I don't normally share other blog's posts here, but this one deserves a special place:

http://6yearmed.blogspot.com/2009/05/quiet-place.html

She gets it. She REALLY gets it.

My 2010 Resolutions

Now that we are officially in 2010, I thought I'd publicize my resolutions. None of these are out of reach, but these will take me effort, which they should do:

1. To continue my weight loss journey, losing at least 20 pounds this year.
2. To pass my pre-paramedic class with an A.
3. To find, enroll, and begin a paramedic program
4. To exercise at least 30 minutes daily for 3-5 times a week.

Uh oh... what did I do now?

I've gone back to the gym lately, more as a result of the weather not being very conducive to riding my bike lately. But I realized I was also losing muscle mass since my knee surgery in July. I just haven't needed to really USE my muscles much. The last time I really had to lift a patient was back in October. So, I needed to get back into a good muscle building regime, along with some good cardio.

I like mixed cardio/weights in a workout, not isolating to one or the other, when I am in the gym. Part of this is to break up the monotony, but I think (for me) that I get more out of my workouts when I do this. I'm not a body builder, nor am I a long distance runner. I am simply someone trying to lose weight, to build some muscle, and generally feel and look better. That said, sometimes I do just use the bike, or the elliptical, but I never just do weights.

Two days ago, I was at the gym, and had moved from the elliptical to a 30 minute weight session. Worked on the legs, and the back, and went to work on the biceps, triceps, and lats. I have a 3-way method on the lat pull-down machine for this. Standard lat pull down behind the neck, forward, and then I work the triceps using the same machine, but with my hands close to the center of the bar, elbows close to the body, and just bring the bar down so my arms are at a 90 degree angle, then up again, not moving the upper arms from my body (so the triceps are forced to work). No problem, right?

Set the machine for 40 pounds. First two exercises went off without a hitch. Then I moved to the triceps. First 4 felt good, then something went "pop!" in my elbow, and I felt a tearing sensation. I stopped right then. Checked out my arm, and moved it. Moved ok. No real pain. Dropped the weight to 30 pounds. 3 pull downs later, the pain returned. OK. I stopped the exercise altogether. This was going to be the end of my workout time anyway, so I went home, and iced my elbow.

Yesterday, I woke up, and my elbow felt ok. Pushing down hurt a bit, but not bad. I went to work, and finished out my day without a problem. Not that a keyboard really works out your arms a lot, mind you. Got home, and was pulling my backpack out of the back seat like a normally do, and went to sling it over my left shoulder, when WHAM! Sudden, searing pain in my elbow! 10 times worse that at the gym. I think they could hear me yell a few streets away from my apartment complex. I know one of my roommates did. Damn that hurt!

I closed up my car, and went immediately into my apartment, grabbed the ice pack in my freezer (A zip-loc bag full of peas - works great), and iced my elbow. This time, the pain didn't subside. And my elbow was feeling hot. Crap! After 45 minutes of icing it, I had some improvement, and could move it a bit without pain, but putting pressure, even typing, hurt. I spent most of last night before bed icing it off and on, fired off a message to one of my docs, letting him know what happened, and went to bed.

I didn't sleep much last night. Positions that didn't allow my muscles to completely rest were uncomfortable (read: painful). I am still waiting for an answer from my doc. I hope he is in this week. If not, I may have to call in and get an urgent care appointment. I don't know if I just tore some old scar tissue in my elbow (from years of bowling), if this is a new injury, or a combination of the two. I can move my elbow this morning, but it still feels warm, and pushing down on things hurts (I can type again with my left hand, as long as I rest my arm while doing it.). I've also started back on some non-steroidal meds (started those last night), hoping the combination of NSAIDs and icing will calm this down. Based on the improvement since yesterday, I am hopeful that I didn't tear anything major, but since I am dealing with ligaments and tendons that don't heal normally, I do have to be careful. EMS-wise, I am not working until Saturday, and if I had to work, I could right now. Might not be the happiest EMT around, but my arm does work.

In the meantime, I am going to work more on strength in other parts of my body, riding, and other cardio. I do have MTB season starting soon, and I plan on participating this year.

New look...

If you've taken notice that the site is no longer dark blue, that is intentional. I decided a change was in order, in preparation for my changing the site in a larger way. I won't tell you everything, but there will be some enhanced functionality added here soon, including links to some of my other sites.

Stay tuned, and please put up with the web "dust" for a little while... :-)

December update

Not much to report lately. I've been working my "day-job", still dealing with the governor taking almost 15% of my salary under the guise of "furlough". Yeah... what its done is to cause me and 200,000 other State of CA employees major problems financially. We don't have the money, so we don't spend it. Less spending is less sales tax money for the state... see where this is going? And he calls it a "haircut"... I call it something else. Oh well, the courts will sort it out... eventually.

Still working EMS (always!), both at events with my own company, and also for the Sacramento Rivercats. Yeah, I know it isn't baseball season. Corporate events... fantasy baseball, meetings, etc. I was supposed to go out of town tomorrow, but that event was canceled due to inclement weather. In the world of mountain bike racing, that is a rare event. Its a little wierd being on a first-name basis with some of my patients, but I treat many of them over and over... kind of a "frequent flyer" system that many working on an ambulance see. One thing I do like is the follow-up I do tend to get. My patients come back and let me know how they are doing, or they email me with updates (Facebook also!). Its nice, actually. Most people working a rig just deliver their patients, never learning about how they did.

Oh... we got snow this week! I know, those of you in areas that get snow frequently are thinking... wow... not. Well, its a rare event here. Monday morning, about 2:00am, it started snowing here in the Sacramento Valley. Most areas got a dusting. We got about 1 to 1-1/2 inches. Didn't stick long, though. The last time it snowed this much was in 2002. Mike had never seen snow falling, so at 2:00am, he was out playing in it like a little kid. I wish I could have seen that, but there are pictures to memorialize it! Here is a picture of the ambulance with snow on it. Temps have been REALLY LOW for this area most of the week. Finally, the temps have come up a bit, but only due to storms that are bringing rain, and the occasional lightning strike. I wish it would snow again. Two pictures I took:

Altamont Pass

The Fremont/Milpitas foothills

What I saw on my laptop Sunday evening... 100% chance of snow in my area.

I'm not going to be traveling anywhere for Christmas. Finances are just too tight. So, I am working on decorating my apartment a bit. Found most of my decorations. Can't seem to find the ornaments for my tree, though... They have to be somewhere... I thought they were in my green and red box, but alas... I am going to be working on Christmas cards tomorrow. So, Mike, Mary, and I will spend Christmas and Hanukkah here (Mary is Jewish, and I am learning about Hanukkah from her, and she is learning my traditions, including the lighting of the Advent candles, and the prayers I make when I light them).

I do hope that the holidays bring great things to all of you. May the Lord bless all of us this coming year, as many are still working on getting back on their feet with the economic issues still facing a lot of us. If any of you are traveling in my neck of the woods, please feel free to let me know! I'd love to have you over!

At What Point?

Note: A few things have been changed in this post, so the person I am referring to cannot be identified. But I wanted to share this with all of you. Chances are, you know someone like this.

A few nights ago, I was on the phone with a friend of mine for over 2 hours. This wasn't a bullshit session. She woke me up at 11:30 in the evening with a phone call, sobbing uncontrollably. She has had bipolar disorder since she was 15, and I could tell within a few minutes that she was clearly off her medications. This isn't the first time she's done this. We've been friends a long time. But this is a lifetime illness, and at age 43, she knows better. It wasn't a matter of affording the meds, although in the past, this had been an issue for her. She makes good money (a lot more than I do), has insurance that pays for her medications, and for her medical appointments that she needs to maintain her bipolar disorder (BPD).

We talked, and she unloaded on me. She was in the middle of a divorce (her 3rd marriage). This time, he was seeking alimony, custody of their 14 year-old daughter, and essentially most of the life she has made for herself. This is hard for most people to handle, but when you have a serious mental illness, it can be absolutely devastating. She had called and hung up on three other people before talking to me. I can't say I didn't see this coming. Some of her recent emails to me seemed, well... negative.

I've mentioned her before in some previous posts, because I have talked with her and even traveled to meet her when she was clearly suicidal. That time, I helped her to check in for what started as a 72-hour stay at a hospital, but which became nearly two weeks long. Each time, she stopped taking her medications. When she is on her meds, you can't tell her from anyone in the crowd. Those meds keep her brain chemistry in check. But, they have side effects that eventually cause her to stop taking them. That's when the problems start. She had been off her meds this time for 3 weeks. Last time, it was just over 2 weeks when she reached me. One time, it was over 4 months, and she was almost to the point of living on the streets. Each time, reality hits eventually, and she comes back. Her employer has always looked the other way, knowing that this occurs with her. She is an incredibly talented software engineer. With her BPD, the timing isn't predictable. Some people with BPD have a predictable cycle. Not her. It can be 3 times in a year, or nothing for 2 years.

Something about the way she was talking told me she had already decided to get help and get back on track again. But I wasn't sure if she had started. Mentioning meds is something approached at the right point, not right away. But, as an EMT, it is part of my thinking, and eventually I asked her if she had restarted her meds. Not yet, but she had gone and gotten them refilled again earlier that day. OK. That's good. She has them. What were her plans at this point? First, she knew she had to get back on her meds to be able to handle any legal actions, especially custodial proceedings. But the depression she was in was keeping her from opening those bottles and taking those pills. Or it could push her over the edge and make her take more than she should. A lot more. Its happened before. Which is why we talked and talked and talked. Letting her dump on me gives her an outlet that I always hope will allow her to see some things clearly and essentially go back and do what she knows she needs to do.

Its hard dealing with someone in the cycles of BPD. Even harder over and over again. But she's my friend. She's been through tough times, and she has an ability to rebound that is just unreal.

By the time our call was ending, she was less upset, but I could tell the brain demons were still working on her.

... She called me yesterday when I was driving home, and let me know she was ok, which was good to hear, and she had started back on the road to her recovery. She restarted her medication regimen, contacted her doc, and had an emergency plan in case she relapsed in this acute period for her. She hasn't spoken with her soon-to-be ex-husband yet, but was hoping to in the next week or so. She didn't do anything on Sunday except stare at pictures most of the day. Pictures of family, of friends, and of parts of her life she clearly wants back, but can't have. Her daughter is staying with her father, who moved out before I was called. I think she understands that she more than likely won't get sole custody of her daughter. We may meet up later this week or early next week, as she is thinking about a little travel while she gets back on track. Can't say its the smartest move for her, but if it works...

I am sharing this story to you, because when I was done talking with her, I realized the drain it had on me that night. I'm not giving up on a friendship, nor do I feel I have to maintain this friendship to keep her going (I'm not that unrealistic). But it made me think about all those people, including her husband, who have reached the end of their rope... at what point do they stop and say, "I can't deal with this any longer"? I'm not at that point, and I don't think I ever will be with her, but it did make me think. When I was dealing with my husband's illness, I have to admit, I felt that way sometimes. When would the rope break? It never did for me, the stresses of dealing with his medical conditions did add up, and took a heavy toll on me (some of which I still deal with to this day)... But it did come very close to breaking. I did almost walk away back in 2002. In my case, I had the realization, through my religious beliefs, that God never gives me more than I can handle. And that includes friends calling me at 11:30 at night needing someone to talk to.

Surgery

Yep. (Warning, what follows is a bit graphic)

Last week, I sent an email to my orthopedist, 'fessing up that I had aspirated fluid that was accumulating outside my knee. Did it by what is called needle aspiration (syringe and needle), following good aseptic technique each time. Not once, or twice, but three times. But, doing this is essentially playing russian roulette, risking infection each time. And the problem wasn't going away. In fact, when I was on my bike, it got worse (presumably due to pedaling). So, we chatted back and forth by email, and he let me know that the only way to fix this permanently at this point is surgery. Not on the inside of my knee, folk. On the outside.

What has happened is that a pocket developed, probably due to a shearing force when I hit the ground that tore away the tissue layer that holds the skin to the underlying tissues. There is an area below my knee that feels "rope-like". This is more than likely the tissue that sheared away. A "pseudomembrane" has formed in its place that is holding the fluid in that area, since the body likes to fill in voids with fluid. The surgeon will go in and open up this pocket, clean up the mess I made (like that rope-like stuff), check on the side of my knee for damage (its been getting progressively more sore since I started bicycling again), repair anything that needs it, and essentially attempt to "tack down" the underside of the skin to the tissue below with absorbable sutures, to keep the pocket from re-forming. If that last item can't be done, then I will be stuck with a drain in my leg for a few weeks (not a fun prospect). Needless to say, I am voting for the suturing.

This surgery will keep me out of commission EMS-wise, for a few weeks. Two weeks of VERY LIGHT duty (Think nothing to supervisory only), followed by a few weeks of ramping up to normal activity. I need to give the tissues a chance to really adhere to each other. Day job-wise, it means I am probably going to be working at home for a week or two, after a few days off for healing and pain control.

I went in and saw the orthopedic surgeon last Friday. Got all the pre-op stuff out of the way already. So, when is all this happening? Next Tuesday, July 21st.

10 Gallons

 

It wasn't until after I donated platelets today that I realized I had donated 10 gallons. For me, thats 40 donations, since I donate either double or triple platelets each time. So, they gave me a t-shirt, a cool clear glass coffee mug, and topped it off with balloons.

I am telling this to all of you to encourage you to donate if you can. I don't do this for money or fame. I don't do it for a t-shirt or a mug (although it was fun to get). I do it because it is the right thing to do. The 40 donations isn't even all of them. It is just since I moved to the Sacramento area. Prior to moving here, I donated through the Red Cross in the SF Bay Area, and in the Los Angeles area. I know a lot of you donated after 9/11. Well, blood is needed NOW. Donate if you can.

Recovery Continues, Work Goes On

Since I got my asthma medications adjusted, things have been improving. I can take a deep breath without wheezing (assuming I don't get my lungs coated in dust like I did yesterday... left me coughing a lot.). So, due to my EMS work that I love, I take two steps forward and one step back, but things are improving.  And I can *run* again to get to someone (proved that on Thursday getting to a patient) without being winded. Starting to taper down the prednisone, and should be off it by the end of next week.

My knee is better also. Just a little fluid left below the knee. I keep putting compression on it, and it is going down.

Hoping to get back on my bike this week. :-)

Asthma attacks... again (Misadventures in stupidity)

Sometimes, I amaze myself at how stupid I can be. I mean, I treat people for asthma often enough, that as an asthmatic myself, I should know better about getting help when I need it. But nooooo... I, like many other EMTs and paramedics, think that we know enough to take care of ourselves when we get sick or hurt. It is an arrogant trait, one that we really shouldn't have.

