The Adventures of MidwestMedic

Young Mom

2005-12-27T23:13:00.000-08:00

I grew up having a "young mom." At all the school functions, she was always the parent that seemed so much younger than those other parents. It's never been an issue for me. I've always felt I have a young mom.

This week I had a patient who had that same birthday as my mom...down to the day.

I was transporting her home after she was in the hospital from being in an MVA. This woman had bad knees and just had a hip replaced (because of the MVA). But, she did seem drastically older than my mother. She even had a mole with gray hair on her cheek. Now, the patient was almost 300 pounds, and a long-term smoker. I suspect this had a lot to do with the apparent age of the patient compared to my mother.

I suspect my mother has aged some..she is a certain age in my mind, no matter how old she becomes. I suspect it is the same phenomenon that makes me appear still as her little boy in her mind.

Having the young mom was ok then, but now that I am grown, I feel lucky having the young mom.

working holiday weekend

2005-12-27T22:35:00.000-08:00

Well, I worked 4pm on 12/24 to 4am on 12/25. It was a slow night. But, of course, we get a call at 0330, causing me to get out of work a bit late. Luckily the kids were still asleep when I got home. The hard part was that I had to work again at 6pm that night.

Legos were the thing of the year for my boys. They both got Lego Ambulances...very cool. It's neat the details they put into these things. It was an O2 tank, strecher, carry-in bag, and monitor. The little Lego Medic is wearing some cool shades too.

The neat thing is that my sons (5 & 6yo) were able to follow the directions on their own and build many different things. It even beat out the Hot Wheels this year...never thought I'd see that so soon.

My wife and I also broke down and got something for us that we have been wanting to get for years. A new 32" TV. Our old 27" tv was 16 years old and the tuner would not go to all the channels anymore. It's so cool...buying something nice for us for once.

from the same womb...

2005-12-27T22:05:00.000-08:00

My boys are 14 months apart in age. They, obviously, have been raised in the same home. That's when I really think about how different they are. Though I could go on about many examples, we experienced a good one this past week.

On 12/22/05, I finally used the gift certificate that I was given on Father's Day. Good thing, the gift certificate was to expire on 12/31. What was it for? A free 30 minute joy-ride flight above our town in a small plane.

The day was slightly hazy, the views were ok, but not great. There was *slight* bumps on the way up but otherwise a smooth flight.

The things is, my oldest was very firmly grasping my had the whole flight...he could turn on his picture smile when requested but otherwise looked scared-sick. My youngest, on the other hand, had his nose smashed flat against the glass of the window exclaiming all the things he was seeing the 1,500 ft below us.

After landing, my youngest ran out on the grass of the landing area, his arms out-streached making plane noises stating he wanted to fly again. My oldest, stated he was "air-sick" and proceeded to vomit on himself.

Both my boys fell alseep on the way home, but I suspect for different reasons.

Personally, I loved the sights but I did get a little motion sick too.

@!#&%

2005-12-27T20:00:00.000-08:00

On 12/21/05, I was working a different shift than normal. Nicely, I was still working with another Paramedic.

We are dispatched to an MVA, pickup truck vs. pickup truck. There was an expected amount of preholiday traffic and the fire department was already on scene and had the pt on a backboard & c-collared when we arrived. This was our only patient from this scene and I begin care in the back of our truck. This patient was not wearing a seatbelt and hit the side of another truck at about 35-40 miles per hour. There was steering wheel deformity and a small spider web like fracture on the windshield right where the pt's head hit.

The pt's a 44yo male, alert & oriented, denies any loss of consciousness. We take vital signs, all within "normal" ranges. The pt has abrasions to both shins and round bruise on his abdomen that's the same size as the steering wheel. The pt's abdomen is distended but the pt states this is normal for him.

I start an 18 gauge IV in the pt's left arm while my partner places the pt on O2 and on the monitor.

All was going well until...

I was pulling the needle back out of the catheter. The design of the catheters we use has us back the needle out into the handle while still attached to the catheter. Once the needle is all the way out, it locks into place and reduces the chance of an accidental needle stick. The thing is, I had about 1cm of needle left to draw back when my partner placed the monitor lead on the pt's abdomen. The pt jerked his arm back, removing the catheter from the needle I was holding. The pt then immediately jerked back. The remaining needle then went through my glove and entered the tip of my right index finger.

@!#&%

I hooked the line I had started to the pt so that he would stop bleeding out the now open catheter. I then removed my glove, cleaned my finger with an alcohol wipe and put on a new glove. I explained the the pt what had happened and apologized for my momentary outburst of expletives. I then called my supervisor to report the exposure.

******

All the pt's tests came back negative as well as mine. There was one interesting result. My resistance to HepB was not as high as expected for someone who has gone though the series of vaccination shots. So, I am being offered a booster shot to hopefully remedy that. At least I know and will get the booster. At least one good thing came out of this.

******

I was pissed at myself the whole night. The amount of paperwork was amazing. But, mostly I was pissed and worried out the "what if's". Definitely have to enjoy this job and be as careful as possible at all times. Next time, the monitor can wait until the needle is gone...

off-topic

2005-12-13T22:48:00.000-08:00

I learned a new word today that I like. Reminds me of the women in my life.

http://www.m-w.com/dictionary/zaftig

:-)

Thank you for teaching us to brush our teeth

2005-12-13T21:56:00.000-08:00

OMG, I had a patient recently whose mouth seemed to be rotting away. It was a gash of brown and stench with the occasional narrow tooth remnant jutting through. The worse part, I almost had to intubate him. I ended up placing a NPA (nasal airway) and bagging him though that. There were some questions about his code status, his jaw was clench tight and I couldn't get an IV. So, I voted for fast BLS treatment and let the hospital work out how far they wanted to go with him. (Less than 10 minutes to the ER.) His pulse oximetry was 79% with a respiratory rate of 40 and unresponsive. I was able to get him up to 96% just by bagging. I've been off the last few days, so I do not know what happend to him. But, he had a bad history and seemed to be an almost-hospice patient with contractures in all 4 extremities, cancer, etc. I'll look into it tomorrow if I remember.

The point of this post was not that run...got a little off track there. But rather, I seem to have a habit of looking at patient's teeth. I guess that's from being raised by a mother who makes false teeth for a living.

I don't like the color of my teeth and my few fillings, but I do know there are some mouths out there that seem to have never felt a tooth brush. Why are they always the mouths that we need to get so close to?

Maps as Lifesavers

2005-12-13T21:44:00.000-08:00

The following post is from http://ccablog.blogspot.com/. I thought it interesting and relevant to those who read this blog.

WFAA.com (also in the Denton Record-Chronicle and a few other sites; free subscription required for each site) has a story about the work of the GIS Corps in the wake of Hurricane Katrina and the role that maps and GIS have played in the locating and resuce of trapped people in need of help. For those of us who work in the field of mapping and GIS, all of this comes as no surprise. But for many others, this is new technology and for some, it is even a source of wonder.From the article: “We're using mapping for distribution sites, shelters, hospital locations, helipads, search and rescue and debris fields,” said Brian Adam, director of the Hancock County Emergency Operations Center. “There is no way we could have made it without our maps.”

******

My interest in Geography shows up every now and then. My town/county does have a GIS (Geographic Information Systems) Department but I have not seen them do any work for any emergency agencies. It would definately be nice to see. Have any of you worked with a GIS team on making sure you have spacial data when needed?

******

Another great free piece of software is Google Earth. I originally used this when it was owned by a company called keyhole (before Google bought them). It's getting better with each update. I just wish they had better images of my area. Luckily, the local GIS department has their informaion on the web that I can access with 2000 aerial photos as one of the map layers.

*******

Now I just want to get GIS maps on the trucks to give me directions to the scene from wherever I happen to be. I know some services are lucky enough to have that. Maybe someday I'll buy the software and receiver for my personal laptop and just bring it in to try out...yeah, when I have the money for that...(eyeroll)

She was beautiful.

2005-12-13T21:02:00.000-08:00

December 10, 2005

I gained a son-in-law and worse, I became a father-in-law.
Heck, now I'm married to a mother-in-law.
How's that happen? It just sneaks up on us dangit!

She was beautiful. My wife cried. The wedding was nice. Everyone, for the most part, behaved at the reception.

I have to say, it was a lot easier being the groom than the (step)father-of-the-bride.

My wife wrote a nice blog entry before the wedding. Here it is:

******

I Hope She Dances...
Current mood: nostalgic

Well, today's the big day. Amber's getting married. Yesterday was very long and very hectic, but today should be wonderful! I only teared up once during the rehearsal - when my Dad was walking her down the aisle. Today WILL be a different story!!

As I was trying the help her get things ready for today, I was blessed with flashbacks for the past 21 years...

I remembered how beautiful I thought she was when I first saw her. I didn't realize that all babies do NOT look alike when they are born!

I remembered that from the start, she was not content to sit still. She had to be on the go at all times. Who ever heard of a baby walking at 7 months?? But she did...

I remembered that she had this precious little personality...a tad sassy toward life (which is cute when you're 3) and definitely an independent kid.

I remembered realizing that she was not a singer!!! Having a 4 year old sing Red Red Wine...Makes you Feel so Fine...way off key is cute though!

I remembered that first day of Kindergarten. I take her to school. Stop the car at the sidewalk. She gets out, as do I. With a look of disgust, she says "Mom! Where are you going?" "I'm walking you into school," I replied. With her little hands on her hips she says, "Mom! I'm 5 years old! I can do this by myself, you know!" Although she let me walk her in just that first day...she was sure to let me know it would not be the norm!!

I remembered watching her hour after hour, day-in day-out, dancing. Tap...jazz...but no ballet! She is not a ballerina!! Give her some funk and she's awesome...Grace. She has none!
I remembered that she can follow instructions. At her first National dance competition in Orlando...coach said, "Never pull on your costume." After this performance she said, "Never pull on your costume unless your top is falling down and you're exposing yourself to the entire world!"

I remembered when her 5th grade 'boyfriend' broke up for her. No, she didn't want the baseball hat back that she bought him for Christmas. She told him to shred it... just to make sure he was still wearing it when he did. (some of that sassy little attitude again)

I remembered when the dance practices turned to cheer practices. I remember traveling, sometimes with Lacee, sometimes just the two of us, all over the country. Made me so happy to have these memories with her!

I remembered the "I Love You" signals that we'd sign to each other EVERY time she took that cheer floor. I remember that being the most important part of the competitions to me.

I remembered the call, "Mom, I got a ticket today" (first week after she got her license) Then 2 days later came, "I'm never driving again!" Wreck 1... then the subsequent 3 calls about wrecking her cars. I was always relieved that she was ok. Although going by ambulance to the ER kinda freaks a mom out!!

I remembered some of the arguments we had...but for the life of me can't remember all the details. That's a huge plus! :)

I remembered her high school graduation and how proud I was of my little girl...not so little anymore.

I remembered how she's grown into such a beautiful young lady. Independent, strong, and able to take care of herself...unless she's sad/hurting. Then she still wants her Mommy.

As I watched her walk down that aisle with my Dad...it was a happy moment, indeed. And I realize that it now comes down to what she has ahead of her. I wish her happiness...and love...and to become one with Regan, yet to maintain her indviduality. But most of all, Amber... I hope you dance!

I love you Bean!

******

I Hope You Dance by Lee Ann Womack is the song I chose to dance with her. Good song.

******

Obviously, this is the main reason I was not driving the 9 hours to see my sister in the hospital.

What is normal?

2005-12-08T19:11:00.000-08:00

When I meet a patient with some form of altered mental status, I always ask if this is normal for this patient. Sometimes the answer comes from a family member, sometimes from paperwork given to me by a nurse. Sometimes a bystander tells me the patient was not like this only moments before.

But, what happens when the patient's normal mental status is not "normal"? Would you notice an elderly dementia patient with a UTI? A autistic patient with a stroke? A mentally retarded patient with a blood sugar of 40? Or, what recently happened to someone I care for, a patient with a history of Cerebral Palsy, severe kidney infection and now suffering from Guillain-Barre Syndrome?

My sister has Cerebral Palsy. My sister has improved greatly during the 29 years of her life. If you met her, you may notice something, but may not know quite what. Her speech pattern is something similar to many people who've had a couple beers. Slightly slow, but still very understandable. Also, she walks at one speed. She doesn't run very well and don't ask her to jump up and down on one foot. But, she walks just fine and wouldn't notice anything unless she was on a large slippery surface where she had to worry about loosing her balance. And to be totally clear, she has no mental deficits. She was a B/C student in school like many people I have known. She did well in areas she enjoyed and not as well in those subjects she did not.

On November 22, my sister gave birth to her first child...a lovely baby boy. No complications that I heard of. They were sent home as normal.

Last week Wednesday/Thursday, my sister was running a fever and feeling pretty poorly. She likely had some abdominal pain, but chalked it up to recovering from her first delivery. She called her doctor's office and they recommended taking some Tylenol and calling them if she does not get better in a day or so. Saturday, the doctor's office is closed and my sister takes a turn for the worse. Her husband takes her into the hospital's emergency room in the early hours of Sunday. My sister cannot walk. She's barely conscious. Her words a slurred. She is responsive to Verbal stimuli, no longer fully Alert & Oriented. My sister's home thermometer read 102F. The hospital's read 104F.

The hospital begins to treat her for an infection they eventually determine to be a extremely bad kidney infection. Describing the infection as severe would not be over-stating the situation. She would need to be evaluated for permanent kidney damage. As the infection is beaten back, her mental status improves. Yet, she is still not talking. Her legs are described as being "like noodles." She also has very slurred speech and hard to understand. Occasionally, she has phrases that are clear as normal, like "I love my baby." She appears to be suffering from depression and is barely eating the chicken-broth-like soup the hospital is giving her.

The hospital is considering discharging her with some antibiotics for the infection, a done deal. She is still not walking or talking. The family is telling everyone this is not normal for her. Yet, everyday a different doctor reviews her chart, see she has CP and when evaluating the patient sees no sign of anything outside the range of CP. Yet, the family still seems to be quite upset. Yet, every time the family explains this is not normal, the nurse are doctor is like "Oh! I saw she had CP. This is not normal for her?" "No! We have been telling EVERYONE this ALL ALONG." Still, nothing is being done other than the antibiotic.

Luckily, my sister's OB/GYN hears of my sister's plight. As with any woman who has just had a baby, she has recently seen her OB/GYN more often than any other doctor. The OB doctor immediately notices the difference in my sister yet cannot do anything for my sister herself. Thank God, though she did commit to contacting A LOT of "the right" people. The next day, my sister was having an MRI, a Neurologist was seeing her and they were doing further tests.

Today, my sister has been diagnosed with Guillain-Barre Syndrome. Seems that most occurrences of this syndrome are proceeded with an infection of some-sort. It's a rare syndrome, affecting one to two people per 100,000. The exact subtype is even more rare. Miller Fisher Syndrome only effect about 5% of those with GBS.

A description of Miller Fisher Syndrome:

"It is characterized by opthalmoplegia (eye muscle weakness), areflexia (absence of reflexes), ataxia (the inability to coordinate voluntary muscular movements such as walking), and, in some cases, facial and bulbar palsy (affecting vital functions, like breathing, and swallowing or speech)."

