So I haven’t written in… well, a year.

Between figuring out my new life at school and keeping up with the amazing opportunities that being a medical student affords, I haven’t had much time to reflect and write about the events of my life. Part of me wishes I could go back and chronicle the past year of my life as a medical student, but I just can’t bring myself to sacrifice the time I know that would require. Suffice it to say that it has been fascinating, exciting, exhausting, and repeatedly humbling. I’ve given more than I thought I had in me and been shown that sometimes even that is not enough. I’ve touched the lives of people around me with simple gestures. I can only hope that the people I connect with get as much out of it as I do. You spend years of your life sacrificing and working to get into medical school, but nothing can possibly prepare you for actual experience. If I had to sum up my first year in a bit of advice it would be, “Brace for impact.” Be ready to accept the challenges. Work harder than you’ve ever worked in your life. Seize every opportunity, whether you think you have time or energy for it. There are so many things that are available only to medical students, don’t get so caught up that you miss out on these opportunities. But don’t lose your balance. I discovered it was important to keep a bit of myself back, but not as much as you might think. It’s much more fun to put yourself out there.
  Things I’ve done this year: sutured more than 15 people (including a man’s face), volunteered at the Denver Rescue Mission, administered care in Stout Street homeless clinic, watched chest tubes placed, started a dozen IVs, scored lower on a test than I did in 5 years of college (and survived it), figured out that my rotator cuff is partially torn without ever setting foot into a doctors office, won free Avalanche tickets from Dr. French, given out free over-the-counter medications and supplements through the Broadway Assistance Center, helped cast/splint a handful of people, organized events, ice skated in downtown Denver, helped incoming and prospective students, celebrated with my classmates, learned and taught surgical knot tying skills, been elected to the UCSOM Surgical Society board, still managed to get some skiing and climbing in, practiced EKGs in an ambulance, pulled over 70 sutures out of one woman’s feet, drank more wine than I can mention, learned that medical politics are even more frustrating that I thought, watched a heart catheterization, met a class full of people that will be part of my life forever. I also went to Hawaii for winter break, went to NYC for spring break, moved to the beautiful City Park area of Denver, and was part of a very special friend’s wedding.
 
To be completely honest with myself, I don’t think I was really going to make it through this year until it actually happened. One quarter of med school is over. I find that exciting and baffling at the same time. The one thing I definitely got out of it is that this is really going to happen. Now I just have to make it amazing!
 

Surgery and life after

So this past year has been one challenge after another. Fortunately, I've pretty much kicked butt as much as I had mine kicked. I helped my family when they needed it. I successfully wrote applications and have been accepted to medical school. I turned down Penn State in order to go to University of Colorado. I moved up to Aurora and I'm finally starting to settle in here. My foot has healed enough to start doing (mostly) proper CrossFit again. Now I need to find a new CrossFit home. Leaving Pikes Peak CrossFit was definitely difficult for me, but the beauty of it is that there are good communities at most boxes. That's something I will definitely need to get me through school. I'm also finally starting to get my foodee back on. I miss eating well and how it makes me feel. That's all starting to change!

One thing I've decided: that as good as Paleo is for my rheumatoid arthritis, I'm still going to allow myself an occasional beer. Not often, but once in a while a good beer just puts a smile on my face.

The next week holds some serious excitement for me! Sunday, I will be riding the Urban Assault Race in Denver. Bikes + obstacles + beer. Next week I fly to LA for the CrossFit games. There are few things as motivating as watching elite athletes throw down.

Mashup Meal

Tomorrow I fly to Hershey, Pennsylvania for my PSU medical school interview. In the interest of not having a bunch of food spoiling in my fridge and not wanting to buy anything new, I decided to make all my meals using up the miscellaneous bits of what I still had fresh. Lunch today consisted of a mostly pan cooked meal. I cooked the fresh mushrooms, onions, and zucchini in a little evoo, a little water, garlic, and Mccormick's Spicy Steak seasoning. The chicken was left over from my crock pot cooking. I added the spinach and chicken to the pan once the veggies were mostly cooked. Easy peasy. Not fancy, not exciting, but tasty and a great way to use up fresh foods when cleaning out your fridge.

And yes, that is my Curious George reads plate. :)

Back to life

The past few months have been less than kind and unfortunately have taken their toll. I've allowed myself to become so overwhelmed by everything that I was drowning in my own pile of hooey. My diet, of course, is the first thing to go to crap. As in, piles of way too many sweets. In the past few weeks, I've started clawing my way back to reality. A surprise visit from The Jen helped dramatically. She was exactly the kick in the pants that I needed. We skied, hung out, and played like kids. It took a couple of days to recover from the weekend, but it set me on the road toward getting my stuff together. Now, with a little luck and a bit of work, I will have my creative juices flowing again! I'm looking forward to a new Paleo challenge. This time around I've started simple, with basic meat & veggie dishes. It's an easy way to get back into proper Paleo eating without too much thought. Dinner tonight included a spinach soup with egg. Delish. Yes, it's definitely time to start making my food interesting again.