On May 17th, I had an asthma attack while returning from an EMS assignment. We had gone through a big dust cloud that was created by an RV in front of us while driving down a dirt road on a mountain. I wasn't affected initially. In fact, earlier in the day, I used my albuterol preventatively due to the heat and dust that was being created from the mountain bike race I was providing EMS services at.

On a scale of mild to severe, this was a moderate asthma attack. Enough to make me cough like hell (a hallmark of my particular asthma), to wheeze, to have more problems breathing out than in (a hallmark of all asthma), and to eventually impact my ability to think clearly. It started out innocently enough. I just had a mild cough, that started about an hour and a half after the dirt road. I even joked to the EMT with me about it. Soon enough, I realized I needed to use my albuterol inhaler. I had it in my pocket; I reached in to grab it, and realized that the outer plastic case was missing. All I had in my pocket was the medication canister. Not good. But, I do keep a spare with me. The other EMT went into the back and grabbed it for me. No problem. Two puffs, and all would be good.

Except it didn't work. I took two more puffs... and two more... and two more, over the course of the next half hour or so. By the way, I was driving. The EMT with me wasn't cleared to drive the ambulance. But, I was in control, and although I was coughing a helluva lot, I was still able to breathe ok. And drive safely. We even kind of joked about it over the air.

I continued to use the inhaler (I use an inhaler with a spacer, which generally provides the same effect as a nebulizer treatment), without any success. We eventually stopped for a bathroom break, and I stayed in the ambulance. I just couldn't get out. I had no energy, and was rapidly getting short of breath. I knew I couldn't drive safely any further. So, another EMT took over driving the ambulance, while I went and became a passenger in the Jeep. This would let me concentrate on treating myself. I headed over to the Jeep, and suddenly a wave of nausea overcame me. I knew I didn't want to puke all over the Jeep, so I quickly went to the front of the Jeep, and stood in a planter area. I didn't think I had actually thrown up, but I since found out I had. My legs were like rubber, and I had to steady them with my arms extended just to stay standing. Eventually, I got into the Jeep. The EMT driving tried to get me on some O2, but I declined (stupid!). I figured I would improve (Big hint I wasn't thinking clearly... I know the progression of breathing disorders, and I was heading into big trouble.). I kept sucking on my inhaler, sipping water, and probably going in and out of consciousness. My vision tunneled, and I eventually couldn't see much. I don't remember much of what the other EMT was saying to me. I think I remember her talking on the radio to the ambulance.


Within 20 minutes, we were at the first stopping point in Sacramento, to pick up my Jeep that had been used at another event. Clearly, I still couldn't drive. But I was so short of breath that I finally said yes to some oxygen. 10 liters per minute via a non-rebreather mask. My vision came back pretty quickly. I managed to pull out my pulse ox meter (measures how well tissues are getting oxygenated - 96-100% is normal) from my fanny pack, and put it on. 84% initially. Eek. Even not thinking clearly, I knew what that meant. The numbers began to come up quickly while on the oxygen, but I had decompensated. My pulse ox stays high and then nose dives when my asthma gets bad. I know at some point, someone mentioned my going to the E.R., but I said no. I wasn't getting worse at that point. This is arrogance. Adults have a right to be stupid. Even EMTs. I should have gone.

Which is exactly what had happened. The oxygen began to make a difference. I started to breathe a bit better, allowing more oxygen into tissues, but keeping a proper mix of carbon dioxide in the body as well. "Blowing off CO2", as many of us in EMS call it, is seen frequently in people who hyperventilate. Many times, they fall unconscious due to blowing off CO2, which slows their breathing, corrects the imbalance, and wake back up. Mine was probably a combination of hypoxia and hyperventilation, since I couldn't breathe deeply, I was breathing rapidly.

The albuterol began to FINALLY open up my airways. And I started feeling better. We made it back, and all of us eventally went home (I was at home at that point, as we all met at my place to go to the events that weekend). I continued to use my albuterol that night, but the worst was clearly over. I did take a long shower to make sure I didn't have anything on my skin that would create further irritation to my lungs.

Should I have gone to an E.R.? YES. Should I have followed up with my allergist the next day? DAMN RIGHT. Did I? NO.Is this an excuse for others with asthma to avoid the E.R. NO WAY! What I did was stupid in not wanting the oxygen or the E.R. trip, pure and simple.

This story should have ended here, but it doesn't.

My lungs have remained "twitchy" since that wonderful day. But, arrogant as I am, I can handle that... I was using my albuterol a couple times a day, but it was "under control". Right. NOT. I refilled my meds, so that I had a full supply with me, and went on a trip to NYC that was planned. It was work-related, and I needed to go. I was given a piece of paper that I had not been previously given by the pharmacy, which mentioned the need to "prime" the new HFA Pro-Air inhaler that was my albuterol inhaler. Especially if it isn't used for 2 weeks. Well, up until May 17th, I had not used my inhaler for at least a month and a half. If it isn't primed, then the albuterol isn't delivered. Hmmm... thinking back on it, this may have contributed to my asthma attack. I made a decision to re-prime my inhaler weekly from then on.

I did ok most of the time out in New York City. Used my inhaler a few times each day, but stayed fairly clear. Did my work out there, and had a lot of fun in the evenings. Coming back, the last dose I needed was earlier in the day, and I didn't use any until mid-day after I got back.

This weekend, I worked EMS as usual. Saturday was in one location, Sunday in another. Twitchy lungs and all, I went out. Both locations were dusty, and I needed more albuterol on Saturday. Got home, showered, felt better, went to sleep, got up, and went to the Sunday event. Dusty and windy there, too. I took a more preventative approach that morning. I used my inhaler before I had any problems.

Well, the problems still happened. I managed to get through the day, even taking care of a patient and transferring him to EMS transport when I was feeling pretty bleh myself. On the drive back, I needed to use the albuterol more and more again. Not as bad as the 17th, but I even commented that I HAD to get in and see my doc to get this under control.

I got in to see him today, thankfully. I am grateful to his nurse who worked me into what must be a very busy schedule for this allergist. His next available appointment for routine care is August. After spirometry, which looked pretty good (I had used my albuterol two hours earlier, before I got the appointment), and a peak flow test (470 out of a norm of 550 to 600 for me), it was obvious that I needed some medication tweaking. He upped the daily inhaled steroid I use (Advair, for those of you who follow asthma meds... it is a combination of an inhaled steroid, and a longer acting version of albuterol called salmeterol to basically keep the airways as open as possible) to the max dose for the next month or two, prednisone if I felt I needed it (I do, and I did start it), more judicious use of my albuterol via inhaler and spacer or by nebulizer, and some blood work to see if we can spot the culprit, since clearly I am having issues when it is dusty and windy. Probably a mold floating in the dust. I will find out soon.

In the meantime, I am taking it easy at least today. Resting, taking my meds, and staying hydrated. I don't know if I am going into work tomorrow or not, until tomorrow. If I am still coughing and as damn tired as I am just sitting here typing while on my bed, I will take another day to get better. I HAVE to get this under control. I certainly don't want to end up in the E.R. fighting to breathe (or getting intubated... been there, done that). My work needs me for my day job, and my business needs me for EMS. And I need to be a better example to my patients.

I need to learn to be a patient patient myself. And to not be stupid.

p.s. Read http://urbanparamedic.blogspot.com/2009/06/heal-thyself.html (I'm not the only one who is guilty of this transgression. This paramedic was truly lucky.)

New York

Greetings from New York... Manhattan, specifically. I am here courtesy my work, to man a booth at a packaging conference. Tomorrow I get to build the booth. The conference actually runs Tue-Thu this week.

I left SMF (Sacramento International Airport) at 11:59 PM last night. Yep, one minute before midnight. Touched down at JFK at 08:05 AM this morning (3 hour time difference, remember). Flight was pretty bumpy, but that isn't too suprising due to the time of year AND the wonderful low system that touched off a major series of thunderstorms in the Sacramento area on Wed night.At one point, there were over 1500 lightning strikes in Sacramento County IN ONE HOUR... that's a lot of lightning!

I don't sleep on planes, generally speaking, and this flight was no exception. I've been up since 3:30 AM yesterday (Sat), and need a few hours of sleep before I will be ready to be a tourist for a while today. I've been told that they will have my room in the next 1/2 hour or so. This lady is tired...

I will post more later. Remember to check out my Facebook and Twitter profiles also:

 Renee Roberts

Twitter: emtgirl

June is here already

Wow... I can't believe 5 months have gone by so quickly! It seems like it was January yesterday.

I am doing ok. Still dealing with the effects of my bike crash on Cinco de Mayo. The fluid on my knee (called a seroma) is keeping me from riding, which bugs me to no end. I may start riding anyway. But I have a trip coming up to New York City on June 6th (Really on June 7th, but the flight technically takes off at 11:59 June 6th... yeah, a real red eye flight!) to man a booth for my day job for the State of CA. The bruising is all gone, by the way. Allergies are driving me nutty lately. But that's what I get for being outside all the time! :-)

I am working madly to get everything together for this conference in NYC. Its gonna keep me busy this week!

EMS work is keeping me busy. Baseball season has started, so I am working EMS at Raley Field now, too. First On Scene EMS is also busy!

Happy Mother's Day!

I wanted to wish every mom and mom-to-be a very Happy Mother's Day today. Take some time for yourself, even if it is just a few minutes, to just enjoy something YOU like today.

Crash Update

My knee bruised up, swelled up, and developed a good sized effusion (fluid under the surface of the skin in my case, but not in the joint thankfully). A good section of it is still numb (which may be really good right now, but worries me). I was hoping the numbness would have improved by now, which makes me think I may have actually damaged some of the nerves in the area that I landed on. Hope it comes back.The bruising is also tracking down my leg, a function of gravity, which unfortunately makes it look worse.

I've been able to work my EMS shifts. Worked a mountain bike event Wed, and a baseball game Thu. I inadvertantly knelt down on it Thursday night, which was a BIG mistake. I am surprised I didn't yell out loud when I did it, but since I was with a patient at the time, I am glad I didn't. Never scare the patient, right? ;-)

I am still icing it during the day. The ER doc prescribed a narcotic to help me sleep, but I haven't needed it since Wed night. Good thing, as I hate taking narcotics.

Earth Day 2009

Happy Earth Day everyone!

I spent this morning working at a booth here in the building I work at, for the department I work for. It was a lot of fun talking with kids, quizzing them about pollution prevention, and giving them prizes whether they got the question right or wrong (I'm a softie!). I also was able to show them that some "foods" they think are safe are actually drugs, alcohol, or worse. It was a poster that had pictures of food, next to the "bad" item. That was really worth doing. I was surprised at how many adults got it wrong.

So, here's a pic of me with Recycle Rex...

 

I also got to do a little snake handling (I love snakes!), and get up close to bees...

Thankfully, they were behind glass... thats the closest I ever want to get to that many bees (Remember, I had one anaphylactic reaction already... don't want to risk another). Before I wandered over there, I even grabbed my EpiPen, just in case they had escapees.




I rode my bike partly into work today, and will be leaving soon heading home on it and light rail/bus. I am using today as the jumping off point to begin riding daily/near daily to work again. I hope to be riding all the way from home to light rail by Friday.

So, what are YOU doing for Earth Day today?

Update

Yes, I am still around! I've just been busy. Went to Dallas for the HHS Training Summit on April 3rd, and got back on April 8th. And I hit the ground running ever since! I worked my day job on the 9th, and then worked opening day for the Sacramento Rivercats (I work as an EMT there during baseball season). Worked the ballpark Friday night, worked in Salinas on Saturday, then back to the ballpark Sunday... then Monday, it was back to work at the day job again! And this week, I got to pack up my cubicle (Its amazing the crap I have accumulated at work in 2.5 years), as we are moving people around in the building. Me? I am moving 3 cubes over to the west... Along with packing, we were interviewing students this week for 3 positions. Whew!

Going back to the training summit, I think I learned more at this summit than the ones from 2004-2008. 2003 was a big learning curve for me (First National Disaster Medical Service (NDMS) conference I attended), but this one... wow! Advanced airway management, ultrasound technique, providing medical on trains during evacuations, and more. Suffice it to say I learned A LOT. This was not a "kick-back" conference by any means. It also reinforced my belief that I have chosen the right path to serve my country as well as a member of my DMAT in the NDMS. This conference allowed a lot of us to express our condolences in person to members of TX-4 DMAT, who lost their unit commander Ozro Henderson, as well as to mourn. Ozro was also in Dallas last year when we were staged for Hurricane Ike to make landfall.  He died shortly after. I wrote about him in a previous post.

Yes, I also had fun. Got to meet up with my good friend Barbara from NJ-1 DMAT, and also the ICE (Immigration, Customs, and Enforcement) folk that watched over us in Houston during Hurricane Ike. I even scored a cool coin from them. Had our usual sister team meeting/dinner with CA-6, which is also a lot of fun! But, I was glad to get back here to Sacramento, even with all the running!

Now, onto some not-so-fun stuff... my ankle appears to be getting worse. Maybe it is just "overuse", but late Sunday, it started hurting BAD. Swelled up pretty good as well. I treated it aggressively, applying the RICE formula (Rest, Ice, Compression, and Elevation). It has calmed down a lot, but today is the first day I have even dared to walk around the house, let alone working, without a support on it. It made me think that perhaps it is time to revisit my doc about it, and the possibility of surgery to reconstruct my ankle sooner than later. I just don't want to be out of commission for 4 months... I might not have much choice.

3 months down...

Wow... We've gone through 3 months of this year all ready. It seems like it should still be January to me. Time is just FLYING by.

I am still losing weight... not sure what I weigh, but the pants are looser and looser all the time. Had to go get a new duty belt today, as I was running out of holes (going in, not out!) in my current one. Donated my big belt, that was way too big now. I even tried on some EMS pants today. They fit, but a few pounds, and they will fit WELL. The pic to the left was taken about 10 pounds heavier ago, at the beginning of March. Still need to get rid of the stuff around the middle...

I am getting ready for the ESF-8 Training Summit (formerly known as the NDMS Conference/Training Summit). I fly out on April 3rd to Dallas, TX. Haven't been there since, oh, September (Hurricane Ike deployment)! Dallas is a beautiful city. I will come back on the 8th, and then work opening day for the Rivercats. Not sure if I am going to my day job that day or not. We'll see (probably will!).

Working EMS is a blessing to me. I love doing it. More than any other job I have EVER had. That's why I got back into it, even though the pay isn't quite there for survivability (Thus, why I work for the State during the day). I see people when they are having a bad day... and hopefully help make it better for them.