Today they began treatment. Family has been told that drastic improvement could be seen in a few days. But, if no improvement by then, it could be months... From what I read, it could be even more. Lots of medication and lots of physical therapy is in my sister's future.

It's baby's first Christmas. My sister should be spending this early time bonding with her child at home. Yet, now she is suffering from pain, near paralysis, and depression in a hospital bed. I wonder what today would be like if they could have started treating her a few days ago rather than just now.

******

Why haven't more healthcare workers realized they need to ask not what is normal, but what is normal for this patient? Many see a history of a disability and just assume that this patient is not normal. That this person is normally asleep, not walking, not talking. All of us need to remember to listen and to ask questions. Charts can be misleading. Treat the patient not the chart and remember, the family and the patient have a lot more history in dealing with their disability than any doctor who does not have the disease themselves.

In an emergency situation, family members will likely and understandably be anxious from the situation. So they might not give you all of the history without being prompted. If a patient's family member tells you that this is not normal, even when normal for this patient might not be "normal" for you and me...LISTEN. And, please, make sure to pass this observation on when you give your report and document your care.

CPR

2005-12-04T20:46:00.000-08:00

Many American's know what what CPR is, even if they do not know how to do it. But, how many people actually know what the letters CPR stand for?

Cardiopulmonary Resuscitation

Cardio = Heart

Pulmonary = Lungs

Resuscitation = Reanimation...returning of life...etc.

As part of first aid class and every higher-level class I have taken since then, I have always been taught to check the ABC's and in that order. Airway, Breathing, and Circulation. They are important in THAT order. Your heart may be pumping, but without an open airway and respirations, the heart won't be helpful for very long.

Americans are learning CPR in greater and greater numbers. But, the public is also becoming a lot more aware of communicable diseases. This has caused a crisis for the patient in need of aid when only bystanders are around. People are doing nothing. Even when they may have at least a decent idea of what to do. It seems that people are afraid to do rescue breathing. Honesty, I don't blame them. Without a barrier between you and the patient, there is a good chance you could swap some germs...and maybe lunch.

So, it seems this thinking is now effecting how people are being trained to do CPR. The use of disposable masks and other barriers has been around for sometime. But, the big change that is just rolling out is scaring many professional rescuers. For CPR, the importance of ABC is being switched around to CAB.

I can understand training someone to at least do compressions if they are in a situation where they are nervous to do respirations. Yes, the residual Oxygen in the system will be circulated around. But, toxic Carbon Dioxide will build up if not given a chance to escape though respirations.

The American Heart Association has a major sway on how CPR is done in this county. With their current revision in their guidelines, they seem to hold the risk of alienating the professional rescuers. Below I have linked to a FOX News article that seems to show a fairly positive outlook on the new guidelines. I have also linked to a blog entry that goes into great detail about why many medics think the whole thing is messed up. Though the blog may be way to technical for readers outside the medical world, I highly suggest everyone read both.

My take on it?

I am about to get my CPR instructor certification for the American Heart Association. I will teach the new guidelines, as I am required. But, I will also talk about the impact of these guidelines depending on the level of my audience. If you have no medical experience at all and a stranger codes in front of you...Call 911 FIRST! After that, do everything you feel comfortable doing. If that is only compressions, so be it. If that is lots and lots of compressions and only a few breaths. Thank you. But, please realize that as professional rescuers, when we arrive, we are expected to deliver care at a higher level. This means making sure we do effective compressions and BREATHE FOR THE PATIENT. I recommend Oxygen delivered though an ET Tube/Bag-Valve. But, if you are a Basic service, please at least to a Bag-Valve-Mask. The key is to assess the patient and do what it best for that patient. Guidelines are just that guidelines (NOT LAW) ...follow your local protocols, they are what will help you keep your job...and hopefully save a life.

Like I said, read the articles.

Fox News

Paramedic Blog - 11/30/05

Anyone for a war on cars?

2005-12-03T22:53:00.000-08:00

OK. Any of us who are in EMS should know that the field really started to grow out of a response to death from traffic accidents. That is why national EMS standards and governance comes from the Department of Transportation. Yes, this may change to the Department of Homeland Security. But, given this study, I wonder if it should.

News Articles:
Car deaths 400 times greater than terrorism
Death toll from road accidents 390 times that from terrorism

Now, if I can only find a link to the actual study...anyone? The articles I am finding annoy me because it seems one news source just uses another news source as it reference of information. Note the difference in the math...390 or 400? I have seen that the results of the study can be found in the journal Injury Prevention...now just to find a copy, preferably online.

OK. I found the article online...a very short abstract is free..but I have to pay for the full article. Now is not the time of year I can justify paying for something like this. Anyone out there read the actual article or study? Link to Abstract

The best quote I have found so far:

"In 2001, road crash deaths in the US were equal to those from a September 11 attack every 26 days."

Cool Job

2005-12-03T22:00:00.000-08:00

Now, in the past, I definately felt I had a cool job as a US Park Ranger. But, occasionally, I come across something that makes me think the person has a really cool job and is lucky to get paid to do such things.

Here is another one. Make sure to look at the pictures. Such a great idea.

Fabien Cousteau, Swimming with Sharks
(NPR story w/ audio interview)

Shark-Shaped Submarine Is Latest Cousteau Star Vehicle
(National Geographic with more pictures than NPR)

Of couse, the grandson of legendary Jacques Cousteau is going to be doing something interesting! Lucky him. I hope he realizes it.

Concern

2005-12-03T21:08:00.000-08:00

One thing about working in EMS is that you can think of worse-case scenarios very easily. Heck, it's what we do. The chest pain may be nothing, but we will rule out what we can and treat for the worse-case scenario.

My family is spread out all over. I grew up about 8 hours from where I currently live. Most of my family is still in that area. My mom, on the other hand, is doing the whole semi-retired lifestyle in the sunny southwest.

We get this email from my mom today:

"I don't know if you've heard, but [my 29yo sister] is in the hospital. [Her husband] took her in to the ER on Saturday morning. She wasn't able to walk and her speech was slow or actually nonexistent. They are running a battery of tests. Still no answers, but they say it doesn't look like a stroke. I am flying back tomorrow. Will plan on staying a week, but that is kinda up in the air till we know more. Just thought I'd let you know what's up. Please say and extra prayer for her. XOXO MOM"

My sister has cerebral palsy. She can walk and talk just fine..her balance is not the best and her speech pattern is slightly slow...just enough to notice. Also, she just gave birth to her first child about a week ago.

So, of course, I am now stressing about this. Yes, stroke is a possibility..but they say that is ruled out. I wish I was there. I am wondering if she accidentally OD'ed on a medication. I suspect they give new moms something for pain..I know they are in a bunch of pain from what their body went through.

I am awaiting more news...until then I am worrying.

Got all the right stuff from her mom

2005-12-03T20:52:00.000-08:00

Our 15yo daughter is at the Christmas dance with her boyfriend tonight. She looked very pretty. I'm glad to have raised a daughter who isn't "high maintenance" but it would be nice to see her dress up more often. She tends to be a pony-tail and sweatshirt girl...nothing wrong with that. Just nice to see her clean up sometimes.

They (double date) are going to the dance, then glow-bowling, and finally end up at our house. They are all spending the night here...boys and girls in separate rooms, of course. Parenthood can be hard sometimes and very hard many other times. But, it is nice to see them growing up as good people.

A card can mean so much

2005-12-03T20:42:00.000-08:00

My service got a thank you card in the mail from the daughter of my first code. It is nice to get things like this from time-to-time. I need to remember to make a copy of the card and send it on to the Fire Engine crew who helped us.

Here is what the note within the card said,

"Thank you for saving my mom's life 11/14/05 in the early morning. After her heart attack, she remained at (Hospital's Name) ICU for 10 days and returned home on Thansgiving morning! We were so thankful!

God Bless you for your help!"

Thank you for the thank you...it really means a lot.

EMT Change of Scope

2005-11-30T14:15:00.000-08:00

The state I live in has just decided to remove Pulse Oximetry from the EMT-B and EMT-A scope of practice. (Click the link if you want to know what it is.)

This issue has really upset a lot of my coworkers. I understand the logic that if a pulse oximetry reading comes back unusually low then the patient should be cared for by a Paramedic rather than a Basic. But, a Basic can give a patient Oxygen and a Pulse Ox is how you can measure the effectiveness of your treatment. Plus, we all are trained to understand there are situations where the reading should not be trusted. (Those suffereing from Carbon Monoxide poisoning will read higher than they actually are.)

What I am worried about is that an over-reaction will occur and EMT-Basic's will not even be able to get this information as part of collecting vital signs. It's non-invasive and currently we tend to rely on your Basic's to collect this informaiton for us when we first arrive. This allows the Medic time to collect more of the "big picture", interviewing the pt, etc.

I am really wondering how this is going to play out...

some good moments

2005-11-30T06:14:00.000-08:00

I had two patients recently that thanked me for what I had done. I've had other people say thanks..but these two really seemed to mean it.

I also had a senior medic compliment me on my IVs. This really felt nice because I really stress about this. I had so much trouble as a student learning this..really I know HOW to do an IV. I just had A LOT of trouble being conisistant. So, though my hands do still shake a little, I am not letting it bother me and I am able to get a good IV the first time almost every time. (There are always those patients that are near impossible to get IVs on.)

Anyway...I remembered this post from the past:
http://midwestmedic.blogspot.com/2005/09/i-am.html

My community has had some tragic events recently and the fire department and police were recognized in the media. The hospitals were also focused on greatly. But, again the medics and emts were not really metioned at all..even those whose homes were barely missed yet will out there saving lives. I am not sure this is the fault of the media...it seems like my agency might have missed an opportunity to show the public what we do. I don't think we even designated a public information officer to help coordinate information to the public...never mind public relations.

For Mom

2005-11-27T14:45:00.000-08:00

This is from another blog I read, but it did make me remember the times I have visited my Mom. I do not agree fully with this list, but it is a good list none-the-less.

"Since anyone remotely proficient with a computer becomes the official household IT person when they go home for the holidays, Top 10 things to do for mom's PC over Thanksgiving"

11 runs in 12 hours...

2005-11-27T14:26:00.000-08:00

OK. Last night did not fit the slow November mold. Most of the runs were no big deal stuff. There were a couple of chest pains but over all it was just sick people who were not following doctor's orders and think that going back to the hospital AGAIN will some how cure them.

Looks like cold and flu season is starting. My shift's number one dispatch code has gone from the usual "difficulty breathing" to "Sick Person".

Survival until discharge

2005-11-27T14:22:00.000-08:00

My partner and I tried to visit our cardiac arrest patient from last week. The problem we had was a good one...she has already been discharged from the hospital. I wish I knew if she had all her mental capabilities restored. I'm wishing her the best.

short notes

2005-11-23T19:53:00.000-08:00

November is the slowest month at my service. This is normal and is expected. Two nights ago, I only had two runs in 12 hours. Last night, I had 6..one of them a refusal. The whole service has only been having 50-60 runs in 24 hours. This is nuts compared to last month when we had a day with over 100. Mind you, I'm not complaining at all. Just a crazy change of pace.

******

I really hate having to work two jobs. I got off the ambulance at 0600 this morning. I started at the computer job at 0700. The thing is, I like 99% of the people I work with there, it's just all the repetative questions about things like "how do i find this web page". But, what really gets me is the amount of stress some people get over things like paper jams. I suspect they do not like my "hey, it's not like somone is dying" attitude. But, really, there is a big difference. I fix the paper jam and move on. What was that? 15 minutes were they had to walk a little futher to get their print out?

I am so ready to quit. Right now, I am thinking it will be the end of January...

******

Update on my first code:

She's off the vent..out of ICU and talking! I got this update last night. Obviously, the hospital had a lot of work on their hands and the patient had an angel watching over her. I do not work again until Friday. Hopefully, my partner and I will have time to check on her at the hospital.

It would be nice to actually have my first code as a medic actually survive to discharge!

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Thanksgiving: Not my favorite holiday. I honesty feel trapped at the realtives for hours longer than I want. The thing is, my wife LOVES the long holiday stuff. I try my best to breathe as little second-hand smoke as possible and not swell up from all the cat dandur. I do love tryptophan... it gives a good excuse to nap..even if it isn't the cause of the mid-day slumber. (article)

This Thanksgiving will be different..as will Christmas Eve with my wife's uncle, my mother-in-law's twin, passing away yesterday.

I expect to be there from noon to evening...and I'll not complain...i don't need to..my wife knows how I feel. But, I'll be there for her. That's why I do it evey year anyway.

Seven Long/Short Weeks

2005-11-23T19:49:00.000-08:00

From the wife's blog:

******

Seven Long/Short Weeks
Current mood: drained

Seven weeks.... 49 days... that's all it lasted.

My uncle passed away yesterday. Seven weeks exactly from the time he was diagnosed with cancer. Seven weeks....

My mom got a call from my aunt on Monday. She needed her to come down there. When Mom arrived, my uncle was sitting on the edge of his bed. He had been for a couple of hours. Just sitting. His pain too great to move. With the help of hospice (wonderful organization, by the way!), they finally got him into a hospital bed in the living room. They catheterized him and informed my aunt and mom that this was it. They expected him to pass by early Tuesday evening. My mom spent the night.

Yesterday was a waiting game. Every time my phone rang at work, I jumped. At 3:30, my sister called me. My uncle's suffering was over. He had passed away 15 minutes earlier. Mom wasn't doing so well and I felt the need to go be with her and my grandmother. I finished up the imperative items at work and left about 25 minutes later.

I entered the front door. There, in front of the fire place, was the bed and my uncle. My mom was standing just past the entry way. I hugged her and told her I loved her. She had hyper-ventilated, she told me...and was so embarassed that she fell apart. I told her it must be the twin thing - she was probably trying to breathe for the both of them.

In the kitchen, Grandmama was talking with my aunt's mom. When she saw me, she sobbed. I tried to console her - but what do you say to someone who just lost a child? Doesn't really matter how old that child is...burying your child does not fit what we think the natural progression of life should be.

The funeral home staff arrived a short-time later. We were asked if we wanted to say our final goodbyes. My mom was first. I was back holding onto Grandmama. How she didn't collapse is beyond me. Grandmama leaned over, told him she loved him and to be watching for her when God called her home. Tears fell freely from my eyes. Can't imagine telling that to one of my children! We left the room and let the funeral home do their thing.

The best part of all this is that his pain is gone. He was right with God. There was no question where he was going. Our sorrows will eventually lessen. We will miss him, but the pain will be softened. And tomorrow, tomorrow on Thanksgiving, we will be thankful. Thankful for the memories we have and for the life we shared with him. And my uncle? He will be having the best Thanksgiving he's ever had!

I love you, Ronnie! Save us a spot at that Thanksgiving feast!

Uncle Ronnie
June 18, 1943 - September 22, 2005

******

if you could just pick up and move...

2005-11-20T20:35:00.000-08:00

Where would you go?

