and I hope we (meaning, I) continue doing it.  I'm keeping track of the menus I create so when I'm knee deep in residency or just busy life next year, they will just magically be done for me!  Give it a shot; you may find it annoying, but it just may be the organizational tool you've been looking for :)

Monday, October 8, 2012

Peanut Butter Cup Bars

Did you have a nice weekend?  I sure did!  Not that I don't love sick-baby-land, because I do, but since this rotation is an "elective", I get weekends off!  NICU, by the way, is great; I'm learning tons and have finally gotten the hang of all the math (yes, math, that's basically all I do:  calculating how many ml/kg/day that baby eats, or the exact number of calories/kg they are getting, including their TPN (fancy Ensure-like concoction meant to run into central veins for people who can't eat), blah blah).  Next week I start my first of 10 residency interviews, so that will be exciting.

These little buggers are like crack.  It's a pretty unassuming recipe, and it requires NO baking.  You really need no machinery at all, though a food processor does help to get the graham crackers to a sand-like consistency.  Everyone who tried them were battling their inner caloric-counting demons, trying to justify just one more bar.  You'll like them too, I bet :)

Peanut Butter Cup Bars

2 cups peanut butter, divided (chunky or smooth)
1 1/2 sticks butter, softened
2 cups powdered sugar
3 cups graham cracker crumbs (about 2 1/2 sleeves, ground to sand-like consistency
1 package semi-sweet mini chocolate chips

Grease a 9x13 inch baking pan

Beat 1 1/4 ups peanut butter and butter in a large mixing bowl until creamy  Gradually beat in 1 cup powdered sugar.  By hand work in remaining powdered sugar and the graham cracker crumbs.  Fold in 1/2 cup mini morsels.  Press into prepared pan and smooth top with spatula.

Melt remaining peanut butter and remaining morsels in a microwave safe bowl, stirring every 30 seconds until smooth.  Spread over PB crust in pan.  Refrigerate for at least 1 hour, then cut into bars.  Store in refrigerator until ready to serve.

Tuesday, October 2, 2012

Jicama Slaw Salad

I survived my first two days in the NICU!  (The neonatal intensive care unit=NICU is for premature babies or newborns who are otherwise ill or unstable...exciting!)  I know the thought of sick babies is hard for some, but gosh darn it, I kinda like it.  Someone has to, right?  Yesterday, I got to scrub into a delivery and "catch" the baby from the OB/GYN people.  She looked great, and after promptly wishing her a happy birthday, I helped the NICU fellow assess and examine her.  Yay!

Onward: the slaw.  This recipe was a big hit at a dinner party.  It's sweetish and a little spicy, with just great flavor.  Also, you can make most of it in your food processor, so it's a cinch!  (Tip:  don't put bell pepper in a food processor; it just mushes.  Slice thinly).

This is a jicama; a Mexican root vegetable.  I see your face; you look scared and a little disgusted.  This is super yummy.  It's crunchy and tastes kinda like a cross between a potato and an apple (ie, plain but a little bit sweet).

Jicama Slaw Salad

1 medium sized jicama, peeled and grated in a food processor
1 red pepper, thinly sliced
1 yellow pepper, thinly sliced
1 cup shredded carrot
1 jalapeno, finely diced
1 cup cilantro
1 cup light sour cream
Juice and zest of 4 limes
Salt and pepper, to taste.

Combine sour cream, lime juice and zest, and salt and pepper.  In a large bowl, combine remaining ingredients.  Pour dressing over veggies, toss, and store in refrigerator until ready to serve.

