Sunday, September 25, 2016

EMT Critical Thinking: Auto accident with cardiac arrest

At the scene of a vehicle crash, EMS find the driver in cardiac arrest. "Give him a shock" begs his wife. Why would you not apply the AED to this patient.

My answer:
As an EMT coming on scene we don't know how long the patient has been in a cardiac arrest. Using an AED when the heart has too much oxygen or glucose would render the AED useless. It would be more important to render CPR to the patient. Also we don't know if the patient has a medical or trauma patient. An AED should not be used on a trauma patient.

Your answer as an EMT student?

AED functions, advantages, disadvantages, and precautions

If a person has ever called emergency dispatch more than likely they probably have been asked if there is an Automated External Defibrillator available. Not everyone is going to have one because they are quite expensive and a person has to be trained to use one. It's always a suggestion that if the building is a large public building then an AED would be a good investment. 

  • Features of an Automated External Defibrillator are:
  • Fully automated
  • Can be semiautomated
  • Record operators use of device and EKG
  • Has several memory modules

What are the advantages of Automated External Defibrillators?
  • Faster than manual Defibrillators
  • Safer
  • More effective delivery of current
  • More effective monitoring
  • Ease of use
Now AED are not perfect and they do have disadvantages. AED seem not to work well with children. Do not use pads on children who are less than 8 years of age unless pediatric AED pads are available.

EMT what is Ventricular Fibrillation, Ventricular Tachycardia, Asystole, and Pulseless Electrical Activity?

Tachycardia is a rapid heart beat. So Ventricular Tachycardia (VT/V-Tach) is a very fast heart rhythm. This rhythm produces a ventricle mode instead of a sinoatrial mode. Should only be applied to patients that are pulseless.

Ventricular Fibrillation (VF or V-Fib)
Disorganized cardiac that produces no pulse or cardiac output.

Asystole
Absence of any electrical activity in the heart.

Pulseless Electrical Activity (PEA)
Heart generate relatively normal electrical rhythms but fails to perfuse the body due to decreased or absent cardiac activity

Two Emergency Medical Technicians are better than one

An Ambulance unit arrives to a scene were the patient needs resuscitation performed. Are two EMT's better than one when dealing with such a patient or is one just going to get in the way.  IMHO three medics are better than one. There is always a need for a driver while the other two are working on the patient.

A single EMT is only one person and can only do one thing at a time. Sure we all can multitask but this is not the case here. The EMT is either performing CPR or doing other things. This lessens the chance of resuscitation of the patient.

Multiple EMT's can exchange intervention, prepare an AED, insert an airway device, prepare a bag valve mask, obtain patient history from by standards and much more.

Ways of dealing with traumatic EMS incidents

Let's face it. We all deal with traumatic experiences differently. It's gotten so bad that it is killing our brothers and sisters. EMS 1 offers self care tips to help with those incidents that we can't just wrap our minds around. 

Fighting Diabetic Neuropothy with a warm bath

I've been dealing with leg pain for many weeks now. Diabetic Neuropothy? I don't know yet because I haven't had the time to get to the doctor yet. I don't want to take another medication for the Diabetes. I'm doing my best to keep my blood sugar low. I'm also trying different home remedies for Diabetic pain.

A friend told me that a warm bath will help with the pain. She says that the warm water helps decrease the nerve activity in the skin. I don't know how that works but I thought that I would give it a try. 

The warm bath water does help for a while. Once the skin and muscles cool off then the pain tends to return. Be sure that the water is not too hot. A persons Diabetic Neuropothy may be so advance that they can not feel the actual temperature of the water. So test with your arm and make sure the water is not scalding.

I think the next step is a heating pad. That would allow for continuous warmth to the skin. I will find a solution to this Diabetic pain. Hopefully my journey will help someone else.

Dealing with the stress of public safety

People just don't understand the stress factor when they apply for a career in pubic service. If they don't have an activity or support group around then then that career could come crashing down quickly. There are different types of stress and there are different ways of dealing with stress. I have to urge you that drugs, alcohol, gambling and addiction to prescription drugs is not the answer. There are ways to deal with the stress, horror, and ride of adrenaline that happens every day.

Sounding board
Your going to need someone or something to voice your stress, concerns, and the horror that you have experienced. At times family member are unable to handle the stress that you go through in your career. That's why it is important to have an outside group to talk to. 