I've lived in a number of places during my not-so-long life. Luckily, a few of those moves included moving to places that most Americans just dream of vacationing. Plus, some of those moves went quickly from planning to reality. But, back then I was young, single, and everything I owned could fit into my 1985 Ford Tempo (plus a carrier on top).

Any future move would be a much bigger deal.

My wife was born and raised in the town we currently live in. She has joked in the past that she would move if it meant she could be a stay-at-home mom wherever we went. I pretty much took that as her way of saying my dream of moving is as likely to happen as her dream of being a stay-at-home mom.

As I suspect with any family, the children, jobs, and home are the main issues if we ever move. Our kids are 21, 15, 6, and 5. The 21 year old is about to get married. Our 15 is in high school and I agree that we should not move until she after she graduates. She's doing well in her high school and I am not sure she would handle a move that well...the whole teenage "you ruined my life" routine is not something I want to deal with. Our younger ones, 6 and 5, are just entering their school age years and though I am sure they would miss many things I believe they would find new friends easily and adjust just fine.

Jobs? My wife works for one of the top 5 employers in our area and has slowly worked her way into some decent pay. Moving could be an impact on her employment. Her employer has "branches" in other areas, but they are not quite the same job and not always available. This goes back to her stay-at-home mom argument.

My job, heck, I am in EMS. Nicely, there are Paramedic jobs all over the place. Sadly, some of the areas I like only have volunteer services. The thing is, I like rural areas...makes it even harder for jobs. This is one of the few reasons I would consider bridging over to nursing. A LOT better pay and jobs almost everywhere. But, to stay sane, I really would only consider a flight nurse position...but then I would really prefer to be a flight medic.

House? Yes, there are homes all over..but where we currently live the home prices are MUCH cheaper. This area has a very low cost of living and moving OUT of this area as opposed to those moving IN, have a lot harder financial burden. A family of four can easily find a home (not new, but nicely maintained) for around $100,000. How many areas can say that?

Why am I think about this tonight? Why am I bothering to blog about this?

I just comes to mind now and then, but there have been to recent things I have seen online that made it come out of the depths of my mind.

******

Anyone consider moving to Kalamazoo, Michigan? I have not until I read this. Mind you, I would definitely check out the school districts first...but look at this for a long term bonus for your children: The Kalamazoo Promise.

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I took this test a year or two ago and got predictable results. But, somehow it has floated around again and someone forwarded me another email about it. It's an interesting survey that matches you with locations that fit your criteria and how you describe yourself, your likes/dislikes, etc.

http://www.findyourspot.com/

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Where would I move? I personally like rural areas but mostly small towns and those resort communities where the population quadruples in a certain season. I can handle the crowds short-term. But, I tend to like the folks who are there when the place is all closed up. I am sure there are towns like this all over the US. But, I tend to favor the northern states because I like the transition area from Hardwood forests to Boreal (northern evergreen) forests. Also, since I grew up in Michigan, I do like having water nearby. I don't really care about beaches. It's more the water, rivers, and lakes I like. Maybe I would like New England, but I have yet to visit there. Currently, I prefer the "pinky" of Michigan....http://www.mytraversecity.com/. And my current "favorite place on the planet" is Isle Royale National Park in Lake Superior.

******

So, back to my original question...

If you could just pick up and move, where would you go?

I don't try to let reality get in the way of thinking where I would go, so please don't let it stop you either. Please post a response and let us know. Or at least go to the Find Your Spot site and let us know if you find any of the results interesting.

Katrina Mental Aftermath

2005-11-16T11:46:00.001-08:00

An NPR story. RealAudio or Windows Media Player required.

EMS workers dealing with the increased level of suicide attempts in their area while also dealing with their own lives.

http://www.npr.org/templates/story/story.php?storyId=5014682

Highly recommended story.

******

This makes me think of Critical Incident Stress Debriefing in general. After the recent trailer park vs. tornado incidient, the local hospitals and fire departments had CISD within 24 hours and again over the following days. Did the ambulance service? No. None. They have a 1-800 number we can call if we choose to get help and all the crews were invited to attend the other CISD meetings. This just does not seem right to me. There is no reason to be superman. CISD is a wonderful thing for most people. Why would an organization that supposedly understands issues like this would not even offer CISD? I don't know the answer to that.

We're not in Kansas...

2005-11-15T20:26:00.000-08:00

But, it may be hard to tell.

Three tornado warnings in my county today. Two during the day and one just after sundown.

There were a three confirmed tornados in the area from what I can tell so far. Luckily none were near my home or actually in my city. But, they did serious damage in nearby towns. Sadly, the picture above is by far the smallest of today's tornados. Also a lot of wind damage in general all over the area. One of the mobile homes that survived the tornado last week was struck by lightning today too. The fire was put out quickly.

Temperatures have really dropped. November should be closer to normal now. At least, I hope so.

Just think of the anxiety level in this town...lots more anxiety related runs.

Tornado coverage

2005-11-14T21:52:00.000-08:00

Here are some links I copied from the local newspaper's website.
Tornado Aftermath, etc.

•SLIDE SHOW 1
•SLIDE SHOW 2
•SLIDE SHOW 3
•SLIDE SHOW 4
•SLIDE SHOW 5
•SLIDE SHOW 6
•SLIDE SHOW 7

Sad

2005-11-14T21:32:00.000-08:00

For those of you following this. My wife's uncle is getting much worse. Seems is wasn't Colon Cancer but had spread there..along with the liver, and lymph nodes. Maybe it started in the lungs, but it really is not important anymore.

******

Here is today's post from my wife:

Final Farewell
Current mood: numb

I said what I believe to be my last goodbye to my uncle yesterday. Hospice has been coming in and last Friday, they changed his life expectancy from another 5 months to 2 weeks. Big change there. It was a devastating blow to the family...although in my heart, I already knew it wouldn't be 6 months to begin with. Cancer, especially in the liver, does not wait that long.

So, yesterday after church and lunch I took the kids on a drive. Drove them around to see the tornado mess...still floors me how bad Newburgh is... and decided to stop by and see my uncle. Two weeks will pass sooner than I realize. What I didn't expect was the drastic change from last week to this week.

Last Saturday he was weak, but still able to move about pretty well. He was talking to us and carrying on conversations. Yesterday, just the mere act of breathing was labored. He sat quietly in his chair. He stared blankly at the floor...glancing every once in a while at the cigarette in his hand to make sure the ash hadn't fallen. His medication is increased, but even Hospice said that he's so stubborn, he'll keep his mind until the last breath. His eyes were very dark and sunken. His skin yellow. His body thin and frail. I'm not sure how much weight he's lost in the last month...but if I were to guess I'd say probably 40 pounds... 40 that he really didn't have to lose.

He had finished a popsicle about 5 minutes before we arrived. We hadn't been there long (maybe another 5 minutes) when he had to get to the bathroom to throw it up. Nothing he eats stays down. Nothing. I just sat there by my cousin...sad. She said she didn't believe he would even make it 2 more weeks. He's been deteriorating at a rate that's hard to believe. It's really the best for him...less suffering...less pain. But it sucks! Apparently he still has some humor left in him. He told my cousin that he's ready and ok to die...it's just getting there that's killing him! -soft smile-

By the time he's coming back out, I decide it's time we leave. He needs his rest. I hug him as he passes me. I tell him, "I love you, Uncle Ronnie." to which he responsds, "I love you too, Dee." And that's when it hit me...I knew I had just seen my uncle for the last time. That was our goodbye.

I broke the rule. I cried. I cried for my sorrow and my loss. Yet he'll be rejoicing soon...so these tears are for me, not him. He'll be fine. -smile-

I love you, Uncle Ronnie! I'm going to miss you!!!

******

My first code...

2005-11-14T21:24:00.000-08:00

First, I must say I am spoiled working on a double Medic truck. It was just nice to have a partner that also knew the protocols and could handle half the work at the same time.

I do not have any notes in front of me at the moment, so here is the short version of what happened...minus a lot of details.

0130: Call comes in..man witnesses his wife's arrest. Due to an earlier heart attack, a local hospital had given this family an AED as part of a pilot-program. No shock was indicated and the husband initiated CPR. Pt is a 54yo female with unknown history other than the one heart attack.

0139: Fire and EMS arrive on scene. This house is on the far edge of our county and I drove WAY too fast to get there. Getting there at the same time at the fire department is rare, they must have had a hard time waking up. Of course the pt is in an upstairs bedroom down a narrow hallway.

We slide the pt from beside the bed to a spot in the room where we could actually get all around her. The pt's is warm, dry, and blue from the nipples up. We attach our Defib pads. Fire starts CPR. Another firefighter attaches the monitor leads.

Pt is Asystolic. My partner intubates the pt. I apply chricoid pressure while looking for an IV site. Tube goes in fine and I start an 18 guage IV in her right arm. Gave two rounds of Epi & Atropine then gave 50meq of Sodium Bicarb.

Pt now in V-Fib. Shocked the pt three times with persistant V-Fib. Amiodarone 300mg. Shock. Pt now in a very ugly looking V-Tach....with a pulse! Pt even takes a breath. Not breathing fast enough..so Fire is still assisting ventilations. Pt is not so blue at earlier. While hooking up an Amiodarone drip pt goes back into V-Fib. Also got another 18 guage IV in her left arm while setting up drip.

Shock. V-Fib. Amiodarone 150mg. Shock. V-Fib. Sodium Bicarb 25meq. Magnesium Sulfate 2G. Shock. V-Fib. Epi. Shock. Effective CPR to circulate drugs between shocks. After the last shock, the pt's rhythm changes to a very pretty looking Sinus Tachycardia with a pulse of 115bpm. Pt again takes a breath but we still need to assist respirations to keep a good rate. Pt now pink instead of blue.

Move pt to Long Spine Board and verify tube placement. Now the fun of moving down the hallway, down the staircase, out the foyer, over some landscaping bricks by the porch and onto the cot. Verify the tube placement again and pt still has Sinus Tach pulse of 115. Lines all still attached and flowing. Of couse, it now starts to rain. Quickly move into the truck and go en route to the hospital. Pt stays in the same rhythm and rate the rest of the time we are with her.

The Pt's pupils were fixed and dilated the whole time. I am not fooling myself on this. People who we meet in Asystole tend to either never make it to the hospital or if they do, they tend to not live past it. But, by the time we left the ER, the whole family was at her bedside and the doctor was explaining the odds and likelihood of things to come.

My thought on the whole matter is that we at least give the family time to say goodbye, be together a little longer, and maybe even hold onto a little hope that the pt's condition may improve.

It's the least we can do. The whole thing from 911 call to arrival at ER was almost exacly an hour. We cleared the hospital at 0249. We took some vital signs and such along the way through this. The pt had a bp of 100/60 in the ER.

PS- Thank God for a great Fire Engine crew. Between them they did perfect CPR, knew how to spike an IV bag, and understood how to move and ventilate a patient without dislodging an ET Tube.

*******

I'm too tired to proof read this post right now. I've only slept 4 hours today. I'm glad I do not work tonight. Another big thunderstorm, I'm sure we'll have some more anxiety attack patients. I think I got all the major points typed out correctly in the post above, I'll check later. Until then, this is good sleeping weather.

Rare nighttime tornado picture

2005-11-13T04:51:00.000-08:00

Photo from a security camera at Deaconess Women's Hospital. It was only visible for a moment thanks to some lightning. Scary enough, this was likely the moment when it was hitting the Eastbrook Mobile Home Park.

For the very short video clip, click here:
http://streaming.news25.us/launch.asp?video=tornado

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Emergency rooms prepared to handle disaster victims
The doctor interviewed first in this article is one of my service's two medical directors.

What were you thinking?

2005-11-12T14:20:00.000-08:00

The call comes in at 5:45am. I get off at 6:00am. The next crew is not in yet and the all other trucks are on runs already. The call is at a nursing home at the very far edge of our area. Off we go. My partner and I are both medics, so we switch off on "who's run" it is. We both do our medic skills, but only one is "in charge"...and has to do the paperwork. This is his run. We are dispatched for a Breathing Difficulty.

80yo female. Earlier in the night she had shortness of breath and jaw pain. The nurse at the nursing home gave her three nitros (one at a time) and the pain went away. The pain came back later, they gave her two more nitros and the pain is still there. They call for us. The pt has no significant medical history other than dementia.

We get there and do our thing, get a report for the nurse while walking down the hall, get vitals, move pt to cot, etc. Pt is awake and talking as normal for the pt. Only complaints are jaw pain and shortness of breath. I'm starting to think possible MI (heart attack)...

On the way out to our truck, the nurse wants us to wait for her to finish her paperwork...quite a bit left. I told the nurse we would be in the truck and she'd need to bring it out to us there.

In the truck, we have the pt on O2, hook the monitor up, start an IV and draw blood tubes for the hospital. My partner was unable to find any good veins on his side of the pt but I did and was able to get an 18 gauge in her right anti-cubital area (inside of elbow). After getting the IV, I see what the monitor says (my partner placed the monitor while I did the IV). She has S-T elevation in leads I, II, and III. There are the only leads available to me. I am still thinking possible MI.

I get out to start heading to the hospital, my partner does not need me anymore and it would be best to start moving. The nurse gives my partner the paperwork and we are off.

On the way there my partner does not seem to be doing much, if anything for the patient. But, maybe I am missing something because I am trying to drive in morning traffic.

We get to the hospital, get the patient in the room. He gives his report while I am out getting the truck cleaned up and cot back in it. When he is back out he calls dispatch and tells them we are available with a Retro of 6 (Difficulty Breathing). Mind you, the Retro-code is how we tell dispatch what the run really was..a check for their dispatching to see if what they tells us we are going to is what we really get. Now, I am shocked. Was I the only one seeing a possible MI here? Luckily, I saw the ER nurse after that and they thought MI too and were caring for the patient properly. Ends up my partner did nothing other than O2 for her. Seems her jaw pain wasn't severe and he did not connect any of the dots. He was going down some sort of breathing difficulty protocol in his head...she did not have wheezing...just short of breath..slightly panicked breathing...ummm..hello??? Could it be because of referred MI pain to her jaw. It's common in women to not have "classic" substernal chest pain with an MI. Heck, the nitro relieved the pain earlier in the evening..should that have not been a clue?

I am going to stop ranting now..I need to get to work. My partner has been a medic for about one year...this is the second service he has worked at..he has been in this service less than 90 days. I was hoping to be partnered with someone experienced...now I am worried.

Anyone else see a possible MI?

To my partner who hopefully never reads this blog:
What were you thinking?

*******
PS - I know I am leaving a bunch of details out of this...some may even be useful for you to form an opinion, but this run actually happened some time ago and this is all I have left in my memory.

Thief in the Night

2005-11-12T13:47:00.000-08:00

From my wife's blog:

Current mood: sad

(My son) and I had dentist appointments Friday afternoon. My dentist office is about 1.5 blocks down from where the tornado hit Newburgh. (Just to the east of Evansville) What I realized today is that the media has not totally represented the devastation this monster brought. Although their focus has been on the trailer park in Evansville...as it should be with the number of fatalities as well as the number of homes destroyed...there hasn't been much mention of the destruction this fiend has left behind in this enitre community. Truly, a thief in the night!!

