Reflections from the Bedside

Update on daughter Julie: lab reports are good, appliances are working, except for her shunt which diverts CSF (cerebrospinal fluid) for her hydrocephalous.

Chair side observations IMHO:

1) Nurses are overworked and stressed;
2) Hospital food is generally tasty;
3) The general public does not understand the importance of hand washing;
4) Hierarchical symbolism in the hospital has changed over the past few years -- every direct patient care provider slings a stethoscope around their neck and wears scrubs. Therefore, doctors distinguish themselves as "physicians" by wearing a sport coats over their scrubs, and leave steths to the assistants
5) RN's are the only nurses employed here at Carolinas Medical Center; LPN's are a thing of the past;
6) 12 hr. shifts are the norm for RNs; charting is half their workload;
7) Lab results still get misplaced/lost. (Julie's most important CSF labs are still "missing" after five days, and the risk of tapping her shunt for more lab work is risky.)
8) Drama is constant; one does not get too excited over minor crises;
9) Common courtesy is often overlooked by patients; a sense of entitlement often pervades the patient's outlook;
10) Ensure that the patient visitor can take care of themselves in all ways before "visiting" the patient, or the visitor will be a burden to all concerned;
11) An hallucinating patient can almost make one believe an outlandish story, simply because they are so convinced of their own reality;
11) In general, people surely do complain about minor annoyances;
12) Pain control is better managed.

Update on daughter Julie: lab reports are good, appliances are working, except for her shunt which diverts CSF (cerebrospinal fluid) for her hydrocephalous. She is to have more x-rays this hour to determine the amount of CSF fluid around her lungs.

Julie is stapled all the way from her clavicle to her bottom. She is quite coherent and the hallucinations have abated. She is not in pain.

Hurricanes, the Republican National Convention, and life goes on.

Urinary Diversion Surgery @ Carolinas Medical Center

Previously, in this NPR Story Corps post, I wrote about our daughter, Juliet, who was born with the birth defect of spina bifida and hydrocephalus. I am writing today about her ongoing surgical experience at the Carolinas Medical Center-University.

Julie underwent a day long surgery Tuesday at the Carolinas Medical Center in Charlotte, North Carolina. Generalized information about this type surgery can be found at Surgery Facts. Another website with more stats can be accessed here at More Information. The procedure was a major ordeal, as the websites explain. I talked with the nurse a few hours ago; she was in stable condition.

Further complicating matters was the additional removal of previously undetected extended, large ovarian masses which pushed the surgery to over ten hours in length. She currently has a nasogastric feeding tube and a pic line for intervenous medication delivery.

Julie is being cared for through the McKay Urology Group, "dedicated to the highest standards of clinical care, research and education with the latest urologic technology". Its programs are nationally recognized for quality and were named as one of the Top 50 Urology Programs in the nation by U.S.News & World Report 2008 edition of America's Best Hospitals.

I am told that Julie's surgeon, Michael Kennelly, M.D., a principal in the McKay Group, is known nationally in this urological practice. She was fortunate to get a referral to this physician and practice.

CarolinasHealthcare:
Dr. Kennelly was one of the first physicians in North Carolina to subspecialize in female urology and neurourology; and, he is currently one of only three doctors in the state who concentrates in these highly specialized fields.

We trust that Julie is receiving state of the art medical care from both her physicians and this teaching hospital affiliated with the University of North Carolina. I will be going to visit Julie in the next few days. This blog will be intermittently posted while I am away from Colorado and staying in a hotel nearby the medical center in Charlotte.

More about the birth defect she was born with can be accessed at The Spina_Bifida_Association or at Spina Bifida Facts.

Here is a picture of Julie and her dog Muggsy taken last January:


Prayers for Julie and Jack, her husband, are appreciated.

Colonial Foods and Carrot Puffs as Appetizer

Our daughter gave my husband a cookbook several years ago with recipes dating back to the 1700's. It was fascinating to read about how much work was involved in simply keeping calories available for life sustenance. Reading over the recipes, it was obvious that cooking was not only labor intensive, but also a challenge when refrigeration and preservation of foods was practically non-existent. That book is not in the kitchen, garage, or in any box of stored books, so it must have gone by the wayside. Maybe someone else is using it now and enjoying it as much as we did.

Another handy cookbook entitled The Williamsburg Cookbook (1975 published by The Colonial Williamsburg Foundation and available through Amazon) says:

Visitors return again and again for the delicious dishes served at Colonial Williamsburg’s famed taverns and restaurants—Chowning’s Tavern Brunswick Stew, Christiana Campbell’s Spoon Bread, Shields Tavern Syllabubs. In this best-selling cookbook, 193 traditional and contemporary recipes have been compiled and adapted for the home kitchen. Commentary discusses the cooking and eating habits of our colonial ancestors and describes meals served to VIP visitors to Virginia’s restored colonial capital.

All sorts of recipes can be found in this cookbook stemming from colonial times. I picked up this book on a visit in the autumn season years ago in this historic Virginia town after having dinner at the Shield's Tavern in Williamsburg.

A beautiful slide show of Colonial Williamsburg, VA can be accessed here: Historical Slide show of Williamsburg in the Fall. That will get you into the mood for fall cooking, for sure.

One recipe from this updated treasury of recipes is for The Shield's Tavern Sampler Carrot Puffs (4-6 servings):

1 lb. carrots, peeled and sliced
1 egg and 2 egg yolks
1 cup bread crumbs
1 tsp. nutmeg, freshly grated
1 tsp orange flower water
3 Tbls. sugar
1/4 cup dry sherry
1/4 cup heavy cream

Cook the carrots until very soft. Drain well. Mash to a pulp. Combine and beat the egg and egg yolks. Mix the carrots, eggs and remaining ingredients together thoroughly.

Gently drop by heaping tablespoons into deep, hot shortening and fry until brown. Place on paper towels to drain. Serve immediately.

We have made carrot puffs from these instructions as an appetizer. These tidbits were sweet an tasty. I will make them again soon, but will try frying them in just a skiff of olive oil as a nod to better nutrition.

Cookbooks are always bestsellers. And historical cookbooks are a fun read, as well.

You might want to publish your own favorite recipes. Who knows, in 300 years, they might be republished. Here is one source that will help you put your cookbook together as either a fundraiser or just for posterity: Publish Your Own Cookbook.