Sunday, January 25, 2015

NSVD: normal spontaneous vaginal delivery: that time when I almost passed out.

Yesterday was my post-call day. What that means is that I was "on call" or in-hospital for 24 hours prior, and I got to go home after watching 4 babies delivered in a foggy haze with judgement similar to after having 2-3 drinks, and pass on out.

I'm currently on my OB/GYN rotation with 24 hour calls. I grumbled about this initially, but the underlying reason makes sense: it's easy to think "YAY BABIES! WOMEN'S HEALTH! SURGERY! MEDICINE! ALL IN ONE PACKAGE!" but not think about what life could be like if you're up for 24+ hours straight, looking down the barrel of a vagina at some unholy hour with a mom that's been in labor for a ridiculous amount of time, who is now too tired to push.

That's why OB/GYNs are awesome. Really, who else can get a living parasite (beautiful, wonderful gift of a parasite) out of your body in <1 minute. OB/GYNs, that's who.

I've been through half of this rotation so far, and have done my GYN portion. I saw some serious surgeries: myomectomies with 5L of blood loss, periurethral abscess drainage with a 200 mL fountain of frank pus, D and C, ruptured ectopic pregnancy, etc. I have counselled women about birth control methods (IUDs galore!), talked about menses, done pap smears, and asked some seriously personal questions. It has been awesome. But nothing has been as nuts as seeing a person pop out of another person. 

I landed on labor and deliver at noon, after going through post-partum rounds in the morning with an awesome nurse midwife who, after asking if I had been on L&D before (labor and deliver...I hadn't) told me "things move fast...maybe you should eat something before you go to the floor." Me being, well...me said no, I'll just go the floor -- after all, I've been on surgery, that's tough and I still got to eat.

One key point I missed there, surgeries, though not always, are frequently scheduled. Babies are not. I introduced myself to the team, and put my things away, and sat down to nutritious and delicious lunch of tofurkey and cheese when the intern pops his head into the break room and says, "three babies, NOW" and leaves the room. I freeze, tofurkey goodness having just touched my tongue, and staring at the spot where he just stood then at the nurse eating her salad sitting across from me until 10 seconds later she goes, "Well...GO!"

I get my butt into gear. Push my lunch back into the it's bag, shove a handful of chocolate almonds in my mouth, bite my tongue in the process, and dash out of the room into the patient room.

Oh my. She was giving birth. Now, mind you, I have never felt like I was going to pass out during any of the other rotations I've been on. Guy throwing up straight up blood? I'm cool. Connecting rectum back to sigmoid colon by shoving a big metal rod connected up an anus? No sweat. Cut open an aorta, get sprayed with bright red blood, stick a vacuum suction in it to stop it? My jam. Seeing a woman, legs spread as wide as can be, no epidural, supported by partner and mom, bearing down, sweating, and actively pooping, with clear amniotic fluid coming from her vagina...I think I'm going to pass out.

The midwife is there. The resident is there. They're supporting her, encouraging her, helping her with different positions, applying pressure to her perineum so it doesn't rip (yes, RIP) when a pot roast tries to come out a hole the size of your nostril. That's hyperbole, but you get the point. Meanwhile, I'm standing back, gloves on, prepared to be the most helpful med student I can be and watch, occasionally translating things to Spanish. It's amazing in how times of fear/adrenaline/whatever you want to call it, things you didn't think you'd remember from high school come back to you. Mind you, it was still quite poor given the context that I took spanish for 7 years.

Anyways, I'm standing back, staring at her vagina/poop/fluid amalgam, and I start to see spots and I think oh no, not here. NOT HERE. Baby >>>>> you passing out. So I squeeze my calf muscles, tighten my abs, squat ever so slightly, and valsalva (push down like you're going to poop) and try everything I can to increase blood return back to my heart and up to my freaking brain which is still seeing spots with my vision starting to narrow in on the sides so ALL I CAN SEE IS THE VAGINA/POOP MIX. Excellent job brain, wise decision.