Beautiful one and two-story homes...gone. $150,000 - $250,000 brick and mortar homes...vanished. Heavily wooded areas...exposed. Houses 1/2 there; the left side of the home is standing, but maybe the right is gone or vice versa. Swing sets mangled around trees or on top of cars. Limbs and toys and papers strewn about. And this is AFTER the first parts of the clean-up efforts.

But there is so much more of an impact that we never think about. Newburgh is a small community. Businesses are feeling the indirect effects of this killer as well. The access to their business was temporarily closed. And now...who has time or money to frequent these mom and pop stores? We need the big guys...Home Depot, Lowes, Contractors, etc. Who has the money to go out to the little restaurants? The daily income they are losing will be felt well into 2006 if not farther. Yes, this twister has taken quite a toll on the place I call home. It brings tears to my eyes.

Our local radio and television stations sponsored an impromptu telethon Wednesday. (Thanks to all the wonderful staff of those venues!!) Our loving community - families, business, etc. - generously donated $1.25+ Million to help in the relief efforts. I live in a GREAT place!! Seems like a lot of money, but only a fraction of what it's going to take to rebuild and re-establish. There's a long road ahead for all involved. Please keep all these people...family, friends, neighbors...in your thoughts and prayers!

*******
A further note from me. Of the 1.25 Million, there was one single donation of $200,000 from the near by Toyota plant. Very cool.

gone so long

2005-11-12T13:44:00.000-08:00

Sorry I have been away from here so long. Two jobs, family activites, life..all keeping me from being online very much.

I have things to post..I'll try to get some different posts up soon.

First, I'll copy/paste one from my wife's blog...it will give away more than I like about where I live, but it's on an important topic that I will likely not blog about myself.

partners, the good and the bad

2005-10-23T21:00:00.000-07:00

An excellent partner in this job can make an amazing difference, especially when it comes to the crazy scenes or handeling a crazy patient.

This past week I have been working shifts that will ultimately not be mine..filling in for people who are off, etc. I've had more than one partner and I've definately had more than one type of partner. One day I was working with another new medic, we were actually in medic class together these last two years. Two new medics together could be a scary thing but she actually has about 6 years of street experience as a basic and advanced tech. The neat thing was that we worked really well together. Many of our patients actually asked us how long we have worked together because of the raport we seemed to have projected. Even a local fire engine company asked us how long we had known each other. I guess part of it came from being in class together and trusting each other after all that time.

On the other hand...

I also worked a couple shifts with a medic who's been a medic for a few years now. I have nothing critical to say about his patient care; he never did anything to endanger a patient or me. We all have our own styles and mine and his are different. What got me is that I started stressing that some of his behavior was going to get me in trouble with the boss. In the end nothing happened, but I still was stressed. The story?

Well, we did a long distance trasport to a VA clinic about 3 hours away. I was in back with a psych patient on the way there. He drove. After the transport, he stated he would drive the first part back because there was a restaurant not too far away he wanted to stop at for food. Okay, no big deal and it was nice of him to drive longer. It's now 9pm and our shift ends at 2am. Dispatch knows we are three hours away, but they expect a little bit of leeway for us to stop for fast-food, fuel or restrooms. A bit down the road he makes the exit for the place he want to go. Now, I notice there is nothing near the off-ramp. The town is actually 15 miles or so from the highway...not too big a deal yet because he seems to know where he is going. We get to the town, and I become aware that my partner is clueless on where he is going and is unwilling to just turn around and go back. We eventually made many turns, drove many miles and ended up on a different highway..and it is now 10pm..and still no food. He calls dispatch to let them know "we are just leaving the VA Clinic"! I talk him into drving another hour down the road..closer to home. He then stops and demands that he will not eat fast-food because he can "get that at home anytime" and pulls into a Chili's restaurant. Buy this time I am tired and grumpy from not eating all day. I go in with him, order only an appetizer and talk him into doing the same...yet his was a special order..wanted a triple order of buffalo wings....so we then have to wait for the food. We eat quickly and then get some fuel for the truck at a truck-stop. I drive the rest of the way home at a speed I really shouldn't be going at. We get back into our home county at 1am on the dot...I amazed myself at how fast we traveled, but there were only trucks on the road and it was late night..I just set the cruise and went for it. The supervisor did not comment at all. I think the thing was that there was a shift change while we were gone and this supervisor had no clue when we actually left. Dispatch could have looked, but it appears nobody ever did. The thing that gets me here is that I am the new guy and I do not want to piss off the "older" medics, but I do not like dishonesty especially in the field I work in...honesty is not just important, it is critical. But, I also got frustrated at his inability to give up on his quest for a meal at a Boston Market of all things and then for him to stop at a Chili's after we were already much later than we should have been.

I know part of my annoyance on this was because I was tired of being on the highway and needed to eat. But, this was just the last issue after many hints that this guy was not someone I wanted to work with long-term. What worries me is that he is good friend with the guy I am going to be partner's with for the next 4 months.....I'll let you know what happens there after I work with him for a bit.

My next shift is my first where I am on a Medic/Tech truck. No double-medic, just me in charge. Then the shift after that I will be on my normal 6p-6a rotation with my normal partner and double-medic again.

No really good runs to talk about. LOTS of Pysch patients and the rest were mostly breathers.

I did have one Manic Bi-Polar lady tell my parter that I was cute. Funny/Scary to have an old bi-polar lady trying to bat her eyelash (singular) at you while she is crazy manic. My partner (the female good partner I had) actually used it as a conversation piece to get her to calm down now and then durning the transport (I drove).

Actually, now that I think of it, there was a full moon recently, wasn't there?

no more down time

2005-10-18T20:00:00.000-07:00

I'm finding it hard to post because I am finding that I want to use any spare time I get for sleeping. After two jobs, kids, chores, and the daily little things of life I find that, by the time I am sitting in front of this screen, the main feeling I have is fatigue. More than anything else, I feel that my schedule is full and not about to get any better. I even feel my spare time getting scheduled. Part of this may be the fact that I haven't used my CPAP in over a week and have been snoring a lot and waking just as tired, if not more, when I awake.

My work schedule is in flux at the moment as I am transitioning into my regular rotation. I am the 2nd Medic on a double medic truck (no tech), 6pm-6am. Having a double medic truck is rare in my service because it is so rare to have enough medics to do it. So, I suspect I should savor it while it lasts. This week I am working noon to midnight, also as a second medic. This is to allow other employees to adjust schedules while fitting me in without anyone having a major adjustment all at once...nicer on everyone's sleep schedules.

Now a summary of some of my runs this past week:

Bi-polar female, suicidal and add a bit of whiskey for fun, shake and serve.

93yo female at an assisted living facility with bright red vaginal bleeding.

60ish female with a pustule (sp?) the size of a crab-apple on her chest, between her breasts and oozing.

70ish male with history of COPD among other things approximately 10 minutes from repiratory arrest.

Some other runs too...but they escape me at the moment. Time to do some things around the house before heading to bed.

1st day but not quite

2005-10-12T18:42:00.000-07:00

I show up at 0800, my first day as a full-time medic. Anything interesting? Of couse...not.

The service I work for is making me go though the new hire orientation again, even though I worked there for over a year and left under a year ago. The kicker is that during the time I was not working for them, I was there all the time as a medic student...basically working for free.

The orientation consists of paperwork, watching hours of videos, cd-roms w/quizzes, observing dispatch, meeting all the managers, and finally FTO (Field Training Officer) time. Usually this whole process can take a few weeks. I expect to be done Friday afternoon.

The videos were boring but one of the managers signed off that I did not have to watch 99% of them....something about wasting my time. The cd-rom quizzes were ok, mostly because I saved copies of my answers from the last time I took them...nothing like being prepared. The FTO time usually takes at least two weeks, but I have been told I am only having one day, Friday 0400-1600. Meeting with the managers has become the most frustrating part. Partly because they all have voiced the same opinion as me..."Why do I have to go though this?" I don't object to the FTO time, but the rest of this seems like an utter waste of time. I have the last of the manager meetings on 10/13. Getting them to stop long enough to talk to me and even say they don't need to talk to me is getting old.

The things that are still bugging me:

I have yet to get any offical idea of what my schedule will be. I will be "released" on Monday, yet I have no idea when I will be working after this Friday. It makes it hard to plan the rest of life with situations like this.
I have my uniforms, but the pager is still on order. Pagers are a big deal in this service because that is how I get a lot of information I need to complete my run reports. Not having a pager is a big pain in the .... They knew my start date a month ago...could someone not order a pager just a little earlier than today?
The FTO is a great medic and I worked with him as a Tech. But, I am still have a lot of performance anxiety type stress building up here. At least on my first day as a medic I will have another medic there with me. I just hope I get the stamp of approval. I just need to keep telling myself I did it as a student during all the clinical hours, this is just another shift of that.
Then the fun shift...some undetermined day next week..my first day on my own, in my own truck with my own tech...time to fly on my own. I'm very excited and nervous at the same time.

143

2005-10-10T18:34:00.000-07:00

143=i love you

My wife and I went and saw a movie on our anniversary. Exciting, I know. But, it's nice to have a date night away from the kids no matter what it is. We went and saw Serenity. If you watched the show Firefly, you will like the movie. If you a sci-fi geek you will very likely like the movie. If you are married to a sci-fi geek you might actually like it too. In this case, my wife is the loving spouse of a sci-fi geek who watched the show. Thank you for suggesting this movie so I did not have to.

1432

We may never know...

2005-10-05T19:54:00.000-07:00

From my wife's blog:

Tuesday, October 04, 2005

We may never know...
Current mood: sad

We may never know God's plan. And some times it's really hard for us to try to comprehend why certain things happen.

My uncle...my mom's twin... was diagnosed with colon cancer yesterday. He's young, in my opinion... 62. It's already pretty severe. Several tumors in his colon and it's already spread to his liver. The doctor hasn't given him much hope...but he's ok with it. He's ready to go home to God...it's the rest of us who are being selfish. My mom is taking this especially hard. Not only is he her brother...he's her twin. And there are some very serious bonds between twins....I've seen it first hand...it truly is amazing.

My grandmother (who is 96) is extremely upset as well. She doens't understand how God can take her son and leave her on this earth...afterall, she's 96, she says. She just keeps saying it's just not right.

My uncle will know more Thursday, but has already said he won't take any chemo. He believes it's in God's hands and it's just his time. He's not even asking for prayers. He feels it's a waste to ask for things in prayers.... prayers are to be for praise. I'm praying for him anyway. And of course, I'm praying for my mom and grandma and my aunt and cousins.

We may never know God's reasoning for why He does what He does. I just hope that I can be as gracious and ready as my uncle...no matter how hard it is for the ones we leave behind....

For anyone interested in Colorectal Cancer:
http://www.colorectal-cancer.net/

"What is the matter?" she asked…

2005-10-05T19:45:00.000-07:00

Sometimes it is not a matter of any one thing making me in a bad mood but rather just a pile up of stuff that just eventually wear me down. None of these issues on their own have gotten me down, but as a whole I think I am just worn-out tonight.

Most of the reasons I list here I take total responsibility for and I know I could correct or avoid on my own. This is not an excuse list but rather me trying to explain my mood of the evening.

I am tired.

I have not eaten well today. As of 9:00PM my total food consumption has consisted of: 1 can of root beer, 1 candy bar, 2 sausage burger patties and a swig of grape juice. I know I should eat better. I really planned on it. This is just how the day turned out.

Work has been putting me though an above average amount of stress. Nothing I could not get through, but made worse by the first two issues above.

I am extremely short on cash.

The past week I have been taking 180mg (per day) of a long-acting Beta-blocker I take rather than my normal about of 240mg. The change is not great in some respects but I have noticed it in others. I am wondering if I am noticing more of the anxiety I would have without the meds or if it is just a side effect of everything else going on in my life right now. Why am I taking less? Because, I need to get my prescription to last a bit longer. Expensive drug that I cannot go all the way off of but I am ok lessening…I need to make sure I have some to get me though any insurance coverage changes coming up. I have discussed it with my doctor and it is OK.

My grandmother called to say that my aunt, grandfather, and she are not going to be able to make it this weekend. My aunt is ill. My son and I are going to be busy Saturday with Cub Scouts. So, they decided that maybe that would try for another weekend. I actually am not surprised by this, I called and talked to my grandmother last weekend to verify they were coming and she would not commit to it. So, I kind of knew then. Tonight was just confirmation. I’d like to see my grandparents. They have not been here since I got married 6 years ago and I have only been back in my hometown a total of a few days in that same time period. I am not really a family person. I am one of those relatives you rarely hear from. But, I am recognizing that everyone is getting older and the number of days I may see my grandparents are getting less and less. “Sad but true.” (Oddly that was a line in a song I am listening to right now.)

Well, other than the headache that goes with the fatigue and not eating, that is the answer to the question of the day. I am not sure if they asked because they cared or because they were frustrated with me. When I do not sleep and eat, my memory of things like future schedules slip out of my brain and I was not remembering things I should know. I also forgot to do normal things like give my son the medications he takes every night. All are good reasons to be frustrated with me. Hopefully I’ll be better after a night’s sleep and a meal.

Go See It Day/tired day/fun & tired day

2005-10-04T21:10:00.000-07:00

Sunday: Go See It "Maize Maze"

It was an interesting day. 5 Tiger Cubs plus parents and a few siblings. We all went to a local farm that had a maze in a corn field. I'm pretty sure it does not count as a trip to a farm because it really wasn't anything to do with the farm. But, it sure could count as a hike. We ended walking in the maze for about 45 minutes in 80 degree weather. The maze was Star Wars themed and had quotes from the movies hidden in the maze. We ended up finding 3 of the 7 quotes. Not too bad given we really weren't trying and it was a group mostly of 6 year olds. The farm was also selling some impressive pumpkins and it was the start of tree-tagging season. You can tag the tree you want for Christmas. You can have it dug up on a certain date and then replant it at your home or you have just have it reserved for you to cut down or have them cut it for you. Overall I think they have a pretty cool farm going on out there.

------

Monday: Tired Day.

I woke up many times Sunday night during the sleep study. Why is it that my nose itches when I can't get to it. I did keep the mask on all night (the whole 6 hours). There was a heater/humidifier hooked to the hose. I think the condensation on my nose and upper lip is what bugged me the most. I'm not sure how much I slept, but I do know I was very tired when I got up and was tired all day. I ended up going to bed Monday night around 9pm. Very early for me.

------

Tuesday: Fun & Tired Day.

Still tired. I think it usually takes a couple days of good sleep...even better a weekend of sleeping in...to catch up from a really bad night. I also did not wear the CPAP all night last night. It's just really irritating. Thank you to the medic who had the link to the other CPAP solution. Neat idea they have there.

Tonight was a fun night though because I got to go out and do something I normally do not do. There is a street fair going on in town and it's a pretty big deal. All the food booths are non-profit groups from the area. I was volunteering for a local nature preserve. I was just the burger cook. But, it was fun. I met some new people and got to socialize and had some really good people watching. There was the full spectrum of people from beauties to "butter faces" (she'd be hot but her face) and then all the toothless-wonders.