Speaking of which, I ran into one of my patients at an event recently. He had sustained life-threatening injuries last year at that same event. Injuries that we found out were even worse than we had observed, and later had been told. He was back doing what he had been doing that day, taking photos at the event. Only this time, he was walking, and not on a bike. I don't get a huge amount of feedback on my patients normally. His was and still is the exception. He is well known in the biking community. But to be able to talk with him at length was really, really nice. He isn't 100%, and may not ever be, but I like to think we gave him a chance to get there.

Adventures in Light Rail Land

Today, as usual, I left work and took the light rail train to a station that I park my car at. Its about a 20 minute ride to my car. Most of the time, it is a rather boring trip. I usually read or listen to my MP3 player on the way to and from work. Once in a while, my trip is punctuated by the occasional person with a mental illness, obnoxious folk, and even criminal acts. But not much.

However,  today was different. We had an operator that decided we should go faster than is safe. There are known areas where the train NEEDS to go slow, so the people in the train don't end up hurt. Well, this operator took a turn fast, tossing us around. Then he stopped early at the next stop. Rather than slowly moving the train to the proper stop, he jerked it forward, nearly knocking one lady from the top of the steps to the bottom. She held on tightly, and was ok.

Then we headed to the next stop. The operator pulled the train around this curve quickly also. It seemed like he was trying to "beat the light" and get through the intersection too quickly. Then, he hit the brakes.

I was standing during this ride, as the seats were all taken. I, and everyone else who was standing, got tossed. I smashed into a plexiglass window, left shoulder first. Apparently, I also hit my left cheek just below my glasses on the window. I wasn't the only one hurt. But it seemed we all just had bruises. Two RT police also got off the train, and it was clear they were shook up.

The next stop was the light rail "employees only" stop. Thankfully, this operator left the train, and another took over. The ride was smooth after this exchange of personnel. So, that proved it wasn't a problem with the train. Just the gray matter between the ears of the first operator.

So, almost 4 hours and two ice packs later, I am sitting here in my apartment. I have this vague tingling in my left hand. My 3rd, 4th, and 5th fingertips get little electrical jolts once in a while. I think it is related to soft tissue swelling putting pressure on the nerves in my arm that lead down to my hand. And I have a nice bruise to show for it on my upper arm.

Oh, I called in a complaint to the RT "Advocate". And I think at least one other did as well. Somehow, I doubt I will ever get a response from them.

"Intelligent" Ads... Don't always work

You've seen them lately. Ads on blogs, related to the information posted in the blog. Sometimes, they are article-by-article. So, you are reading about soda pop, and an ad for a leading soda company is there. Or sports news, and there is an ad for an electrolyte replacement product or energy bar. You get the idea.

Sometimes, though, this technology fails miserably. A few minutes ago, I was reading in Google Reader, a news feed program I use to keep up on a lot of blogs and news sites. And this showed up (Click on it to enlarge it):

Yeah, its a news article about a plane crash, and the ad is for a radio control plane. Oops.

Bored pockets

Got this Tweet today:

lancearmstrong@@@@@@@D@d00 085

Shortly afterward, I got this:


lancearmstrongWhoops, sorry about the booty tweet.

Yes, that is THE Lance Armstrong.

I've done this to my friends without knowing it, until I get that "WTF?" message back. Most often, I call them without knowing it. Some have had to suffer while hearing my pants pocket, my horrid singing (Does that count as torture?), or most recently, my cussing out a driver that cut me off on the freeway while driving an ambulance (He never knew I cussed him out).


So, it seems that many of us with smartphones suffer from sending things randomly via "Pocket Mail" or "Pocket Messaging". There is even a recent commercial for the new flip-style Blackberry, featuring "Butt Calling". Heh...

Time Change... and Time To Check Your Emergency Kit!

With the upcoming change to Daylight Savings Time this Sunday, I wanted to remind everyone to:

• Check/change your batteries in your smoke detectors
• Change your clock (Spring forward!)
• Check your emergency supplies kit (You do have one, don't you???)

Disasters can occur anywhere, at anytime. An emergency stockpile should include a three- to seven-day supply of nonperishable food and water for each person in the home.

Recommended items for emergency supply kits include at least one gallon of water per person per day, flashlights, batteries, portable radio, extra clothing (including good walking shoes and/or boots), first-aid kit, copies of important documents, pet food and supplies, medications and personal hygiene supplies for each family member. Most of this can fit in a large garbage can (33 or 45 gallon), as you can see on the left.

For more information, including a list of emergency supplies, see the Web sites at www.ready.gov or www.bepreparedcalifornia.ca.gov.

Death Valley and (eventually) Orange County

Got back at midnight last night from what was a whirlwind tour of California...

On February 6, I took one of our ambulances, and a friend/EMT Jim, and headed toward Bakersfield. I wanted to leave at 6:00am, but due to technical difficulties (i.e... a diesel fuel leak), we had to repair it before we took her out for the drive. Ended up leaving at 9:00. Picked up my friend/EMT Anita in Bakersfield, and headed through the desert to Death Valley. Got to Furnace Creek around 9:30pm, and dropped off pretty rapidly to sleep (I had gotten up at 3:15am). It had been raining, and continued to do so all night. We had found out when we checked in that the marathon we were working was not going to be in Titus Canyon, due to snow and flooding. I really wanted to see Titus Canyon... maybe next year. So, now the race was going to be in Badwater, the lowest point in Death Valley.

We got out there, and began to set up shop. It stopped raining long enough for us to get the ATV out that I would spend the next 6 hours on, set up the gear on it, and get me going right after the racers took off. It began to rain pretty quickly after the race started. It wasn't hard rain, just constant. I got soaked and muddy pretty quickly. I had put on my polypro long underwear, which helped to keep me warm, although not dry. After 2 hours, though, my hands were numb. Got them to come back to life periodically by using the ATV engine to warm them. Jack-rabbited around, keeping an eye on the racers the entire time. These are hardy marathon runners! Death Valley can be brutal any time of the year, but add cold and rain into the mix... well, they did incredibly well! Jim and Anita kept shop up at the Start/Finish.

Toward the end of the race, I began to follow the last ones in. It also got colder, and was raining a bit harder.  Water was becoming more apparent in the low area of the race. The racers had to jump over the streaming water.

I started getting really cold, and shaking. As the last racers crossed the finish line, I hung back, to allow them their moment of glory (and a decent finish line photo, I hope). Jim began to wave wildly at me. I came in, and he told me that there was massive flooding in the valley, and that the rangers were going to close Badwater Road any minute now. I drove the ATV all the way up to the trailer, and we got it loaded quickly. I got behind the wheel and we (The three of us, all the racers still there, and the event organizers) all left Badwater. We drove through several areas of flash flooding, and made it to the Furnace Creek Ranch, where we quickly found out that all roads in and out of Death Valley were closed. Yep, we were trapped. There was mild flooding at Furnace Creek, but the folk running the resort know how to channel the water. No problem for us, except that we couldn't leave. Not that we were planning to until morning.

I ended up mildly hypothermic, and took a 30 minute shower to warm up. Even 12 hours later, I was cold. But I was functional. I made a decision that alcohol that night was not on my menu that night... Hot food was. We got dinner, and after talking with the event organizers for a few minutes, ended up back in our rooms. I let Anita and Jim know that if the road was open when we woke up, we'd leave immediately.

The next morning, I checked with the hotel front desk. They told me that 190 westbound was open, so we packed up, checked out, and took off around 8:00am. Oops! 190 west was NOT open. In fact, we found out from the rangers that we could have made it to Stovepipe Wells, but that it was physically impossible to make it farther. They call it a "hard closure". I call it washed out road. After speaking a little more with them, we found out that 190 east was open, all the way to 127. Took it down to Baker at I-15, back to 58, and up 99 to home... Long drive, but not really longer than it is over the mountain.

Dropped off Anita in Bakersfield so she could head home. Had more technical difficulties with the ambulance while heading home,but we finally made it. Got home around 10:00pm. Threw my clothes in the laundry, and got a few hours sleep. Then I got up, packed, and went to the airport. My day job took me down to Anaheim, where I was until last night, working a conference, on my own. It was a long week...

Slain woman "broke lease"

In a shining example of greed and inexcusable behavior, Broadcrest Foothill Apartment Homes in the Los Angeles area has sent a demand letter to the ex-husband of Alicia Ortiz demanding her estate pay $2821 in rent and penalties for giving "insufficient notice to vacate."

I am absolutely amazed at the overt stupidity of this company. More so that they were greedy enough to use a law that is designed to stop people from breaking leases just to move to another home. It has nothing to do with people getting killed by their spouse or anyone else. "Gee, I think I am going to get killed today... did I send that 30 day notice to my landlord?" I am surprised that they haven't tried to get the damages caused by blood and fire in the home from them also.

OK, Broadcreast Foothill Apartment Homes, WAKE UP! WHAT YOU ARE DOING IS WRONG!

San Diego Firefighter first professional one legged firefighter in the US

Wow... you need to read this guy's story... http://calfire.blogspot.com/2009/02/san-diego-firefighter-first.html

This guy doesn't let ANYTHING stop him!

Night Crawler Syndrome

Lately, I have had a serious case of NCS (Night Crawler Syndrome). I fall asleep around 8:00-9:00pm, and wake up around 2:30am or so. And I can't fall back to sleep.

So, I've been doing something with myself... exercising at the gym, working on website programming, and even heading into work at o'dark thirty. I get to work early enough that I have to sign in, rather than just going to my office.

What does this mean? I don't know. With the exception of today, since I am caffeine-free at the moment, I am not more tired than normal. In fact, I've had more energy lately. I am hoping that by getting off the caffeine, I will start to restore my normal circadian rhythm.

Of course, the upside of this is that I get A LOT of work done without interruptions!

KI6VKQ

Yep, that's my callsign! I've been watching online, and it was granted today. W00T!

Now, to find someone to talk to...

BMI under 40!

Having just updated my weight loss ticker above, I just had this realization that my Body Mass Index (BMI) is now under 40! When I started this weight loss journey, it was over 45.

While I still have a long way to go, this is, for me, a MAJOR milestone. It means I can continue to be deployable as a DMAT member, it means my health is better, it means I move easier, it means I WEAR SMALLER CLOTHES that don't wear out as quickly, and it means that I believe I can do anything I put my mind to.

And it reminds me I am doing well, and to stay on track.

Hackers Crack Into Texas Road Sign, Warn of Zombies Ahead

This from Fox News:

Transportation officials in Texas are scrambling to prevent hackers from changing messages on digital road signs after one sign in Austin was altered to read, "Zombies Ahead."

Read the rest of the article here.

Although it is illegal, this is fun hacking. And no, I had NOTHING to do with it.

Hugs

I was on the train this morning (My daily ritual for getting to work without paying horrendous parking fees downtown). Sat in a seat near one of the doors. At the next stop, a woman got on, who was shall we say, of significant size. Dressed very nicely, though. It looked like it was hard for her to get up the stairs, and honestly, she looked to be in pain. Due to her size, she needed a seat to herself. She instead sat on one of the stairs. None of the guys on the train offered their seat to her, so I did. I told her I was getting off in a few stops, and she could have my seat. She politely declined, but said she'd grab it as soon as I got off the train. I tried to convince her, but no go.

As I got up to get off at my stop downtown, she got up off the stairs. She let me know she had a hip problem (Thus why she looked in pain), said thank you for offering my seat earlier, and HUGGED ME. I haven't had a stranger hug me in a LONG TIME. It was nice, actually. I told her it was not a problem, and stepped off the train.

Honestly, we don't hug people often enough. Especially those we love.

I passed!

That picture is my Certificate of Successful Completion of Examination (CSCE), for my Amateur Radio Technician Exam. So, this means that I am now a Ham Radio Technician! I will get my callsign next week sometime, when the information is entered in the FCC database. I'll let you know my callsign when I get it.

If I were in a CA prison like this, I'd never want to leave

This from San Francisco Chronicle:

"Aerobics and yoga classes, workout rooms and open-air courtyards were just a few of the amenities recommended for California's hospitalized felons in a draft report for the court-appointed receiver tasked with overhauling the state's prison health care system...

...The recommendations called on the cash-starved state to spend $8 billion on seven new hospitals - each roughly the size of 10 Wal-Mart stores...

The report also suggested that the new prison hospitals include:

• Workout rooms to "promote wellness," featuring exercise machines and space for "therapeutic activities such as aerobics, yoga, (and) group exercise." Plus handball courts.
• Outdoor courtyards "where patients will be encouraged to participate in recreational therapy programs such as horticulture."
• Gymnasiums with a basketball court and a music room, a crafts room, game room and therapy kitchen.
• Outdoor running tracks.

The report also said there should be day rooms for patients featuring a "quiet room for reading and study, as well as a separate room for group TV watching." Each should include "a liberal use of sound attenuation materials and be designed to maximize natural light to create a normative environment," the document said.
The report also recommended plenty of landscaping along the perimeters of the lockups to hide the fences and electronic surveillance systems.

The overall idea is to create something that doesn't resemble a prison, the document said - hence, designers should "explore a unique blend of hospital, community college and residential scales as a basis for the site plans."

I don't call this a hospital. I call this a spa. And if I lived like this, I'd never want to leave. We will have people committing crimes to get this lavish treatment.

A hospital is there to treat injury and illness. Not to cater to people. When they get out of prison, then they can enjoy the luxuries that the rest of us get to have IF WE PAY FOR IT. Now, I will grant... give them an area to run in. A simple track can be built. And a general purpose room can be used for basketball, yoga, etc (Hey, our kids have to deal with it, why can't prisoners?). BUT LANDSCAPING TO HIDE THE FENCES? NO! I WANT THEM TO REMEMBER WHERE THEY ARE AND WHY THEY ARE THERE! The federally appointed receiver is clearly not thinking here.

Hypothermia on the train platform

This morning, I decided to take the train into work (mistake #1). Basically, I park at a local station, and ride in. I park for free (vs downtown which is $8.00/day). And I am giving less emissions to the atmosphere via my Jeep. So, I see the train go by, and figure I will get on the next one (usually 5-7 minutes apart as this stop is near the end of the line). Usually ensures me of a seat anyway.

OK... 15 minutes later, we are all still waiting for the train. Oh, it was 34 degrees out there. I had my polar fleece on, and a cap, but no gloves (mistake #2).

Now, 25 minutes later, one train car goes by. Stops briefly, then continues on. We never see it again.

35 minutes later, a 4 car train arrives. We have approximately 150 people now waiting on the platform, all looking like me... shivering, slightly hypothermic, and darned greatful that the train was there. We all get in (Thankfully, it was warm inside!). I got a seat, NEXT TO THE HEATER along the wall. But many others ended up standing.

We got to the end of the line eventually, took on a lot more people, then headed back. When we got to the same platform we all got on at, the look of the people there was priceless. You could see them mouthing "Oh My God". But they got on anyway.