Luckily, it works. Either that or it was the midwife saying, "grab some sterile gloves, you're delivering the placenta." Probably that -- I work well when given direction. Brain clears up, I grab some gloves, and watch for another 30 minutes while this amazing, incredible woman pushes and pushes and contracts and contracts her baby's precious little head out. And yep, it ripped when her baby's head popped out, and I cringed but and she didn't care at all. Or maybe she did, but was too excited and overwhelmed by her new baby girl that she didn't care. I don't know, I haven't done it yet.

The rest is the resident walking me through delivering the placenta...the cord gets longer, there's a gush of blood, and out comes something that looks very much like it's a prop from Alien vs. Predator. Then there's stitching up her vagina and cleaning up hot mess of blood/poop/fluid down there so we can lay her down properly. But she doesn't care. Why should she? She's did it, she's got her mom and partner next to her, and she's getting ready to go to sleep (pass out?) with this new baby girl she brought into this world resting on her chest. 

Sunday, January 4, 2015

Belated candy gifts

Whoops, I meant to post this before the winter holidays were coming to a close. Whoopswhoopswhoops. But life got in the way. The making of the gifts, the sending of the gifts (after the traditional gift giving day because who can keep track of pesky USPS holiday hours?), the traveling, and all that relaxing.

But I took the pictures, and I made them, and so why not? Then it's all about figuring out what to say. Something clever? Something profound? Or just the recipe because who really reads this part anyways.

Let's face it, you're here for the food pictures, and the recipes. This part is mostly for me. It's like a diary but you can skip ahead to the good bits. I get to put my profound, life-changing thoughts out there and feel comfortable knowing that most people will scroll right by them. I'm not joking, that fact is actually relatively comforting and part of what makes blogging cathartic.

That and it's a way I can look back on medical school and say look! You can be creative! You can make things! You can write things, and have opinions all while creating tasty tasty treats! Fight injustice with your words, and make pistachio apricot bars while doing it! No, this post is not about pistachio apricot bars sadly, it's about candy.

The type of candy that doesn't need thermometers, or confectioners sugar, or melon ballers. There's nothing wrong with that, but that's just not what it's about right now. It's about making it happen when you're tired. It's about bringing it when you're don't have time to go to the shop, and bringing it damn well. It's about delicious candy. So feast your foodie eyes on my candy creations, and feel the comfort in knowing you can make beautiful, tasty things with little sleep and no thermometers, but with a lot of sass and love.


Pretzel Toffee With Pecans

1 cup salted butter
1 cup light or dark brown sugar (depending on how molasses-y you like things)
1 bag pretzel thins or saltines or ritz crackers, really any salted, crunchy cracker will do. The pretzel thins can be found in Trader Joes
8oz semi-sweet chocolate
Chopped Pecans
Salt

Line a 9x13 inch pan with aluminum foil, and spray that with cooking spray. Lay down a layer of your crackers/pretzels, etc. It's okay if they overlap a little, but you want a nice layer of it down. Turn your oven on to 350.

Mix the butter and sugar together in a medium saucepan over high heat and bring to a boil for 2-3 minutes. Really watch the color here, if it seems like it's getting too dark for your liking, turn it off. If you don't know what too dark looks like, keep it going for 2.5 minutes, and then turn it off. It's really an eye-ball it kind of recipe. If you don't use salted butter by the way, add 0.5 tsp salt to the butter-sugar boiling mixture.

Pour the mixture carefully over your pretzel layer, covering it completely. Don't worry if there's a little bit uncovered, it'll spread. Put that in your oven for 10 minutes.

Pull it out, and let it sit for 1-2 minutes to harden slightly. Then pour the bag of chocolate on top, the heat from the toffee will melt it, and spread it evenly over the toffee. Sprinkle with the chopped pecans, and some salt.