I finally got the apple cider I've been craving. I ended up drinking two pints of it. Mmmmm.

One week until I start as a full-time medic!

"...between places at the moment"

2005-10-01T21:18:00.000-07:00

This photoblog is on an interesting theme lately. It's all Detroit area pictures, portraits of homeless people. Below the pictures are quotes from the person featured. It's actually quite interesting to take it all in.

If you have a good Internet connection, I recommend this link:
http://www.snowsuit.net/archive/ then just click on the pictures that interest you.

Otherwise go to http://www.snowsuit.net/ and keep clicking on the "Previous Image" link to load the images one at a time.

Make sure to read the quotes.

surprise

2005-10-01T19:34:00.000-07:00

I really like a good cold drink of fresh apple cider. It's something I don't get often, usually limited to October of each year. I usually buy the cider made at a local orchard. But, today I was in the store and impulse-bought a jug from a display they had in the produce area. It's not made locally, but I figured it would be good enough to fulfill my craving. Well, it's been in my refrigerator all afternoon. Time for a nice tall glass that I have been waiting for. I chugged down about 12 oz. of the ice cold, brown apple cider before I notice something odd. My stomach is not happy with what it is getting. My nose is now getting a wiff of something odd and my taste-buds are not giving me the reaction I had been expecting. This apple cider is very fermented and I just consumed a pretty big gulp of it. OK, for those of you thinking "hard apple cider", this is not the reaction I had. I've now gone though a few different items in my frig to get the taste out of my mouth and my stomach is still twisting tightly in protest of the treatment it has received.

All I am thinking now is thank goodness that I said no to my son when he wanted a glass with his dinner. He has a sensitive stomach and even more sensitive palette. I don't want to scar his future with such a great thing as apple cider with an experience like this when he is so young.

(tummy grumble grumble)

So tired it hurts

2005-09-30T21:00:00.000-07:00

That's how I have felt most of this past week. I also am behind on all the things that I had been keeping up on. This blog is just one of them. I haven't even been reading the blogs that I used to read daily.

(My wife just looked at me oddly. "What?" I asked. "That's just the most I've heard you type in awhile." Notice I was only a couple lines into this when she said that.) Back to what I was saying...

It doesn't help that the blogs I read seem to have typed near book-length blogs this past week. I've missed the few shows I wanted to watch on TV. Luckily, my wife taped all but one of them. I've just felt so tired all day that when I get home all I want to do is go to bed.

When I get to bed, I am having trouble wearing my CPAP all night. I tend to wake up multiple times a night with the mask irritating me. I even have a new larger mask for my big "schnoz". I've decided I really hate the CPAP even though I likely just need to find another mask design. I have another sleep-study to go to Sunday night, so we'll see what happens.

Tonight my wife was offered (and accepted) a promotion at work. It's in the same general area, but she goes from being a pay-grade 9, supervisor, salaried, with occasional evenings and weekends to a pay-grade 11, M-F 8-5, hourly, non-supervisor. Not counting any possible overtime (probably not likely) it will still be a $5K/year raise!!! Thank you honey! The new pay rate will go into effect in two weeks. Just in time for my pay-cut when I go full-time paramedic. We'll almost be totally flipping pay rates. I'll be going to what she has been making and she'll be going to what I have been making. Kinda odd how life works out sometimes. I still plan on staying at the computer-job for 10-20 hours per week to earn some needed cash at a pay rate that I can't get anywhere else.

The computer-job is running me ragged this week and I think it will continue next week. I think they finally see the end of my full-time days coming and I have been slammed with a lot of projects that need to get done ASAP. We now have the domain upgraded to Active Directory but are still learning Group Policies and how to implement them well. I am still getting quotes from electricians and suppliers of battery-backups and generators for that project and that needs to get further along before we install the new VoIP phone system. They are also bidding to get some new clients and get some old clients back. Part of this involves asking me how fast we could implement some changes and design/publish some web sites for them. All of that is fun because I need to estimate fairly accurately taking into consideration that I will not be there and I am not too sure of the employee being left in my absence. Anyway...

Going to a Maize Maze on Sunday. The current activity for my son's cub scout den is to visit a farm or historical site. A local farm is having a corn maze this month in one of their fields. So, we are all going to meet up on Sunday with our families and go though the maze. I think it could be fun. Something I never did growing up as a city-boy.

My wife and daughters went to the high school football game tonight. While they were out, I took my sons to see Magnificent Desolation: Walking on the Moon at the local IMAX theater. I still like the IMAX Space Station better, but what IMAX non-Hollywood films lack in length they really make up for in stunning visuals. Being 3D also is fun for the kids (and me too). There are some upcoming IMAX films that look good. The preview for Deep Sea 3D was amazing. Plus I do not know anything other than the title for "Wonders of the Great Lakes" and I already want to see it. (The Michigander missing home, I guess.)

Just over one week until a start as a full-time medic! WooHoo!

My mother, her husband, my grandparents and my aunt are all coming into town for a long weekend in about a week. (They leave the day before I start as a medic.) So, we'll see how much blogging I get done around then. There is a festival going on in town next week and that will give me something to do out of the ordinary. I've volunteered to work a fund-raising food booth for a local nature preserve on Tuesday night. I told them years ago that I would volunteer for them sometime and last week they actually called me. It's the least I can do.

I'm starting to feel like I have a full schedule coming up. I guess the tired feeling is not going away anytime soon. Enough for tonight..bed time and time to track down the teenage daughter.

I've said it before and I'll say it again

2005-09-22T07:45:00.000-07:00

Children should not put anything smaller than their elbow into their ear.

No long-term damage but hopefully he will know better next time.

Now NOSES on the other hand....just kidding...just kidding

How about mouthes? OK, I'll stop now.

Don't go there...

Links: Poetry

2005-09-21T20:19:00.000-07:00

I read my wife poetry tonight. I should probably do it again sometime.

This poem is in no way romantic, but still very interesting/good.

I'm that Guy

******

Jed's other poem:
http://www.stewdio.org/jed/
Requires Quicktime

It's actually a music video. It's text from an old Apple II. What's drawn me to this is that I remember learning BASIC on an Apple IIe. Ahhh..the good old days! (eyeroll)

Link: CIA - The World Factbook

2005-09-21T08:35:00.000-07:00

Rereading my post from last night made me remember this link that has been hiding in my favorites for a long time. Good trivia and statistics about the countries of the world.

http://www.odci.gov/cia/publications/factbook/index.html

Canada goes that far west?

2005-09-20T21:00:00.000-07:00

My wife can attest that I have been ranting about a few things tonight. But there is one thing that happened to me at work today that I am still going on about.

The following story is true, the names have been changed to protect the innocent and the ignorant.

The scene: Cubicle farm, four workers wasting time on the clock talking about one's recent vacation to Glacier National Park in Montana as well as Banff and Jasper National Parks in Canada. Showing of pictures, postcards, etc.

John, Jane and I are talking to each other. Ditz is talking to us and but we are not really talking to her (why? you'll see). Here is what I remember being said and how I was so amazed by her ignorance I wanted to vomit from the sheer effort to stay polite.

John: Yeah the trip was great. We left Glacier and then saw Banff and Jasper. I'll definitely go back again. That part of Canada is beautiful.

Me: I'd love to take a train from one side of Canada to the other. I think that we be just great...if only I could afford it.

Ditz: Canada goes that far west?

(there is a pause in conversation as all of us are thinking of what to say...)

John: Canada is the second largest country in the world...

Me: ...by area, not population.

Ditz: Where were you? I know you can get to Canada from Michigan...

John: I was in western Montana...

Me: Other than Alaska and Hawaii, you can head North from any state in the US and eventually end up in Canada.

Jane: Well, you could go east from Alaska...

Ditz: So how far does it go again?

John: The US and Canada have the world's longest undefended border. It goes from Maine to Washington...

The conversation changed from here as we all tried to ignore her again. John and I debated whether Nunavut was a province or not (it's actually a Canadian territory). But, Ditz is not a dumb person, she is in her mid-thirties and works in the accounting department. Heck, she is not even blonde. Notice how little I actually talked in that exchange. I have a degree in Geography and I am fully aware that American's are lacking in geographic literacy. But, come on now. A unimpaired adult in the US should be able to identify Canada and have at least an idea that it spans from the Atlantic Ocean to the Pacific. I was truly just repeating in my head that I did not want to say anything that could be me fired...I was actually feeling sick from the effort.

Here is the SHORT list of what I believe every adult in the US should be able to identify on a world political map. (I have met many who can't, so I also would say that they need to be high school graduates before holding them to this list.)

The USA
Canada
Mexico
Iraq (someone you know could die there, please know where it is)
The state that they are in
They must locate the city they live in on a US map that has that city labeled. (like a road atlas or the like)

Sadly, I would require MANY more if I was teaching a class. How about these that I think are so simple but are so hard for many:

The Atlantic and Pacific Oceans
The Continents
Gulf of Mexico
Capitol of the state they live in
Washington DC
Those in Michigan (where I grew up) must name the Great Lakes and identify

I had to end the list there for now. I know I am not a good judge at this because I really do not understand. I am one of those freaks that can locate all the US states and the provinces/territories of Canada. I can locate over 90% of the countries of the world on the first try and I can even discuss some major cities (London, Hong Kong, Sydney, Moscow, etc.)

I just think this kind of geographic knowledge is why I have such an easy time following world news and even the US politics that involve international issues. Because, I may not know where a specific town in northern Iraq is I can understand how Kurd independence issues there can effect Turkey (borders Iraq to the North) because it also has a large Kurd population. Just knowing that they are in the same region/neighbors gives you that type of knowledge.

I just don't understand, this just seems to simple to me. I know it is harder from many others. But, I do not think it is because I am smarter. I really think this is all stuff that can be learned. Why are we not teaching it to the level that we should? Geography is one of the foundation subjects that so much other knowledge is based.

Some links on the topic:

Survey Reveals Geographic Illiteracy (2002)

Take part of the survey that article was about (really recommend)

National Geographic Bee (contest for Grades 4-8)

National Geographic GeoBee Challange (online game for kids)

GeoSpy (another online game for kids)

Play the games...I hope you get more than average.

*******
Pseudo-Related:
Picking Diplomatic Plums for Allies
Why do we pick Ambassadors that know so little about where they are going?

what do you believe?

2005-09-19T17:08:00.000-07:00

NPR has an interesting series going on every Monday called "This I believe". It's a radio series originally from 1951 and reborn in 2005. I have found the 3 minute segments interesting. If not for the beliefs of the person's essay but for the thought they stir in my own mind.

First I suggest I suggest everyone check out the archives of This I believe. Make sure to notice that there is more than one page and also check out Edward R. Murrow's original introduction to the series from 1951.

My thought is that maybe some of us should think about writing our own essays of what we believe. Maybe we would not have the courage to share them with others, but it would do good for us all to think on our beliefs anyway. When I think of my beliefs I tend to go in one of two directions, I tend to be quiet or I will ramble on forever, depending the topic. So, I like the idea of limiting yourself to 350-500 words. It forces some sort of structure.

So, give it a try. At the very least, put your thoughts in a journal for just yourself. For those of you with blogs, think about sharing it with the rest of us. If you want, consider submitting it for inclusion in the radio program.

This I Believe

Edward R. Murrow's 1951 Introduction

Essay Tips

More Cub Scouts

2005-09-18T19:10:00.000-07:00

Today, the Cubmaster (the person in charge of the whole Pack) called me to congratulate us on how well my son is doing. I had left him a message earlier on his answering machine. We had to call in to let him know because my son qualified for a special baseball cap as a prize for doing so well on the first day.

He also wanted to ask me again if I would be the Den Leader for my son's den. My son's den consists of 5 Tiger Cub's and their Parent Partner, including my son and I. The Cubmaster said that they (the other Leaders) thought I would be the best selection. They saw how well my son and I have been doing and I had already said once that I would be OK doing it once I figure out my new work schedule. So, by the end of the conversation, I agreed to be the Den Leader. My son was sitting with me and he said it would be "so cool" to have me as the Den Leader.

Being a Den Leader for the Tiger Cubs is slightly different than being a normal Den Leader. Tiger Cub parents are expected to host one meeting and plan/do the meeting for the night. My job is to coordinate the schedule and assist the parent. I also sign-off on the scouts activities completed and award advancements when earned. Well, I have Leader training this Thursday. A night of awareness training about things like child abuse & neglect and various other stuff.

******

Saw a copy of this on the web and I wanted to share it. A brochure came to my son last week. It had information about selling popcorn and the prizes he could earn. But, what I found cool was how most of the information was in comic form. It immediately got my son's attention and he read the whole thing himself without prompting by me. It seems like a very good idea for a company wanting to get information to children.

Check it out: http://www.trails-end.com/TEPublic/docs/ComicBook.pdf

Would you like some popcorn?

2005-09-17T19:00:00.000-07:00

My six year old is in his first year of Cub Scouts. Today was our fist day ever of selling popcorn. It starts with a "Blitz Day" where we try to sell to at least 10 customers. The popcorn sale lasts for one month, but the hope is to get the majority of the selling done this weekend. The goal this year for every scout in his pack is $200 plus one extra sale. The proceeds from the extra sale will go to the packs in the area affected by the hurricane. The thought being those scouts will not be able to raise any funds this year and they could really use the help.

The lowest priced item sells for $10, Carmel Corn with Peanuts in a collectible tin. Very popular item, but the boxes of microwavable popcorn are said to be better than anything in the store and many people bought those too...$15 for a box of 15.

I got a head start by selling to my coworkers on Friday. But, my son and I added on to that greatly today. We started at 10:00, door to door. We ended around 18:30. We did stop for lunch and some other small errands. But, most of the time it was him and I walking the neighborhoods.

At the end of the day, including my pre-sales at work, 65 customers for orders totaling $1,225.00. He'll get a special "Super Seller" recognition if he can reach $1,500 buy the end of the sale, to recognize those who are well above average. All of this will help pay for local scouting events but also for my son to go to summer camp next summer.

I'm proud of my son for all his hard work. His voice is raspy tonight from all the talking he did, his feet are tired and he fell asleep quickly when his bed-time came. But, he never complained and he was always ready for the next house. I never forced him or told him to keep going, he was always, "Where should we go next?" He was always polite and gave his little speech well to every home we went to. He remembered to not walk on people’s lawns and always thanked everyone, even if they did not want to purchase anything.

Got nothing else done today, but it was good weather and a good day to be a dad.

I'm tired.

******

Note to everyone: Hopefully next week we will get the code we need to sell the popcorn online. The website is there but you need to enter a code for the scout to get credit for the sale. The credit is important because an average of 70% of the proceeds make it to the scouts, 45% to the specific pack who did the selling. We want to make sure the right pack gets credit. orderpopcorn.com . The prices are the same as buying it directly from the scout, you can buy them anytime (but now is good) and it is free shipping directly to your home. This way out of town relatives can support their little Cub Scouts.