It was really cramped quarters in the train. We all took solace as we watched people with similar responses to the folk earlier... "OMG", "Holy moly", etc. It kept us laughing. About 10 minutes into the trip, the feeling came back to my fingers,

Finally got to my stop downtown. It was a mass exodus off the train. And there were still a lot of folk left on the train. Makes me wonder what the maximum occupancy and weight is in those cars...

And I HAVE TO put a pair of gloves in my backpack until the end of winter.

Ahem... Terror again, nearly 7 years later

I've been wrestling with posting this, and finally decided to do so.

January 2nd was just another day. I went into work early, so I could leave early. Got out early enough to get a few things done. Paid my rent, my car payment, got my brakes worked on, and even managed to get my mammogram done. I reminded the mamogram radiology tech to make sure I didn't get sent a postcard this time if there was a problem, like I did in 2002 (Not a good way to find out you have a possible problem. In fact, I think it is the worst way to find out.).

January 6, I took off for the Consumer Electronics Show in Las Vegas. Its my yearly migration to the city I call my second home. And it is my vacation.

Janaury 9, while I was sitting in the press room at the Consumer Electronics Show, I got a phone call from Kaiser Radiology. The rep on the phone informed me that they saw something suspicious on my mammogram (The one I had done on January 2), and that I needed to come in for more films and an ultrasound.

Talk about a bombshell. As I was talking to the rep, certain things came up in conversation, such as the possibility of another biopsy, like I had back in 2002 (Which showed that I didn't have cancer). When I repeated the word biopsy, the room got suddenly quiet. Even though I was being quiet on the phone, this is a room full of press people, who listen to a conversation with one ear, and use the other to hear anything else that might give them the edge on an article. Oops. I guess that word freaks them out as much as it does me. I made an appointment for Monday afternoon.

I got really upset. Not there. Never in the wolves den. I actually had an interview I did after that. Don't ask me how, but I did. When I got back to my car, I let loose. I cried, I yelled. Why AGAIN? DAMMIT! WHY? I needed someone to talk to, so I called my stepfather. He's been through this before himself, beating testicular cancer. So he knows what its like to get that phone call. He let me vent. And once I was in a listening mood, he reminded me that I needed to take this one step at a time, and to not dwell on it. Get it out of my mind for the rest of the weekend, and what happens on Monday happens.

I was able to keep my fears at bay until I got on the road back to home. With 10 hours by myself while driving home, the what-if's began to creep into my head. My mortality. And all the "joys" I had the last time I went through this. I finally began to sing, just to keep my mind clear while on the road. It worked. I was able to complete my trip without really dwelling too much on the possibilities, as long as I kept singing.

I did stop at my cousin's house in Tehachapi to say "Hi". I didn't tell her. She's got enough on her mind right now, with another baby due very soon. I didn't want to say anything until I knew.

Monday, I went to work. Then in the afternoon, I went to the appointment. The lady who registered me at first couldn't figure out where my appointment was in the system. Then she asked me, "Which doctor ordered this?" I had no idea... Finally, she found what she needed to find.

A few minutes later, I was called into the back. The volunteer had my radiology chart, then told me, "Its going to be a while. There are others ahead of you." Beg pardon? I reminded her I had an appointment for additional films and ultrasound. "Oh?", she asked. She looked more confused than the registration clerk. Was I in the right place??? She led me into the "waiting area", where I changed into a mammography gown, and sat down to wait. There were two other ladies there, one was a "walk-in", coming in for her normal mammogram, and the other had already been diagnosed with a lump, and was there for more films to determine size, shape, etc. before her biopsy.

Evenutally, I got called, and had the 3 films taken. Talk about squishing! OUCH! It literally takes your breath away when they smash your breast as flat as possible to get a good film. But 3 good shots they got. I didn't budge while she took the pictures.

The radiology technician took the films to the radiologist, who cleared them. She came back after several minutes, telling me all way good. Glad to hear it. But, I want to SEE it for myself. I wanted to see the film in question, why they had concerns, and the new one showing why it was clear. So, I told her that. She told me the films were on the doctor's desk. I told her, "I can wait".

I think she figured out that I wasn't going away. She knew of my medical background from our talking while she, uh, squished me. She left, and a few minutes later, she returned with the radiologist. He was very polite. He showed me my 2006 image, the one from early January, and the one from that day. And I can see why they were so concerned. It didn't look good on the film from early January. But the ultra-squished breast showed no problem there. Oh, and I didn't need an ultrasound at that point.

As a CYA, they want me back in 6 months. No kidding! If they don't call me before then, they will hear from me, rest assured. I don't want my life interupted for anything right now. Especially cancer.

I got to my Jeep, and took off from the parking lot. Right as I got to Arden Way (for those that know the Sacto area), I lost it. I was crying, but not sad tears. They were tears of absolute joy. Tears that spoke 1000 words, all saying "Thank God!". I got it back together, and continued on.

The folk in the car next to me must have thought I got really bad news, not really good.

 The text I sent to those I told read:

ITS CLEAR! OMG ITS CLEAR! I saw the films myself! WOO HOO! Thank you for all of you who were praying for me.

For those that I did tell, THANK YOU AGAIN FOR PRAYING FOR ME DURING THIS TIME! :-)

For those I didn't tell until now, please understand I wanted to wait until I knew what was really going on before I let you know.

 

Back to life...

The Birth of an Idea 17 Years Ago

"Almost precisely 17 years ago, a young British researcher from Cern, the European organisation for nuclear research, gave a presentation in Texas on a technology that was to change society dramatically. That same month, the Cern newsletter announced it to the world: it was called the World Wide Web."

• Can you remember life without the World Wide Web?
• Can you remember life without email?
• Can you remember life without a computer in your home?
• Can you remember life without your cell phone?
• Can you remember looking up newspaper articles on microfiche or microtape?

For those under 30, most really can't. They've always had access to these technologies. Today, I honor what started out as a presentation that changed our lives in incredible (and sometimes scary) ways. Please take a look at this article (The quote above came from this article). Read it... its very eye-opening, and a reminder to us of what we have now, courtesy a few dreamers.

Cold and Wet Days

Winter has finally arrived. Yep. It is cold AND wet here in Northern California. How cold? Well, the low this mornig at my apartment was 37. For the Sacramento area, this is fairly cold in December. Not the coldest here, by any means, but add the rain into this mix, and the words "bone chill" come to mind. The snow level is currently around 1200 feet, which is low for this area. We have actually gotten snow in Sacramento Valley, but it doesn't look like it is going to happen this time around (Too bad, actually!). I've been in much colder temps (How's -20 in Indiana sound?). But when you are outside...

Yesterday, I worked a cyclocross bike event in Monterey. I love working these, but yesterday was just COLD. We had our small propane heater, but the poor fingers just would not get warm for more than a minute or two. The rain started around 1:00pm and really didn't let up after that. Thankfully, conditions were really good, race-wise, and we didn't have any major injuries. Not even road rash yesterday, which is really unusual for this group. Shivering bodies aside (and many were!), I am glad they all had fun!

Sparta - The Mean Kitty Song

You need to watch this video!

Compassionate Friends Candle Lighting

Tomorrow night, at 7:00pm local time (Local time to YOU), please light a candle in remembrance of all those who died in childhood, regardless of the cause. From the Compassionate Friends website:

Worldwide Candle Lighting

The Compassionate Friends Worldwide Candle Lighting®, held annually the second Sunday in December, this year December 14, unites family and friends around the globe as they light candles for one hour to honor and remember children who have died at any age from any cause. As candles are lit at 7 p.m. local time, creating a virtual wave of light, hundreds of thousands of persons commemorate and honor the memories of children in a way that transcends all ethnic, cultural, religious, and political boundaries.

Now believed to be the largest mass candle lighting on the globe, the Worldwide Candle Lighting, a gift from TCF to the bereavement community, creates a virtual 24-hour wave of light as it moves from time zone to time zone. Hundreds of formal candle lighting events are held and thousands of informal candle lightings are conducted in homes as families gather in quiet remembrance of children who have died, but will never be forgotten.

The Worldwide Candle Lighting started in the United States in 1997 as a small Internet observance but has since swelled in numbers as word has spread throughout the world of the remembrance.

I may be on the road at 7:00pm tomorrow night while returning from work, so I will light my virtual candle at 7:00pm on this site. I light my candle for:

• Luke Covey (The son of my friends, Steve and Nicole Covey)
  
• Kimmi Burnett (My cousin)
  
• Tommy Hunter (The son of Alicia and John Bennett)
• Tammy Williams (My daughter's friend from junior high school)
  

If you can make it to a ceremony near you, I invite you to. Check out the Compassionate Friends website at the link above for information about a ceremony where you live (Worldwide, folks!).

Making My Weight Loss Work Public Again

As of this moment, I am back on track. I had a medical monitoring appointment (a yearly requirement of my day job). They were happy with my progress over the last year. This gave me focus again in losing weight. Besides, I have an important reason (aside from feeling better, and being smaller) to lose the weight: My ankle. I want to be in the best shape possible for the surgery, when I decide to have it.

So, I have added a new feature to my site... my weight loss ticker.

Now, I have no excuse to not keep losing weight.

...And Back

Got back from Death Valley around 10:30 last night. I wish it could have been longer. I love that area. I know most of you don't see deserts as God's beauty, but it is. And what incredible sites!

Anyhow, the marathon went well. Had a few patients, including a rather dehydrated runner who may have probably has an infection. Bad combo. I wanted her transported out, but she refused. She has that right... .

Onward To Death Valley

On my way to work EMS at a marathon out in Death Valley... be back Sunday late.

Sleepless in Antelope

For the third night in a row, I keep waking up after falling asleep. My ankle has this ache that goes up into the fibula (The bone going up your lower leg on the outside. Not your tibia - A.K.A. shinbone). I guess it is referred pain, but it is enough that I can't sleep.

Might be a benadryl night tonight, just so I can get some sleep.

Happy Thanksgiving!

I wanted to wish everyone a Happy Thanksgiving. I am actually "off duty" today (No day-job, no events), so I am cooking a bird this year. Got the 17lb wonder, and 7 people to feed (including myself). Looks like I will be eating leftovers for a while. I just couldn't turn down the price!

So, just a reminder to everyone: MAKE SURE YOUR TURKEY IS COOKED! As a microbiologist (and a victim of a Salmonella infection last July), Camphylobacter and Salmonella are nasty bugs to get. They can leave lasting effects, and have been known to kill people each year. There are a lot of sites (like www.butterball.com)that will help you make sure the temp is correct, but 165 degrees in the center of the stuffing (if your bird is stuffed), or 180 in the thigh will make sure you don't get sick. Personally, I cook my turkey unstuffed. And don't leave the bird out for people to pick at all day. Bacteria will take every chance to survive. And you are a food source for them as well (That's why we get sick!).

Black Friday

Are you planning on going to any Black Friday sales?

I don't think I am, simply due to the fact that I have no money. My Jeep broke down last night, and I need to get it repaired before I can do anything else, financially-speaking. There are a lot of Black Friday sites, but my favorite is BFAds.net. If I had money, there are a lot of good deals out there!

So, let me kow if you are going out Friday (Or Thursday for some of the sales!).

Uh oh, my nerdiness shows

Can You Say "Hematoma"? I knew you could

 

No, I wasn't attacked. It is the unfortunate side effect of some dental work. It took a lot of anesthetic to get my upper right teeth to be numb, and one of the injections happened to get a vein.  Not real comfortable (read: Painful) the first 2 days, but isn't bad now. This is day 3 since I had the work done, and the bruising is becoming very evident. Wonder what it is going to look like by my birthday on Sunday...

Not what I wanted to hear

Five weeks ago, I rolled my ankle. Not doing anything incredible; I was just reaching for something across my bed of all things. Didn't seem that bad, but it hurt. I treated it with the usual formula (RICE):

• Rest
• Ice
• Compression
• Elevation

It improved relatively quickly. However, a couple of weeks ago, it really began to ache, up into my fibula (One of the bones in the lower leg). My thought was, "maybe you have a stress fracture". So, I got in touch with my old podiatrist by email. Didn't hear back, so when I went to pick up some meds from the pharmacy, I stopped by. Talked with him briefly when he passed by me in the hallway heading somewhere else. Got an appointment, and got some x-rays taken.

Flash-forward to today. I saw him, and we chatted about my ankle, while he found the area of what we call "point tenderness" that was the worst. It wasn't in the bone. The pain I was feeling was "referred pain" (pain that starts somewhere else), probably due to the previous nerve damage in my ankle. Its that nerve damage that allows me to walk on a potentially severely injured ankle without screaming. The pain was clearly in an area of soft tissue (Non-bone). I was figuring he would offer a few options, one of which was injecting it with a cortisone drug to get it to calm down.

Nope. He dropped a bombshell on me. He told me that I need surgery AGAIN to essentially reconstruct the ligaments. Either I overstretched the repair I had in 1993 (and previously in 1992 which didn't take), or I tore it out (I had the extensor tendon from my ring toe harvested in 1993 to recreate the anterior talofibular (ATF), posterior talofibular (PTF), and calcaneal ligaments. Took months before I was allowed to put my foot to the floor after that one, and a year before it was ok to walk without support (Most of the time, I was in a "fracture walker", a removable cast that looks like a ski boot). This time around, it will take cadaveric ligament grafts to fix. Hmmm. Not real thrilled about that, but my tissue isn't usable. And two months non-weight bearing, along with another 2 months in a fracture walker. Hmmm. Thats four months directly out of commission, in terms of EMS work. Ugh.

I don't have to do it immediately, but it does need to be done. My ankle will dictate more than anything when I have to get it done, but I am thinking next summer might be a possibility. In the meantime, the doctor built up the outer edges of my boot inserts to keep me from turning my ankle while walking. He wanted me to be in a fracture walker again, but after we talked, my work boots are a good support for it (just about as rigid on side-to-side movement). I have to be able to work. At least right now.

Flashbacks

I've never been one to have flashbacks of negative events. Even all the stuff I have seen in EMS never really came back to me as if I was reliving them. Not until today, that is.

I was on my way to the light rail station in my Jeep when suddenly the guy behind me (in a huge black pickup truck) slammed his brakes to avoid hitting me (I was already stopped, and he was not paying attention for some reason). Heard the tires screeching, and watched through my rear-view mirror as he got closer and closer to me. He managed to turn to the right and stopped about an inch away from me. Whew! Got my heart racing this morning!

I got to the light rail train station and hopped on. The adrenaline rush was still with me, and I suddenly started having flashbacks to my accident in May 2006, when I was hit from the rear by an unlicensed, uninsured, illegal immigrant who LEFT HER CAR at the scene of the accident and took off (Hit and run, literally). It was like I was back there again. Really started to shake me up. I wasn't hurt very bad in that accident, so I don't know why I am feeling like this right now, except that it was another close call. Back then, I was just really pissed off. Now, I am just upset.