Reinventing an Old Favorite

Chicken & mushrooms in a cream sauce over mashers.

The paleo version:

Chop cauliflower into small pieces and cook in a pan. Once cooked, mash. Season with garlic powder, onion powder, and ground pepper.

Pan cook the chicken & mushrooms in a little evoo. Season with garlic powder, onion powder, a tiny bit of Italian seasonings, and fresh ground black & white pepper. Once the chicken is cooked, add a little bit of coconut milk and allow it to thicken a bit on a very low heat.

Set chicken next to a scoop of cauliflower on a plate and pour mushrooms and sauce over the top of both.

This one was so good, I've made it twice this week.

Blueberry soup?

While experimenting with paleo friendly foods to eat while sick, I discovered something fantastic. By doing nothing more than heating some frozen blueberries in the microwave and then smooshing them up a bit with my spoon, I created a sort of blueberry stew. I think if I put the mixture into a food processor or mashed the berries up more, the consistency would closely resemble tomato soup. Another option would be to heat them on the stove in a sauce pan. I think this would also create a smoother soup, or allow you to smoosh up the berries more. As it was, the process was quick and easy and the results were delicious. I highly recommend this tasty treat for a cold night.

The idea for this came from my mother and my Swedish upbringing. Yes, blåbärs soppa is something I grew up on. I haven't had any in years. This is an extremely paleo friendly version. On day, I'll have to get my hands on a box of the pre-made stuff and see if it is also paleo friendly. Nom. Nom.

Paleo & Gastroenteritis

Wednesday evening I came down with a nasty case of the stomach flu. I guess it's just one of those little "benefits" of working with people who drive themselves too hard. If you're sick, don't come in to work and spread it around to your coworkers, please! At any rate, I was up most of night with it. Without going into too many details, lets just say I spent way too much time in the bathroom. By Thursday morning was so weak and drained that I could barely moved. After having found someone to cover my shift in the ER, I crawled back to bed and began thinking about how I was going to fuel my body with the basic necessities while I couldn't eat. I'd been drinking as much water as my stomach could tolerate, because I knew dehydration is a major concern during this kind of stomach illness. But only drinking water won't cut it for very long. Losing all your electrolytes without replenishing them can lead to complications from hyponatremia (too low sodium) and hypokalemia (too low potassium). The commonly recommended diet for gastroenteritis is the BRAT diet: bananas, rice, apples, and toast. Well, obviously this presents a problem for a Paleo eater since half that diet is not on the menu. This was my solution:

I'm a firm believer in the value of western medicine. Bismuth Subsalicylate (the pink stuff) helps a bit. Any over the counter anti-diarrhea/nausea mediation is worth keeping around, but make sure you read the ingredients. Some flavors of Tums even have gluten in them.

For the first 24 hours, I could not really tolerate any form of solid food. I drank plenty of water, some black tea with locally produced honey & salt (get those electrolytes and a few calories), and a cup of watered down chicken broth (recipe from The Primal Cookbook) with salt added. I also managed to eat 2/3 a banana, one slice at a time, and 1/2 a snack cup of applesauce. A good trick for the banana is to slice it up and put it in the freezer. It keeps the individual slices from going brown. Plus, the coolness is soothing. Don't expect to put any of this stuff down in large portions, everything I ate or drank was spread throughout the day. The broth took me 2.5 hours to drink and even the first cup of tea took a couple of hours.

Hours 24-36, I slept... a lot. When I woke up Friday morning I ate the rest of the banana and the apple sauce in one go. Not completely better, but greatly improved!

Hours 36-48. I successfully ate one soft boiled egg and half a baked apple. I'm actually starting to feel hungry, but don't want to eat more than my poor shrunken tummy can handle. 41 hours into it, I decided to test my limits a little further. I had my chicken broth with chopped up cooked carrots & cauliflower and a shredded slice of deli turkey. Almost real soup! I ate the other half of my baked apple and heated some frozen blueberries into a soup.

Here's the short version:
1. Use over the counter upset stomach medication.
2. Liquid diet: Black tea with salt and honey. Weak broth (only add salt if your broth is homemade and doesn't have any to begin with).
3. Add some soft solids: Skip the rice & toast. They have minimal nutrients anyway. Bananas & apple sauce.
4. Advance diet as tolerated. Cooked veggies in the broth. Baked apple. Soft boiled egg.


Despite these efforts, this has been a horrible case of the stomach flu. I had no intentions of losing 5 pounds in 36 hours, but I simply could not put enough food into my body. Obviously, I don't recommend this form of weight loss. Hopefully, no one ever needs this post, but in case you do get sick, this method seemed to work fairly well for me.