For those of you from outside the USA or Canada, my son is a "Tiger Cub", the youngest level in the Cub Scouts. The Cub Scouts are the young version (6-10yo) of the Boy Scouts of America. Information on the Boy Scouts can be found at http://www.scouting.org/

local monopoly/pseudo-resignation letter

2005-09-14T19:01:00.000-07:00

So, on my lunch today, I went to the local ambulance providers office and signed the offer of employment. The rest of the meeting just made me think of them being a local monopoly and you can tell. Though I have not been an ex-employee long enough to get a sign-on bonus, I have been away long enough that I have to go through orientation again, drug screening, phyical agility test, Field Officer Training, emergency vehicle drivers training, etc...everything all over again. What is the logic in that? I was told it was important to be consistant. Sadly, I do not see the consistancy in one key point that is important to me. If I am "new" in every other way why am I not new when it comes to a sign-on bonus? Ugh.

******

After returning from lunch and signing the letter at the ambulance office. I wrote the letter below and gave it to who I think is kind of "my boss". I actually answer to the entire executive committee, but this is the person who approves my time-off requests and other activities like that.

The pseudo-resignation letter/request to go part-time:

(Ambulance Company Name), the local 911 ambulance service, has made me an offer of full-time employment as a Paramedic starting October 10, 2005. That week I will be working during the day completing my new hire training. The following two weeks I will be with a Field Training Officer (FTO) and working during that FTO’s shift. After that I will be assigned a shift that is still open for this current rotation (for the next six months).

Currently, I do not know any details about what shifts I will be working past the first week. As I get more details, I will share them with you.

I know (Company Name) has a lot of important IT-infrastructure projects coming up between now and the end of the year. During past meetings, it was mentioned that (Company Name) would work with me on my schedule so I could remain an employee here, even part-time, during this transition to my new career. I would like to see that happen, if at all possible. The one favor I ask is that I would be able to keep my medical benefits until I am able to get them at (the Ambulance Company) (after 90 days).

I believe this transition period will prove beneficial for all involved. I will be working in a field I feel drawn to while (Company Name) will still have access to all the IT knowledge and experience I have gained, including all those (Company Name)-specific details that are so hard to train people on, but so useful in long-term employees. I’ve mentioned in the past how there has only been enough work in IT for 1.5 employees, meaning that some days there was little to do while others even two employees were overloaded. I believe that by keeping me as a part-time employee while (Technician who I currently supervise) works full-time, we can have a better fit, give (Technician) a chance to grow into more of a leadership position while still having me here for the harder projects, where my experience is key.

Please, let me know any questions you may have and I will answer them as quickly as possible.

Sincerely,

(My signature and typed name below it)
------------

Well, the VP I gave this to said he would discuss it with the other VP's and get back with me. He said it did not sound unreasonable. The thing going for me is that I have been totally open and upfront about leaving. I actually gave a two-year notice back when I enrolled in paramedic school. Also, at a recent meeting where the whole executive committee was there, including the owners, I was told by the CEO that they were willing to work with me to keep me in whatever capacity they could. But, who knows. I've seen this company do some pretty stupid things over the years. I also don't want to be too optomistic about it, look what happened to the sign-on bonus thing..that would have been nice too. So, even though this was only a letter stating my request to go part-time, I am considering it a pseudo-resignation letter because who knows how it will end.

Also a note for family members who read this: I put October 10th. I actually start on October 11th. Yes, honesty is important to me but the 10th is my wedding anniversary and I in-no-way want to start a new job on that day. The 10th is a Monday and so, it makes it easier to start any change at the current work to reference a Monday as the day it changes.

Keeps on ticking

2005-09-13T10:00:00.000-07:00

My IT job gave me a watch today. Actually, I had ordered it using this "point" system they have here. I've aquired enough points over the last couple years to be able to get this watch and have the company pay for it. I think it's funny to have a nice new watch to show how little time I have left at the company...at least as a full-time employee. I still plan on working for them part-time for at least a few months.

I called the local 911 ambulance provider and agreed to sign the offer of employment letter. I'll be going in tomorrow to get that formality done. After that, I'll start working on my letter to my current employer requesting a change to part-time status. My first day as a full-time paramedic will be October 11, 2005.

I am pretty sure my current employer will want to keep me for awhile because we have some big-time projects going on until at least the end of October: Upgrading the domain from Windows NT to Windows 2003/Active Directory. Installing a new UPS and emergency generator for the server room and installing a new VoIP phone system for the whole building. Lots of fun stuff. A lot easier if they keep me around and all the various information that I keep filed in my head. We'll see...

Remember

2005-09-11T18:24:00.000-07:00

Thousands died on September 11th, 2001 due to the madness of human violence.

Please Read:
In Memoriam
Honoring EMS personnel who
made the ultimate sacrifice,
not for family or friends,
but for strangers

PDF file

******

National EMS Memorial Service

******

Exhibit 13

Interesting site featuring scraps of paper found in the debris of the World Trade Center and music from Blue Man Group. Broadband REALLY recommended.

******

Not only should we remember the courage of our fellow first responders, but we should also take this as a chance to learn how to improve to help keep it from happening again. Yes, that really could go into talk of some political issues and terrorism. But, to keep it EMS related, JEMS has a list of things here that they put together in 2002. http://www.jems.com/911/

******

Sadly, when putting this post together I noticed how few current sites are out there discussing 9/11. Those I saw, including television coverage and special events, here locally were 9/11-Katrina mixed events. Now, I do believe it is appropriate to mix these issues this year. But, I am worried to think that 9/11 might not have been mentioned as much this year. I guess next year will be a test. Katrina will have it's own mark on US history. 9/11 will not be the day to remember it...but to clarify it makes sense this year, it is still an ongoing current event.

Good Example from Firehouse.com:
Firefighters in New Orleans, Mississippi Remember Another American Tragedy - 9/11

shelter from the storm

2005-09-09T19:23:00.000-07:00

a good mix of music styles and performances. But, the little monologues were the moving parts.

I think non-AOL users can connect using this link.
Windows Media Player required.

Broadband is HIGHLY recommended.

http://music.aol.com/videos/katrina_benefit

******

The story of Demonte Love, 6 years old and a great big brother.

http://noonesin.mishmishah.com/?p=73

wanting to go

2005-09-09T15:00:00.000-07:00

The thing that has been bugging me this week is that, like so many I know, I would really prefer to be down on the Gulf Coast helping than being here in the Midwest. I have the web sites where I could apply to be deployed. I have skills that would be useful and I have the desire to help. The thing is, I have a large family and I am unsure how I could afford to be without a paycheck for two weeks. I know the people from the coast have bigger problems than that, but my responsibilities to my family are stronger than my ability and desire to go there and help. It makes me feel bad though. I'd like to find a way to raise money, or even just vacation hours, at the office I work at to pay part of my salary while I am away. But, where I work is not large enough for such a fundraiser.

That is a thought though...would you consider yourself a volunteer if you were still getting paid by your regular job even though you were not there? It seems like a way some company owners could give back to the victims and their employees could give also by spending their days helping others in need. If my employer believed in such a program, it would really help me feel better about working there and likely make me a longer-term employee. Just an idea…

******

This article makes me wonder though about going at all. Or at least really lose faith in the distribution of volunteers. I think I would do anything...but I also know that my skills would really make me more useful in some areas than others.

Please read/or watch the video:
Firefighters: We were misused in Katrina efforts.

Thoughts?

******

But, in the same vein...

This guy's mom reminds me of the dad I want to be for my boys:
http://maddogmedic.blogspot.com/
(Read 9/9/05, 9/8/05 and in that post there is a link to 8/22/04)

Oh, how they grow!

2005-09-07T22:00:00.000-07:00

Happy birthday to my youngest! He turns 5 years old today.

How is it that they grow so fast while we do not? (At least that is what I am telling myself.)

Heck, my wife barely looks a day older than when I married her. Why the eyeroll dear? I love you too.

I'm taking the day off from work and blogging. Time to play with the kids while they still want to be with us without a fight.

***

RE: Offer of Employment. I've decided to not talk to that company again...until next week.

More Katrina stuff

2005-09-07T13:00:00.000-07:00

This reporter used to work as a medic. So, of course, I am going to read his article. It seems to me that he notices the EMS perspective better than other writers I've seen.

Reporter's notebook: Treating those left behind
By Robert Davis in USA Today

The disappearing bonus...

2005-09-06T19:48:00.000-07:00

Offer of Employment Letter Part 2.

Where to begin...where to begin...

They say that I cannot have the bonus because I was employed there less than a year ago...mind you not much less..but less just the same. The part I don't get is that on the advertisement on their website there is no mention of the bonus being conditional and I talked with the Operations Manager when I applied and she also did not seem to know of this condition.

Here are some bits of emails today about this:

Mr. (MidwestMedic):

(Operations Manager) is out of the office this week – so, I will do my best to respond to you today. The (regional) office provided me with a copy of the actual ad. I had no idea what it stated until this morning.
(HR Assistant)
***
Thank you for the update. I have copies of the ad I read at home, if that would help you, they are in a form I can email to you. It's just the listing on the (companywebsite.com) website when you do a search for a opening and go to the one for Paramedics in (my town). The part that gets me is that it does not say anything like "certain restrictions may apply" or anything like that. I also did the extra step of emailing (Ops Manager) and asking her also.

As always, your help is greatly appreciated.

(MidwestMedic)
--I then emailed PDF files of printouts of the listings on their website.
***
Mr. (MidwestMedic):

Please accept my apologies for taking so long to get this matter resolved. I received a copy of the information on the sign-on bonus from our Human Resource Dept in (regional office). The program outlined specific terms and conditions. One of the conditions stated: “former employees are eligible for the bonus only if more than one year had passed since they had worked for (company name) and were eligible for rehire”. They indicated that the program was developed with specified terms and conditions. They must remain consistent. It appears that you would not be entitled to the sign-on bonus due to the fact that it has been less than one year since you terminated employment with (company name).

I sincerely hope that this does not cause you to completely rethink your decision of working with us again.

Let me know your thoughts and thanks again for your patience.

(HR Assistant)
***
Again, I thank you for your time on this matter. Would you please email me what you have as the date I terminated employment at (company name)? I do not want this to be a deal breaker also. But, it is really something that could change me from being able to work full-time to only Per Diem at best. I have financial responsibilites that I am unsure (company name)'s pay could support without me getting the sign-on bonus or getting my medical benefits before 90 days. Since neither of these seems to be possible, I will need to rethink your offer, talk with my wife, and get back with you.

(MidwestMedic)
***
I then forwarded this to the Operations Manager's personal email address with the following added:
(Ops Mgr First Name - We are on 1st name basis), I know this might be out of your control but I think (company name) is being a bit misleading with this whole bonus thing. I have attached a copy of the job postings that I applied to. Also, it seems even local management like yourself didn't seem to be fully aware of these policies. That just seems to be counter-productive from (company name). You know I really *want* to work for you and (company name). It's just this issue plus my ability to financially survive the first 90 days and then the first year. It's just a money issue like so many other things. I'm sorry. I really am not sure what I am going to do.

So, that is where things are at the moment. It's bothering me a bit tonight, so I am not sure I want to blog on it more than I have at this time. I know they really need people. But, it would really be bad for me to wait until January to start working for them. It would be too much time outside the industry with my skills melting out of my memory the whole time. This is just frustrating at best.

Medical professionals wanting to help

2005-09-06T19:15:00.000-07:00

1-866-KATMEDI

Also,

https://volunteer.ccrf.hhs.gov/

and

http://www.medicalreservecorps.gov/

Update from New Orleans/Acadian Ambulance

2005-09-06T17:32:00.000-07:00

I really recommend this post that has been relayed from someone at Acadian Ambulance in New Orleans. It is way too long for me to copy here.

Update from New Orleans/Acadian Ambulance at EMSLive Forum

EMSLive: Katrina and Acadian Ambulance

2005-09-06T13:50:00.000-07:00

Make sure to check out EMSLive tonight. The interview is going to be with someone from the ambulance service in New Orleans.

Show listing:

"What can I do help?" seems to be the raging question that many of us at home are asking as we watch the images from the affected areas in Louisiana and Mississippi. We would all like to jump in a plane and offer our services, but that may not be the best thing to do. So how can we support the men and woman of the Acadian Ambulance Service? To find out, we will talk directly to Paramedic Mike Burny, the Operations Manager with Acadian Ambulance Service. Tune into EMS Live to find out what you can do to help out.

EMSLive has a weekly online broadcast and there is a chatroom during the show.
www.emslive.com
Every Tuesday
9PM-10PM Eastern
8PM-9PM Central
7PM-8PM Mountain
6PM-7PM Pacific

I'll see you there.

UPDATE: For those of you who missed this, there is a podcast you can download and listen to.

Suspended disbelief...

2005-09-06T10:00:00.000-07:00

Most of the blogs I read out there are in one way or another journal-like. Some are news, pundits or whatever. But, by far, almost all are non-fiction.

I came across a blog today that is fiction. But delivered in a blog form that never tells you it is fiction, it just assumes you will figure it out. It's a bit dark and it's a bit twisted. But, it is neat when you first read it, you wonder if it is real..or maybe based on something real. It's an interesting read. The author is definately talented.

Not something I would recommend for everyone, but it is something I will read each time a new post comes out. It reminds me of how I heard Charles Dickens' stories used to come out...as a serial in the paper. Each post is just a bit more of the story.

The Man on the Clapham Ambulance:
http://claphambulance.blogspot.com

Computer Guy: HTML Tags

2005-09-06T04:00:00.000-07:00

In a past comment, a reader asked what an HTML tag was. What I found is that Blogger tells you that you can use the b, i, and a tags in comments but gives you no hints as to what any of that means. You either know already or too bad. Well reader, don't feel too singled out, I suspect you are not the only one who wants to know. (Hi mom.)

I'll put some links at the bottom of this posting that have all the details that I am going to just skip over. It's just that a topic like this could go on for a lot more than one post...heck one of the links is a book.

The quick basics:

Web pages are made in a number of computer languages, but what you see in a web browser is called HTML (Hyper-Text Markup Language).
It says Markup because there are little marks you can't see without knowing where to look.
As someone writting a web page (or a comment), you can place markups (aka tags) in those little brackets to control how the text looks or add images, links and so on.
The comments section on Blogger pages only allow certain tags. (b, i, and a.)
b = bold
i= italics
a= anchor, or what you use to make a link to another page
there is more to it than just typing the tag, you have to have a tag to close it...tell it when to STOP being bold, etc. I could get into it here, but the links I have provided go into that.

HTMLDog: HTML Beginners Guide

HTMLDog: HTML Tags

Dummies: Looking into Text and Tags

To see the HTML tags for this page, right-click off where there is no text or image and select "View Source". (Assuming you are using Windows and Internet Explorer. There are ways in other browsers and such, they tend to say view source, you'll just have to look around for it.) Note: This page uses something called style sheets and a little bit of javascript. So, it's a bit more complicated than just tags, but it is all stuff that a beginner can do with help...and patience. The web is full of resources on this far greater than I could ever be. Good ol' Google can show you the way.

