The MacMedic

A day to myself

The rain continues but I am not going to let that stop me from enjoying myself. I have only the most tentative of plans, which is very unusual for me, and I was only able to tell my wife that I woudl be getting on the subway at some point in search of something interesting and to find some geocaches. Other than that, I am trying to just let things happen and see where I end up.

The Complex

We just got back from the Blue Man Group performance of "The Complex" at the Charles Playhouse. Initially all I could say was "Wow!". The show was incredible. To a certain extent I cannot even describe it well enough to explain why I liked it.

The stage and the instruments created by the Blue Man Group had a feel that was a combination of industrial, futuristic, and mechanical nightmare.

Three men dressed in black with all their exposed skin painted cobalt blue on stage and three musicians in black clothes with flourescent pain on their faces and clothes and playing under blacklight started the show. The music was unique, and drew me in. The narration, and the actions of the Blue Men alternated being comical, though provoking, and, yes, sometimes downright strange.

The show combined some commentary on the state of communications with lots of comedy and music played on instruments of their own creation and various percussion pieces. The instruments they had created were almost completely made from PVC piping assembled and reassembled in various ways that allowed the to bring unique sounds and visuals to life. Striking the pipes with sticks, paddles, and other pipes was the main method of producing the sounds. The instruments ranged from a slide "drumbone" played with two of the Blue Men working the two sliding sections of large PVC pipe and the third striking one end with sticks. The coordination between the performers and their obvious skill was very impressive. While their drumming on somewhat conventional drums was impressive I was most impressed by their PVC pipe organ. Created of PVC pipes of varying lengths and struck with a closed cell foam paddle each pipe varies in length so that each provides a different note allowing them to play complex peices of both classical and rock music through the coordinated actions of the three Blue Men on stage. The music they played ranged from their own creations to bits and pieces from "Bolero", "White Rabbit", "Superfriends Main Title", "Back in Black", and so many more that I can't even list them.

I have not done the show justice by a long shot. All I can say is that I enjoyed it immensly and will be going out of my way to see the group again. I found them to be musicly, creatively, comicly, and thought provokingly appealing.

Traveling in the rain is boring

I know it seems obvious but it was the theme for today. After a morning getting the kids out to school, packing, and getting our stuff into the car we left a little before noon for Boston. The trip started out well with only light rain for the first hour or so. Once we hit the Massachusetts Turnpike the rain got heavier and heavier until it was pouring. Still, the trip wasn't too bad and I was looking forward to getting to the hotel and out into the city.

For someone who doesn't live or work in a large city it was fun to walk around a larger city even in the rain. There are few cities that I would actually want to live in but Boston always makes the short list. Very distinct neighbourhoods, small community feel with big city features. I am realistic, I know that Boston has it's bad sections, crime, poverty and all the things that go along with larger cities but, for the most part, it feels comfortable.

We'll be going to see The Blue Man Group tonight after dinner and my wife starts her conference in the morning. I'll be on my own during the day for the next 2 days.

Maybe I should be Scottish

One of my colleagues was kind enough to point out the MacMedic Tartan and suggested I acquire a kilt and assorted finery to go with it.

While I was amused to find a tartan using my nom de plume (so to speak) I somehow think that I'll pass on the kilt. I have neither the heritage for it nor the legs.

It's alive

Well, after a two days of feeling like I'd been run over by a truck I am feeling a little better but still not back to anywhere near ready for prime time. On the other hand, all my kids are healthy and out to school and I have stuff to do. We'll take it slow and see what we can get done today.

Yeah, right

I have been so sick for the past day and a half that the thought of writing anything was just not even entertained. I'm feeling a little better tonight which is a good thing because my wife and I are supposed to go to a birthday dinner for a very close friend at a really wonderful French restaurant. I'm going but I doubt I will be eating much. Too bad too, the chef at this place is incredible.

Oh well, I'll settle for making it through the night without feeling worse than I do right now. If this were any other ocassion I would just skip it.

Medic 2 - End of the night shift

The night started out well with there being enough time for me to complete all the usual beginning of shift duties. The evenings calls were of no consequence being either routine ALS or BLS downgrades. It was steady until just before midnight when things stopped. I was able to use the time to get a lot of work done and felt like I had cleaned up almost everything that needed to get done, for work at least, before I left for our few days in Boston later next week.

By 0400 though, I was feeling pretty poorly. I was still pretty happy with what I had gotten done but I had begun to get sweaty, have chills and abdominal cramping. As much as I didn't want to admit it it sure looked like I was coming down with the same thing that my kids had had for the past couple of days. I was looking forward to going home.

As usual, because I was really wanting to go home (at least it felt that way) the last call of the shift came in around 0600. Respond with the ambulance and rescue for a maternity. I thought the bear was getting me at this point. I was wrong, it was going to get much worse. I had only been responding for a couple of minutes when the dispatcher called an update that delivery was "imminent". That made me really unhappy. I have a pretty terrible track record with prehospital OB calls starting with a prolapsed cord 3 days after getting certified as an EMT at age 16 and going downhill from there.

As I pulled up to the scene the patient was being carried down the front stairs to the stretcher. One of the EMT's on the rescue came over as I was getting my gear to give me an initial report. The patient was 36 and a patient of the High Risk OB practice at the large academic hospital about 30 minutes down the coast. She was 38 weeks pregnant, had ruptured her membranes about 4 hours earlier and was contracting every 60 to 90 seconds. That was all I needed to hear, time to go. Total scene time? Less than 3 minutes.

