Quick & Healthy Chicken Enchiladas

My husband rarely gets excited about something I cook, so I was shocked when we both loved this recipe for quick and healthy chicken enchiladas. Enjoy!
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Chicken Enchiladas

This recipe can be layered to save time or you can fill each tortilla and roll in the traditional way. Turkey, pork, or beef can be substituted for the chicken, Top each serving with extra Mozzarella cheese.

2 cups cooked and cubed/shredded chicken

1 cup chopped onion

1 cup low fat Ricotta cheese

1 cup nonfat plain yogurt

2 oz. grated, low fat cheddar cheese

2 oz. grated, part skim mozzarella cheese

12 corn tortillas

2 cans (10 oz. each) enchilada sauce

Preheat over to 375 degrees. Mix first six ingredients and set aside.

Spray a 9-inch by 13-inch baking dish with non-stick cooking spray. Pour ½ can of enchilada sauce in bottom of pan. Follow either method below for layered or rolled. Bake for 20-30 minutes or until heated thoroughly.

Rolled Method: Place about 1/3 to ½ cup of filling on each tortilla and roll to enclose (cracks in tortillas are not as noticeable after cooking). Place seams side down in baking dish. Top with remaining sauce.

Layered Method: Follow this order: 1/3 of the tortillas, ½ of the filling, 1/3 tortillas, 1 can of sauce, remainder of filling, remainder of tortillas, remainder of sauce.

Yield: 8 servings

One serving: 1/8 of recipe

Calories per serving: 275

Fat: 7 grams

Disappointment

Working in healthcare, I am always faced with disappointment. My patient's test did not go well; my patient is not working hard enough at home; my patient is just not strong enough; the healthcare system is broken and my patient pays the price. The list goes on and on.

Sometimes, disappointment is easy to brush off. It is a sad fact, but all too true. This past week, I had several disappointing situations. The most disappointing of all was that my coma patient got rejected by a brain injury rehabilitation facility.

He had a heart transplant, one of the grafts failed, he suffered an anoxic brain injury, they repaired the graft, he didn't wake up, he developed a non-healing sternal wound, he went to an LTAC and got no cognitive therapy, he came to our LTAC and I did the best I could with him, he was evaluated by a brain injury rehabilitation facility, he was denied because of his poor prognosis and length of time since injury (3 months), he will go to a nursing home with no therapy, he will ROT!

This is the broken healthcare system. I know it is broken, but my coma patient makes it all the more real. I cannot tell you how disappointed I am. And the worst part of all of it.....he has a brand new donor heart.

(Sorry for the depressing post...remember, I blog for myself as a personal record. Thanks for reading!)

Whirlwind Christmas "Vacation"

Jon and I got back from our whirlwind Christmas "vacation" a week ago and we are still feeling the effects of such a draining trip. Individually, each destination was great, but roll them all together in a 10 day window of time and you do NOT have a vacation.

We started out traveling from Houston to New York (Buffalo) to spend Christmas with Jon's family. This was our first married Christmas together, so all the new traditions were being made. Before we were married, we decided to alternate Christmas each year and we're trying really hard to stick to that plan. We mostly just visited with family and relaxed. I did a little shopping with Jon's mom and we took his parents to the Melting Pot as part of their Christmas gift. I, unfortunately, still didn't get to meet Jon's brother, who didn't show up for the festivities.

The day before we were supposed to leave, we learned that Delta changed our flight to California and that we would have a 5 hour layover in the Atlanta airport. We called Auntie KK and she was nice enough to feed us and entertain us for a few hours.

We arrived in California for Morgan and Adam's wedding late. We picked up our rental car and it was pretty much non-stop from there. We helped Morgan get ready for the rehearsal dinner and Jon was even given the task of taking Morgan's wedding dress to the church! Not to brag, but we know we helped a lot and I'm sure the wedding wouldn't have gone so smoothly had Jon not taken on so much responsibility! The wedding was beautiful and the reception was fun; got to spend some time with old friends from college and make some new friends too. Jon even got an invitation to visit one of our new friends in Japan and go to Tokyo Disney.

Speaking of Disney, Jon wouldn't let us leave California without visiting the Mouse first. We spent December 30th and 31st at the parks. The 30th was cold and rainy and COLD!!! It was a good thing we packed our winter clothes for NY or we wouldn't have been able to stand it. Since it was already misting outside, we decided to ride Splash Mountain on the first day. I insisted that Jon buy us ponchos, and it was a good thing, because we got SOAKED! So, soaked in fact that it wasn't even fun. We ended up leaving the park, going back to our hotel room and drying our shoes with the hair dryer, putting on our winter clothes, and then went back to the park. The rest of the evening was pretty fun and we made sure to stay dry.

On the 31st, we knew the parks would be packed, so we made sure we had all the clothes we needed when we went in and knew that we wouldn't be able to leave. By 5:00 pm, the fire capacity was met and if you left the park you wouldn't be allowed back in. It was wall-to-wall people. Everywhere!!! They even made a majority of the walkways one-way. By 11:00 pm, we'd had enough "fun" and were ready to head back to our hotel. We had an early flight home and were in bed by midnight. Happy New Year!

We finally made it back to Texas and are so thankful to be home!