There are many in public service that offer weekly events so that people of the same career path can open up to each other in a non bias atmosphere. 

There are groups in the city that offer trauma counseling. Check your local hospital or phone book. 

Create a journal. It could be a hard bound journal or something that you have created through a word document. Writing stuff down allows you to think for a while. I personally write things down and then try to find solutions for them. So when the same stress or trauma arises then I know what will work for me.

Exercise
I have found that the only way to get rid of that adrenaline rush is by being active. Running, Judo, Karate Walking, Swimming, Volleyball and many other sports help. Sports that you can be competitive in can also help. Just remember that your there to be competitive and have fun. Don't get stuck on winning all the time or you might have another issue to deal with.

Arts
Photography and painting help me deal with the stress and horrors of the career. My mind is able to focus on something else other than what went on at my last shift. 

The important thing is to find your way of dealing with stress. We are all not created alike. What one person does to deal with the stresses of public service will not work for another person. If you find yourself using alcohol or drugs to deal with your career then please seek help. I personally don't want to lose another brother or sister in public safety.

Saturday, September 24, 2016

Ol south pancake house in Fort Worth Texas

Many have claim Ol South pancake house the best breakfast in Texas. I would say that I and my work partners agree but we are never there for breakfast. Ol South Pancake house in Fort Worth, Texas has been serving customers 24/7 for the past 54 years. When citizens see local Police and Medics then you know the food is good.

At first I wasn't impressed with the menu. There are some decent options but nothing stuck out at first. Over the five years of returning for a good meal I have learned to love the menu options. Of course I have my favorites.

Of course it's not all about the food. The staff at Ol South Pancake House makes everyone feel like family. Whenever there is a problem with the food they have no problem correcting it. They're always there to make sure that you have a fresh cup of coffee.

Now let's get to the food:
New Orleans Benedict - A classic egg benedict with Andouille sausage added to the plate. It's a must try in my book. 

Big Country Omelet - Sausage, ham, bacon, tomato, onion, mushroom and cheddar cheese. My suggestion is to add spinach. It's a great addition to an already great omelet.

Steak and Eggs - Most tender steak I've had at a family restaurant. 

Ol South Pancake House
1509 S University
Fort Worth, TX 76107

"One of the best restaurants near Fort Worth Texas"

Dealing with Diabetic Neurothopy with over the counter pain reliever

Since I gained a bad case of Cellulitus from edema, I also found out that I have Diabetic Neurothopy. At times I have no problems with it. Other times I shooting burning pain in my feet and legs. I really do not like to take prescription drugs so I'm trying to find some home made alternatives. 

Over the counter pain reliever does help a little. I personally like to use Tylenol or some form of acetaminophen. Naproxin tends to inflame the edema. Honestly I would like to find some kind of vitamin or food to take instead. 

Pain relief may have to come with a mixture of heating rub, warm water soaks, pain reliever, rest, and other options.

Large doses of Acetaminophen (Tylenol) or Naproxin can cause liver damage so be sure to check with your medical practitioner.  

Let's talk about friction

One of the most important tools on the job is our feet. Day in and day out they provide support for everything that we have to do. This why it is important to take care of our feet daily. So the question is? Are your shoes causing friction on the job? How does a person stop the pains of daily wear and tear on their feet?

Clean, soft, dry feet
Be sure that feet are clean, callouses are scrubbed down, and feet are dry. Be sure to have powder on the feet and in the shoes. This will keep the feet dry and will stop fungus from growing. Do not use Vaseline on your feet. This will cause blisters on your feet.

Invest in a good pair of shoes
Well made boots and shoes will offer better support to your feet. Some brands that are suggested are Danners, Haix, Rockies, and Tactical Research. Many have suggested that you soak the boot in warm water and then wear them for the rest of the day. 

Invest in a pair of good socks
It seems that black socks have a dye in them that don't allow them to breath so be sure to wear white cotton socks. Be sure that your work socks are sweat wick. Sweat wick socks will draw the moisture away from your feet.

Invest in a larger size
Larger size boots and shoes will allow for thicker socks and better insoles. Many go a step further and make sure that their shoes can be resoled with more cushion. 

Buy multiple pairs
Rotating your boots will cut down on wear and tear. When the three years are up then buy a new pair.

