Ketchup

Yes, it has been 6 months since I last blogged; and there are good reasons for that. But I'll just give you some highlights from the last 6 months -- other than the mundane everyday stuff:

*I did finally get my Christmas tree down before Easter.


*The Bataan Memorial Death march was AMAZING!! The outcome of that can be read here . Some pics of training and the event are below.








I was able to shake hands with some of the survivors, which was incredible. One 91 year old survivor marched the first 9 miles, as well as the 90 year old widow of another Bataan survivor. I have told people that even if they do not want to march, they should try to make it out to the event just to see these amazing veterans, whom are becoming fewer each year. 26.2 miles that day, I had never done anything like that before (I also did the Susan G. Komen Race For the Cure 5K the day after an 18 mile practice march, I just walked that one.) I'm excited for the next year's March on March 27 for which I plan to do an all-female heavy team. My battle buddy Marsha won the female individual heavy this year so I'm sure she will prepare me well.

* I had 22 days of field training in the Middle of Nowhere, New Mexico. I didn't really mind the majority of it. I didn't have AHLTA notes to do, I got more sleep, sunshine, and fresh air. Sure, it was over 100 degrees in the summer, and I was getting a little annoyed by the people who since the first day kept declaring, "It's hot!" Yeah, like whining about it is going to make it any cooler, quit contributing your hot air! Near the end I think I had enough of the drama and some organizational issues that I was looking forward to getting back to the real world.

* While I was in the field, I had my first mass casualty (the basic definition is when your medical resources are overwhelmed, which was pre-planned as having more than 4 patients). This happened to be on an otherwise quiet Sunday afternoon when all of my leadership (officers and non-comissioned officers) were gone and it was just basically myself and about 3 medics and an x-ray tech. There was a freak windstorm that pulled up our tent (the brigade aid station) from where it had been re-staked about an hour earlier. This tent, after knocking me over, flew over and knocked down the tent about 15 yards away that was serving as the patient hold area, and our company tent (serving as the medical support for the brigade) was knocked down as well. Everything was completely scattered as if a tornado had gone through, which was basically the case. Not even 2 minutes after this happened and I just barely picked myself off the ground, an ambulance pulls up and says, "You have two patients!" I verbalized my thoughts when I responded, "You gotta be kidding me!" We picked up a couple litter stands and proceeded to work on a guy with a concussion and a heat casualty. Another head injury patient is brought over and this guy was pretty bad. Word got out that there was a mass casualty and random people from the rest of the batallion came over. It was a blessing how everyone came together and that all of the people involved in the care were not hurt. I threw in people, including the chaplain and the social worker as well as other observers, to serve as human IV poles, hold stabilization, get ice packs, and other random jobs. 3 patients turned into 4, then a couple people who were injured or sick over the past few days were brought over. I admit that for a moment I was thinking, "C'mon, really? At all possible times, you decided NOW to get help?" In the end, all 6 patients turned out to be okay. The serious head injury who I wanted to get air evaced out had to go by ground, and he was in the ICU for a day, but recovered well and wanted to come back out. I sent back the other 2 head injuries as well and the other PA showed up in time to take care care of the last patient who had been sick for three days. Yay for mass casualties! I thought that we had filled our quota and would not have to do a mock mass casualty, but I was wrong. The last day and a half of training I was stationed at an ambulance exchange point with two of the medics. We had responded to a Humvee accident at 3 am that morning where 4 people fortunately had minor injuries but we did not get back until about 5:30 in the morning. At 7 am they decided to do a mock mass casualty with 40 infantry soldiers who had just completed a 25 mile overnight training exercise. Half of them did not know what their "injuries" were. Amongst them there were a few soldiers who really were dehydrated and a couple of them had some really messed up feet.

* Patients continue to keep things interesting for me. I have had some interesting ones. I had one week where I had to call patients up after 730 at night and tell them to go to the ER because one had a pulmonary embolism and the other an ectopic pregnancy. I'm sure the ER was wondering why I was still at work at 730 at night. One patient asked, "Can I eat dinner first?" I said no. He later came back and brought me and the other PAs a homemade macaroni and cheese dinner for his gratitude. This happened to be the same day that I had to be counseled because I got 2 patient dissatisfaction surveys over the last few months, which I actually fond to be kinda funny. I have had some moments where patients had tested my patience. I even yelled at and threw an E-7 (Sergeant First Class) out of sick call after I chewed him out for not holding himself accountable and disrespecting me. I'm still trying to build up my "mean" side. Army "customer service" is a lot different than civilian customer service.

*Oh, and to help me be a little more aggressive, I got promoted to the rank of Captain. Yes, I am now Captain Anderson. It's a rank I have to get a little comfy with because it will be a while beofre I will be a major. At least I won't be called "LT" anymore.