Put it in the freezer for 20 minutes, pull it out, and use whatever tool you want (hand, dull kitchen knife, etc.) to break it into pieces, and enjoy!


Trail Mix Bark

8-16 oz bag of semi-sweet chocolate
Dried apricots, chopped
Dried cranberries
Pistachios
Other toppings you want (white chocolate, pretzels, other nuts, other fruit)
Salt

Take your 9x13 pan, line it with aluminum foil, and spray it with cooking spray.
Put the chocolate in a microwave safe bowl, and put it in the microwave on medium high for 30 seconds, pull it out, mix the chocolate together to distribute the heat. Do this for 30 seconds until the chocolate is melted and viola! This is how you melt chocolate evenly in the microwave.

Spread that over your 9x13 pan. Sprinkle the dried fruit on it, and push it down so it sticks in the chocolate. Then add the pistachios and push down. Then sprinkle the salt on top. Put it in the freezer for 20 minutes, and break it up, and you have bark!


Trail Mix Bites

Same ingredients as above
Heavy duty plastic bag
Put your dried fruit and nuts out so you can grab them quickly, because the bites dry quickly.

Lay out a large piece of baking sheet paper. Melt your chocolate. Use a spatula to put it inside a plastic bag. This is a messy, messy process. That's okay -- don't wear your nicest whites is my only advice. Cut the tip of the bag off, and squeeze out dollops of chocolate onto the baking sheet. As soon as you're done, place one dried fruit and nut in the center. Do this quickly, the chocolate dries fast. Then salt it. And you're done. Let it dry and enjoy.

Sunday, November 30, 2014

The Shah (now Shah-Hoppenfeld) Tex-Med Holiday Extravaganza! AKA Thanksgiving 2014 in Review

My whole family is vegetarian. Well, my immediate family. For generations, we have been vegetarian. When my parents first moved to this country, that was a bit of a novelty. There weren't vegetarian restaurants galore, and whole foods selling all varieties of "fake meat." There was peas, cabbage, beans, and the occasional magic of tofu. Obviously this is hyperbole (sort of), but it's how they felt when they described it to me.

So obviously we never had the ginormous turkey for thanksgiving, and whatever it is people eat for the winter holidays. But my mom, always the light and life of our family, had a brilliant idea when I was a little girl of tex-mex holidays. After all, we love (no hyperbole) Taco Bell for it's vegetarian-friendly-at-no-extra-cost menu, so why not? Thus was born, the Shah (now Shah-Hoppenfeld) Tex-Mex Holiday Extravaganza!! No matter where I am, or who I'm celebrating Thanksgiving or the Winter Holidays with, I need Tex-Mex.

It reminds me of home, of tinsel wrapped around my banister, our big obnoxious plastic tree that was awkwardly bent at all angles but no one cared enough to fix it, my brother playing Golden-Eye, my dad looking at coupons for all the upcoming sales and separating out the worthwhile from the worthless, and my mom dancing in the kitchen taunting our dog with food singing "dancy-dancy, dancy-dancy, dancy-dancy-re!"  It might not make sense to you, but it makes perfect sense to me.

Now our family is bigger, with a lot more distance between all of us, but whatever. Nothing can stop the Shah (now Shah-Hoppenfeld) Tex-Mex Holiday Extravaganza. Full name, copyright pending.

So this year, we added in some new "traditionals" to the mix of our traditional. So along with tacos with all the fixings, we had cranberry sauce, brussel sprout salad, mascarpone mashed potatoes, and mushroom gravy.

So here's to what I'm most thankful for: a great family who will always add our own pzazz to tradition.

Cranberry Sauce Modified from Laurie's Little Kitchen. Made it 2 days ahead of time to let the flavors meld. I made it in a slow cooker, and just dumped all the ingredients in -- instead of water, I used red wine, and for the spices I used 1 stick of cinnamon and 1 anise. I took the anise out half way so it wasn't overwhelming, and took out the orange when it was done cooking but left the cinnamon stick in. Loved it, will make it again. 