Prepare for the anger

It doesn't matter what part of public service that you work in there will be a day when someone calls you every name in the book. There will be a day where someone wishes violence towards you. There will be a day where you will have to defend yourself against an attack.

What does a person do when the attack is a wave of verbal nastiness? After accumulating ten years of experience in public service the first response or returning anger with anger is not the answer. This will just give the other person fuel for more negativity and anger.

Protect your personal space
At times verbal attacks may turn into physical attacks. It's important to protect your personal space. Your personal space is an arms length away from you. If the other person takes a step towards you then take a step to the side or behind you. Tell a person to back up or get out of your face will only cause more anger from the other person.

Remember that it's not personal
Citizens, clients, and patients most of the time are responding to the situation. When people curse and stomp around they don't know how to verbally explain why they are angry. Or they don't know what the next step is to solve the problem. Even is someone seems to be attacking you verbally, don't take it serious unless they are talking about acts of violence towards you.

Act instead of reacting
Once there was a citizen who was getting into a Police Officers face and calling him every name in the book. The Officer responded with "How do you want me to solve this problem?" Instead of reacting to the citizen the Officer offered to take action. This tactic really does work. The level of anger drops down immensely when citizens realize that you are trying to assist them.

By all means learn how to protect yourself physically. Carry gear that will protect you if it is allowed on the job. The most important thing that a person in public service could do is learn to talk people out of a harmful situation.

There are several books that teach a person how to do this. There is an Institute that teaches Verbal Judo. They are so well known that county and city police take their classes.

Tuesday, September 20, 2016

We are not unbreakable

If there is one lesson I have learned as a First Responder and as someone who is trying to improve her health it's that we are not unbreakable. Truthfully because of our career choices we have to be more diligent about our physical health and mental health. This is especially true if the person is a First Responder and they are dealing with something like Diabetes.

Today was my first meeting with Dr. Michael Castillo. It looks like I have another Michael in my life that is watching over me. Uncle Michael (retire LAPD), Uncle Micheal (retired Veteran), Michael M. (BFF of 14 years) and Arch Angel Michael.

We talked about my weight loss, Diabetes, exercise, edema, and eating plan. It seems that I'm not eating enough calories. I'm also not eating the right type of calories. Most of my calories have come from meat protean and some vegetables. It seems that I'm not feeding my body enough potassium, Vitamin D, and Vitamin B. So I've been demanded to add more vegetables to my meal plates.

I understand why potassium is important from my text book lessons as a medic. I guess I will have to do some research why Vitamin D and B are so important to Diabetics.

Does this doctor think that I'm rich? When a person is a struggling college student they can't afford pricey fruits and vegetables. But if it will keep me from spending more money at the doctors and on medication then I'll do it. The only thing is that I have never been good with meal planning, so this is going to be a challenge.

This might be a fun challenge though. Hopefully it will help the people reading my blog.

Sunday, September 18, 2016

This spokesperson for healthy First Responders is starting over

I've had some great success. In my weight loss journey I have lost 115 pounds. That is nearly 32% of the weight that I need to lose to get to my weight loss goal. Many would probably ask why I'm starting over with such a big success. Well I feel like I've just been lucky and winging it the past year and half.

I feel that it is time to really get serious and track everything that goes on when it comes to food. I also believe that I need to be more active. There are a couple of 5K walks that I want to be healthy enough to train for. If there is an emergency at work. I want to be able to run up those stairs to the clients instead of waddling to the clients. I'm a big girl. I've been larger all my life and I do carry my weight well. I just want more....

I want...
To not have so much pain
To have the energy to volunteer more
To be healthy enough to be part of neighborhood watch and Fort Worth's emergency crew
Fort Worth is the city of health and I want to be a Representative of that
I want to be able to climb in and out of those ambulances
I want to be a guide and inspiration for anyone who is trying to improve their lives.


Saturday, September 17, 2016

Starbucks Coffee Chili Mocha Latte and Frappuccino

When I saw that Starbucks Coffee was putting chili and chocolate together, I became really excited. Though I'm yankee as yankee can be, I love food from around the world. I grew up on drinking Aztec hot chocolates when it was cold outside. There is just something about chili powder that adds great flavor to mocha. My concern is that this Starbucks Coffee product was not going to be able to stand up to memories of childhood. 