**To peel your jicama, cut it into fourths, then use a sharp knife to (carefully) peel like a potato.  I found that a vegetable peeler wasn't sturdy enough to deal with the waxy skin

Friday, September 28, 2012

Triple Chocolate Orange Cookies

That was a pretty big blogging hiatus I just took, again.  Between spending the month in Madison, WI on an away rotation and really not cooking much of anything, I didn't see the point.  Also, I'm in the middle of applying to residency (the three years I"ll spend after this, being a "doctor" but learning how to REALLY be a doctor), which is going swimmingly but was sorta time consuming.  Anywho, today is my last half-day in Madison, and at lunchtime, I'm headed back to Chicago!  You can't believe how much I've missed my kitchen, husband, and puppy (in no particular order :)

This weekend should be a fun one:  I have some great recipes planned (perhaps some will be worthy of sharing :), a trip to an apple orchard after brunch with great friends (even though no one in the Midwest could actually GROW any apples this year secondary to weird weather), and just plain relaxing!  Monday I start my next rotation in the NICU (neonatal intensive care unit), the scariest place on earth.  Not just for parents, but for med students, residents, and doctors in general.  Talk about the smallest margin of error ever!  I'm kind of pumped though...

I can't just ramble on and not at least supply you with a recipe.  I made these forever ago, and I actually crafted the recipe itself.  It seems like a basic cookie recipe, which it is, but chocolate and orange might be my favorite flavor combo, and this really lets that shine.  Plus two kinds of chocolate chips and cocoa powder?  Dreamy :)

Thanks for stopping back to read!  I've missed you!

Triple Chocolate Orange Cookies

1 3/4 cup flour
1/3 cup cocoa powder
1 tsp baking soda
1/2 tsp salt
1 cup butter
3/4 cup white sugar
3/4 cup brown sugar
2 tsp vanilla
Zest from 1 orange
Juice from 1/2 orange
2 eggs
1/2 cup white chocolate chips
1 1/2 cups milk chocolate chips

Preheat oven to 375.  In a large bowl sift together flour, cocoa powder, baking soda, and salt.  In a mixer, cream together butter and sugars.  Add vanilla, orange zest and orange juice.  Beat in eggs 1 at a time.  Slowly add flour mixture to butter mixture.  Quickly beat or fold in chocolate chips.  Spoon onto prepared cookie sheets, and bake for 7-8 minutes, rotating once.  Transfer to cooling racks.  Enjoy!

Friday, August 31, 2012

Peanut Butter Cup Pie

I took a bite out of that far one.  Don't judge me.

So this recipe is delicious.  Peter's favorite candy is a Resees Peanut Butter Cup, and this pie matches the flavor profile pretty well!  The weirdest part is that you melt Cool Whip with chocolate chips for the topping!  I've never had to do that before and it looked like it would be a mess, but it made the smoothest topping.  Who knew?

On Sunday I'm off to Madison!  I'm staying with a (seems to be) nice host family and will have a roommate, a fourth year med student from Colorado.  This feels suspiciously like my freshman year in college all over again; unknown roommate, I have no idea where I'm going, etc.  It will be super weird to be away from Peter and Lady for a month, but I'm excited to "scout" Madison's program (oh yeah, and make them love me too :)

Happy Labor Day Weekend everyone!

Peanut Butter Cup Pie

Prepared graham cracker crust
1 package (8oz) fat free/low fat cream cheese
1/2 cup plus 1 Tbsp creamy peanut butter
1 cup cold milk
1 package sugar free instant vanilla pudding
2 1/2 cups Cool Whip, divided
3/4 cup chocolate chips

Beat cream cheese and 1/2 cup PB in a mixing bowl until smooth.  Add milk and pudding mix, and beat until smooth.  Fold in 1 cup cool whip.  Spoon into crust.

Microwave remaining cool whip and chocolate in a bowl, stir until smooth.  Cool completely.  Then, spoon onto PB and smooth.  Refrigerate until ready to serve.  Before serving, microwave 1 Tbsp peanut butter in a sandwich-sized plastic bag for 10 seconds to soften.  Cut a small corner out of the tip, and drizzle over the pie.