Brussel Sprout Salad - From my head. Sauteed up 2 bags of TJ shaved brussel sprouts with some olive oil, soy sauce, and a little bit of balsamic just until the shavings were wilted. Then mixed in cut up dried apricots, slivered almonds, and pistachios. Definitely one of the evenings favorites and will most certainly make it again. 


Butternut squash and apple soup - Modified from a food network site. Instead of carrots, I used 2 apples and used vegetable broth instead of chicken broth, and butter instead of peanut oil. I also added in garlic and onion. Overall, a phenomenal and easy soup to make. Especially if you get pre-cut butternut squash from TJs. Can you tell I use Trader Joes a lot? Served with sour cream, creme fraiche, or mascarpone with scallions.  
My brother sniffing the soup
Mascarpone Mashed Potatoes and Mushroom Gravy - Definitely the winners of the evening. The mashed potatoes are from What's Gaby Cooking and the gravy is from Oh My Veggies. I basically followed both recipes exactly, except I used some Thyme in the mashed potatoes, and didn't peel them. For the gravy, I didn't use shallots, but instead used a red onion since I really enjoy the flavor more, and didn't use mushroom stock but used regular vegetable stock from Better than Bouillon (which I love).  
The evening's winner. Barely any left by the end of the night.

Our Traditionals -- Spanish rice, guacamole, salsa, sour cream, tortillas (corn + flour), hardshell tacos, chips, lettuce, beans, etc. It was wonderful, although I did learn that making spanish rice in the slow cooker does not turn out as well as stove top. Everything else was great though. 


Then of course the extras:
Krinkle in his bed.  
Cooking Thanksgiving Dinner with Tyler!
The Shah (now Shah-Hoppenfeld) Tex-Mex Holiday Extravaganza!

Monday, November 17, 2014

GF Cucumber Canape

My goal: increase the number of posts I churn out. I love to write, good or bad, I love to write...which any of my friends from college who knew me first year (looking at you Sam and Liz) will laugh at. But whatever, writing is cathartic and expressive and lasting. With a blog though, there's a certain pressure to post something interesting or funny, or anything people want to read. And sometimes it's fun to write for the audience, but mostly it's stressful, so it's way more fun to just write for me.

I digress from my main point which is cucumber canapes. I've been searching the web and my mind-brain, high and low, for gluten free thanksgiving recipes that my mom (and of course the rest of my family) can enjoy and I came across this little gem. It's easy to modify for what you like, and takes like no time to make.
A wonderful amuse bouche or a simple side dish. Hate goat cheese? Try ricotta flavored with sage. Or whipped feta. Can't stand olives? Go with marinated mushrooms. Or roasted red peppers. Or even marinated lemon slices. Want to change the flavor? Pickled ginger with a little toasted sesame seed oil drizzled on top.

Cucumber Canapes

1 cucumber sliced as thinly as you like
Goat Cheese
Topping like olive
Salt and pepper for garnish

My only tip is to make sure the goat cheese is at room temperature so you can scoop it into a plastic bag, cut off the tip and pipette out the cheese onto cucumber slices.

Thursday, November 13, 2014

4 ingredient Coconut Macaroons and Surgery

Time is of the essence right now. I pre-make all my lunches, pre-prepare my protein shakes at night so my breakfast is drinkable, set my to go cup under the coffee maker so I just have to press a button, and after much trial and error have all my clothes laid out in the most time efficient manner so that when the alarm goes off at 4AM, I can hit snooze once, and then tumble out of bed and into my work clothes. Brush my teeth and let the dogs out after I hit the coffee button, brush my hair, put on some mascara, grab my lunch, kiss the hubs, and pet the dogs, and BOUNCE out the door to get to work on time.

It's dark when I get there, it's dark when I go home, but the OR is filled with bright lights, and of course blood, guts, etc.