Starbucks Coffee Chili Mocha Latte almost got it right. Once you get past the sweetness of the whip cream, the latte holds the right spicy mixture of chocolate and chili powder. Thankfully the chili did not overpower the drink. This is something that I hope that they keep around for the holidays.

Starbucks Coffee Chili Mocha Frappuccino was not so lucky. I think that the spiciness of the chili gets lost in the coldness of the drink. What should be a mixture of warmth and sweetness just tastes like a Starbucks Coffee Mocha Frappuccino. Perhaps if there was a chili or cinnamon oil they could use. 

Why is Starbucks Coffee topping its new spicy and sweet drink with salt. Every new drink has a garnish of some sort on top of the whip cream. The garnish ends up being chili powder with salt. This doesn't go off well at all. I would have been more impressed if the chili powder mixture was a combination of brown sugar and chili powder.

When to call Advance Life Support

When should an EMT contact Advance Cardiac Life Support? Who is considered ACLS? Does your state and city protocol influence when ACLS can be contacted?

Contacting Advance Cardiac Life Support is important. It's the fourth step in a patient surviving a Cardiac Arrest. An EMT on scene should always follow city and state protocol when dealing with any trauma or injury. This includes contacting ACLS.

Who can the ACLS be?
  • Higher level EMS provider
  • Paramedic
  • Hospital
  • Clinic with a Doctor present

Kate's Fall Apple Salad

I think your going to love this recipe. I absolutely love fall fruits and vegetables. O.K. I'll be honest. I love all fruits and vegetables but especially fall and winter vegetables. Apples are not only in season but many varieties are on sale. 

The old saying "An apple a day keeps the doctor away." This salad offers a large amount of Fiber, Potassium, and Vitamin A. Fiber helps with digestion and your heart. Potassium helps with all muscle contraction and cell activity.

What you will need for Kate's Fall Apple Salad recipe:
1/2 cup of frieze lettuce
1/2 cup of shredded carrots
1/2 cup of shredded apple
1 Tbsp of lemon juice
handful of raisins
2 Tbsp of sliced roasted almonds
2 Tbsp of Raspberry vinaigrette
2 Tbsp of Olive Oil

Mix the frieze lettuce, shredded carrots, shredded apple, and lemon juice together. The lemon juice will keep the apple fresh looking. I personally like using granny smith apples because they are tart and smooth grained. I don't like using red apples because they have a very soft grainy texture.

Add the raisins, roasted almonds, vinaigrette and olive oil. Mix the salad well

I hope you enjoy this recipe as much as I do!

EMT Safety precautions around Automatic Electonic Defibullators

So your team has arrived at a scene where an AED is needed. What rules should you follow to keep yourself, your partner, other EMS providers, the patient and by standards safe. What should you look for while doing scene assessment? 

When using an Automated Electronic Defibullator:

  • Do not be in direct contact with the patient when using an AED
  • Call "I'm clear, your cleared, everyone clear."
  • Make sure that everyone is cleared from the patient
  • Make sure that your not in or near water
  • Make sure patient is not diaphoretic (sweating heavily)
  • Be careful of metal. This includes equipment, flooring, catwalks and other surroundings.
  • Watch for nitroglycerin, nicotine, and analgesic patches
Follow these rules as an EMT and you will keep yourself safe.

AED maintenance and certifications

All skills and tools have to be maintained. What's the biggest issue with AED maintenance? How often should an EMT or Paramedic update their skills using an Automated Electronic Defibulator? 

An AED should have a scheduled maintenance plan to insure that the machine is functioning properly. It would be a horrible scene if a AED is needed and the batteries no energy in them. Battery failure is the biggest issue when it comes to AED maintenance. Either the connections become to old or the batteries have not been changed. With all batteries, rust may become an issue if they are not changed often enough.

As for the EMT, skills should be refreshed with this device every 90 days. This will give the EMT the chance to practice and learn new AED products. 

Speaking of refreshing skills. There are some great applications that are in beta or are out on the market that keep track of when EMT and Paramedic skills have to be tested again. In the near future, I plan to provide links to local and worldwide test sites.

AED and Pacemakers! Are they safe together?

An EMT and partner arrive on the scene. A patient is in cardiac arrest, CPR has been performed, and defibullation is needed. Can an AED be used on a patient who has an automatic implanted cardio defibrillator? Where should the pads go on a patient who has a cardiac pacemaker?

