Monday, December 23, 2013

almost Christmas or for some of

 made these tonight for tomorrows monday walk . never sure if i'll have anyone to share them with, so close to christmas.  we shall see.  messy but still  kinda cute i think.
 needed this serene shot after these past 3 nights.  they kept giving me pretty busy patients.  i had a few blond moments.  nothing dangerous, just silly blond stuff.  it happens.  this morning i was trying to learn how to prime the continuous dialysis tubing and i must have popped a hole in my saline bag.  it's doing it's priming thing when suddenly i start hearing water and look up to see a geyser of water spraying all over the room.  that messed it all up and  this delay meant the doc decided we'd all done so great getting this guy stable that he'd stop it and give it to the next patient that needed it.  dang filter only lasted 6 hours, but i guess it did it's trick.
 thanks to nelly for all her help last night.  we tag teamed the patient and together we brought him out of the drain.  work is pretty stressful but it's also fun to hang drips wildly and titrate like crazy and get all those numbers back to ones that a person can live with.  i've had patients with blood pressures in the 40's to 60's and that is the top number.  was remembering a patient who spiked a temp of 108F and dropped his blood pressures to the 40's.  you work hard, but it's amazing how all that hard work can pay off in a matter of hours.  that can be very rewarding.
 i'm not always the smartest as far as being able to explain in detail why i do all the stuff i do in rapid succession to get a person back from the brink of death.  i think over all these years you develope a sixth sense in some ways.  you just know.  i've got pretty dang good instincts.  you can't knock experience when you are faced with patients as sick as the one i met last night.  the nurse you have can make a lot of difference in the outcome.
 this is from a snowshoe the other day gasline-powerline to tank trail.  fresh pretty.
 rio opted out, but she has joined blossom and i on two walks in the bog this week in between shifts.  it warmed up a bit.  it's snowed off and on as well.
 lots of shoveling of snow and snowshoeing this past week.  then add on work giving my body and mind a beating, i'm pretty tired tonight.
 chatted with my sister a few times.  called her back as there was an article in the paper the next day that i just had to tell her about.  i'm always half joking that one of these days i will open a hospital which will have only brain dead patients in it.  patients whose families refuse to let us remove loved ones from ventilators despite their being brain dead.  well a family in california got a judge to prevent this exact thing.  it's sad but their daughter had complications from a tonsilectomy and ended up brain dead.  they are obviously not ready to hear this or accept it so they went to court and got a judge to stop the removal of "life" support on their brain dead daughter.  my hospital idea of housing dead people may just have a future.
 must have been tired the other day.  i hopped in the shower and then got myself a little freaked out.  everything looked a bit different.  as i get older i live in fear of dementia.  it would be horrible and i see it all the time and feel so badly for those folks.  so if i forget something or can't find a word, i'm sure it's early onset signs and symptoms.  not to fear, as it turns out i had taken the towels off the shower door to wash and forgotten to put up clean towels before i hopped in the shower.  this meant that a great deal more light got through making it seem brighter in there.  i'm a freak i know it!!
 of course this also meant i now had to traipse through the house naked and wet to get to some towels.  brr.  i often wonder what the dogs think of us.  i mean when they want to go for a walk they are just ready to go.  us humans though, we've got to take these showers, put on layer upon layer of clothing. it must just seem to odd to them. perhaps they even pity us for our lack of fur.  what a burden it is in the winter for humans. sometimes i just sense the dogs looking at us humans with pity and curiosity.  we are strange beasts i guess
 do love the dogs.  stopped to write this in the snow as blossom stopped to pull ice chunks from between her toes.
 she is not under a tree here she is on the powerline trail.  the branches were all laden with snow and hanging very low,making passage for this strange human a bit more challenging.  several times i know i came close to whacking myself in the eye with twigs snapping back at me.  no blood was shed and i survived this run through the thicket.  this is also why i avoid this part of the trail in summer.  seems a good place to accidently run into a grizz.
 at almost 50 i must admit i mostly feel invisible to members of the opposite sex.  sad but true.  however, the other night as i was wandering around the hospital on my lunch break (well not wandering so much i went to the cafeteria) anyway as i was coming down the stairs a guy was coming up the stairs and he was totally checking me out.  nice to be checked out...doesn't happen too often.  he seemed happy with what he was seeing.  of course, my first instinct, which i did not do, was to say something like dude i turn 50 this year.  in the end i just smiled and walked on.