It's a privilege to be able to see inside the human body, to be able to stick my hands where no one else's hands have ever been before. Which sounds totally odd and gross, but it's such a surreal feeling when you realize, hey, that's small intestine that I'm touching, or hey, that's a beating human heart that I just suctioned blood out of...it's nuts.

Then, if you're lucky, you get to suture. Take the U shaped needle in the needle drivers, and the forceps (not to be called tweezers as I was informed), and get to work on some tissue. Got vertical, go horizontal, no...hold it like this! Like a pencil, why are you putting your fingers like that? Don't tear the tissue! Excellent, that's right. Do it again. It's ridiculously exciting, and worth standing there for 10 hours barely suctioning and not spoken to, to have the privilege of feeling things, seeing things, and maybe even suturing things.

But time is definitely of the essence--study when you can, sleep as much as you can, eat when you can--my bastardization of a common phrase in surgery.

For me, bake when you can. Hence the 4 ingredient coconut macaroon that turn out delicious in under and hour. Dip them in chocolate, add in nuts, dried fruit, or any other flavors you want...crushed candy cane for the holidays? Pumpkin puree for the fall? Anything really...the macaroon is your oyster.
one kind of bad picture...I was too busy eating them to get a better picture

4-ingredient Coconut Macaroons 

3 cups sweetened, shredded coconut
4 egg whites
1 tsp vanilla or almond flavoring
salt

Mix egg whites, vanilla, and salt together. Add in the coconut. Mix together. Let rest for 10 minutes. Then form into mounds with your hands or a scooper if you have one. Make sure they're well stuck together.

Bake at 350 for 15-20 minutes, and then enjoy!

Sunday, September 14, 2014

Brunch Time! Easy Vanilla-Almond Baked French Toast

It's been a struggle to sit still recently and just enjoy the moment. Most doctors tell me, "Enjoy medical school, you'll never get the time off that you do then!" but then I everywhere I turn, friends are publishing papers and going to conferences, getting involved with all kinds of research, and I'm...petting my new puppy. Not to say that petting my new puppy isn't amazing, but it does leave one wondering, "Should I be doing all that?"

Those who know me know that I tend to obsess. It's a double edge sword really: if I need to sit down and study, I will sit down and study for 14 hours straight; if I lose something, I'll spend a hour and a half searching for it, and if I get concerned about whether or not I need to be doing something with my career/academics, I'll sit there and mentally chew on it for days until I'm out of my mind with nervousness and I internally implode and finally calm down.

Healthy, no?

Well, I'm a lot better than I used to be with the latter two. I don't really have an hour and a half to search for stuff now, and really what good does it do me to sit there and  constantly stress about whether or not I'm doing the "right thing" for my career?

So I just try not to. I'm not super successful, but when I catch myself careening over the edge of "what about research? Ahh! What if I don't get a residency? AHH! should I be going in after hours and shadowing?? AHH!" I just stop myself, take a deep breath, and eat a damn cookie. It's all gonna be okay, and I'm pretty happy. That, my friend, is a lot right there.

Speaking of happy, this french toast makes me happy because it's so unbelievably easy.  I found this recipe on one of my favorite blogs under the "Pretty. Easy." heading, and it definitely looked anything BUT easy.
 

It wasn't a lie though, it's crazy easy, and people come over and are all, "You made that?!" and you're all, "Yeah" in a bashful yet subtly cocky way. That's right, subtle cockiness will get you far. Fair warning, it's an overnight recipe, which can throw people off for the easiness factor, but trust me, it's easy. I've said easy about 8 times here, EASY.

