Saturday, May 21, 2005

Phlebitis and Infiltration and Anaphylactic Shock! Oh my!

Had clinicals this week. Surprise! It was fun! Attitude is everything and I had a couple of patients with incredible, postive, goal-oriented attitudes!

My favorite! A post-op patient who knew the get-back-on-your-feet checklist by heart! She gave me an update on her deep breathing and Incentive Spirometer (the tube with the hose you inhale from to give your lungs a workout) every time I walked into the room. And half the time I met her in the doorway -- on her way out for a walk with her daughter or husband or grandkids.

This patient was recovering from colon surgery, NPO (non per os -- nothing by mouth). You've just had your colon resectioned to take out perforations or a cancerous growth, you don't want to start cramming stuff down your pie hole to force that poor colon to grind and squeeze and do peristalsis (the wavelike muscular contractions of the alimentary canal which contents are forced onward towards the glorious light at the end of the tunnel). So the patient was getting TPN (total parenteral nutrition -- TPN will drip through a needle or catheter placed in your vein). In this case, the patient Aminosyn. Now she was getting the lowest possible dose of it, 3.5% (a lower amount of amino acids in the fluids), so she could get it through a peripheral vein (higher %s get it through a vein next to their heart). But Aminosyn can do tissue damage even at that low level. And since her Phosphorus was low, we were putting some of that in the IV bag, too. And Phosphorus burns as well. So every time I went in her room, I took a look at her IV site. Sure enough, it started to swell and turn red.

Ahhhhh! Phlebitis! More later...

Friday, May 20, 2005

The Real 101st Fighting Keyboardists!

This is amazing! Wish we'd had this when I was in. "The sites, which are accessible to captains and lieutenants with a password, are windows onto the job of commanding soldiers and onto the unfathomable complexities of fighting urban guerrillas... Most captains now have access to the Internet at even the most remote bases in Iraq, and many say they’ll find at least ten or fifteen minutes every day to check the site. They post tricks they’ve learned or ask questions like this, which set off months of responses: “What has anyone tried to do to alleviate the mortar attacks on their forward operating bases?” Here are snippets of conversations posted on Companycommand and Platoonleader in the past year: ... The more aggressive you look and the faster you are, the less likely the enemy will mess with you. It is okay to tell your soldiers what the regulation is; but as a commander, you should make the effort to get the soldier home for the birth. A single wall of sandbags will not stop any significant munitions. Take pictures of everything and even, maybe more importantly, everyone. The right photo in the right hands can absolutely make the difference..." Jonah Goldberg! Your country needs you to blog from Iraq! Jine up now!

http://www.newyorker.com/printables/fact/050117fa_fact

Tuesday, May 10, 2005

Colonel David Hackworth. I'll remember you...

A guy who wasn't afraid to try something and fail. He took the worst battalion in the Army and turned it into the best. He "understood the atmosphere of violence. That meant he knew how to keep his head, to think in danger's midst. In battle the worst thing is paralysis. He mastered his own fear and learned how to kill. He led by example, and his men followed."

He was kicked out of the Army in 1971 because he told ABC News that Vietnam was a bad war that couldn't be won. At the same time predicting, to within the year, how long it would before the S. Vietnamese regime fell. Our most highly decorated veteran of Korea and Vietnam. From there, he went on to become a leader of the Australian anti-nuclear movement, an investigative reporter and a great writer.
http://en.wikipedia.org/wiki/David_H._Hackworth

And here's the organization he started to encourage other warriors to think and speak and act for change...
http://www.hackworth.com/index2.html

Monday, May 09, 2005

Oslo Girl

Oslo Girl -- wow! When we Americans visit a foreign country, we're stylin' if we learn to ask for bread at the bakery and tickets at the train station, (ask me sometime about 'Je voudrais un billet.' and 'Wo ist die Kaserne?') . This American girl -- this Norwegian-American girl! -- has been living life All-the-way-Norway for years. Here in the land der-unbegrenzten-Möglichkeiten, 8 years after leaving Europe, I make lefse at Xmas and drive around with a Norge bumper sticker... and wonder if I'll ever cut the ties to my homeland again.


Too many sequins? Impossible! Posted by Hello