An AED can be used with a patient that has a cardiac pacemaker. Be sure to not place the pads over the pacemaker. Why? That would be like giving a car a jump. While it's needed to start the car, EMT's should not apply 
electricity to the pacemaker.

If the patient is unresponsive look for scars on the chest or upper abdomen to assess if the patient has a pacemaker. Also look for medical identification tags like the one above. Treatment for an implanted cardio defibrillator is the same as any other cardiac patient. 

If the patient is responsive then let the ICD operate, do not use an AED, stabilize the patient and prepare the patient for transport.

Automated Chest Compression and more!

Emergency Medical Technicians and Paramedics have some many tools to work with on scene. Every one has it's own advantage and disadvantage. Automated Chest Compressions, Mechanical Piston Device, Long Distributing Band CPR, and Impedance Threshold Device. Which do you use and what do you like the best as an EMT?

Automated Chest Compressions
  • Able to maintain good depth
  • Able to maintain rate
  • Able to maintain good sequence
  • Efficiency of this device not yet proven
I believe that I have an older copy of the Brady. Several institutions are using ACC's. This includes my favorite medics on Nightwatch. 

Mechanical Piston Devices
  • Can be attached to a back brace
  • Configured to a specific rate and compression
  • Useless if runs out of compressed gas
  • Large, heavy, and cumbersome
Long Distributing Band CPR
  • Band that can attach to a back board
  • Lighter than the Mechanical Piston Device
  • Improved results compared to CPR
Impedance Threshold Device
Prevents air from rushing in during ventilation relaxation mode

Monday, September 12, 2016

Support our Dallas sheep dogs with books

The truth is that Police Officers love to eat. With the threats going on these days, sadly some Officers don't get to taste those treats that come into the station. Don't fret there are other ways to support our cities protectors. 

Santa Cops is currently having a book drive to benefit children in Dallas Texas and the surrounding city. Many children do not have the privilage to visit libraries often. We 
all know that reading at an early age is important.

Katie is asking for gently used books to be donated from today till September 16th, 2016. You can find out more about Kates Books and Santa Cops by following the links. 

Eating at Kroger Grocery salad bars

My partner and I usually love going to the local Kroger Grocery store for a mid shift meal. I love Kroger's because they usually have a sandwich deli, sushi bar, coffee bar, bakery, salad bar, and larger mixed deli. There is so much to choose from that a person could pick something new for lunch every day. I personally like to dive into the fresh salad bar.

Kroger's Salad bar usually consists of three different kinds of lettuce, several choices in salad toppings, and salad dressings. Sometimes the store like to include pre-made pasta salads, chicken salads, shredded chicken, turkey salads, and other pre-made salads. The one thing I have noticed is that Kroger Grocery never includes a sign that states what their pre-made salads are.

Not only can this turn away customers but it can be dangerous to someone who has allergies to certain foods. In truth in my opinion the grocery store chain puts customers who have allergies in danger just by having open containers of peanuts and other nuts. My frustration is putting a mixed salad into my box and not enjoying it.

On that day there were three different salads that had mayonnaise in them. I added it to my salad thinking that it was some kind of deviled ham salad. When I bit into the pre-made salad it was horrible. The only flavor that my taste buds tasted was salt. I couldn't tell if the meat that they used was ham or some kind of salmon. In truth I wouldn't feed the mixture to a stray starving cat.

All in all I haven't given up 100% on Kroger grocery salad bar. I will be skipping the pre-made salads though and sticking to the fresh vegetables.

Saturday, September 10, 2016

Patient and EMT nonverbal communication

A patient may speak another language. Or they may not speak at all. There are still ways an EMT can communicate with a patient and get there job done. There are five tips that an EMT can perform or look for within a patient.


  •  Posture
  • Distance
  • Gestures
  • Eye Contact
  • Haptics 
Open arms, hands, relaxed shoulders convey a message of concern, confidence, safety, and care.

Do your best to not enter patients intimate zone without asking the patient. Observe nonverbal cues with each culture. 

Smiling can actually open up communication with a patient but some cultures process smiling as a bashful gesture. Be sure to at least make and keep eye contact when communicating with a patient.

Haptics are a study of touch. You will be surprise how many patients will accept a pat on the shoulder or someone holding their hand. I once had a patient wrap themselves around my calf because they felt comfortable. 