*I have been house/fish/cat-sitting for one of my co-workers since July. This involves taking care of four cats, three of them are females. You can bet there's a lot of drama that goes on.

*My last tidbit of news is that I am finally on "leave", a.k.a. vacation for 2 weeks. I'm spending it with my now three adorable nephews and sister and brother-in-law in Alabama. My newest nephew, Jacob Watkins, was born on July 20. He had some beautiful pictures taken already as seen here. More pictures to follow.

Reasons Why I Still Have My Christmas Tree Up

I was thinking this weekend that maybe I should put my Christmas tree away (see previous post for picture).It's only 2 feet high and has a few ornaments other than the round glass ones, so it should have been done a long time ago, right? Well, here are some reasons why it's still standing by my fireplace:
1. Time. It's just one of those things that has not been on the top of my Saturday to-do list, especially since I did take an 11 hour nap after my road march last week (fell asleep at 3 pm, woke up at 2 am on Sunday morning).
2. It provides some "greenery" since it is just barely warming up to temperatures that a plant might survive in...but then comes the wind...
3. I don't have to water it.
4. The red base and red ornaments are festive enough for Valentine's Day. i guess I could acknowledge the holiday in some way. Maybe the red could be patriotic enough for the 4th of July? Maybe? Haven't you heard of celebrating Christmas in July? I did do it on my mission.
5. Since it is still winter, I can leave my snowman ornament on.
6. My Norwegian ornaments (thanks to my sis!). I can leave it up until at least the 17th of May!! (Sytennde Mai is Norwegian Independence Day, how else am I going to celebrate it in El Paso?)
7. Are we not suppose to celebrate Christmas everyday?

A Few Quotes of the Week

Here are some memorable quotes from the last week, at least the G-rated ones...



* Medic: "This patient has MAD tenderness in their left knee!" I really hope they didn't document "mad tenderness" in their note. I'm trying to come up with a collection of lines taken from patient notes written by medics during sick call and use them for a future post.



* "Are you nervous Ma'am? Why are do you look so nervous? You're trembling!" This was the soldier who had to supervise me as I gave a urine sample for a random drug test. It could be the fact that I was trying to hurry for the three patients I had waiting up for me in the clinic, the company commander had to stop by and talk to about a patient before I went to the clinic, the fact that I had nothing to eat in the last 5 hours, or the fact that I just don't like having people watch me pee! I have come to terms with supervised random drug screens, as this was my third, but this person was a little bit too much into my business. As one fellow soldier says, "We get paid to have someone watch us pee!" Living the dream....



* Ruck march team member #1: "Do you see the horse?" Team member #2 " Oh yeah, yeah, I see it...yeah right..." Apparently in the Organ Mountains near White Sands and Las Cruces, New Mexico (which do look pretty cool) one of the mountains supposedly looks like a horse. Someday when I see it, I'll get a picture of it and show you, but for now...

I'll Bring the Strobe Light

That was my remark following the suggestion that we should throw a "block party" or rave for the new offices that my brigade's PA's as well as myself moved to this week. The three other providers and I moved next door to the same building that houses the lab, behavioral health offices, dental clinic, and pharmacy, so we claim the little nook or hallway that makes up our four offices and the three medic screening rooms. So far, I've noticed a couple things that I have to get used to: 1. I'm feeling a little more claustrophobic and can't get my usual laps around the building as I talk with other providers. 2. Since the other PA's offices next door, our evening "documentation-music" can be heard very easily and might even clash. My singing might be heard as well, but it's okay. My neighbor and I sang along to the same song the other night. We'll have to do some karaoke for our "block party." On the plus side, I do FINALLY have a working telephone IN my office!! This makes life so much easier now. A couple weeks ago I finally got my printer again and will never have to hand-write a profile again, woohoo! Oh, and my Outlook email account got fixed, and I found out that I had over 300 messages.

