Café

If you're a coffee-aholic like I am, these cartoons will brighten your day. If not, you still might like 'em! :-)

Coffee Cartoons

Change of Color

The fall colors are just about at their peak right now in Flagstaff and the city and mountain are gorgeous.

Because of our local climate (i.e. high elevation and very little precipitation), there are very few deciduous type trees that thrive here. Pondarosa pine is the most common type of tree, but the next most common is the aspen.

I love aspens. Not only are they very aesthetically pleasing (at least in my opinion), they also make a wonderful quaking sound when the wind rustles the leaves. Hence the name "quaking aspen", I guess. In the fall, the green leaves turn to a bright yellow color that, as the fall light filters through them, fills the forest floor with a warm, buttery light that keeps you warm even when the air is cool.

Unfortunately it won't be long until the wind and snows come, knocking the foliage to the forest floor. Luckily, we took a hike last weekend and were able to get some great pictures of the leaves. So I'll shut up now and post some pretty pictures. I hope you enjoy them.

Wet Roads, Traumas Arrive

I saw and participated in one of my first major traumas today. It was not a very uplifting experience.

The hospital I'm at for my clinicals is pretty small and most major traumas are automatically sent to Flagstaff or Phoenix since both cities have hospitals that are rated Trauma 1. But today they sent us one for reasons unknown to me.

It was an 18 year old man who had been in an MVA. The poor kid had hydroplaned on some wet asphalt slid off the road and was ejected from the car. He had head, neck and abdominal trauma and was in pretty bad shape. They called us for a stat portable chest and pelvis x-ray and would later do a CT scan of the head and neck areas.

It was amazing to watch the docs and nurses swarm around him, all of them doing their jobs with infinite efficiency. I attempted to do my part, namely x-raying the patient's chest and pelvis, in as timely manner as possible.

Upon visual inspection it was clear the kid was in pretty bad shape and once we got the CT scan there was no denying his condition. The head trauma he had sustained had caused a massive bleed in his brain and he was more than likely brain dead already.

At this point they transfered him to Flagstaff since my hospital doesn't have a very advanced neurology dept. The news of his condition hit me harder than I would have expected. I thought about how his family's life would be forever changed by the events of that day. I did my best to continue on during the day, x-raying patients and keeping a cheery demeanor with them. But I kept thinking about when the doctor would finally have to break the news to the kid's family that he was almost certainly brain dead and would most likely not survive for many more hours. How would I react if I were given the same news about my brother, mother or wife? There is no way to know how one will react until one is put into that situation and with any luck I will never have to find out how I would respond.

My First "Tipping" Experience

I had an interesting first experience today. One that most people will never get the opportunity to experience in their lives. I "tipped" a BE patient for the first time.

"Tipping" a patient is a nice way of saying that I inserted the tip of an enema tube into the patient's rectum and administered liquid barium sulfate into their colon. Nice huh?! I hope most of you never have to experience it.

And believe it or not the "tipping" part isn't the worst of it. In many patients the barium, and air that is added later, expands the colon and makes the patient feel like they are having horrible gas cramps. I have never had one myself, but from what the patients have been describing to me during the exam, I hope to never have to have one........or at least put off having one for many years!

BEs are often done in conjuction with or instead of a colonoscopy to look for problems in the large intestine like colon cancer, diverticula, polyps, ulcerative colitis, Crohn's disease or even appendicitis. Most of your organs are not visible on standard x-rays, so in order to visualize the colon a radiopaque material (in this case barium sulfate) is used to coat the inner lining of the large intestine and then air is injected to expand the walls so all parts of the intestine are visible on the x-ray image or under fluoro examination.

BEs are a very common exam and provide the doctors with a lot of good information about the condition of the colon.

Truthfully, I had been dreading my first experience tipping a BE patient. In school the instructors always tell horror stories about techs being pooped on by elderly patients who have not been prepped properly or of patients being unable to hold in the barium and letting loose all over the table. But so far I have not seen this and, although I am sure it happens, I don't think these problems are very common.

I guess I was most concerned with the rather intimate aspect of actually tipping the patient for the first time, but everything went well in this case. I explained to her what I was going to do and made sure she was ready before I did anything. Another tech was there to make sure I did everything correctly.

I'm actually extremely relieved that my first time is over and that it went so well. I know that they wont all go so well, but at least I can always look back and remember that my first BE tipping went smoothly.

What are you Sinking about?

har dee har har!

HIV positive patient

I had my first HIV positive patient today. It was a little surreal. She didn't fit any of the stereotypes of what one might have for an HIV positive person. She was young, healthy-looking, well-spoken and polite. She seemed like your typical college-age women from anywhere in the US. She wasn't the one to tell us she was HIV positive (it was evident in her chart) and we didn't talk about it with her. All she needed done was a simple abdominal series and single view chest x-ray, so discussion of her condition was not warranted.

On a lighter note, I did my first shoulder x-ray today. Not too exciting but the pictures sure came out pretty. The shoulder is a really strange and complex joint and it's a wonder more people don't have problems with it. The patient needed both shoulders radiographed (he had been bucked off his horse a few days earlier). The tech I was with did the first one, showing me his techniques for positioning, and I positioned the patient for views of the other shoulder. Unfortunately, I couldn't comp this time because I have to do at least one exam with supervision before I can actually comp on it, but I'll be ready next time.

Camping trip to Lockett Meadow

Here are some pics from my wife and my camping trip to Lockett Meadow, a few miles north of Flagstaff, AZ. The meadow and hills are full of aspen and in the fall the colors are amazing. Our campsite is at about 9000 ft asl, so the nights are already pretty cold....... like 25 degrees F cold!! But we brought plenty of blankets and the fire kept us warm until we headed for the sleeping bags. It was so cool to hear the elk bugling in the distance. They kept at it for hours. My wife was sure the male was looking for a booty call! :-) Anyway, enjoy the pics.

Our camp site

Becky looking at the San Francisco Peaks from Lockett Meadow

Me at a pulloff on our way to Lockett Meadow

Becky holding an aspen leaf

View from Lockett Meadow the morning after we camped

Yeah...........it was frickin' cold!!!!!!

Me contemplating the meaning of life or something just as philosophical, I'm sure ;-)

aspen

interesting plant

Becky holding some aspen branches