As always be careful of age, gender and culture of the patient

Thursday, September 8, 2016

EMT open ended questions vs closed ended questions

An EMT is at a scene and has a lot of information to collect. Many questions can be straight close ended questions like name, age, and medical history. There are open ended questions where patients will have to answer in their own words. 

The difficulty comes when an EMT asks an open ended question and the patient is unable to answer it. At times if may become difficult to not turn one question into a closed question. 

Examples of open ended questions:
Explain the pain to me?
Where is the pain located?
What were you doing before you passed out?

Examples of closed questions:
Have you taken any medications in the past 12 hours?
Do you have history of asthma?
Do you have a history of heart attack?

Weight loss journey through pictures

They say that they see the weight loss. It has been a year long journey and I have a way to go. My life and career depend on my weight loss though. I will not quit! So this is where I will keep a photo journal of my weight loss.

I was at my largest at 550 pounds. There had to be some muscle in there though. I was still able to walk a mile. It was a slow mile but I was still active.
 
113 lbs lighter and on the road to a great career
 



Run for our fallen Fort Worth bothers and sisters!

I can't fathom how many steps our Fort Worth Fire Fighters and Police Officers have taken to protect it's city. A 5K and 1 mile run is a single step compared to what these men and women do daily for the city of Fort Worth.

That's why it's important to come out and support the Annual Fort Worth Fire Fighters and Police Officers 5K and 1 mile run/walk on Saturday October 15th, 2016. It starts at 8:30 a.m. and ends when the last person crosses the finish line. Which will probably be me *wink*

Proceeds of the run/walk will go towards the upkeep of the Firefighter and Police Memorial near Trinity lake in Fort Worth, Texas. Each day, the Police and Firefighters of our community exemplify personal courage and commitment striving always to ensure a safe environment for our city and its' citizens.

The Fort Worth Police and Firefighters Memorial was built to pay tribute to the lives of peace officers and firefighters who have fallen in the line of duty. The monument is in memory, and an expression of appreciation for our lost heroes who gave the ultimate sacrifice for the citizens of Fort Worth.

I hope that you'll grab your running/walking shoes and the entry fee in support! Follow the link to find out more information about The Fort Worth Fire Fighters and Polices Officers 5K and 1 mile run/walk.

Wednesday, September 7, 2016

Sweet EMT B Chicken Tex Mex Salad

For being a yankie, I love Tex Mex food. Though I still think that ribs should have BBQ sauce on them. I thought I would share with you my favorite Chicken Tex Mex Salad. This is great to eat on shift and carries well if your working a truck for your shift. Your more than welcome to add your own favorite things but the basis are:

Two grilled chicken breast
1/2 an avocado
1/4 cup of black beans
2 cups of lettuce (remember to stay dark green. Iceberg is going to do nothing for your health.
Couple of Tablespoons of mango salad
1 diced radish
2 Tablespoons of your favorite dressing

I personally like to use vinaigrettes that have a fruit flavor added to them. Any vinaigrette that adds garlic tends to make the salad heavy tasting. It is my goal to keep the ingredients fresh and earthy tasting. 

Thursday, September 1, 2016

We are all bueatiful

It doesn't matter what color we are and what size we are. We as human beings are all beautiful. Be honest I know that your thinking that the title has nothing to do with health and fitness. In truth, I'm sure many of you are wondering why a black South Caroline Trooper embraced a white Supremacist. 

How does this have anything to do with weight loss, health, and fitness. One of the things that I'm learning through my EMS education is that the quality of your psych is just as important as the health of your body. There is no place in the world for hate. There is especially no place in the world for self hate.

I have a friend that blushes each time I give him a compliment. Sometimes I wonder if people have been filling his head with negativity. He has so much going for him and he doesn't even know it. He's got a great personality. He's supportive. He has a great smile. He has these guns (biceps) to die for.

So my challenge to you today and every day is to be kind to yourself. Point out the beautiful things about yourself till it kills you. I want you to start believing the things that you say. I'll be the one to start

  • Compassionate
  • Caring
  • Drive
  • Amazing burgundy hair color
  • Hold my body up with pride even if I'm 200 pounds over weight.

Jack N Box Portobello Mushroom Burger

Not every day is perfect when it comes to dieting. Some days we have to have splurge days. I'm always looking for something to splurge on. Well no my weight loss program is pretty much by the book but there are days when I'm looking for something different to eat. Sometimes it does turn into a splurge day.