$2.37 a gallon

I never thought I'd be "happy" that gas is down to $2.37 a gallon (This is at a local 7-11 Store). Can't say I am happy, but at least I don't feel I am putting my paycheck in my tank. For a time, the price of milk was less than gas.

And the price of diesel... wow! It went up to $5.49 at one point, but it now sub $3.00 (Just barely). When filling a 30+ gallon tank on an ambulance (We have 2 of them), it adds up quickly. Local agencies were having a hard time due to the cost of diesel for a while. Some volunteer ambulance agencies had to cut back or shut down operations when the price was that high. They are still struggling.

Making Strides Against Breast Cancer

Well, I walked the walk! It was a lot of fun. Steve, Nicole, Brent, Brandon, little Genna, and I all walked the full 5K walk around downtown Sacramento, going into Old Sacramento, through the K Street Mall, and back around the Capitol. I didn't even feel it! Guess that means I have been walking a lot more lately!

 

The balloon arch all walkers went through at the beginning of the walk

 

The Capitol with the tents on the west side (Front entrance)

 

Pic I took of myself

 

I walked in memory of Annina. She was a good friend and co-worker. 

Annina passed away September 19, 2008.

 

Taken after the walk. Yeah, that's a 2-meter radio on my backpack strap. I am such a gearhead!

Loma Prieta Earthquake - Oct 17, 1989

19 years ago, the Loma Prieta earthquake hit with a magnitude 7.0. It left most of us who were living in the San Francisco Bay area at the time more than a little shaken. I remember going two days without power (and two weeks of unpredictable outages), learning to cook EVERYTHING on a barbeque (I can bake bread on a barbeque!), viewing the untold damage, and feeling ever-so-blessed that my family was not hurt at all. Here are some pics from that time:

 

The Cypress Freeway in Oakland

The Bay Bridge (Only 1 person died on the bridge, trying to "jump" that chasm).

Rory, the kids and I were walking along this sidewalk the Sunday before the earthquake. I still think that in the blink of an eye, we could have been wiped off the face of this Earth had the quake happened when we were walking there.

 

Support columns protrude through the top of Highway 1 near Watsonville.

 

The infamous "red tags" on buildings, bridges, and freeways all over the Bay area. 

(Note: There are still buildings and freeway overpasses red tagged to this day there)

For those of you outside California who are looking at these photos and wondering why I and millions of others would choose to live here, we have THE BEST WEATHER IN THE WORLD! We have the 5th largest economy in the world! We have one big quake every 15-20 years. And due to the size of California, we aren't all feeling the shaking when it happens. I will take an earthquake once in a great while over tornadoes, hurricanes, horrendous lightning storms, and ice storms ANY DAY.

Please pray for the 68 people who lost their lives that day, and for their families who are grieving for their loss to this day.

Events and Rattlesnakes

I remind people all the time to watch out for wildlife when they are hiking, biking, or otherwise spending time in the back country. All manner of critters are out there... bobcats, cougars, bears, raccoons, and rattlesnakes. I tell them, so they don't have run-ins with them, resulting in a medical need.

So, imagine my surprise when, at an event at Toro Park this past Sunday, I found this guy at my feet:

Yeah, thats a Western Diamondback. Little guy, around 16 inches long. But perfectly capable of laying me out. Seems he was just moving past me. I stopped and let him continue on. Didn't seem to mind me at all...

Problem is, he decided to continue on to the race course. Just as the last mountain bike race was getting started. Although he was VERY young, I was amazed at how agile he was, avoiding getting hit and killed by the cyclists. Talk about FAST! Wow!

Then he continued on. Right toward a car next to our medical station. Someone brought me a long pole, and I "guided" the little snake into the bush, away from people.

Veni Vidi...

Vomiti

Never Forget

It was seven years ago today that this nation was attacked by terrorists. It changed many of our lives in ways we are still discovering. We traded some of our openness and freedoms for what we hope is enhanced security against further attacks; TSA screening everything we own when we board a plane, "LiveScan" fingerprinting and increased background checks for simple things such as employment, RealID coming up, and more.

It was on September 11, 2001, after the attacks, that I made the decision to join DMAT CA-11. I had tried to join the military years and years ago, but they wouldn't take me, since I was missing a kidney. I have always felt a strong need to give back to my country. I remember filling out the application that day, and have been a member of this team since then. Interestingly enough, my application sailed through in record time (Karma?).

Today I sit in a hotel in Dallas, waiting with my team and many others for Hurricane Ike to make landfall. Whether we move before it moves in, or afterward, is up to the folk well above my level. Some teams are out there evacuating patients, others like us, are waiting for our missions, which will eventually occur.

Please take time today to honor those who died as a result of these horrid acts. And take special time for those who died trying to save so many... the firefighters, EMTs, and police. They truly died serving their country on that day. If you don't already volunteer, consider it. It doesn't need to be DMAT... local non-profits are always looking for volunteers.

Training and Stress

While Hurricane Ike decides what to do, we are here training. It seems like busywork, and to some extent it is, but there are aspects to deployments that need reinforcement. Even to those of us that are deployment "veterans" (i.e. those who have been on a 2 week mission in austere settings before), you can't learn enough of some subjects. For the new folk, it may be their first introduction to a subject while out in the field. So, if you hear me referring to training, realize it is for a very good reason!

Stress can be a big problem on deployments. So, we are given downtime for obvious reasons. It lets us "let our guard down", stand down, cool down, whatever you want to call it. Sharing a room can be a stressor for some people who are more accustomed to having a hotel room by themselves. Eventually, living in a tent, a gym, or other location can (and will) add to stress. I am writing this entry during a 1-hour period of downtime.

So, just to let everyone know, I am doing fine. Kicking back in my room right now! Another training at 3:00pm... (Eastern time, that is)

Hurry up and wait

Well, we made it to Atlanta yesterday. Red-eye flights are fun... NOT! I can't sleep on planes. I've tried, nothing helps, even diphenhydramine only makes me drowsy. Every noise or vibration keeps me awake (Yes, I have tried earplugs). So, we made it to our hotel, got checked in (Checking in 35 people takes a bit of time!), and got to our room. Switched rooms, when there was a plumbing issue (Toilet leaking). Got dinner, and got to bed. Some of my teammates went out for a little while to wind down... I didn't need that. My bed is so friggin comfortable, I was out in moments! I am going to thoroughly enjoy this time here, since I believe in the "No good deed goes unpunished" principle. Chances are, once Hurricane Ike hits, we will be sleeping on cots in or on our sleeping bags (Been there before!).

More to come later!

Deployed to Atlanta

Well, my team (DMAT CA-11) has been deployed. We will be on our way to Atlanta to pre-stage for the expected landfall of Hurricane Ike. We are leaving at (get this) 12:25 AM on a flight to Houston, then on to Atlanta.

Finishing packing my gear... hope I don't miss packing something important. I use lists, but all of us manage to forget something!

Activated

Tonight, I got activation orders, effective 11:00 am tomorrow. Will let you know when/where/etc as I know.

Holding pattern

I am still waiting to see if I am deployed. In the meantime, life goes on...

Hurricane Gustav

... is making landfall as I write this entry. I am currently anticipating being deployed in the near future (24-48 hours) to the region. Depends on the amount of damage, the needs of the evacuees, and what NDMS decides to do. For those of you who are curious, there are teams that have been "pre-deployed", and are staged (waiting) in safe locations in nearby states. Others are already handling special needs populations that were evacuated to Dallas and other areas.

I just heard on the news (NBC) that the storm surge is topping one of the levees. Not good, folk. There is also a barge and a boat on the loose in one of the canals. They can actually damage the levees.

Gone... but not as far away as they could have been

Today, Diana and Jonny moved out. Diana made some decisions that she felt would be best for her and Jonny. She wanted to move from Antelope to Philadelphia to be with her boyfriend, but he isn't quite ready for that level of relationship.

So, she went back to Salt Lake City. NO, SHE DID NOT GO BACK TO HER EX! She went back to set up shop with a friend of hers who had a baby about 5 months ago. She left around 3:00am, and got there in the early afternoon. We kept in touch her entire trip, and her trip went well and safe.

So, I sit here with a (temporarily) empty apartment. My old roommate Mike is moving back in at the end of the month. Hey, he pays his portion of the rent on time all the time! And he has and continues to improve his life. He is a good friend, inherently honest to the core, and I trust him implicitly. He doesn't mind my wanderings at 4 in the morning when I am on my way to an event. And I get cat-sitting out of the deal if I go out of town, say, to Salt Lake City. :-)

Google Maps Street View captures house fire

No kidding. You need to see this one to believe it.


View Larger Map

The local Fire Dept was on scene already. If you want the link to this picture (At least until Google removes it), clicking this link will give you the location.

Update: Google took the photos down, but here they are:

Gas Prices... anyone else see something disturbing?

Take a look at this mapping of the price of gas in the Sacramento area vs the price of crude oil:

Notice a disturbing trend? BEFORE the price of crude topped out near $147.00, the price of gas had already peaked, and was falling. It peaked a full month before the price of crude did. Some thoughts on possible causes for this effect:

1. We were using A LOT LESS gasoline (3% drop? I can't see that causing this effect YET)?
2. Less trading? (I doubt this... but, if someone has this info, let me know.)
3. Someone in the oil industry (AKA refineries and huge gasoline companies) KNEW that the price would soon start falling on crude oil.

Now, personally, I am seriously betting on number 3. Insider trading and insider knowledge DOES affect industries, including this lovely volatile market. If this isn't a marker of this, I don't know what else is. After all, it was this industry that said we would see prices fall only after about 6 weeks AFTER the price of crude topped out. Hmmm... something wrong with this picture? I hope I am not the only one seeing this.

Disappointment...

... doesn't even begin to describe my feelings right now. I caught word that the letters went out late last week regarding acceptance into the paramedic program. I knew I qualified, so it wasn't that I was expecting a "sorry, you didn't make the cut" letter. So, I eagerly went to my mailbox to retrieve what I thought was going to be my acceptance letter into the paramedic program.

"Thank you for submitting your application to our 2008 Part-Time Paramedic Academy. Unfortunately, the number of qualified applications did not meet the required minimum in order to provide this important course to the public."

My jaw hit the floor as I was reading it. THEY CANCELED THE PART-TIME PROGRAM! Paramedics are retiring from EMS and leaving EMS due to low pay in droves (many are firefighter-paramedics... firefighting pays a lot better than paramedicine alone... better benefits also.), and they canceled it! Why? Not enough people applied to the program... I don't know how many applied, how many were qualified, but right now, all I can think is there is at least one person who won't be a paramedic for at least another 6 months beyond the 2 years she was going to give up to do this.

Something needs to change, and change quickly. Otherwise, there won't be enough paramedics out there to provide the advanced life support that our increasing aging population needs (some of them are the very paramedics retiring).

I had already committed the next 2 years of my life to getting my paramedic license... For me, it wasn't the money. It never was. If I want a lot of money, I know how to make a lot of money. Its the love of medicine, pure and simple.

This really sucks.

Update: I decided to write a letter back urging them to reconsider. More later.

Randy Pausch, 1960-2008

Randy Pausch died this morning. He was a Professor of Computer Science, Human-Computer Interaction, and Design at Carnegie Mellon University (CMU) in Pittsburgh, Pennsylvania, United States and a best-selling author, who achieved worldwide fame for his "The Last Lecture" speech on September 18, 2007 at Carnegie Mellon University.

Below is his "Last Lecture" titled "Really Achieving Your Childhood Dreams". It is 1 hour 16 minutes long, and I encourage all of you to watch it.



Mr. Pausch had been diagnosed with pancreatic cancer in 2006, endured chemotherapy and surgery, and in 2007, was told his cancer was terminal and was given 6 months to live. He made it longer than that, and created that lecture not for his students, but for his children.

I need your help

I have helped many people and organizations over the years: financially, emotionally, spiritually. Some of you read this blog. Now, I need your help.

I need to raise about $1200 before Aug 23rd, to pay for my paramedic program (Books, tuition, malpractice insurance, uniform, etc). That is the first day of class. Until my month-to-month costs go down or my income goes up, I am barely keeping my head above water. BUT I NEED TO GET MY PARAMEDIC LICENSE. This is a part-time paramedic program through a local highly-rated community college. When I am done after 4 semesters, I will have earned another degree (An associate degree, but another degree nevertheless). But most importantly, it will enable me to provide a much higher level of care to my patients.

If you can help, I ask you to please make a donation through this link:

Can you help? Please? All donors will get recognition (unless they request otherwise) through a donors list on my main web page.

Fire Updates

Unless you've been under a rock lately, you probably are keenly aware of the fires going on here in Northern CA. Here are some interesting statistics:

- The region's wildfires burned almost 250 square miles despite the efforts of more than 12,000 firefighters. (50 MILES X 50 MILES... imagine that... that is the size of most of L.A.)

- Fire crews from 41 states have arrived to help California firefighters battle hundreds of blazes that are darkening skies over the Central Valley and San Francisco Bay area.

- A Chinook helicopter with five Washington National Guardsmen has left Fort Lewis to help fight the wildfires. The aircraft headed to Sacramento on Friday. (That is a BIG helicopter!)

- The Sacramento Metropolitan Fire District said five fire departments in the area have sent 107 firefighters and officers, along with 20 engines, to help fight the fires.

- The smoke is everywhere. Visibility is currently less than one mile. Everyone is coughing. Those of us with asthma are doing our best not to become patients right now (Especially those of us in EMS). Current readings are PM 177 (177 parts per million parts of normal air - Thats alot of junk everyone!)

- The Governor has asked President Bush to declare many counties here in Northern CA disaster areas, allowing him to obtain extra much needed resources. That MAY include DMATs, folk! In the minimum, it means money, manpower, and machinery.

... Makes we want to huff oxygen... (Not really)

George Carlin (1937-2008)

One of the most incredible comedians of our time, George Carlin, passed away yesterday from heart failure. Clips of his humor can be found on Youtube.com and other sites, in that rare event you have never heard or seen his work.

Rory and I loved to go to his shows. We actually met him many years ago at Comdex, when he was walking the convention floor and was trying to learn about some of the computers being showcased there. We walked and chatted for a few hours, with Rory and I showing him different models of computers from different companies, and providing a comparion/contrast on them. I think he ended up buying a Compaq computer, if I remember correctly. What was really interesting was the number of people who flat out did not recognize him at all.

His monologue titled, "Seven Words You Can Never Say on Television", is quite entertaining, and later helped to define decency laws in the US (Seriously!). Check it out:

Fuel Prices and Its Fallout

Everyone is aware of the absolutely wonderful gas prices today. Diesel is up there as well (Actually, considerably higher than gasoline). The fallout from that is obvious, as well as not so obvious. On the obvious side, we are becoming more careful about how we are using our vehicles: Combining trips, cancelling trips and vacations to stay close to home, using alternative modes of transportation, and even riding with friends and "co-shopping". It means that overall fuel consumption is decreasing. More on this in a moment.

