Motorcycles and apple pie.

I passed my motorcycle class!!  Which means I can go to the DMV, take a written test, and get a motorcycle license.  Then I can go buy my scooter.  As much fun as riding a motorcycle is, I just don't feel safe doing it here in LA.  I'll just zip around from work and the grocery store on my scooter.  

For some reason, maybe the cool weather, I got the hankerin' to make an apple pie.  I had never made one before but the apples are beautiful right now.  I haven't had good luck with baking but tonight I pulled this out:

It turned out really tasty.  Two successful endeavors in one day.  

Moto, baby...

This was the first day of my riding class, learning how to ride a motorcycle.  I've probably been talking about learning since I was 21 or 22.  I realized that if I didn't do it now I probably never would.  So this sweet ride is what I rode today at my class.  Super comfortable... No "crotch rocket" for me.  I felt super awkward at first, like learning to drive a car for the first time. It seems like there is so much to remember:  the clutch is controlled by your left hand, you shift gears with your left foot, and gas and brake with your right hand.  It's a lot to learn but, oh baby, when I'm making those turns and shifting into 3rd gear (as high as they will let you go) it feels soooo gooood!  The more practice I got, the more natural it felt and I understand why people are so passionate about motorcycles.  I am a realist and will probably not buy a motorcycle while living in LA.  A scooter is fine for me.  But when we leave this (god forsaken) place and live somewhere where people are a little more cognizant of other drivers, Noah and I will be cruising our bikes up and down the coast...  So much fun!!

Why it sucks to be a postal worker...

The charge nurse from the ER calls me and says she is sending over a patient who has come from an Urgent Care center.  "She's chopped off the top of her finger and she's got the finger with her".  

Well, that sounds exciting.  I get everything ready in anticipation.  A bowl of ice, some saline solution,  a ton of gauze and IV stuff.  The patient comes in with her hand wrapped up and a cardboard box.  I get her settled, make sure she is not in pain (the urgent care had properly medicated her), and eagerly open the box.  (Wounds, to me, are like unwrapping Christmas gifts.  I can't wait to see what is underneath the bandages.)  The box holds ice packing and, in a small plastic bag, the tip of her finger, from the knuckle to the tip.  It's pale but properly packed.  I set it aside and begin to unwrap her bandages from her hand.  She turns her head away as I get to the bloody end and there it is:  a chewed up stump at the end of her middle finger.  So cool.

Here's the story:   She's a Filipino lady who works at the post office.  Apparently, they keep their stamps in a locked safe.  It's big and heavy duty.  She is closing the safe and before she can pull her finger out of the way, the safe closes on her finger.  On instinct, she pulls her finger away and realizes that the tip is missing and blood is gushing out of her little stump.  Her co-workers are alerted to her distress.  Problem is, they can't find the tip and realize it must be in the safe.  So they have to have her tell them the combination so they can open it and retrieve it.  The tip is retrieved and sent with her to the urgent care.  (They sent her to an urgent care because it is a "workman's compensation" claim and must go through their affiliated care provider first.  Another glitch in the medical/insurance system.)  

I must say I totally respect the urgent care for their appropriate handling of the "body part" and the fact that they contacted a hand specialist and told him to meet the patient at our facility.  It was successfully (so far) reattached right in the exam room.  Kinda surprised he didn't have to take her to operating room.  We of course gave her proper pain medication as well as prophylactic antibiotics.

I hope she is doing well.  I think she is lucky that this injury occurred at her federal job and she will be completely taken care of as far as bills and compensation go.  I see so many partial amputations from illegal immigrants that never claim it as workman's comp because they are not legally employed by the company.  I even had one guy leave without telling us, his partially amputated finger still dangling.  

101 uses of a carrot...

A patient came into the ER with the complaint of "something stuck in my rectum".  His story was that he was "impacted" (meaning hard stool is stuck in the rectum and regular poo can't get by).  To solve his problem he decided to insert a carrot to dig out the offending hard poo.  Well, the carrot got away from him and lodged itself so deep that he was unable to get it out.  The doc who examined him is this cute little Asian girl who looks all about 14 years old but is a fabulous doctor.  She told us that she attempted to retrieve the carrot with forceps.  Unfortunately, once something is lodged in the rectum, a vacuum seal is created, making extraction difficult.  She tried to pull out the carrot, just to have it sucked back in.  She tried again to pull it out and once again it got sucked back in.  This happened about 5 times when the man turned around (imagine him  on his hands and knees) and said, "Just pull it out already!".  Appalled, she said "What do you think I'm trying to do?".  For god's sake, did he think she was just pulling it out and pushing it back in for fun?!?  

She realized she could not get it out on her own and called the GI (gastrointerologist) specialists.  Basically they performed a lower endoscopy which entails putting a rubber tube complete with a camera up the rectum to pull out the offending object.  After two hours of trying they were unsuccessful.  They even tried to burn holes into the end of the carrot to get a better grip.  No dice.  What they were successful at was taking photos of the carrot.

The decision was made to send the man to the operating room.  Poor guy, I saw him sitting outside his ER room, slumped shoulders, looking so defeated.  And he looked like a regular guy, not like what you might imagine.  I felt sorry for him.  I read the operative report the next day:

Patient was placed in the lithotomy position. (On his back, legs bent and spread wide open, much like getting a gynecological exam.)  Medications were given to relax the muscles.  (The rectum is just a nice, tight muscle).  Spreading devices were used to open the orifice as much as possible.  Reaching in with a special clamp, the surgeon was able to remove the carrot in its entirety.  All 13 inches of it.   