Today I thought I would try the new Jack n Box Portobello Mushroom Burger. It's a burger. good to go. It has Swiss cheese. even better. It has mushrooms. jack pot! At least that's what I thought before I bit into the new Jack n Box burger. It seems as if I was looking at Fool's Gold.

I don't know where the chef went to school. There are no Portobello mushrooms on this burger. What you will find on the burger are sautéed white button mushrooms. For a burger that is under $5 the company would not be able to afford to put the larger variety of mushroom on the burger.

The presentation was horrible. I don't expect anything to look like it's from the Jack n Box advertising. This was ridiculous. It was as if the sauce, butter, and Swiss cheese had already coagulated. It did not look appetizing at all. The bun looked like it had been glossed over with wax.

I guess I would be Captain obvious in reporting that I would not be eating a Jack n The Box Portobello Mushroom Burger as a future Weight Loss Splurge. Now Curly Fries are a whole different topic.

Textbook communication process with a patient

Emergency Medical Technicians and Paramedics have been taught to think out of the box. Sometimes textbook rules just don't work when they are at a scene. There are several tools that can be used on scene to communicate with patients.

A. Make a good first impression
B. Introduce yourself and ask for the patients name
C. Use Mr./Mrs. for elderly patients
D. Introduce the rest of your team
E. If client says "No" try using an open ended question to persuade them to see medical care.
F. Speak in a clear, calm and slow tone
G. Use a professional tone of voice
H. Respect patients privacy
I. Limit interruptions why caring for patients
J. Be aware of body language
K. Try to control the physical environment
L. Be Courteous
M. Actively listen
N. Be honest

There are times when I've seen medics not introduce themselves personally but they will let the patient know that they are EMT's, Fire, or Paramedics. Sadly I have also seen medics become confrontational with patients. When a person comes into this career they have to understand that they will have calls at all hours. Yes at times, a medical unit will be called out at 3 a.m. in the morning for a simple cold. Just remember to keep it professional.

Three ways to communicate with patients

There are several ways of communicating with a patient when an first responder is on scene. The follow three are mostly not ways of communicating but they are things that will help make interaction with a patient easier. The three ways are reflection, empathy, and confrontation.

Reflection
Redierect patients feelings back to him/her. Reflection promotes empathy, respect and understanding. For example in the past I had to deal with a client/patient that was dealing with a lot of fear. Fear was gripping her so much that she couldn't catch her breath. I had to let her know that I empathize with her. I had to let my hard exterior down and share that I too would be scare. Then I was able to get her to take some deep breaths with me until medical transport got there. 

Sure it looked silly. Sure I let my soft side show among a building full of people that live by the street. It helped her till we could get her on oxygen.

Empathy
This allows an EMT to understand how something has affect the patient. An important characteristic to have. Recognize someone else state of mind and feelings.

Confrontation
Sometimes EMT's have to confront a patients feelings, attitude, beliefs and behaviors. This is done with the desire to help the patient. Though you may have to get confrontational with a patient it should always be done with sincerity. 

Some times the times to be confrontational with a patient is when you know they need to go to the hospital but they are refusing. We can't force them to go to the hospital but we can try to persuade them. I had a patient who's blood glucose level was 350. She needed to be admitted to the hospital. She wouldn't go. Sometimes we have to remind them that the ultimate result is death and remind them what they have to live for.

My Weight Loss Goals

Weight loss goals are important. It's important to have large goals. The way of achieving those large goals is by having smaller goals. Those smaller goals then should have smaller goals to achieve them. There are things that a person can do every day or even every few hours that will move them towards their goals.

What are my weight loss goals?

80% body 20% body fat
Size 14 cargo pants
Help others have a better life
Career in public safety
Ability to save a life
Scuba Diving around the world
Snow Boarding
Body boarding
Black Belt in Judo
Black Belt in Karate
Kayaking the rivers
Parasailing
Sail Boarding

Dance Classes
Roller Coasters around the world

It's all about weight training and modification

Have you ever been really set on getting a work out done. Then things don't seem to go as planned. That's exactly what happened today at Planet Fitness. I was ready to rock a lower body work out. The only problem is that I was not able to fit my legs in some of the machines.

