Vomiting Blood

A 22-year-old man came in saying he had been vomiting blood for several hours. He also had abdominal pain, felt weak and dizzy. He had never had anything like this happen to him before and had no significant past medical history. He looked uncomfortable and a little pale. His abdomen was tender, his heart was beating fast and he had blood on his clothing. (See below.) All of this made me worried he was bleeding internally, probably from an ulcer in his stomach.

I told him I was going to ask the nurse to start an IV and draw some blood tests. I also explained the need to put a tube through his nose into his stomach to see if he were still bleeding. He agreed to this potentially life-saving course and I went on to see my next patient.

A few minutes later, I was approached by the nurse. As she was getting ready to pass the tube into his stomach, she got additional history. The patient had eaten nothing in the last twenty-four hours but Flamin’ Hot Cheetos. I then took a second look at the “blood” on his pants and tested it. No blood. Just pure Flamin’ Hot Cheetos juice.

So, instead of a potentially life-threatening hemorrhage, he had a bad stomach ache from eating too many Flamin’ Hot Cheetos. We gave him some IV fluids and some medicines to make him feel better. We sent him home, admonishing him to be a little more wise with his diet in the future.

If you look through the many recipes on this blog, you might notice that dry, crumbly cookies are not well represented. I think it was the “chocolate-chocolate chip” part of the recipe title that caught my attention. Plus, I just wanted to try something new. Chocolatey and buttery. Good combination.

Recipe By:

Mercury News

Yield:

48

Ingredients:

1½ cups unbleached all-purpose flour
½ cup unsweetened Dutch process cocoa powder, such as Droste or Hershey’s European Style
½ teaspoon baking powder
¼ teaspoon salt
½ pound unsalted butter, softened
1 cup powdered sugar
1 cup miniature semisweet chocolate chips
4 ounces chopped white chocolate, Callebaut or Baker’s premium preferred

Directions:

1. Heat oven to 300 degrees. Line two baking sheets with parchment paper.

2. In a medium mixing bowl, mix together flour, cocoa, baking powder and salt.

3. Using an electric mixer, cream butter and sugar until smooth and light. Add sugar, increase speed to medium and beat until the mixture is smooth, about 1 minute.

4. Decrease speed to low and add flour mixture. Mix, scraping down the bowl sides as needed, until flour is completely incorporated into the dough and the dough holds together, about 2 minutes.

5. Stir in chocolate chips by hand.

6. Divide dough in half. Working on wax paper, press each piece into a 7-by-5-inch rectangle, about ½-inch thick. Use a large, sharp knife to cut each piece of dough into eight strips, each about 5⁄8 inch wide. Cut each strip into three cookies, each about 2¼ inches long. Use a wide spatula to transfer the cookies to the prepared baking sheet, placing them an inch apart. Bake cookies for 25 minutes.

7. The tops of the cookies will change from shiny to dull. Cool on cookie sheets for 10 minutes, then transfer to wire racks to cool completely.

8. Melt the white chocolate. This can be done in the top of a double boiler or in a 175-degree oven.

9. Remove from heat as soon as the chocolate melts and stir until smooth.

10. Spoon white chocolate over one end of each cookie, covering about a third of the cookie and letting any excess drip back into the chocolate bowl. Cool on rack until chocolate is firm.

Rafal, a good friend and nurse from the emergency department, sent me these pictures of him visiting his hometown of Krakow, Poland. I’m pretty sure that’s the furthest a Tad Bag has traveled and come back with a picture to show for it.