Sunday, August 26, 2012

Thai Turkey Lettuce Cups

These lettuce cups are fantastic.  I know what you're thinking:  how can lettuce leaves be exciting?  It's the filling, which takes a bit of chopping and a few sauces but oh my, they are fantastic.  This is a recipe I'd save for a leisurely day off where you can enjoy the process.  It really doesn't take that long to prepare, but the prep is a bit more than some of my other recipes.  What's even better: this is a healthy dinner option!  Lean turkey breast, a bunch of veggies, and homemade sauces.  Plus, no real starch!  (These are served in lettuce cups as opposed to over a bed of rice).
To serve these bad boys, place washed Boston lettuce leaves on a big plate, then everyone gets a bowl of the filling.  Serve the sauce on the side.  Yum!

Thai Turkey Lettuce Cups
1 lb ground turkey breast
4 green onions, chopped
1 red bell pepper, thinly sliced
1/2 a large red onion, thinly sliced
1 cup shredded carrot
1/4 cup soy sauce
Juice and zest of 2 limes
2 cloves garlic, minced
1 Tbsp grated fresh ginger
2 Tbsp water
1 Tbsp corn starch
Several heads butter lettuce or other small, cup-like lettuce leaves for serving

Peanut Sauce
1/4 cup peanut butter (chunky or smooth)
2 Tbsp water
4 tsp sugar
1 Tbsp soy sauce
1 tsp rice wine vinegar
Juice from 1 lime
1/2 black pepper

Combine ingredients for peanut sauce and set aside.  In a small bowl, combine soy sauce, juice and zest of limes, ginger, garlic, water and corn starch; mix well.  Preheat a large skillet or wok over medium high heat and saute turkey until done.  Add vegetables and saute until crisp-tender.  Stir in soy sauce mixture and stir until thickened.  Serve turkey mixture with lettuce leaves (fill lettuce leaves like a cup) with peanut sauce.

Tuesday, August 21, 2012

How to Save a Life

Another of my articles, this one's about how the lay person (that's you!!) can save a life.  No really, you can.  Enjoy!