On the not-so-obvious side is the financial fallout in other ways. Grocery prices are increasing (some is fairly evident, others more subtle), truckers are beginning to refuse to haul since they aren't making enough to even cover their fuel costs, and one that is noticed by the EMS community: It is costing us A LOT MORE to move our diesel ambulances. In April alone, for 2 ambulances (yeah, two), we paid out over $1,000 in diesel costs to cover events we were scheduled for. A year ago, it would have been half that. Scary? Your local EMS providers, especially the municipal fire departments, are struggling to find the money to pay for this fuel. Who will pay? You! Your taxes will have to increase to pay for the greed of others. Or you will pay directly by getting a bill for the ambulance trip you may take. Those who use these services as glorified taxicabs (Those on public assistance tend to abuse the system more than others, but this is by no means limited to them) will end up pushing the bill off onto you, again through increased taxation.

Now, back to the decreased fuel consumption. Our roads are supposed to be maintained in part by the taxes we pay on gasoline and diesel fuel for road use (Farmers don't pay it, by the way). Less fuel consumption results in less taxes collected. This results in less money for the roads (or other programs if the money is siphoned over to it from the funding). Crappier roads will be the result. Fun, huh? And another interesting side note: With less fuel consumption, allowing for the laws of demand and consumption, shouldn't the price of gas be dropping, not increasing? Are the gas companies playing the market, and manufacturing less to keep the demand high? Or are they just being overtly greedy and not lowering prices when there is less demand? Food (er, fuel) for thought...

Celebrate the First National CPR/AED Awareness Week, June 1-7

In December 2007, Congress declared the first week of June each year as National CPR/AED Awareness Week. June 1-7, 2008 will mark the first National CPR and AED Awareness Week with the goal of encourage states, cities and towns to establish organized programs that provide CPR and AED trainings and increase public access to AEDs.

Doing CPR isn't difficult. It is the one thing that anyone (including older children) can do and possibly save someones life. Witnessed cardiac arrests happen every day in the U.S. If CPR is started immediately and/or an AED (Automatic External Defibrillator) are used, the chances of survival increase dramatically. Having performed CPR myself on more than a few people over the years, I can tell you that 5% is better than 0%. At least they have a chance.

So, take time this week to find a CPR class in your area, and take it. I have embedded a video below that teaches "Hands-Only" CPR, but you really need to take a class to get the "feel" of it, so-to-speak, and to gain the confidence to be able to provide someone the necessary circulation with your hands until their heart restarts, or it is helped to start through defibrillation. The CPR class will teach you additonal information.



Remember, ANYONE can have a sudden cardiac arrest, anywhere. And you may be the difference between life and death for that person.

Road Rage

Yesterday, while I on my way to pick up more EMS supplies, I saw first-hand what road rage can be like. We all hear about it, but to be in the middle of it... that's another thing.

I was getting on Business 80 here in Sacramento, to then merge almost immediately onto US 50 on my way to Rancho Cordova. No biggee. I travel this route all the time. As I am getting on the on-ramp, a maroon Dodge Ram pickup truck pulls a U-turn from a one-way street (She had been going the WRONG WAY), right behind me. She pulls up extremely close to my bumper. Traffic was slow-go, and I found myself braking every 10 feet or so. Each time I brake, she pulls right up to my bumper. She hit her horn. Yeah, that's gonna make a difference.

At one point, I got tired of this, and pulled forward and then "Brake Tested" her. She literally pulled within an inch or two of my bumper and began the angry hand motions, and hitting her horn again. So, realizing I have something at my disposal most don't, I hit the rear flashers on my lightstick. Nice BRIGHT amber lights. She backed off a bit. So I shut them off.

As I was almost at the merge to eastbound US, she pulls suddenly to my right IN THE SHOULDER of the freeway! She pulled up right in line with me, and begins to THROW STUFF AT MY CAR! Near as I can figure, I got her Pepsi, her morning donut remains, and cigarettes. Nice... She is also yelling out her window, but I am not about to roll mine down to hear what she is saying. I got on the phone to the CHP, and let them know about this very angry, very DANGEROUS person. I gave them the description of the vehicle, and the driver, and I made them aware that she seemed either having an anger management issue, or she was under the influence. After all, she got on the on-ramp by driving the wrong way on a one-way street initially. I pulled into the next lane to my left, and got onto US 50. She was stuck where she was, and forced onto westbound US 50. Thankfully.

This whole incident sure got my adrenaline flowing! I hope they stopped her before she caused an accident... and/or killed someone.

Close Call #2

Today, I was in downtown Sacramento in my Jeep, waiting for a bike ride to start that we were providing EMS for gratis. It was extremely windy. I was at 6th & L, when suddenly I heard a "CRACK!"... The next thing I knew, a LARGE branch had come down inches from my Jeep. I was amazed how close it was to me. I will post the picture of that branch later. Whew!

Allergies and colds

The last few months have taken their toll on me due to allergies, which exacerbated my asthma, which had been under wonderful control for a long time. I seem to finally be getting a handle on it again, but I am amazed at how tired I have been due to allergies. It is the increased energy (along with the ability to breathe through my nose again) that was my clue that the end of seasonal suffering is near. THANK YOU! This whole past month has set in motion some interesting problems that I will go into detail on in a future post.

Unfortunately, it is sometimes difficult to discern allergies from colds, which was the case last week. It was only through some careful reasoning that I really realized I had a cold at the same time. I've been left with a nagging cough from the cold, but my lungs are clear, so it seems to be post-nasal crud. Or part of that particular virus' signature.

Looking for lower gas prices? Check this out...

http://www.californiagasprices.com/ is a site dedicated to helping us find the lowest gas prices. You can do your part by adding gas prices as you find them in your day-to-day driving adventures.

Padded lampposts to protect texters?

In yet another one of those, "Why are they doing this?" moments, somewhere in London, England, lampposts are being padded to PROTECT PEOPLE WHO ARE WALKING AND TEXTING USING THEIR CELLPHONES. Here is the article from ITN:

-----
Padding to protect pedestrians

People who have been injured while walking and texting on their cell phones may be in luck.

A London street is experimenting with padded lampposts to protect those not paying attention from banging into them, ITN reports.

A study conducted by 118 118, a phone directory service, found that one in 10 people has been hurt while focusing on their cell phone instead of where they were walking, ITN reports.

The test lampposts will be given a trial run in London’s East End on Brick Lane. If the trial is successful it will be rolled out in Birmingham, Manchester and Liverpool.

The survey found that almost two thirds of respondents lost peripheral vision while texting, and more than a quarter wanted lines on the pavement to create routes for texters to walk while using their phones.

The study claims that 68,000 people were injured in the U.K. last year while chatting or texting on their cell phone, Infomatics reports.

118 118 will provide the padding, and in return will be allowed to advertise on them.
-----

OK... Here's my take on it... Stupid people should not text and walk at the same time. Sit down and send your message!

Busy-ness

Wow! These last few weeks have been CRAZY!

Jan 28 - Went down to WestPack conference and worked there until Jan 31 for work. Had two of my co-workers with me. Worked out really well, though!

Jan 31 - 10:30pm - Got home from southern CA.

Feb 1 - 7:00am - Got in our ambulance, heading for Death Valley.

Feb 2 - Worked in Death Valley. Nobody had to get transported - YEAH!

Feb 3 - Came home

Feb 4 - Out the door at 4:00am to Southern CA again to pick up a new (well, new to us!) ambulance

Feb 5 - Home after midnight... Got up and gone by 6:00am, heading for ANOTHER conference! This one was near San Francisco. Started feeling sick on the way (scratchy throat, nose getting stuffed up.)

Feb 5-7 - Attended the CUPA Conference. Learned a lot, but I was REALLY sick. Did what I needed to, work-wise, but went to bed around 6:00pm on the 5th and 6th. Started feeling better on the 7th (Nyquil and fluids, yeah!), finished out the conference, and headed home.

Feb 10 - Out the door again, this time for Monterey for a race. Treated a few racers, sent one to the hospital. Asthma flared a bit, so I was on albuterol every 2 hours.

Yes, I am feeling better. As I said, my asthma kicked up a bit, due to that nasty cold I got, but it is under control again. Hey, I gotta breathe, right? And I don't want to end up a patient!

The Danger of iPods and other MP3 players

I saw this on another site a few minutes ago. The New South Wales Police Dept (Yes, in Australia) has embarked on an interesting campaign to remind people to be aware when listening to music on headphones. I especially like the body outline.

Post CES: Lots of great stuff...

... and a sore knee to finish it off.

I got a lot of cool swag at the show. The usual promo stuff, pens and the like. A lot of USB drives, including a few 1GB models. Tshirts (not many, these appear to be out of fashion now). Some product, including WeatherDirect, a cellular emergency power system, a cellular extender, a speaker for MP3's, headphones (3 different types), and a Jawbone (it is a Bluetooth headset given out to ANYONE presenting and abandoning their old BT headset to the folk handing it out). Pics to be taken soon, and I will post them at that time.

My knee on the other hand may have been aggravated by the 9+ hour ride home (My bad for wanting my Jeep in Las Vegas). Dunno, but it started getting seriously sore on Wednesday during the show. Sore enough that by the time I left a party Wed night, I seriously considered dipping into a more potent painkiller that I brought for my elbow (Which did surprisingly well, probably because I didn't carry anything with my left hand for long.). By Thursday night, I was in a lot of pain. Ice packs and pain meds got me through the night, and I was able to drive home yesterday. Again, by the end of the trip, I hurt BAD. I am still sitting here taking it easy today, going through the swag. Tomorrow will also be a "take it easy" day.

A little history: I had a problem with knee pain as a teenager and young adult. Had knee arthroscopy in 1986, which showed my knee in good shape. The lateral collateral ligament on the outside of the knee was WAY too short, and it was lengthened in that surgery. My knee has been in good shape until last Wed... overuse? Underexercise? Dunno... but I have to get it feeling better ASAP.

CES was a blast, however! I love going every year... even if I end up hurting.

Addendum: After speaking with several people at my work, it appears a bug might have been the culprit for my knee pain. When I got sick earlier in the week, it may have been the start of a virus that finished out nailing my knee. On the 15th, it was fine again, like nothing had happened.

Batten down the hatches!

In case you don't know, there is a series of MAJOR storms due to hit here in the western US. Northern CA is expected to take a significant hit, including 3-6 inches of rain, up to 10 FEET of snow in the higher Sierra elevations, winds 40-60 MPH (or higher), and well, enough potential of street flooding to make me grateful that I own a Jeep.

Nice map, huh? (Source: My Weather via KCRA.com)

Oh, in the midst of this, on Saturday, I am due to drive to Las Vegas... I think no matter which way I go, I am in for a wild ride.

Stupidity

Doing the dishes doesn't usually involve being stupid. However, I managed to do just that. While doing dishes this morning, I set a pan to soak. No biggee. However, this is a HEAVY stainless steel 12" diameter frying pan. I then set it on the counter and stacked a few more items on top of that. Did a bunch of dishes. Still had more to do, but I went to work on other stuff to allow the ones I did to dry.

Fast forward a few hours. I put the dishes away I washed earlier. I reached to close the dish cabinet, and managed to knock the stack I created earlier off the counter. Yeah, the one with the frying pan full of water. It all landed squarely on my foot, right at the base of my big toe. OUCH! It bruised instantly, reminding me of the encounter I had with a brake rotor on my big toe (other foot) over 10 years ago. In that one, I had a nasty fracture (The doc didn't believe it at first, since the big toe has a THICK bone to it). It healed eventually. The whole thing hitting my foot and the floor eventually made a very loud noise.

I just stood there and Diana yelled if I was ok. I told her I wasn't sure. She came out, and I warned her it was wet all over there (including my pants that got splashed back on). I also told her I wasn't sure if a glass bowl was broken or not, since I knew she was also barefoot like I was. I grabbed some frozen corn for an ice pack, and made it over to the living room and iced it for a while. Finally called to get an x-ray to rule out a fracture.

A little over 2 hours later, I got the news... NO FRACTURE! Just a nasty bruise, thankfully. Still doesn't diminish how much it hurts, but at least it isn't broken. Thank God! With a conference to go to next week, and some EMS work later this week, I couldn't afford to have a broken foot. So, I managed to do something very stupid, and got lucky.

Don't do what I did kiddies. Make sure if you stack stuff up, it won't bite you back for not being careful.

Rainy weather... and illness

Well, now that the rainy weather has made it to Northern CA, one other thing has made it here. The flu and other nasty bugs. I started feeling crappy yesterday, and today a sore throat has been creeping up on me, and I feel worse. That, and a fever. No other symptoms, so I am considering that this might be strep throat (bleh). If it is, then the fix is relatively easy: antibiotic therapy. If not, then it is more than likely a virus, and will have to run its course. My guess is, one way or the other, I will know by morning. I guess its good I don't have any planned patient contact until after Christmas. And at my day job, I can just hang a sign telling people I am sick, and avoid contact with others (well most of the time).

Back drinking more fluids... I now return you to your normal web browsing.

The Leader of the Band (1951-2007)

I was getting ready for work very early this morning, and was watching the news as I do just about every day, and found out that one of my favorite music artists, Dan Fogelberg, passed away from prostate cancer yesterday. I knew he had been battling it for a few years.

This talented artist's music influenced a lot of my thinking (and my choice of music) over the years. His gift of the ability to pass on incredible emotion in his music is one that many of his fans deeply appreciated. When I moved from home in 1984, I left the song, "The Leader of The Band" on the turntable at my father's house, with a note asking him to play it. I don't know if he did, but I do know that when I retrieved my music collection later from my father's house, that 45 was not in the collection (Do you still have it dad? If so, please keep it. I meant the thoughts in the song that day!). Here are the lyrics to that song, for those of you that may not recall it, or who have never heard it:

The Leader of The Band

An only child alone and wild

A cab'net maker's son

His hands were meant for diff'rent work

And his heart was known to none

He left his home

And went his lone and solitary way

And he gave to me a gift

I knowI never can repay

A quiet man of music

Denied a simpler fate

He tried to be a soldier once

But his music wouldn't wait

He earned his love thru' discipline

A thund'ring velvet hand

His gentle means of sculpting souls

Took me years to understand

The leader of the band is tired

And his eyes are growing old

But his blood runs thru' my instrument

And his song is in my soul

My life has been a poor attempt

To imitate the manI'm just a living legacy

To the leader of the band

My brother's lives were diff'rent

For they heard another call

One went to Chicago

And the other to St Paul

And I'm in Colorado

When I'm not in some hotel

Living out this life I've chose

And come to know so well

I thank you for the music

And your stories of the road

I thank you for the freedom

When it came my time to go

I thank you for the kindness

And the times when you got tough

And Papa I don't think I said

"I love you" near enough

The leader of the band is tired

And his eyes are growing old

But his blood runs thru' my instrument

And his song is in my soul

My life has been a poor attempt

To imitate the man

I'm just a living legacy

To the leader of the band

I am the living legacy

To the leader of the band

Goodbye, Dan.