I guess this was a highlight of the past few weeks. The first two weeks after the break were especially hard. They say that the day/week coming back from vacation is always hard, but these last two weeks were the type of Whiskey Tango Foxtrot weeks where I thought, "C'mon now, REALLY??" My first week back we were down two of our providers who were on leave, so that left me and another PA to handle sick call. Some of the patients had things that had been going since before or during the holidays and were just NOW getting it checked out, like guy with shoulder pain for three weeks (he actually fractured his humerus) and another guy who broke his hand over a week before. I got to know about the fracture clinic real well. And then there were the "incidental findings" of x-rays from lungs that didn't quite sound right. One had a hietal hernia (stomach pooches through diaphragm - which was actually great, because I had been working this guy up for chest pain), and the other was a young guy who had some weird calcifications and a 7mm nodule in his left lung. And then there was this awkward kid who I had seen for a couple of other things before who was complaining of headaches and turns out that on an MRI he has a brain mass. I referred him to neurosurgery, and the same day after his appointment he calls to complain that he knows more than the neurosurgeon handling his case. So what am I suppose to do?? Oh, and then there was the very brief phone conversation I had with a commander when I was trying to explain why I sent a suicidal patient (his soldier, who had 2 previous attempts before) to the ER and the only thing he asked me was, "Didn't you ?know he was being seen by behavioral health?" Uggg, that 's a whole other story, but if I had a little more rank I would really have told him what I wanted to say. These two weeks were finished off with me giving a lecture that I had spent hours on preparing and with little sleep, for which I only had 5 medics in attendance. Yeah. Thank goodness I had a four day weekend after that. It was much needed.
My fifteen mile ruck march for the Bataan raining was also very therapeutic, despite a couple of blisters. I am actually training heavy now (35 pound rucksack (backpack)) but unless I find another soldier to take my place, I may have to go back and support the light team. Our practice was cancelled this weekend due to predicted showers ("I'll bring a poncho!!" ) and I was a bit bummed because it turned out to be a very sunny, although cold and windy, day.

Still living the dream...

My Next Big Goal

My next big goal is the Bataan Memorial Death March, which takes place in White Sands, New Mexico every year. Every year, thousands or people from around the world -- military member, civilians, amputees, children, adults, and the elderly-- participate in a march in memory of the soldiers who survived and died during the 60 mile Bataan Death March during World War II after they were forced to surrender to the Japanese. The intro to the movie, "The Great Raid," offers a good summary of the events of the Bataan Death March. It's a bit heavy, but pretty honest too.

Some of my military friends are forming a team to participate. We've been practicing for the last month every Saturday morning on Transmountain Road and through Franklin Mountains State Park. I've decided to be on the "light" team (just carrying water) because I really haven't been able to "PT" everyday and this is my first march, but I did try the 35 pound ruck sack the last time and it wasn't too bad (of course it was only for a little more than half of the 10 mile practice hike we did). Maybe I'll build up. We'll see.

This was after the weird November snow fall going up Transmountain Road. A perk of training on Saturday mornings and enjoying quiet, lovely views like these. A lovely view of Texas and New Mexico (Soccorro, far left)
For more information on the Bataan Memorial Death March, you can go here. Does anyone want to join me??

It's beginning to look a lot like Christmas!

I broke out some of my very few Christmas decorations (mainly a few nativity scenes and a tree from Target) last week.

I also got a lovely poinsettia that was left over from the Holiday Ball. I guess it was one of the perks of staying until the end and dancing the night away. I told my fellow PA that we should cancel sick call on Monday to go to Legal Services to account for damages to the dance floor bece WE TORE IT UP!! And I was sober too. There might be someone out there who is waiting to black mail me with video of my moves, so beware!

A couple weeks ago El Paso was hit with a freak snow storm. It wasn't that bad, it's just that El Pasoans are not used to snow. A few days later there was another storm but it mostly left EVERY road (including I-10) covered in ice! I think I wore out my guardian angels that day as I did a little "gliding" on Fred Wilson Blvd early that morning. Of course I didn't get the message that the base was going to open up two hours later that morning.

Another tid bit, one job I'm really glad I don't have: the security gate people. Yeah, they have looked pretty cold recently. Maybe when I roll down my window to hand them my ID, I momentarily blast them with a little Christmas music and heat. It has warmed up since, so don't let a little cold weather deter you from visiting me in the "beautiful" city of El Paso!

It's been one of those weeks...

These were my daily goals for Thursday:
1. Have my computer/electronic medical records system working. I was kicked off of the system at 8:30 the night before. I guess that was my sign to go home. Fortunately, it was working the next morning.
2. Talk to the clinical nurse psychiatrist about a patient whose needs exceeds that of a primary care provider. This was also my first "will not see again" patient. I've started THE LIST.
3. Not end the day with a mentally unstable patient, unlike the previous two days. Yeah, one of those weeks.

On an up note, my goals for tomorrow include:
1. Road march 6 miles through Transmountain Road. More details later.
2. Finish about 9 patient notes that had to be put off due to other events this week.
3. Go grocery shopping at the commissary when it is actually open. Open!
4. Prepare my lesson for Sunday school on Sunday. Yep, I'm subbing. It's actually from Preach My Gosple, chapter 2.
5. Enjoy my Bluebelle Groom's Cake ice cream (chocolate ice cream with strawberry swirl, chocolate cake pieces, chocolate covered strawberries, something like that.) I have been thinking about this ice cream for well over a month! It's my reward for setting a new personal record on my physical fitness test -- which I completed when it was 35 ndegrees outside. I think I will remember to bring gloves when it's that cold next time. Maybe keep the long pants on for the run too.