At first the even red headed dragon tried to raise her head. You know which dragon I'm talking about right. I could have felt ashamed. I could have walked right out of the gym. I could have never returned because I was too embarrassed. 

Not this future Medic and not this Fort Worth citizen! "I give up!" is not in my vocabulary. "Modifications" is a word that I will be using a lot during this health and weight loss journey. My life depends on the goal of better health. What I do for a living depends on stronger legs, core, and upper body strength. 

I'm a very large woman that can't fit into some of the leg machines. That doesn't mean that I can't make modifications to my work out. I'm sure that I can still get the results that I'm looking for. I just have to study what machine works out which muscles and then find exercises that do the same thing.

The major exercises that I want to focus on are:
Climbing stairs to strengthen the knees
Squats 
Lunges
Ballet first position
Ballet second position
Calf raises

There is a form that EMT's and Medics use to lift people on a gurney. It's called the power lift. In truth, a person is using almost every muscle in their body. I'm going to have to be prepared to power lift a 100, 200, or even 300 pound person on the job.

What I'm trying to say is to erase "I give up" from your vocabulary. Replace it with "Try again with modifications". Try again when you think your up for the challenge. If your not where you want to be again, then proceed with more modifications. Just don't quit Fort Worth, Texas!

Shy around a Dallas Fireman

In my weight loss journey I wasn't even thinking about dating. Then for it to be a Fort Worth Fireman. I have to admit that I'm surprise and I'm not surprise. I'm surprise that someone could be attracted to me at this size. I'm very critical of myself and I tend to expect other people to be critical of me too.

I'm not surprised that it's a Fireman because of the people that I work around. Most of the men that I interact with tend to be either Firemen, Security Guards, Correctional Officers, Sheriff Officers, Paramedics, Police Officers, Constables, Parole Officers, and Veterans.

One day we were having a conversation via text and I called myself some really mean names. We haven't been intimate. So I wanted to give him a warning. I think I called myself "Fat, Obese, Ugly" and the response I got. I could tell that he was one upset Latino. 

"Don't say that ever again. Self worth begins from within"

I would never call someone else my size these names. I try to find the beauty inside of everyone. Why is it so hard to see my beauty. Why do I struggle so much with my own self worth. I'm a rock star at school. I'm a rock star on the job. Yet when it comes to my feelings about my body. Well......

weight loss lunch and dinner idea

To help those who are having problems with making meal decisions. I thought I would post what I have been eating on my weight loss journey. I really try to keep it simple. I'm also trying to head more towards the direction of a Paleo diet. Process food is just not healthy for anyone. 

cereal
whole milk

1/2 chicken breast diced
2 Tbsp mayonnaise
1 Tbsp rough mustard
2 slices of whole grain bread
apple slices
1 ounce of swiss cheese

1/2 grilled chicken breast
2 cups of spinach
2 Tbsp of unsalted butter
1/2 bake potato
2 Tbsp of sour cream

Have confidence when dating

If there is anything that I learn on my weight loss path is that you have to have confidence. It doesn't matter how much you weigh when it comes to dating. You have to have confidence. You have to know how you wanted to be treated. You have to know what you really want in a relationship.

I have ruined a relationship with a Fort Worth Police Officer and a Dallas Firefighter due to lack of confidence. I brought up the negative stuff in my life. I didn't point out all the positive things about my life. Sometimes I don't know why I try to date Police Officers, Firemen, and Paramedics. I feel economically and physically inferior to them. 

Personality wise, I'm a Rock Star next to them. I can take them for a ride for their life when it comes to communication.

Sometimes I just wish my body size matched my adventurous personality.

More Dinner Ideas

It's another day of my weight loss journey. I have a feeling that I am falling into a eating trap of boredom. It just seems that I'm eating pretty much the same thing every night. I think that this stems from watching television shows onFood Network. I've got this idea in my head that every meal has to be fantastic with all of these sauces. The problem is that all of these sauces are the things that got me into trouble.

So what did I have for dinner today?
2 chicken, kale, and Romano cheese sausages
1 cup of mixed green vegetables
1 bake potato with sour cream and butter

Lunch
5 Whole grain crackers
2 ounces of marinated Octopi
Diced green onion
20 baby carrots
2 Tbsp sour cream with Mrs. Dash seasoning

Breakfast:
2 glasses of milk
1 apple