And the word of the year is...

W00T


Yep. W00T. I've been using this word for YEARS. Contrary to popular belief, it didn't start with gamers. It started with hackers (the good ones, not the ones causing havoc). It moved into gaming, but it has been around for a LONG, LONG time.

For more info: http://www.news10.net/display_story.aspx?storyid=36196

Colds Suck

I haven't had one in such a long time. Not sure where I picked it up, but timing of it suggests my Thanksgiving family gathering (And no, don't ANYONE in my family be upset that I got sick. We had the times of our lives out there!).

Yet, there I was yesterday, starting to sneeze, getting more and more congested during the day at work, feeling cold when I wasn't, and achy. By the time I got home, it was clear I wasn't going to do much last night. I had the foresight to cancel my Girl Scout meeting, so I wouldn't "spread the wealth" to my girls. Oh, did I mention my nose is still healing, so every time I sneeze, it is a new adventure in pain? Yeah. Fun.

I guess it was good that I planned to work at home today. It has let me get work done without getting out of bed.

Anyhow, Nyquil is my friend. Whoever created that vile concoction is my friend. I can't take it during the day. But you can bet I do at night right now. With an Amaretto chaser, the stuff is actually tolerable. Illness also gives me a good excuse to enjoy a particular Tomato Bisque I love. It has enough spice to get through my nose. Only problem: It is $5.00 per quart. But soooooo yummy.

Honoring Our Veterans

Please take time today to honor those who serve, and who have served, to defend our country. Regardless of your political beliefs, they deserve our respect for their willingness to lay down their lives defending us.

I thought I would share a picture of my grandfather, Willard Dorsett, taken during World War II, that I found. I wish I had a picture of my other grandfather, Alfred Meyers, that I could show you. Both served in World War II with distinction. I am so proud of their service.













I have also added a picture of myself with two of my brothers, Josh and Daniel. They are both serving currently. Josh is in the Army reserves, and Daniel is active in the Air Force. Daniel is on the left, Josh on the right. Why am I in uniform? I am in a DMAT, part of the National Disaster Medical System. But I am not the focus of today, they are. This is just the only picture I have of them in uniform.

17 Mo old Breaks Grandmother's Nose

Yeah. Either that, or the worst bruise in the world.

Jonny and I were cuddling Friday evening, and he suddenly turned over and whacked me with the back of his head. HARD. I felt and heard the crack of the cartilage breaking away from the bone right where the two meet. Weirdest sound from the inside. Thankfully, our roommate was here and grabbed one of my instant ice packs (once I told her where it was) and brought it to me. She took Jonny and I sat there icing my nose for the next half hour, dealing with my eyes tearing, even though I wasn't crying.

I let Diana know by text message (she was at work at the time) once I was able to, and she asked if I was going to the E.R. I told her no, since the fracture wasn't displaced (my nose still looks like its usual self), they wouldn't be able to do anything except refresh my ice pack. And take $50 from me.

I have some bruising, although it is hard to spot. Thankfully.

Needs evaluation and Going Offline (Maybe)

Yesterday, I was part of a strike team evaluating medical needs in evacuation shelters. We first went down to a town near the Mexico border, and discovered a small town that had their act together beyond belief. They take care of their own, and they do it very well! It was refreshing to see. Mountain and desert communities rely on each other, not outside resources. In fact, the prevailing attitude was "Thank you for coming, but we are fine. Oh yeah, who the hell asked you to come here?" They were pleasant, but it was apparent we were not needed, nor wanted.

We then got another mission to go to another town. As the crow flies, it isn't far (about 40 miles), but due to the fires, it was a LONG trip through El Centro, then up into mountains. It was a 300 mile detour. I have to admit, I got to see a lot of the southern CA desert! It really was a pleasant trip.

The second shelter was bigger, but still well organized. Once we ascertained that they had no pressing needs, we were sent home. They first wanted us to take the long road home, but we found a shorter route, and got home several hours earlier than we would have (We still didn't get back until 10:30pm).

Due to shifting patient populations, we are leaving our current sleeping accomodations, and moving elsewhere. As a result, the network I set up is going bye-bye. I need to take it down, so my WiFi (and thus internet access) is going down in a little while.

I will update more as soon as I can.

Rollover

I was heading to SF with my Girl Scouts this morning, and as we were passing from Vacaville to Fairfield (a kind of no-mans land between the two cities), noticed a vehicle that had left the freeway and landed on the frontage road. He had obviously rolled the car a few times. The girls saw it too, the prevailing comment, "Oh, my God."

I pulled over immediately as far as I could on the shoulder, told my girls to stay in the car buckled up, grabbed my jump bag, and went over to the car...

Initially, there were three people there. Took me a second to figure out who was in the car. It was a single occupant accident, and even though the guy rolled the car three times, HE WALKED AWAY FROM IT! Upset, yes. Slight injuries, yes. Major injuries? Well, aside from the potential of internal injuries due to the mechanism of the crash, he had no head, neck, back, or extremity injuries. Now, he was pumped on adrenalin, so I can't be sure, but I'd be willing to bet he got cleared at the hospital in record time.

Oh, CHP dispatch: PLEASE EDUCATE YOUR DISPATCHERS. When I tell them that a vehicle rolled over multiple times, they should not ask, "Is anyone injured?" Send the friggin' paramedics out, just to be sure, PLEASE.

I hung around until fire got there, then handed him off ASAP to get to my girls. I was really concerned about them on the freeway, and rubberneckers hitting them. We talked about the whole thing. I think a few of them are interested in emergency medicine now. :-)

A Long Day

Today I worked another triathlon, one that kept us quite busy. Right off the bat, injured people. Minor stuff, but an indication of the day, IMHO. And that was before the race started. Swim went portion went well. We kept an eye on a few swimmers, but everyone made it out of the water. Got a few more folk with minor injuries, easy to treat (bandaids and such).

Ended up with a bike crash near the beginning of the bicycle portion of the race (which was also a loop-around point). Two racers collided, with one going over a metal pipe-type gate. Based on MOI (Mechanism of Injury), we chose to C-Spine him in preparation for transport to the hospital. Fire Department got there, and before they even evaluated the patient, essentially convinced him not to go to the hospital. Argh. But, at that point, they had "control" of the patient (and legal liability if something goes wrong... we chose to be cautious). We stood back, and let them evaluate him after they got him off the board. We still think it was a bad idea, but the patient and the medics made the choice, not us.

Had some other slides/crashes, but none so serious as the one I described above.

During the run portion, we were notified of a runner down on the course at one of the aid stations. That was all we had. We kept trying to get the aid station on the radio, and finally got a garbled message, the gist of which we heard, "heart attack". Damn! We got on scene, and found a runner down with crushing chest pain, diaphoretic, low blood pressure, and thready pulse. Not good. Got the patient on O2, and began transport in our Jeep to meet up with the ambulance at a major intersection nearby (We are on-scene BLS only). Re-evaluated vitals, pain level, and pulse ox while the fire department and ambulance were en route.

The FD got there, took control of the patient, re-evaluated vitals again, and then decided to give him nitro spray under his tongue. Nitro is used to dilate blood vessels, allowing more blood flow to the heart, and reducing pain. Problem is, the FD EMT sprayed it several inches from the patient. While it did make it into his mouth, he sprayed me as well. Nitroglycerin can be (and was) absorbed by the skin and mucous membranes. While I didn't take a breath at this time, I suspect my face and eyes took a hit from the spray. As a result, I entertained a minor headache for around a half hour that ensued from the exposure. Not horrid, but he should have been a lot more careful. And hey, more medication would have gotten into the patient. He was then moved onto a gurney, and headed off to the hospital. FYI: Looked like an Left Anterior Descending MI (Aka "Widowmaker") on the ECG, according to my partner.

That pretty much wrapped up the race. While we were out with this patient, one of the other EMT's was dealing with a line of "road rash" from crashes, minor falls, etc. As I said, it was a long day. But hopefully one that everyone will be ok, including the possible MI (Heart attack).

Oh, all this occurred in around 3 hours.

What did I say about heat?

Back on 9/2/07, I wrote an entry regarding heat. And now, we see the effects of heat and lack of effective planning. The Chicago Marathon occurred on a hot day (for Chicago), that was also humid. Races happen all the time in hot and humid weather. What made this different is that it appears that the race organizers did not adequately anticipate the consequences of so many runners needing to cool down. They had the equivalent of 1.8 million cups of water. Problem is, the runners used them to douse themselves as well as to drink. The water was near the end of the race, not interspersed along the route. The heat was anticipated. Adequate "all weather" planning is a must for large events such as this.

Over 250 people were transported to area hospitals. And yes, one runner died, although the autopsy showed that it was due to mitral valve prolapse, not heat. Heat obviously had something to do with his death, but it was a heart ailment that actually caused this man to die.

Eventually, race organizers shut the race down, after 3-1/2 hours. Did the runners all stop? NO. Many continued on, partly due to what I call "runners tunnel vision". They want to keep going, no matter what. This is expected during races. I treat athletes that want to continue even when I know darn well that they should not. And yes, I override them on occasion. And for good reason.

The paramedics and EMT's out there in Chicago performed incredibly well in the face of a LARGE MCI (Mass Casualty Incident) that played out over a large area. WAY TO GO!!!

Email Address Portability - A Stupid Idea

This morning, I saw an article on CNET, "FCC Asked To Mandate 'Email Portability'". Unlike telephone portability, this is just STUPID. Why would I want 'someaddress@aol.com' forever? If I want an email address that is truly mine, my own domain is a better idea, which is what I have. It is truly portable, and it is mine. I don't know that any given domain (except mine) will last forever. If I pay for mine each year, it is mine to use as I want.

The CNET article provides several reasons why this is just idiotic and silly.

When I read this article from the Ventura County Star, I felt strongly that I had to share it with all of you. Each of us in EMS has our "nightmares", those cases that hit us especially hard. And yes, I have a few that strike me hard when I think of them even today. Some come back to haunt me when I have a similar case, or when we all talk about something. Personally, I have been a part of 3 CISD (Critical Incident Stress Debriefing) events, and one "Defusing" (A chance to just openly vent). All of these will remain confidential with all of us that participated. I can share with you that even the most hardened firefighter, policeman, and medic can break down at these very important meetings of all involved.

The last paragraph especially points out that we EMS folk are human. Keep in mind, when I first became an EMT, "suck it up" (AKA "deal with it yourself") was the common method of dealing with the unthinkable. We have learned a lot over the years; this attitude resulted in burnout and suicide among EMS, police, and fire personnel.

Saving lives sometimes trigger crises

First responders' roles to lessen suffering and save lives sometimes trigger their own crises

By Cynthia Overweg
Correspondent
Wednesday, October 3, 2007

When paramedic Brian Williams got the emergency call, he knew he was about to encounter a tragic scene.

Along with police, firefighters and others, Williams was on his way to one of the most notorious crime scenes in Ventura County history.

When his ambulance crew arrived at an apartment building in Newbury Park in August, they found 6-year-old Sev'n Molina had been brutally killed with a meat cleaver.

The first responders were not only confronted with the mutilated body of a child, but also with the boy's critically wounded mother, a seriously injured neighbor who had managed to stop the attack, and a violent suspect, who had to be restrained with a police Taser.

While first responders are specifically trained and equipped for the difficult jobs they do, the strain of repeated calls to scenes of human anguish can take an emotional, psychological and physical toll.

"The violent death of a child is the hardest call there is. There is nothing that can train you to deal with that," said Williams, who pronounced Sev'n Molina dead at the scene.

He also stabilized Sandra Ruiz, the boy's mother, who had near-fatal stab wounds, and rushed her by ambulance to Los Robles Hospital and Medical Center for emergency surgery. A second ambulance crew attended to the injuries of Diane Cox, the woman who intervened in the attack, and took her to the same hospital.

When they arrive at the site of heartbreak and danger, whether a man-made tragedy or a natural disaster, emergency responders — firefighters, police, paramedics, chaplains, and crisis intervention workers — work to alleviate suffering and save lives, sometimes at great personal risk. But their vital role as public servants can sometimes trigger a private crisis within.

"When you're on the call, there's no time to think and reflect. It's only later, sometimes much later, that incidents like these get to you," said Williams, who lives in Newbury Park and has been a paramedic for 20 years.

Senior chaplain and certified trauma responder Larry Modugno, who works for the county Fire Department, also went to the apartment where Sev'n died and said it was one of the most traumatic things he's ever seen.

"As chaplains, we make ourselves available to anyone who needs us. Often, all that is needed is a hand on the shoulder or a few words of encouragement, but more was required in this case," Modugno said. He said he stayed as long as necessary and then went to the hospital to be with the two surviving victims.

Team assists after incident

To help first responders deal with the inevitable stress created by the work they do, a critical incident stress management, or CISM, team is assembled after a traumatic incident.

CISM is a volunteer, peer-driven support network, chartered in Ventura County under the International Critical Incident Stress Foundation based in Maryland, regarded by many as the nation's leading crisis intervention program.

A CISM team consists of emergency responders, chaplains and mental health professionals who specialize in stress-related disorders. Within 48 hours of a traumatic event, emergency responders have the option to attend a "debriefing," a meeting where they discuss what happened, have the opportunity to express their feelings in a supportive setting, and get further assistance if needed.

Not inclined to seek help

"First responders deal with the trauma and grief of others every day. In so doing, they can become traumatized themselves," said Scott Barash, a licensed clinical social worker with the County of Ventura and a CISM team member.

Barash said the personality traits that make emergency responders good at their jobs can also make them less inclined to ask for help.

"These are very resilient and compassionate people who need to be able to lighten up and not carry the stress around," Barash said.

The slaying of Sev'n Molina caused a tremendous amount of sadness among responders, said Capt. Jerry Hernandez, spokesman for the sheriff's department.

"He was chased down and struck repeatedly with a meat cleaver. Along with other deputies, I saw the body of that poor child. We were all traumatized by it," said Hernandez, who added that just repeating the details of what happened can be uncomfortable.

"These are normal reactions to a very abnormal event," said Stephanie Huhn, emergency medical services coordinator for the Oxnard Fire Department and a CISM team member involved in the debriefing of responders. "Because of the horrible nature of the crime, I felt some dread prior to the debriefing, and that's normal, too. It's not easy to see co-workers in distress, but I'm there to validate how they feel because I've been in similar situations myself," said Huhn, who was an emergency room nurse for 23 years.