Red Cross Ad

2005-09-05T21:24:00.000-07:00

Some ads I don't mind.

Attn: Bloggers - Give some of your blogspace to a worthy cause. Heck, then follow the link and give some money too. I've even heard of a campaign that asks that you give "some amount" plus a penny. They are using that as a clue that the donation came from a blog ad/link.

Bloggers: Use this link to get instructions on adding an ad to your site..they come in all shapes and sizes.

Think of it as an easy way to do some public service.

http://www.redcross.org/psa/bannerorder/all/

Primer + trivia = wikipedia

2005-09-05T19:58:00.000-07:00

NOTE: I want to start of by saying Wikipedia is not a totally reliable source for information. It is community written. But, it does have editors and it tends to be good from a lot of information. Actually one of the links I am putting here tonight is tagged for needing revisions. Any volunteers?

The purpose of tonights blog are for people who want some good trivia like information about the history of ambulances or paramedics or just want an easy primer on what some of the stuff I talk about. If you have a problem with any of the information on the pages linked, take it up with Wikipedia...they would likely just say become a member and fix it yourself.

Ambulance:
http://en.wikipedia.org/wiki/Ambulance

Paramedic:
http://en.wikipedia.org/wiki/Paramedic

I went to these as part of my general surfing I do, but I think they fit with the "I am..." blog from earlier.

My soft spot

2005-09-05T14:27:00.000-07:00

Pictured: Dottie, 8yo Dalmatian/? mix and Nevada, 6 month old German Sheppard/Lab mix.

I read this article: Katrina Evacuees Distraught Over Lost Pets and couldn't help but wonder what I would do. Mind you, I would have had my family & pets on the highway long before that hurricane hit. My wife will back me up when I say I can be a blunt pushy @$$ when it comes to getting my family someplace safe when a big storm is coming. And the one time the field beside my house was ablaze, Dottie and I were the only ones home. I made darn sure she was at my side when I left the house.

But, if I really was in the situations mentioned in the article, I'm not sure what I would do. I am experienced with dealing with blood, guts, gore, etc. But, don't mess with my family and my dogs are family too. I would make sure my family got on a bus out of town. But, would I be able to stay behind with our dogs to look for another way? How bad does it have to get for me to tell my puppies goodbye? I feel bad for those who had to face that and, unlike me, actually had to make the decision. Like my shifts on the ambulance, I am able to care for people but still emotionally keep my guard up. But, this article really hit one of my soft spots.

Please read the article and if you have a furry one at your home, give them an extra treat tonight and tell them you love 'em.

I am...

2005-09-04T20:50:00.000-07:00

Sometimes I wonder how much people really realize we are out there until there is the actual moment where they call 911 or somebody else calls for them. I think most people think of us almost zero..even zero compared to other public service professions...fire, police, even the water main repair folks. That is part of the problem EMS is having. Tax payers do not want to pay anything, nevermind MORE, for a service they do not even think of as a service to them. EMS as an industry needs to get more into the public consciousness. I used to watch a show call Paramedics - Life on the street. It was pretty much a knock-off of the Cops concept. But, I loved it because it showed real paramedics doing there job. I know Cops is still on, if not as popular. Reality TV still seems to be going strong, even if it is all contests now. Can't we have a great show like Paramedics back?

Also, how about some more exposure in mainstream media..or even the non-mainstream media. Here is a link to a photo essay that I wish there was more of:
http://www.hyperreal.org/~doug/stories/para/.
The photo at the start of this entry is from that story.

I also hope that there are more medics out there that think about how we look to the public when we are out there, just sitting in our trucks. Remember for most of the population, that's as close as they get to seeing us until the 911 moment. We want to give them the impression that we are the people they WANT to show up, not the people they are stuck with getting. That's one of the steps in beating the "Ambulance Driver" misconception.

I am more than the fastest ride to the ER.
I am more than a taxi that Medicare will pay for.

I am a skilled heathcare professional that stands ready to face poor work conditions, even worse pay to go where we are needed...no matter the circumstance...to be the one to breathe for you, shock your heart, or dry your tears and take your hand in the first moments of what you may one day just remember as the worst day of your life.

Links: The Map Room & Cartography

2005-09-04T15:10:00.000-07:00

OK, so this might be my old geography degree showing itself. But, I really thought this was a neat blog. Also, for those of you looking at Katrina info all the time, there are some nice satellite images.

The Map Room:
http://www.mcwetboy.net/maproom/

another good one is Cartography:
http://ccablog.blogspot.com/

Day of Rest

2005-09-03T20:40:00.000-07:00

Well, somehow I managed to do almost nothing today. I ran to the store and got dog food and a new collar for my amazingly growing puppy. I cleaned the trash out of the car. I went to the video rental store and got some movies. That's it. If you really think about the time spent on those things, I managed to do a lot of nothing today. Know what? It was a good day.

***

I received a letter today from the other service I applied to. A letter is never good. If you are going to get hired, you get a call not a letter. Well, somebody else was selected for the position and my application would be on file for the next 12 months. Oh well, it would have been nice, but I think I saw it coming. My testing that day was not my best showing and combine that with my lack of experience compared to some other applicants there, and that was that.

***

My wife showed that "Offer of Employment" letter to a lawyer friend/coworker of hers...really really smart guy. Well, he felt the same way. Something just didn't smell right.

Part of me wished it could be resolved Monday, but I shouldn't curse a holiday off when I am lucky enough to have it. I'm worried that they are going to try to find some reason to get out of it. Now with my options more limited for employment in this area, I have more pressure to accept a worse offer than I would really like. But, I am lucky to have full-time employment already, even if it is not in the field I want. I have to remember it could be worse...much worse.

***

Another link to share. It needs Microsoft Media player to play the videos. So sorry for anyone without that. But, it does have some really good news clips about Katrina and after.

http://video.msn.com/v/us/v.htm

Six Degrees of Separation

2005-09-02T19:18:00.000-07:00

So, I am ok with the idea of becoming a father-in-law. My step daughter is 21 and she is to be married this December. He's a nice enough guy. Mr. "Always" Right a little too often for my tastes...likely because I am Mr. Always Right. (just kidding dear). But, seriously, I am glad to see my step-daughter happy.

The thing is, today I met part of his family for the first time. They are nice people. The mom was very polite and complimented my wife’s cooking and my grilling more than once. (Always a plus.) But, it is just an odd thing to think about relations like that. I thought of being a father-in-law and eventual grandparent (no time soon please). But, being related to all these other people even in some extended way is nothing I ever really thought about.

Kind of reminds me of the game "Six degrees of Kevin Bacon." Or the whole theory of people are connected to almost everyone else by 6 or less acquaintances. (See the play/fim Six Degrees of Separation.)

So, if you thought of the blogosphere. This whole six degrees could reach even further...don't even think of how Google connects us all. (So, how small of a world is it becoming?)

Offer of Employment

2005-09-02T18:53:00.000-07:00

So, today I get an Offer of Employment Letter faxed to me. Actually, I asked for it to be faxed to me so I could look it over before going in to sign it. Good thing.

The majority of the letter was no big deal. It stated the pay rate, the starting date of the position, certifications I would need to prove I had. I also would have to pass a background check, driving record check, drug test, and physical agility test. But, what it said was not an issue. The issue was what was missing. In the ad on their web site there was mentioned a $3000 sign-on bonus. I had also asked the Operations Manager prior to applying if I would be eligible since I was a prior employee (not a current employee). She said she believed so. Please also note that this service is extremely short staffed and would likely hire any medic they could right now. So, I called and talked with the HR person.

I had two questions:

Where is the sign-on bonus?
Is there any way I could get the medical benefits moved forward from the normal 90 day waiting period?

Later in the day, I was told that the 90 day period was a corporate-wide rule and she would not be able to move it. So, I explained the costs involved with renting the CPAP I just received and that I would not like doing that out-of-pocket without getting the sign-on bonus. I figured the 90-days rule would not change but I figured it would just strengthen my request for the bonus by asking. Well, the jury is still out on the bonus, they said they needed to contact the corporate office...

The whole thing that makes me nervous about this is that I felt like I was talking to a used car salesman the whole time. They kept asking me to come in sometime today and sign this letter. They asked multiple times and tried to get me to commit to a certain time. I never did. I said I needed these issues addressed first. That seemed to be an issue with them because Monday was a holiday and so the HR person would not be in until Tuesday. What makes it really odd, my agreed upon start date is October 11th. So what’s the rush? Just did not seem right to me to rush in and sign this so fast.

What am I not being told?

Doctor's visit

2005-09-01T19:28:00.000-07:00

I went to the doctor's office today. Not for being sick, just a normal follow-up to that sleep study I had last week. I can actually say that it was an interesting visit. Usually when I go to the doctor's office I do not hear anything I do not already know. Mind you, I say that with a lot of respect for my current's MD's. But, heck, this is my body and I am knowledgable enough to have an idea what's going on...even when I choose to ignore it.

But, like I was saying. Today was good. The main issue I already knew. I have sleep apnea. The neat thing as all the stuff the sleep study showed. I kinda figured what it showed, I knew what all the wires were for. It was just neat to see all the results spelled out in a report.

First a definition for those who need it, the results refer to AHI or Apnea/Hypopnea Index. Apnea = not breathing, Hypopnea = breathing slower than you should. AHI is the two combined into one total. Also, they only count times that were over 10 seconds long. The average is 4-5 times per hour for a normal adult of my size.

Believe it or not, I do not mind sharing this information with the net:

In a 6.6 hour span, I slept 5.5 hours.
My AHI was 191 during that time. So, think of it as that I stopped or near stopped breathing 191 times in 5.5 hours. The doc considers this severe sleep apnea (go fig).
My apnea was just as bad on my side (33/hr) as on my back (36/hr).
My blood oxygen level dropped to 90%, which in the scheme of things is not so bad.
My heart rate dropped to 55/min (60-65 is normal for me) during apnea and then rose to 87 at the end of apneas.
Perecent of sleep time in each stage of sleep: Stage 1: 16.7%, Stage 2: 63.9%, Stage 3&4: 6.6%, REM: 12.8%. Notice the amount in stage one and two compared the the rest. Never got enough deep sleep.

This lack of deep sleep along with the low oxygen level and up-down changes in heart rate lead to greater risks for hypertension, stroke, heart attack, etc. All the bad stress on body type problems.

So, guess what. I now have a CPAP machine to blow up my nose when I'm sleeping to hold the airway open. We'll see how it goes. I have another sleep study to go to in about a month for them to see if it needs to be calibrated more and to see how I am doing. Fun, Fun.

***

Thank you DJ for the great comment to a post I made a few days ago about medic pay vs. nurse pay. Please check out his blog at:

http://psychonomic.blogspot.com/

(insert post here)

2005-08-31T19:48:00.000-07:00

Sorry, not much to say today. Not feeling well. Talked via IM with the Operations Manager of one of the services I've applied to. She wants me to start ASAP. I've told her October 11th would be the earliest. I have some doctors appointments I want to get out of the way before I mess up my insurance coverage. Also, the 10th is my wedding anniversary. No way do I want to start a new job that day.

Check out the "Clicked (MSNBC)" link I have on the right side of my page. Lots of good links usually, but extra active with Katrina links lately.

Good Night, sorry about the lame posting tonight. Feel free to spice it up by adding comments. Thanks.

I hate being sick...

2005-08-30T19:38:00.000-07:00

I don't like even calling myself sick...it's more like I feel ill...or even better...I feel "not well". Saying I am sick just implies a bunch of stuff that I am trying to avoid.

Well, nothing happened today, did very little at work except for the normal helpdesk-think for people type questions. It is raining like crazy here. Left overs from Hurricane Katrina. I'm really interested in how Acadian Ambulance (www.acadianambulance.com) prepared for this and how they think their plans have worked out. I suspect they'll be very busy until they get the whole city emptied. Then I suspect they will be even busier when people move back in and have to deal with a dirty and damaged city. Best of luck to all down there in LA, MS and AL.

Lots of testing, Little pay

2005-08-29T16:10:00.000-07:00

Has anyone thought about how much we study and test for a career that pays as little as EMS does?

The normal argument is that Paramedics tend to consider themselves equal or at least similar to most nurses they know. Nurses tend to know a lot about their specific area of care, and I know some nurses that are amazing in their knowledge and patient care skills. The thing is, that is not the average. I really have met quiet a few nurses that really have very little clue what they are doing, other than that they do exactly was the doctor says and only that. Mind you, I am sure there are medics and EMTs out there like that but with their protocols. The thing is, medics make half of what a starting nurse makes in this area. Half. They each have specialized training for their area. From my experience medics are more prepared to deal with unstructured situations out-of-hospital. Medics have standing orders/protocols that make it easier for them to deal with a wide range of issues without having to contact a doctor (medics and intubate (tube down throat) a patient where 99% of nurses can't.) There is also the legal issue that outside a hospital, a nurse is only able to deliver first aid until EMS arrives. They may be knowledgeable and skillful, but the laws reflect that nurses are for hospitals and clinics (near doctors) and EMT/Paramedics for out-of-hospital.

Now, I know some arguments from nurses tend to say EMT/Paramedics are just for advanced first aid and are not their equal. Well, EMS professionals do like to talk about their latest trauma run, but medical (non-trauma) are overwhelmingly more common. Paramedics do a lot of sick-person care. Now, an average run for me could take an hour and a nurse in the hospital could be with that same patient for days. But, I know the ER nurse will pass this patient off as quickly as he can. Also, how long do you think a nurse in a doctor’s office or convenient-care office would be with this patient? In those cases it would be almost zero. Those tend to be the ranges of patient care I see from nurses...zero to hours to days of intensive care. So, why is a medic making half the pay of the nurse who gets your vital signs and leads you to a room in the doctor's office?

Well, I am ranting. Maybe it is the cold medicine talking. I'm curious to see if anyone comments about this one. I'd like to see if anyone with no EMS or Nursing experience would have something to say. Perspectives from the outside are sometimes helpful. So, if you are a random reader and actually have made it though this whole posting; please let me know what you think.

***

Go to www.salary.com if you want to find your own numbers. Also note that education *could* be different for a nurse and a medic, but they are not always. Some medics have Associates degrees and some have Bachelors. Same for nurses (Associates or Bachelors).

***

Does this all come down to supply and demand? The demand for nurses is high right now. But since the demand has pushed the pay up, it has increased the size of some nurses egos. Thoughts?

Sick on test day

2005-08-29T15:33:00.000-07:00

Of course the nastiness that hit my family last week and this weekend seems to be starting on me today. Luckily, all for me so far is the feeling like crap part.

This morning was testing day for one of the services that I've applied to. The test was 60 questions was OK. I'm not sure if I am performing my best today, but the questions were not insane as I had feared. We then had two scenarios. The trauma scenario was pretty straight forward with a drunk falling down the stairs and possible head injury. The medical was also not insane. It was a male pt with a possible AAA (abdominal aortic aneurism) and a bp of 80/40. There were other details, but the bp was the key. I treated with a fluid bolus and dopamine. The thing that I hate is that after the scenario I realized that I never said I would just generally treat for shock by raising his legs and covering with a blanket. I did it in my head and I've done it with all my real patients. But, for some reason, in this scenario, it never came out of my mouth. Grrr... I'm not sure it is something that would fail me, but I am worried that is something that would make another candidate better than me. By the way, I did mention PASG (Pneumatic Anti-Shock Garment aka big blow-up pants) and inflating just the legs. But, I said to the tester and he agreed that it would likely never happen in reality. Nobody locally uses PASG anymore, but they are still in the testing scenarios because they are still in the national testing scenarios.