The trip towards the hospital was dreadful. It was raining heavily, I was feeling crappy to begin with, and the patient was getting more and more uncomfortable. She gave us a little more history as to why she was high risk. VBAC, vaginal birth after cesarean section, she had a c-section for her last child and was going to deliver vaginally this time. That was just one last thing to make me really uncomfortable. One of the big problem with VBAC is the possibility that the uterus will rupture during labour. Outside of the hospital there is not much I am going to do about it but if it happens both the child and the mother are in grave danger and all I would be able to do is watch and tell the driver to drive a lot faster.

She was a neonatal nurse at the same academic hospital and had some definite ideas on how things were going to happen. She didn't want me to start an IV for one thing. I'm OK with that for the most part. I agreed to try and follow her plan as best I could and she agreed that if anything happened outside the norm we would be moving on to MY plan.

As we travelled she grew more and more uncomfortable and as we hit the city limits she started to complain of rectal pressure and the urge to push. I felt pretty stupid but all I could say to her was "please don't push" but there wasn't much else I could do besides that and trying the whole breathing thing that I learned when my kids were born.

We rolled into the Labour and Delivery unit and straight into a labour room and all I can say is that it's been a long time since I was this happy to turn a patient over. Her doctor went in to check her and came out again to give the nurses some orders. 10 cm is considered fully dilated and ready for delivery. This patient was "a rim" which the doctor said was like 9.999 cm. The patient had delivered a healthy baby boy before the ambulance crew had even been able to finish stripping the dirty sheets off the stretcher. Can you say close call?

It took forever to get the ambulance crew out the door to head home. I guess I understand it. This is not a call that you do everyday and who wants to pass up the chance to get to see a newborn. I finished my paperwork while they were ohhing and ahhing. Eventually we started to head back.

I felt really awful for the entire trip back and by the time I returned to do shift change (2 hours late) I just needed to leave.

Total calls for the night: 6
1 ALS transport
1 BLS transport
1 BLS downgrade
1 Cancellation
2 Cover assignments

Total milage for the night: 97

CD for the night: "Cracked Rear View" by Hootie and the Blowfish

Medic 2 - Beginning of the night shift

The day has been pretty awful. I did get some sleep but it was only 30-45 minutes at a time and I am feeling pretty run down. I almost wish I could call in sick, stay home, and go back to sleep, but that just isn't the way I do things. We'll see what the night brings but no matter what it is I am going to be pretty wiped out by morning.

The gods hate me

Clearly I have offended one of the gods somewhere. I don't know who and I don't know what I did but I will be home with a sick daughter again today. I love my kids dearly, but being home with one sick kid or another for the bulk of the last two weeks has really worn me down. My 6 year old again, she felt fine all afternoon yesterday and last night and was sick when she woke up this morning.

What makes today even a little worse is that I have to work tonight at Medic 2 and really need to get some quality sleep. It's going to be a long night otherwise.

Daddy Duty

It has been a rough day at home. With a sick kid home my day of sleep didn't happen. Instead it was entertain a child all day and try to get ahead on some the the household chores that need to be done. My daughter felt fine all day so we did manage to get a lot done. All my eBay sales were packaged and shipped, house was cleaned, telephone calls were made, laundry done. That is all fine, well, and good but what I really wanted to do was get some sleep.

Medic 2 - End of the night shift

Very busy at the beginning of the shift with 3 of 4 calls coming in during the first 2 hours. They were nicely spaced so I always had a chance to clear up from one before the next came in. That was very considerate of people to get sick that way. The last one of the run of three was actually in Medic 3's district. Medic 1 & Medic 3 were both out on calls and I had not even been dispatched to the cover assignment yet when the call for chest pain, 50 y/o female came in. It was quite a way from Medic 2's quarters but I was still the closest paramedic to the scene. I am not at all comfortable with the disposition of the call once we got to the ED but I am very comfortable with my care.

I intercepted with the ambulance about a minute after they left the scene enroute to the hospital. When I got in the back I found that they had the patient on the stretcher looking very uncomfortable and complaining of 9 out of 10 right sided chest pain and numbness radiating to her right arm accompanied by shortness of breath, nausea, and a lot of sweatiness. She was pretty pale as well and I was not comfortable with the way she looked.

Her 12 lead was unremarkable with the only thing out of the ordinary being an incomplete right bundle branch block but I remember quite well that women can have atypical MI presentations. The ambulance had already given her 324mg of Aspirin so I put a line in and gave her sublingual nitro which gave her no relief. She did, however, get some relief from the Morphine and Phenergan she got after that and by the time we arrived at the ED she had less pain, although it was still there. I figured that she stood a good chance to get an overnight visit or at least held in the ED for a few hours to do some serial enzymes. I was pretty surprised when I called a couple of hours later and found that she had been discharged with a diagnosis of arm pain. The doctor that saw her has been doing this for a long time and is on my short list of people that I would let work on me or my family so I doubt he overlooked something. I am waiting to see him next so I can ask if there was something I missed in my exam. I had been going down a completely different path that I thought was reasonable and probable. We'll see.

When I got home this morning I found that I would be home with my middle daughter who was home sick from school with, yup, you guessed it, the return of the GI bug that came through her sister had earlier in the week and all the kids had last week.

Total calls for the night: 6
2 ALS transports
1 BLS downgrade
1 Refusal of care
2 Cover assignments

Milage for the night: 133

CD for the night: "Night Train" by Oscar Peterson