"We see things in our daily jobs most people never see in their entire lives, unless they've been in a war," said Capt. Barry Parker, spokesman for the county Fire Department.

He said one event that stands out in his mind involved a traffic collision on Highway 101 in Camarillo. He was first on the scene to find a man and a woman trapped in the front seat of their van.

"The woman was screaming for her baby, but I didn't see one. Then I noticed a car seat on the highway. I went over to get it and found a dead infant with massive head trauma. Images like that get glued into your brain," said Parker. He said sometimes a traumatic memory can be re-triggered by a similar event or by passing the spot on a road where something terrible happened.

"We talk about these things at the firehouse, and we help each other," Parker said.

Disturbing images or nightmares eventually go away, said Barash, but when they don't, it's a signal to ask for help.

"Emergency responders are better prepared to handle a traumatic event because of their experience and training, but they're not super-human. Like the rest of us, they can be overwhelmed and need reassurance and support," he said.

Banned Books Week

Regardless of the content, books should not be banned from libraries. It is amazing in this day and age that groups of people will harrass libraries, city council meetings, and county boards to convince them that a certain book is horrid and unfit for anyone to read. Hey, let ME make that decision for myself. I did make these decisions for years for my own children as well. If I had concerns about a book, even an assigned book from school, I read it, and then made the decision to allow or disallow my kids from reading it. More often than not, I encouraged them to read it, and then we discussed it. Now that they are grown, they too are making this decision. BUT IT IS OURS TO MAKE, not a group of folk using their religious or moral beliefs to push their belief onto me.

Here are the "10 Most Challenged Books of 2006," as listed by the American Library Association's Office for Intellectual Freedom.

1. "And Tango Makes Three" by Justin Richardson and Peter Parnell
2. "Gossip Girls" series by Cecily Von Ziegesar
3. "Alice" series by Phyllis Reynolds Naylor
4. "The Earth, My Butt, and Other Big Round Things" by Carolyn Mackler
5. "The Bluest Eye" by Toni Morrison
6. "Scary Stories" series by Alvin Schwartz
7. "Athletic Shorts" by Chris Crutcher
8. "The Perks of Being a Wallflower" by Stephen Chbosky
9. "Beloved" by Toni Morrison
10. "The Chocolate War" by Robert Cormier

Challenge yourself. Instead of bowing to others, try reading ONE of them sometime this year. I suggest Beloved, by Toni Morrison (#9 on this list). Then decide for yourself if it such a horrible book. Now, these books are not without controversy. I am aware of that. Controversy sparks conversation, and in other days, Shakespeare was controversial.

Here are the "Most Challenged Books of the 21st Century (2000-2005)," also from the American Library Association. Note that some books are on both lists. Makes me more interested in reading them...

1. "Harry Potter" series by J.K. Rowling
2. "The Chocolate War" by Robert Cormier
3. "Alice" series by Phyllis Reynolds Naylor
4. "Of Mice and Men" by John Steinbeck
5. "I Know Why the Caged Bird Sings" by Maya Angelou
6. "Fallen Angels" by Walter Dean Myers
7. "It's Perfectly Normal" by Robie Harris
8. "Scary Stories" series by Alvin Schwartz
9. "Captain Underpants" series by Dav Pilkey
10. "Forever" by Judy Blume

Notice in particular one title, "Of Mice and Men". Why is Steinbeck repeatedly on the list? I read it years ago. I don't feel that there is anything in the book to warrant this. "Harry Potter"? Geez... it is FANTASY. It encourages children to read. And the books are great reading!

Happy Banned Books Week! Read on!!!

2974 and still counting - 6 years later

The official death toll from 9/11/01 now stands at 2974 after a woman who worked a block from the World Trade Center became ill and died 5 months after the towers came down. She died from lung disease not present before 9/11.

Why do I say "and still counting"? Because there are first responders (firefighters, police, EMT's, and paramedics) who are becoming ill at alarming rates, due to their response to the World Trade Center. "WTC Cough" was the start of it. Now, cancers, asthma, and other problems are surfacing.

I am not attempting to detract from this ominous anniversary. What happened still shocks me to this day. It still seems like it happened yesterday.

Please remember those who died. But also remember and pray for those who responded, risking their lives, and who may ultimately give their lives for doing what they do.

Cough, Cough, Choke, Choke

(cough) If you aren't in Northern CA, then you probably may not be aware that we have not just one, but two big fires going on. (cough) The first in Plumas County (the Moonlight Fire) has burned over 15,000 acres, and another in Santa Clara County (the Lick Fire) has burned over 14,000 acres. Both started during Labor Day weekend.

Here is what the (cough) skyline looked like yesterday.

Needless to say, the air is full of particulates, and ash. Makes dealing with lung problems (such as asthma) real fun (cough). Ironically, it is a little fun to be able to look at the sun without protection, but the tradeoff (cough) is not worth it. The winds should push some of this smoke from the Moonlight fire out of here tonight. Sure (cough) hope so (cough) (cough). Only one problem... those winds will push the smoke from the Lick fire into the valley.

Wanna know what major CalFire incidents are going on? Its quite educational. Go to http://fire.ca.gov

Addendum: The Moonlight Fire grew by 14,000 acres yesterday. Explains a lot why there was so much smoke.

A little bit of history

A long-time friend of mine (and Rory's), Craig Miller, discovered recently he may be sitting on money. He bought a Mark-8 computer in 1976. This is one of the original microcomputers, folks. Turns out it may be worth as much as $5,000 - $12,000 (Not bad for not being used since 1980). He has had it stored in his attic and garage.

Wanna see history? Go here: http://mysite.verizon.net/genoahous/Mark8/
(Remember while looking at this, it was before CRT's became popular).

Oldest system I have my hands on is my Atari Portfolio. This little bugger ran DOS, and still works! Wonder how much it is worth...

Heat

OK. I am getting up on my soapbox now.

Heat Hurts and Heat Kills... Heat Hurts and Heat Kills... And I am going to say it again. Heat Hurts and Heat Kills.

Why do I mention this? Because every day I work outside in the heat working EMS, I see people who:

1. Don't drink enough fluids
2. Don't drink enough fluids
3. Don't drink enough fluids

And I see them with heat cramps, heat exhaustion, and heat stroke. I treat them at baseball games, football games, races, triathlons, walking on the street (twice, as a bystander).

Dehydration can affect ANYONE. Once you become dehydrated, you become very vulnerable to the effects of heat. Heat cramps first. This is where you feel cramping in your muscles, and you may become nauseous due to stomach cramping. This is INTENSE, and painful. Treatment: more fluids, cooling, and working out the cramps. You'd think that would convince people to drink more fluids. Nope.

Once you pass through heat cramps, next is heat exhaustion. It feels like exhaustion. And more nausea, vomiting, fainting, and maybe a low grade fever (a degree or two high). The cause is the same. Dehydration. Treatment is fluids (sometimes intravenous, due to nausea and vomiting), quick cooling, and maybe a trip to the E.R.

Don't treat that, and you can move on to heat stroke. Red skin, hot skin, not sweating. Temperatures can go to 106 degrees or higher. Highest I have seen was 107 in someone. We checked his temp twice, and on ourselves, because we didn't believe it when we saw his temp was that high at first.

He didn't make it. Temps over 105 can cause significant brain damage, as your brain literally begins to cook and cells die. Oh, and other cells in your body, like heart muscle, liver, and kidneys. Treatment is rapid cooling, including ice packs EVERYWHERE (even the groin and around the neck), intravenous fluid therapy, supportive care such as ventilation (breathing for someone who isn't breathing on their own - or not enough). Guaranteed trip to the hospital for heat stroke. And a stay there for a while, too. If you survive. Heat stroke is LIFE THREATENING, folks. People die from heat stroke every time there is a heat wave. And maybe without the heat wave.

Some medications and conditions increase your risk of heat injury. Know what you take, and how it makes you react to heat. Keep a list of your meds on you. I've even treated someone for heat stroke in 67 degree temps. Really. She was vulnerable to heat due to a medication she took, and she ran in a triathlon. Oh. She was also dehyrated.

Why do I say this? Because it is preventable. Absolutely preventable. And yet, I see people with heat injuries just about every day I work in extreme heat.

• If you aren't acclimated to heat, start to become acclimated. It doesn't happen instantly.
• Drink plenty of fluids, well ahead of the heat. Like days ahead of time.
• Drink plenty of fluids while in the heat.
• Drink plenty of fluids after heat exposure.
• Gatorade/Powerade/Deluge by itself is not good. Alternate with water, folks. Really.
• Keep drinking fluids. Hey, don't get dehydrated in the first place.

OK, now that I have said this, how much should you drink? 8-10 8oz glasses per day is what you should drink daily (unless your doctor tells you otherwise). On hot days? Try 15-20 8oz glasses. Thats about a gallon of fluid. Yesterday, I drank approximately 2.5 GALLONS of fluid. But I know my body, and what it requires when I am working in 105 degree temps. I am moving around, sometimes bolting around on runs instantly (Yeah, even at my weight... I can run pretty fast!). I don't drink that instantly. It is in small amounts all day long.

Off the soapbox now.

BTW, yes, I have been a victim of heat cramps and heat exhaustion. Last year, even taking care of myself, I sweated more than I could take in. Why did I develop symptoms? Simple. I didn't start out well-hydrated. I felt like crap. My head hurt, I was nauseous, my muscles ached (even days later, they hurt), my pulse raced, and my temp was 102. I was tempted to ask a medic friend of mine to come over and start an I.V. on me. I hate needles. So I kept sipping fluids all night long.

And as I said, I have seen people die from heat stroke. Which is why I take heat seriously. I hope you do, too.

A Little Tuesday Humor

I was searching over at emsa.ca.gov (Emergency Medical Services Agency here in CA), and got an error when I clicked to search by date instead of relevance. Now, we are laid back here in CA, but this was an interesting response to get. Click on the graphic to read it better.

Note the message.

Me, Simpsonized

How do I look as a Simpson's character?

Go to http://www.simpsonizeme.com and have fun!

Summertime Colds

Bleh.

I thought I was just tired from the craziness of the weekend (see my previous post). This morning, I was slightly congested, and now I sit here sniffling and coughing. Hope it ends soon.

Bleh.

Of medicine, odd temperatures and exhaustion

First, I am writing this after coming off three days straight working 16+ hours. So, if I come off a bit negative, I am sorry.

As summertime has hit, things have gotten busy for me. Since I work multiple jobs (my "day" job + 3 other part-time jobs), it can get... hectic. Friday, I worked my usual 8 hours, then worked at the ballpark for a game. Got home ala 11:30pm, then was up and running at 5:30am, picking Diana up from work, going to pick up the ambulance, then have her drive home with Jonny. Got home, threw my uniform on that had been in the dryer from working the night before... then off to the soccer matches to work! Worked that from 8:00am-6:30pm, then went home, quick shower, and threw on my shorts and work shirt to work a shift at the ballpark (We had a no-show... seems to happen more this time of year). Game didn't even start until 7:30, as it was "Dusty Baker Day", and things ran late. The work at the soccer matches was BUSY. It was very hot (105 degrees), and we had kids crashing due to heat. Even sent one to the hospital, but hers really wasn't a true heat-related issue. Something else was going on there... more later.

Got home late, threw the uniform in the laundry, putting my shorts in also, since I baked that day in my long pants and enjoyed being in shorts that night at the park. Hit the pillow and that was I remember until 5:30am again yesterday. Woke up, threw everything in the dryer, got ready for work, tossed the now dry clothes on and went to pick up my partner for the day and get back to the soccer fields.

Except for one thing... I put my shorts on, since it was hot the day before. Remember what temp I said it was on Saturday? Not yesterday... the high was a whopping 75 degrees (That's a 30 degree difference!). I froze my tush off out at the field for the first 4 hours. It was cold, windy, and a little smokey from a brush fire nearby. The brush fire got knocked down quickly, so that didn't linger too much. But wow... I ducked into the rig just to stay warm! While I was in there, I made use of myself and cleaned it up. My partner helped me also (She and her husband own the ambulance). Her husband got there and I took off pretty soon after that to get ready for my shift at the ballpark. Heh... I put my pants back on instead of shorts, and dug out my jacket that I haven't seen since the first week of June. Glad I did. I got damn cold at the park last night by 7:00pm. By the time I left around 10:00pm last night, the temp was in the 50's. Wierd... I have never seen a two-day change in temp like this IN AUGUST. Normal is around 93 degrees this time of year. I honestly never thought I would be shivering in Sacramento in August.

In terms of medicine, the girl we treated at the soccer matches bothered me to no end Saturday. Her problems didn't seem like a heat issue. Usually, we cool them off, and they are doing well. She didn't really improve much. Her problems seemed more neurological (She complained of a sudden onset headache, which *can* be heat related, but most of the time is slow to onset). Crying incessently, poor grip strength, poor reflexes, couldn't follow simple commands, and overt confusion including not recognizing her mom. Mom and her coach denied any head injury, fever, anything that would explain any of this. And she really didn't seem hot. We still cooled her off just in case. Got her on high-flow oxygen. Temp slightly elevated, but nothing out of the ordinary for running around on a soccer field in 105 temps. Oxygen helped a bit. She woke up a little more, but couldn't speak at all. Completely aphasic. She seemed more post-dictal than anything (For you non-medical folk reading this, like she had a seizure). Things just didn't add up, if you know what I mean. I started considering the possibility of a hemorrhagic stroke. Yeah, it happens in kids, too. Being that she improved a bit with the O2, that was less a possibility. Got her transferred to the hospital.

Both my partner and I were just going over this in our heads constantly (and discussing it at the ballpark... he works there also.)... and for good reason. Turns out the next morning, we were told that she HAD been in a head-on collision with a goalie. Aha! Concussion and a seizure make a lot of sense now for the symptoms she had. Last I heard, she was doing ok and home. The crappy way we were treated by the fire department that showed up is enough for another blog entry... but I will leave that alone.

So, what's the take-home lesson for this? If it quacks like a duck, walks like a duck, and swims like a duck... it probably is a duck. If things don't seem right, they aren't. Trust your intuition. It will guide you well with your patients.

Last night was busy at the ballpark... slow early on, then a TON of foul ball hits, including one patient that went to the hospital (Yes, as I have said before, baseballs do hurt and can do a lot of damage). I was so busy, I didn't even realize that the game had ended for 20 minutes!

So, I am back at my "day job", and exhausted. I sure hope I don't get called to work tonight... I need the sleep tonight.

BTW, I still do love emergency medicine. Its just that I get worn down sometimes.

Does caffeine come in an I.V. form?