Try it, you won't be disappointed.
Easy Vanilla-Almond Baked French Toast
Adapted from Pairs Well With Food

1 Loaf Challah Bread, sliced into 1 inch thick slices and laid out to dry for 30 min to an hour (honestly, I skip this step most of the time)
4 large eggs
2 egg whites
1.75 unsweetened vanilla almond milk (or regular)
1 tsp almond extract
1 tsp vanilla extract
0.5 tsp kosher salt
5 tbsp sugar
2 tbsp unsalted butter
1.5 cups sliced almonds
Maple syrup for serving

The night before
Put your bread in a pan for the overnight soak. Mix together the eggs, egg whites, vanilla almond milk, vanilla extract, almond extract and 3 tbsp sugar. Pour it on the bread, make sure it coats the bread evenly. Cover it, and stick it in the fridge overnight. If you're pushing it, you can soak for as short as 30 minutes and it's still delicious.

The day of
Preheat oven to 400F. Pull out your soaked bread. Line another baking dish (the one you'll bake the bread in) with parchment paper/butter the dish (<--what the butter in the recipe was for)/whatever you do to get things not to stick. On a plate, pour out your sliced almonds. Take one slice of the soaked bread, let the liquid drip off of it, and then coat one side of it with sliced almonds, and place it on your baking dish. Do this with all your bread.

Tip: I usually put the pieces of bread down into the baking dish first, then I put the sliced almonds on by hand, gently pressing them down to get them to stick.

Take the 2 leftover tbsp. of sugar and sprinkle them over the top of french toast. Bake for ~20 minutes. Serve hot with maple syrup!




Tuesday, September 9, 2014

Brown Butter Frosted Rosemary Corn Cake

I always get turned off by desserts with more than 4 words in their name. It gets complicated with so much stuff going on. Salted Caramel Brownies. DONE. I can make that. Oreo cheesecake? Yes please. Cherry-Vanilla-Almond Cupcakes. Thank god cupcake is one word, because I can make that. 
But bear with me (I just looked up whether it was bare or bear...it's bear), this is legit. And delicious. And amazing. 

I don't like frosting, but brown butter frosting has got me hooked here. 
Fair warning, the corn bread cake is a olive oil cake and a bit "rustic" if you use not super fine cornmeal like I didn't. I like it, but if you like your corn bread smooth, get a smooth corn meal. 
It's not too hard to make and you'll wow people because you made something with more than 4 words in the name. 

Brown Butter Frosted Rosemary Corn Cake
From adventures in cooking
Cake
3 cups flour
0.75 cup cornmeal
2 tsp baking powder
1.5 tsp baking soda
1.5 tsp salt
2.25 cup sugar
6 eggs
1 cup olive oil
0.33 cup apple cider
1 tbsp vanilla extract
0.25 cup fresh rosemary, chopped (don't use dry) 

Frosting
1.33 cup butter
3 cups powdered sugar
3 tbsp honey
Make the frosting first by browning the butter. Basically put the butter in a saute pan over medium heat and let it melt down. In about 5-7 minutes it will caramelize/turn brown. It will start to smell nutty, and caramel-y and delicious. That's when you know it's done. Be careful though, it can burn pretty fast, so you want a caramel color, not a black color. 

Here's a useful video for how to brown butter in the microwave, which is a lot less likely to burn. 

After it's done browning, put it in a heatproof container in the fridge and let it cool and harden. While it's hardening, make the cake! 

Preheat the oven to 350, and line/butter/flour 2 9-inch round cake pans. Mix the dry ingredients together in one bowl. In a cake stand mixer, or by hand, mix together the eggs and sugar until well-blended. Then add olive oil, apple cider vinegar, and vanilla extract. Add the flour mixture in thirds, mixing well after each addition. Add in the fresh rosemary and mix by hand to prevent over mixing. Evenly distribute the cake mixture between the 2 cake pans and bake it for 35-40 minutes. When they are done, pull them out to cool. When they're cool, cut off the top of each cake so that you have an even base on both cakes (it makes it easier to frost).

While the cakes are baking, you can make the frosting. Pull out the cooled and hardened browned butter. Put it into your cake stand mixer (including the brown bits...they'll add color and be pretty), add in the powdered sugar and honey and mix together in your stand mixer until they are frosting-like. 

When the cake is definitely cool (or else the frosting will melt and be a tasty puddle), frost it.