Coma Stimulation

I got to do something really cool today. Multisensory stimulation for disordered consciousness, also known as coma stimulation. We have a man on our unit who is in a "coma" after an organ transplant mishap. There are different levels of consciousness, which is why coma is in quotations. This man is actually not in a coma, he is in a vegetative state. Surprisingly, a vegetative state is a better level of consciousness than coma. It is not, however, the greatest state to be in.

I've never done multisensory stimulation before, but went to a presentation on it at our national convention. The presentation was very informative and had demonstration videos. The unit that I work on is not a brain injury unit by any means, so I felt sad that this man was getting no kind of arousal therapy. Hence, my eagerness to try multisensory stimulation.

Though my man didn't magically wake up, which is what all the nurses thought would happen, he did show some promising signs of arousal. Multisensory stimulation doesn't have much research behind it yet, so the techniques can seem a bit strange. Have you ever scrubbed a patient with a ScotchBrite pad or pricked their toes with a seam ripper? Yeah, me either until today. But, it was pretty cool to see the responses those techniques elicited. I'll keep you posted on his progress.

If any of you speechies would like a copy of the presentation, just let me know!

Goodbye Baby

Our beloved Toby went to dogie heaven on Saturday. He was exactly 6 months old. Who knew you could fall in love with a dog so much so fast. My heart is in a million little pieces just thinking about how much I miss him.
Toby was sick ever since we got him. He got a tape worm 2 weeks after he came home with us and things just went downhill from there. He got giardia after that and was never able to shake it. Over the past 6 weeks or so, he started losing weight and not acting like his happy self. We initially thought it was just another bout of giardia, but it was much worse.He was supposed to have "little boy" surgery on Tuesday. We took him to the vet early in the morning and had a feeling that he wouldn't be able to have the surgery, since he obviously wasn't feeling well. The vet called us later that morning to tell us that he was in pretty bad shape and was septic. His white cell count was 600 (normal is 7,000 to 10,000) and he had zero infection fighting cells.We spent the next 5 days trying everything we could to nurse him back to health. He spent a few days with the vet but came home with us at night. We had to give him subcutaneous IV fluids, antibiotic shots, and try to get him to eat. He was just skin and bones. I took off work on Thursday to take care of him so Jon could get some work done and I'm so glad I did.On Friday, I knew he still wasn't feeling better. Jon took him to the vet and he stayed all day getting IV antibiotics. His white cell count had improved to a measly 900. I met Jon at the vet with my mom and we told the vet we just wanted to take him home.We spent his last night letting him eat peanut butter toast and sleep with us under the covers. It was a very sleepless night and we thought he would pass several times. In the morning, my family came over to take him to the vet with us. He rallied a bit and at a whole piece of peanut butter toast and walked around before we left. His increase in energy and eating gave us a bit of hope, so we had his blood drawn again. His white cell count was only 1,300, even after strong antibiotics. His leukocytes were also misshapen and immature.
It was then that we knew it was time to let him go. With my family surrounding us and Jon and I holding him, he went to sleep and was finally not suffering.Jon and I are taking it pretty hard. We cry a lot. It just baffles me how much we love and miss him. Though he was just a dog, he was our family member. We love him so much and miss him terribly. Please pray for us for healing, especially for Jon.

Funny Patient Quotes

Patient sitting in an ancient wheelchair in my office, looking very uncomfortable.

(Me) Are you in pain?
(Pt) Yes.
(Me) Does your bottom hurt?
(Pt) Yes.
(Me) Is there anything I can to do make you more comfortable?
(Pt) You could rub it.

Patient just admitted to our unit. Another patient, down the hall, is screaming.

(Me) Mrs. H, You're in the hospital. Remember, you had surgery.
--Blank stare from the patient, who looks very scared.
(Pt) Am I on the maternity ward?

Warning...Depressing and Morbid Post Ahead

Well, the last few weeks have been very rough at work. We rotated positions, which happens every six months, and I am now a floater again. My main responsibilities are to my cancer patients, the LTAC, and then to the hospital, if I have extra time. In these first two weeks, most of my time has been spent on the LTAC, where EVERYONE IS DYING!

Working with old people who have dysphagia, we know that death is a very real possibility. However, it is very rarely staring at us at the end of the hall. In the last two weeks on the LTAC, two of my patients have died, one has coded and gone back on the ventilator, and one has aspirated and gone back on the ventilator. Ick...

I was on the unit when one of my patients died. Though she was 85, her family had still not decided to make her a DNR - Do Not Resuscitate. Friends, I highly encourage you to discuss "code status" with your parents and loved ones. When an older person codes and is resuscitated, the physical trauma their body endures is horrific and they usually don't survive anyway.

So, when my patient coded, they attempted to resuscitate her; they gave her CPR and shocked her heart. She had a trach, and from my position in the nurses station, I could hear the air rushing out of it every time they compressed her chest. It was the most awful sound. They had to continue resuscitating her until her family could be reached. The case manager makes those calls..."Mrs. XXX, your mother's heart stopped and we are trying to revive her. But you need to come now because she is not going to survive."

When they finally stopped, everyone in the nurses station just sat there. My patient was the second person to die on the unit during that week. It was just too much. Though I never really had any meaningful interaction with my patient (she'd had a stroke and was quite unarousable), hearing the air rushing out and knowing the physical trauma her body went through really shook me up.

I went to the chapel in our building and prayed and cried. She wasn't my family, I didn't really know her, but she was my patient. Being a Catholic, I know she is in a better place. Unfortunately, that only makes it a little easier to deal with.