It’s 7pm, and you’re enjoying dinner at your favorite restaurant.  Suddenly, you notice an older gentleman at the table next to you has collapsed and doesn’t seem to be breathing.  Now you’re at a baseball field on a very hot summer day watching your kid pitch, when you notice that a player on the other team seems disoriented and uncomfortable.  Or how about you are at a family barbeque and your niece is stung by a bee, and now she can’t breathe.  What are you going to do?
            These are all real-life situations that are bound to come up at one time or another.  Hopefully a medical professional will be with you, but what if you are the only one there to help?  What would you do?  In this edition of “Stethoscopes to the Streets,” let’s talk about some common emergency situations and what every layperson could do to help until medical personnel arrive.  Come on, I know you could save someone’s life!
            Firstly, let me preface by saying the first thing to do in any emergency situation is to call 911.  Right away, before you do anything.  Even doctors who happen upon an emergency in public will call 911 before doing anything, because an ambulance has lots of equipment and people to help, not to mention a direct connection to a hospital!  So lesson 1: call for help, or send someone to call for help.  Secondly, I think it’s very important for everyone to take a course in Basic Life Support, or BLS.  This 4-hour course is available at virtually any town, usually at a college, hospital, or through the American Red Cross, and covers topics like cardiopulmonary resuscitation (CPR), the Heimlich maneuver for choking people, and how to resuscitate an infant.  It also demonstrates the use of a defibrillator, an integral part of resuscitation of someone who is suffering from ventricular fibrillation of the heart.  It’s only four hours of your time, and you’d be able to help employees, family members, friends, and strangers.  Go find a course.
            Now that the formalities are taken care of, let’s talk about a sudden collapse!  This could be due to many things, but in an older individual, a sudden heart arrhythmia or severe myocardial infarct would be the most likely causes.  Again, please take a BLS course because they will spend a few hours on this topic and I’m only going to give it a paragraph, but here’s where to start.  After you call for help (911, or send someone to call), check to see if the person is breathing.  If they are not breathing, give two rescue breaths by pinching their nose shut.  Check for a pulse.  No pulse?  Start compressions by placing one hand on top of the other in the middle of the person’s chest and forcefully pump downwards.  The American Heart Association now says that it’s OK for lay rescuers to administer JUST chest compressions (no rescue breaths) in a pulseless patient.  The idea is to keep up the blood flow to the brain, and every time you stop compressions, the brain is without oxygen.  Otherwise, you can give 30 compressions then 2 breaths.  How fast do you compress?  Sing the song “Stayin’ Alive” by the BeeGees in your head (I’ve actually hummed it aloud in the ER when I was giving compressions; it really works!!)  The pace of that song is about 100 beats per minute, perfect for trying to pump a heart.  Another thing you’d learn if you took a BLS course is that if you can find a defibrillator (an AED, or automated external defibrillator), use it right away.  This is a special device that administers a shock if it senses that the patient is in a “shockable rhythm” (never mind what this means; that’s in the weeds of cardiac pathophysiology).  Basically, turn the device on and put the pads on the patient’s chest like the diagram on the AED shows.  Then it will talk you through the whole thing.  Hopefully, help has arrived by now.
            Do you know how to identify that someone might be having a stroke?  Being able to figure that out is the most important thing for helping a stroke victim. By the way, stroke is the leading cause of disability in this country, and the third leading cause of death, so an idea of what to do could really help someone. A stroke is the result when the blood supply is cut off from a certain part of the brain.  The brain does a lot of things, and each anatomical part of the brain has a different role.  This is why there are so many manifestations of a stroke.  A few things you can look out for are the following: clumsy hands or feet, drooped face (one side), slurred speech, speech makes no sense, sudden loss of vision in one eye, and an unsteady gait.  Again, this is a small sampling of symptoms but it’s a start.  The first thing to do if you’re even suspecting a stroke is to get the person to the hospital NOW.  Time is brain.  Every second that ticks by without blood supply to that certain part of the brain means there is less chance that the person will be able to regain full function.  Until help arrives, keep the person from harm’s way.  Also, if they are able to swallow (they do not have any problems with speech or moving their tongue) and they are conscious, give them 325 mg aspirin (the equivalent of 4 “baby”or 81 mg aspirin tablets).  Although 15% of strokes are caused by a hemorrhage within the brain instead of a blood clot, one of the leading neurologists in Chicago told me on my neurology rotation that if you are alone and waiting for help to come, aspirin is still the best thing you can give to try to help. 