 a lab test was ordered over this stretch for antifreeze toxicity.  it wasn't positive but i do have a little something to do with this test being at our hospital. years ago a toddler came in being treated for accidental ingestion of this.  the doc i was working with was saying that the results of this send out lab wouldn't be available for several days and she'd just have to continue to treat this toddler.
at this point i mentioned that in my days as a veterinarian technician we ran antifreeze tests right there and that she would have the results yes or no in a matter of a few hours if she sent the blood to the local veterinarian. she was pretty shocked by this and a phone call was made.  sure enough, they could run the test in their clinic and we'd have the results back in a few hours.  so we drew the lab and someone drove it over.  the test was negative and that changed the treatment course, saving the toddler unnecessary treatment.
 seems great, right?  well, the doc got in big trouble for this.   i guess someone found it offensive that a human's blood was taken to an animal hospital for testing.   hell we are all animals/mammals first right?  thankfully this isn't a doctor who backs down and i think she offended them further by stating that perhaps the animals in anchorage were getting better care than the humans.  she loves to tell this story.  anyway, still makes me laugh when i hear of this test getting ordered.
 my impact on the world can seem small sometimes.  will have to try and watch "it's a wonderful life" this week.  we do all make a difference in this world we live in.  sometimes it's not earth shattering but it does hasten or alter treatment in patients so that is helpful
 i'm also responsible for how the prayers are done at the hospital.  this of course always shocks people a bit as i'm not seen as overly religious or churchy.  i do consider myself a spiritual being but i'm not keen on organized religions.  just find that they often become corporations rather than houses of God.
 anyway, when i arrived at providence, which is a catholic hospital they would play this old tape of the Lords prayer every morning.  the tape was horrible and one could hardly understand it.  i ended up having a conversation with one of the clergy that wanders about the hospital helping families and patients about my thoughts on this taped prayer.  basically i said if i were God i suspect i would be offended that in a religious based hospital they seemingly were unable to find one person each day to simply recite this rather short prayer. anyway, next thing i knew they had tossed the tape and were doing the prayers live twice daily. now the various pastor/spiritual advisors take turns giving a prayer of their choice.  it's for sure more interesting.
 blossom is working on her feet in these.  busy trying to remove the big balls of ice from between her toes.  she's always got twigs and stuff on her. my friend calls her my velcro dog.  it totally fits.
 socchi is fast approaching.  i do enjoy the olympics and winter is always really cool as they are generally some athletes from alaska.  we are pretty heavily represented.  a curler is going and a snowboarder and cross country skiers.  many local favorites.
 blossom looks pretty cute with all that snow on her
 saw that we have responded to the russian governments anti gay stances by sending openly gay delegates to the olympics. i think that is a very good way to deal with it. makes the point without being too confrontational, just put a good face on the situation. heard elton john interviewed on npr a bit ago and he was saying that he'd always been welcomed in russia and had debated whether he should go or not but he had decided to go just to show support of the gay population in russia.  often the best way to help people change is just to meet them one on one.  we are all basically the same.  we want to be happy and live good lives.
saw this cute little train set in texas with a polar bear/penguin train.  the cats were watching it zip around the tracks the other night.
 these are from a late walk around the bog today.  just a trace of sunset but it was quite lovely out. loved the light.  forgot blossoms toy which is why she is looking back so hopeful.
 there are a few movies out that look interesting. i'll have to see if anyone is up for a movie next stretch off...or sledding again.  hmm.  may be time to try another hill.  all this new snow!! guess the landscapes for the animated movie "walking with dinosaurs" was actually filmed in alaska.  does make it one to watch i think.
 got a few things checked off the list today despite being pretty tired.

 most important was getting these dogs outside and walking.  we just had solstice.  i always love winter solstice.  i don't mind the low light of this time of year, but i won't say i mind the returning of longer and longer days.  Happy Solstice...:-)  actually summer solstice always makes me mildly blue as it's a long day but after that day it begins to shorten.  pretty amazing living up here.  the seasons change dramatically and the light is never really predictable.

getting late and i am still tired. best to get some rest for my weary body.   never sure what Christmas will bring at work.  less elective surgeries but it can get crazy all the same.  plus lots  of staff want it off so it can be shorter staffed those days.  off to rest....

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