Now it is just a waiting game. I do not think they are hiring very many positions and they did not say during the testing. So, I am staying a little pessimistic on this just to be safe. The other server I've applied to is not as nice to work for, but they have already said they would love to have me. So, no need to stress too bad today.

Now I'm waiting for my wife to get home from work and then I'm going off to bed and hope I feel better when I wake up in the morning and have to go to work.

ever-growing blogosphere, ever-shrinking universe

2005-08-26T19:36:00.000-07:00

Here I am surfing the web tonight and clicking around on some blogs. Then I read this guys description of himself. I was amazed at how much we have in common. So much so I actually read the page to my wife. (NOTE: I send my wife a lot of links to read, but they have to really peak my interest for me to stop her in what she is doing to read it aloud.)

Here, read it for yourself. He's been blogging a lot longer than I have, but there are some interesting similarities. I think one thing he does not say on this page, but does on another is his part-time job as a Park Ranger.

http://maddogmedic.blogspot.com/2004/01/getting-started.html

Here is a little about me that I am prepared to share with the blogoshpere, in the order that it flows out of my brain:

I am male.
I am married.
I have children.
I am currently 32 years old.
I live in the Midwest, though I have lived elsewhere.
I have a BS in Geography and an AAS in Paramedic Science.
I am a NREMT-P (www.nremt.org)
I really enjoy patient care.
I really really enjoy the occasional adrenaline rush of EMS.
I handle chaotic and emergency situations better than most people I know.
I currently work as a network administrator.
I really really dislike working in an office.
I do not want my mark on this world to be that I helped a rich person become richer.
I believe in public service.
I am a former US Park Ranger.
I have lived in cabins with no electricity for more than camping.
I have gone months without even seeing/hearing/smelling an automobile.
I enjoy academic life, talking with smart people, and debate.
I wouldn't mind being a college professor or lawyer (constitutional law).
I have a very mild case of Essential Tremor. (www.wemove.org/et)
My ET is being treated, I tend to notice it more than others now...most days.
I believe one of my sons has ET (too early to be official).
I tend to vote for Democrats.
My wife tends to vote for Republicans and I am ok with that.
I believe children should have heroes...preferably not celebrities.
My hero as a child was a fireman.

Well, I could likely go on for awhile, but I think this is good. You can figure out more about me by reading this blog as it grows.

Puke & Squirt

2005-08-26T06:30:00.000-07:00

Though that could be a title of some run reports, this is actually the theme of my home right now. Seems my wife was up as many times as I was for the sleep study. I get home to find my wife still in bed, she got an OK to go into work late. Both my sons (6 & 4) have been up multiple times in the night puking and with diarrhea. I apologize to my wife for not being here. But, since she has 3 hours until she needs to be at work and the boys are now sleeping semi-peacefully. I decide to make my bi-weekly run to Wal-Mart while everyone is sleeping. Actually a very good time to go: 0630 on a Friday. Very few people there and most of the stockers were done. I only had the floor cleaners to deal with. I get home just after 0800 and I make sure to stop and get the wife some coffee on the way home...definitely a day she'll need it.

Now it is time for me to sign-off and enjoy my day off...well, do laundry and clean up after the "little squirts"...oops, I mean my boys.

Sleep Study

2005-08-26T04:30:00.000-07:00

Well, last night I went and had a sleep study performed on me to verify my sleep apnea I've reported. A local Pulmonologist has opened a sleep disorder clinic with a very cool twist. Instead of sleeping in a hospital bed and being studied. He actually has leased out a section of a local hotel, a nice one too.

So, I arrived at 1930 last night and checked in at the front desk as directed. They call up to the nurses office and tell me when I can go upstairs to meet her. Well, after meeting the nurse and being led to my room, I just hang out for the next few hours. It's just a normal hotel room, TV, bed, chair, etc. The thing is that this room has some added equipment on the night stand and a camera on top of the TV that's pointed at the bed and a intercom box in the corner of the room. Sadly, there was no Internet access in these rooms. Seems the hotel did not wire this section like the rest. There was one wireless network, but it was secured and it was for the sleep study equipment anyway.

There are three patients tonight. (All in separate rooms, of course.) The nurse and I had agreed earlier that I would be the last one she prepared for bed, since I had the latest normal bed-time. Well, she later stopped by the room and said it was time. We went to her office (a converted hotel room) and I set in a large chair. She then leads on each of my legs, my chest, all over my head and face as well as a microphone on my neck near my vocal cords. She then circled my head in gauze to help keep the leads in place...mind you they already have some glue-gunk too. All these had wires of various colors and lengths that lead to a box where she plugged them into specific ports. I was able to pick-up this little box and then walk back over to my room and get in bed. After in bed there we two more things that weren't as mobile. The little box was hooked to a big box. This big box also had a pulse-oximetry sensor to be taped to my finger. She, of course, saved the worst for last. There was something similar to a nasal cannula. No O2 comes out of it, it actually is a sensor to see if, where and how I am breathing. The cannula had the prongs for my nostrils like normal, but it also had this other tube connected that has this open hard plastic thing that extended from my nose to just past my bottom lip (approx. 1.5cm wide). One set looks at breathing through the nose, the other through the mouth. We then had to calibrate everything, she had some straps she put around my chest and waist to measure movement and we tested the microphone on my neck. Then it's night-night time with the aid of a sleeping pill they provide.

As hotel beds go, this one was nice, but actually they had really good pillows. There was a very strong thunderstorm that I wish I could have gotten up and enjoyed, but I would have had to call the nurse to get out of bed, and I suspect she wouldn't have liked the reason...potty ok...everything else not a good reason.

Well, the night was like most others, I had trouble getting to sleep, woke up at least 3 times that I can remember and had trouble getting back to sleep each time. The nasal cannula was very annoying because the prongs were hard plastic, not soft at all. Also, the couple times the cannula moved out of my nostrils, the nurses voice came over the intercom telling me to move it back. What is with that anyway? Even a nice nurse like her has to wake you up multiple times a night!

Once 0530 arrived, it was time to get up. The nurse came in, turned on ALL the lights and removed the electrodes with some of my chest a leg hair for good measure. I had a survey to complete and then I was allowed to take a shower. (highly recommended to get all the glue off.) Then it was check out time, but not until I enjoyed the hotel's continental breakfast (also above average in quality and quantity.)

I'll see the doctor for a follow up in one week to hear the results of the study. I already know I have an enlarged uvula, large tonsils for my age, and a narrow/high palette. So, I suspect to hear that I'll need to sleep there one more night to get a CPAP machine calibrated for me.

Hey, this is one of the reasons I have told the local ambulance providers that I could not start full-time for them until October. I want to get this all done before I would be between insurance providers. Just think of how all of this would cost out-of-pocket?

***

Good sleep disorder and treatment information:

WebMd

7 Mistakes for your First Week Blogging

2005-08-24T17:23:00.000-07:00

I found this blog entry enlightening. I think I've done OK, I just fudged on Rule #1. I have a theme, I just started a little early (just before I start the new job.)

http://blog.studentnyc.com/archives/26

The age of innocence

2005-08-23T19:58:00.000-07:00

Just one of those days where I feel crappy… not feeling well, work being a pain and tired all day.

Then we get a call from the school...

We are told that my son (6 yo) had touched a girl in an inappropriate place. That's really all that we knew. The teacher said she was floored. My wife and I were speechless. So, tonight we had a talk with our son. Here's his story: They were playing on the playground and he was tickling her and it seems when not paying attention he accidentally put his hand "by her private parts." She told him to stop and he stopped...

Well, I feel awful. After I explain about the whole necessity of avoiding even getting close to any private areas and how even accidents can be bad....I feel bad because I know how this all happened. During the past six years, we have known my son is very ticklish. Sometimes just threatening tickling would get him giggling. Well, one of the most ticklish spots is on the inside of his thigh half way between his knees and his "privates". Well, I suspect he was attempting to tickle the same area and did not realize that a little girl at school might not like that. He cried for some time this evening before I was home and our talk. I feel bad.

I understand the need for my son to act appropriately and I explained it to him. But, I feel that he lost a little bit of his childhood innocence today. As a parent watching my children grow up so fast as it is, it is sad.

WooHoo

2005-08-23T19:30:00.000-07:00

I got my first comments today. Thank you Stacey! Now I know someone other than my wife has looked at my blog.

Stacey's blog:
http://thingsthatmakeyougoblah.blogspot.com/

Big day for the boys

2005-08-22T19:58:00.000-07:00

The day started by taking my youngest boy to his pre-school orientation. He seems eager if not excited. Let's just say he seems to be looking forward to it, if also taking in the whole change aspect of it.

The day ended with taking my oldest son to sign up for Cub Scouts. He is going to be a Tiger Cub. This is the youngest group reserved for 1st graders. He is extremely excited and it made it even better when he saw some other boys from his school there. I'm actually excited about this too. This is so much more my thing and so much more what I want to pass on to my sons. Much more than what? Well, things like little league. Mind you, I think it is great to have physically active children, even if I am not the best role model in that regard. But, other than swimming lessons (every child should learn to swim), this is something I believe in. I want them to learn leadership and public service. I'm hoping the scouts will help in this.

The one thing I am worried about is that as a Tiger Cub, a parent is required to be with the child at the meetings. The meetings are only about an hour long, I have heard. The issue I am trying to overcome is that I have no idea what my schedule will be in the future. EMS work schedules aren't always conducive to other regular activities. We'll have to see, hopefully I can work something out with the den leader to have the meetings on nights when I am free.

http://www.scouting.org/

EMS Haiku

2005-08-22T19:56:00.000-07:00

Saw this and thought it was great:

Blood, tears and vomit
I can deal with all of it
But stupidity

The day is coming

2005-08-21T19:58:00.000-07:00

So, the owner of the company I work for sat everyone down for meetings this past week. This took awhile, we are about 70 employees right now. Seems we have lost a client's business. Not, the biggest client, but a noticeable loss none the less. She (the owner) is letting three employees go that day. My department is only two people. I'm the network administrator and there is one technician. We are in the meeting together. We find out that neither of us are going that day. But, my coworker is going to have some majorly changed job responsibilities. Instead of being in the IT department, he will be in GAD (Graphic Art Department). The logic there is that he shows talent in Flash and web design. Too bad he just finished a degree in IT and is working on a higher degree in network security.

He's upset. He is hiding it relatively well. But, I would not be surprised if he starts actively looking for another job. He asked about how much IT he would still be able to do. He would be my "backup." He mentions me "eventually leaving." Mind you, everyone at the company knows I've been training to be a medic. But, it seems the Executive Committee members forgot that time keeps going by. This prompted the fun question "So, what ARE your plans? If you're leaving we need to know." My answer? "I did just get my National Registry certification. What's that mean? I have more paperwork ahead of me. But, to get to the point… It would be ignorant to think I'll be here forever. I expect I'll get a job offer in the next 6 months. What I say to that offer, I have not decided."

I then pitched the idea that I could continue to work part-time for them if I get offered a full-time position in EMS. In effect, flip-flopping what I've been doing as a part-time EMT/full-time IT. One of the EMS services I've been looking at works 11 24-hour shifts per month. The other service works 12-hour shifts in a 4-on/3-off/3-on/4-off rotation. The owner said she'd like to work with me on keeping me...full-time or part-time. But, I still could see and feel the stress in the room. I am waiting to see how this goes. I only see the need for 1.5 network people in this company. Meaning they only sometimes need two people. Maybe it will work out. It really is a better part-time job than I could get anywhere else.

Thinking back on it, I wonder how I came up with 6 months. I just made it up on the spot, but it seems fairly accurate. I test next week for one service, but they only have one opening and I am one of many applicants. The other service said they'd love to have me. But, I told them I couldn't start until mid-October. So, who knows. It could be two months instead of six. Close enough. Right?

Change

2005-08-20T18:38:00.000-07:00

As I mentioned in the last post, I am working on a career change. The thing is, many people don't seem to understand the change. I currently work 40+ hours a week as a Network Administrator. The pay is good, but not as good as people tend to imagine. Though I have always enjoyed the helping and teaching aspects of this job; it's never really been "my thing." I work with people who live and breathe programming, networking, etc. It is their calling. Given the current IT job market, I hope the person who eventually fills my position has that calling.

How did I ever get into computers if I really didn't want it? Just like I suspect many of us end up in jobs we never really planned for. Life happened. I was a Park Ranger out in the woods. I met my wife and "settled down." I moved to her hometown. No parks. I needed a job. After a few odd-jobs to keep busy, I landed a series of jobs in computers. I've always come across as a bit smart, and I am a decent student. So, my knowledge of computers grew and now I've been in my current position for five years.

Two years ago, I had a supervisor that just drove me crazy..made me really hate my job. But, what I hated worse was the feeling of being stuck in that job. So, I decided to enroll back in school. Mind you, I already had a BS (in Geography.) So, I thought hard about what I wanted to do in life. My desire to help others plus my ability to think quickly even under stress led me to a Paramedic training school. I knew of EMS from my time as a Park Ranger and my grandfather is a retired firefighter. So, I've been exposed to a first-responder type lifestyle already.

The two years of training went by fast, I have gained new friends. I've faced some personal challenges and I am about to start this new career in what I believe is my calling. Heck, I even got another degree. So what if it is an Associates degree when I already have a Bachelors.

I've put applications in at two services in the area. One I worked for as a EMT-Basic. They have already said they would love to have me. Also, the other service sent me a letter inviting me to prehire testing on 8/29. So, things are looking good job wise. Yes, it is a pay cut. But, doing the job you want to do does make a difference.

I can ramble on about this for quiet awhile, maybe some other time.

In the Beginning...

2005-08-19T20:30:00.000-07:00

OK. Here I am starting this whole blogging adventure. I've considered this for awhile and I also read a few blogs daily. Though I like some free-form blogs, most that I enjoy are more focused than that.

So, for now at least, I am going to try and focus on topics that interest me the most..mind you they are huge topics.

My family may get mentioned occasionally. I really don't WANT to blog about them or really about my friends either. But, how can I not metion them when they are such a large part of my life.
My work. I actually have one job that I am thinking about leaving soon and I am about to start another in a whole new field. I expect to blog about this more than anything. Like most adults in the US, I tend to spend a lot of my time and energy dealing with working.
A few odd topics I have an interest in. This includes Essential Tremor, which is a condition that runs in my family.

Like most who blog about work, I am going to be making an effort to change names and not mention anything that could give me any legal or employment issues. So, don't plan on any good gossip here either. Just thoughts from a guy who has been known to be a bit blunt, a bad speller and worse typer, and mostly honest-to-a-fault.

Lastly, welcome..lets see how this goes.