            On hot summer days, heat illness is an urgent medical situation you might happen upon.  Heat illness is a spectrum of overheating disorders, commonly when the elderly or babies are exposed to prolonged heat, or when young, healthy individuals overexert themselves in hot conditions.  Symptoms of heat illness or impending heat stroke (a more serious condition where the body can’t regulate temperature anymore) are profuse sweating or worse yet, someone who stops sweating, increased thirst, but with little to no urination, confusion, dizziness, fainting, muscle cramps, and a fast, weak pulse.  If you see someone with these symptoms, get them to a cool place, preferably an air-conditioned area.  If they are conscious and able to drink, help them take fluids such as Gatorade or other sugary, electrolyte-filled liquids.  Strip off as much clothing as you can, because clothes will trap in heat.  Find some fans and get them blowing on the person.  If you have ice, ice packs, or other cool objects, place them in the armpits, neck and groin areas (this helps cool down the body core faster).  If the patient is unconscious or starts seizing, call 911 right away but try to get them out of the heat as best as you can.
            This one is a bit obscure, but it might happen!  What if you’re at work and a co-worker operating a piece of heavy machinery like a power saw and manages to amputate a finger or hand?  A similar scenario could be an accident with a knife.  Very dramatic, indeed, but your actions could enable the surgeons to successfully reattach the lost body part.  If possible, first get the person to safety (and shut off any machines that may cause more damage), and call 911.  The thing we really need to do is stop the bleeding right away. Apply plenty of pressure or apply a tourniquet (as I mention in the next paragraph).  Ensuring proper hemostasis, or stopping blood flow, often involves two people, one of which might be the injured if they can help.  After we have stopped the bleeding, our next priority is to try to save the severed body part.  This involves keeping both ends of the amputation clean and moist, and we’ll do this with saline and sterile gauze if possible, found in a first aid kit.  I’ll describe the proper method using these items, but clean bottled water and thin towels could do the trick in a pinch.  Gently rinse the two ends with saline.  Loosely bandage the injured end attached to the person with gauze or towels, applying pressure to stop any further bleeding.  Then, soak some sterile gauze in saline and wrap the unattached part (the finger, etc) gently.  Place the gauze-wrapped item in a plastic bag if one is available, then put the plastic bag on a bed of ice.  Do not put the body part directly on ice: this will damage the fragile vessels and nerves that will later be needed during reattachment.  Ta da!  You just saved an appendage, and more importantly, saved a life!
            Speaking of bleeding, do you know how to effectively make it stop?  I think many people have at least some level of understanding about this, but let’s review just to be on the same page.  There are obviously lots of reasons and ways that a person could start bleeding, but one thing to keep in mind is that many people (especially the elderly) are on “blood thinning” medications like coumadin, which could cause them to bleed excessively, disproportionate to the injury they sustained.  Of course, arrange for transportation to the hospital if bleeding is excessive.  Then, find a first aid kit and/or clean towels.  You’ll want to have the patient sit or lie down, then apply constant, firm pressure over the site.  If multiple sites are bleeding, do a little “triaging” and do your best to stop the major bleeds first.  If pressure alone doesn’t fully stop the bleeding, there are a few tricks to try.  First, raise the bleeding part as far above the heart as possible.  The heart is obviously pumping blood, and if the injured area is dependent (or hanging downward with gravity), that pumped blood is just going straight for the injury, and subsequently onto the floor.  If the bleeding is VERY brisk from an arm or leg, you can use a belt, a shoelace, or scarf to tightly tie as close as you can to the trunk.  This means tying the scarf at the armpit or groin.  It’s not safe to use tourniquets like this for very long, but the limb would be OK until you get the victim to the hospital.
            Finally, what would happen if someone around you had a severe reaction to peanuts or a bee sting in your presence?  My mom has pretty severe reactions to bee stings, and I’ve made sure my whole family has had this tutorial.  I’ll review for everyone.  People who have severe allergic reactions can have swelling of their airways that can compromise breathing as well as dilate all of their blood vessels, leading to shock.  If the patient is carrying an EpiPen, or you could find one in short order, use it.  The EpiPen has a dose of epinephrine, a drug/neurotransmitter that will cause the airways to dilate and the blood vessels to constrict, simultaneously helping the patient get air into their lungs as well as keeping their blood pressure up, thus preventing shock.  Simply place the pen on the patient’s exposed thigh and push the plunger (directions are on the container).  The needle will be safely hidden after giving the medication so you won’t injure yourself.  Anytime an EpiPen is used, the patient should go to the emergency room, even if they feel better.  The dose of epinephrine may wear off, or they may have some side effects from the epi itself.  If the reaction is not so severe that they have passed out or are having trouble breathing, they may have a bad rash or localized swelling (especially after stings).  Give the patient a dose of Benadryl (diphenhydramine), which is an antihistamine that will counteract the products released during the allergic reaction.  Sometimes patients are prescribed prednisone, a steroid, to be used in high doses if they come in contact with a substance.  If you have these handy, give the patient the dose described on the bottle. 
            Emergency situations are scary, even for medical students and doctors.  However, a little knowledge and a lot of staying calm can go a long way to helping save a life.  Go get BLS certified, always call for help first, then do everything you can to stabilize until the people with drugs, equipment, and wheels to the hospital arrive.  It’s important to remember to always keep yourself out of danger first (you’re no help if you’re hurt, too!), and remain calm no matter what.  Anyone can help save a life, especially you!