Do I believe his story?  Not really.  Do I feel bad for him?  Absolutely.  Maybe just a fetish gone wrong.  His paperwork said he was married.  Did he have to explain to his wife why he spent over 8 hours in the emergency room and accumulated a gigantic bill?  Maybe she already knew...  Does she do the grocery shopping????

Last minute weekend!

Had to plan a last minute weekend to get out of town. I'm so burnt out on work right now. Every little irritation seems ten fold. Noah has also had a hard go of it at his job. Economy is slow so his bosses are up his ass about every little thing. So we decided to drive an hour and a half to the sleepy little seaside town of Carlsbad just a little north of San Diego where Noah spent a lot of time as a kid.

We get to our hotel room and try to decompress as the sun starts to set outside our room.

I've never liked when people took pictures of the inside of their hotel room but we had this amazing light coming in off the patio.

Our view from our patio. So serene and calming. The funny thing about this hotel is that they had all these "activities" for people to participate in like "Bingo at 7pm in the library". I felt like Patrick Swayze was going to be offering mambo lessons on the veranda at 4pm.

Hung out with Noah's friend Chris who still lives there. Both avid surfers. Noah got to surf while here. It makes him so happy!

Of course, Noah continued to work.

But we had so much fun and a much deserved break from La La Land. Back to work tomorrow of course...

Guns...

I was not raised in a family that had guns.  A little surprising since I grew up in Alaska where people had shotguns in a rack behind their heads in their pickups.  We had neighbors that hunted and brought us elk and caribou meat.  But my parents never owned their own.  (That I know of.)  Noah was raised by a single mom that also did not own any guns.  So where am I going with this?

We had an earthquake not too long ago that kind of freaked me out.  It got me thinking about earthquake preparedness and how stupid I would feel if "the big one" happened and Noah and I had nothing.  So my big project lately is getting ready for a disaster.  We cleaned out our closet of some shelf space and got to work.  We got the usual:  water, batteries, and non perishable foods.  Simple enough, I thought.  Then I tried to imagine what it would be like with no electricity or gas and no fresh running water and I got a little Y2K.  I went to REI and bought candles,  a huge box of matches, water purification tablets, and a camp stove with tanks of propane.  I stowed our important paperwork in one waterproof container.  Noah and I have stashes of cash in small bills in different spots in the apartment.    I stocked up on basic first aid supplies including antibacterial solutions, large amounts of gauze, butterfly bandages, and ace wraps.  (Also some first aid supplies I won't list but believe me, I'm prepared for anything).

So Noah and I were feeling quite contented and prepared.  Then one night we were watching the news regarding the latest hurricane disaster in Texas.  One story focused on the fact that people were looting and stealing from other people and that the option of calling the police (on phones that no longer work) was not an option.  One woman told the camera, "We are our own protection right now".  Well, that really freaked us out.  We live in LA.  A lot of people live here.  A lot of weird, crazy, unethical people.  We already have a lot of crime.  Multiply that tenfold when people are desperate.  So we've decided to buy a gun.

We are trying to do it as smart and responsible as possible.  I won the football pool at work and used the winnings to sign me and Noah up for a gun safety class.  Next Sunday, we have one on one training and will get to shoot five different guns (three handguns, two shotguns) in a safe environment with a professional to teach us.  We wanted to get a feel of different guns to guide us in our "home protection" purchase.  We have spoken with several of our friends who either grew up with guns or were trained in the military.  The overwhelming response is that we should buy a shotgun.  Number one, if anyone were to come into our house uninvited, the sound of the shotgun being "pumped" usually drives the bad guys away.  The sound is unmistakable.  Number two, if it comes down to actually having to fire it, accuracy is not an issue.  Noah and I do not have children and in four years have never had a child in our home so that issue is negligible.  Also, gun cases come with locks on them that can only be opened by whoever knows the combination.  

Chances we will actually use it?  Less then 1%.  Feeling super protected just in case?  Priceless. 

Thoughts? 

Charlie Tuna says no...

Had a disgustingly busy weekend in the ER this week.  And so many of the people really needed attention, unlike a lot of our "Santa Monica wounded" who could wait a day or two to see their doctors.  We had our share of abscesses, broken bones, lacerations, and abdominal pains.

The worst thing I had to witness this weekend was horrible parenting skills.  I know, I know, I am not a parent and shouldn't tell people how it should be done.  But, I saw some horrible behaviors from children and their parents and I saw some incredible kids with their equally incredible moms and dads.  Whenever I see children panicking and scared, I always try to imagine what it would be like for me to bring in my nieces with a deformed arm or a gash on their lips.  I would be super protective (what I call the mama-bear or papa-bear syndrome), so I allow people to be upset and cry if they need to.  I even allow people to be rude and aggressive, to a point, because they are just trying to protect the little people that they love so fiercely.  But, there is a point where I draw the line...

A 4 1/2 year old was brought in by his dad and grandmother.  He ran into a coffee table and had a gash on his forehead.  It definitely needed stitches if it was going to heal properly.  Sometimes we can use tissue glue but only for superficial cuts and the outcome is not as "aesthetically pleasing" as stitches.  And when it is on your face, well, most parents reluctantly agree to the stitches.  Yes, kids are scared.  Yes, they cry and try to bargain their way out of it.  And yes, we put them in a papoose, hold their head still, and try to console and distract them while the doctor pokes their "owie" with a needle.  It totally sucks for the kid and us.  We hate it but as adults our brains can process the fact that sometimes it hurts more to make us better in the end.  Kids can't think this way.  They are terrified.    

Anyway, the dad of this poor kid prefaces this encounter by telling us that his wife is a psychotherapist and grandma is a behavioral therapist and they want this to go as smoothly as possible so that their kid "doesn't hate hospitals as an adult".  What a way to set yourself up for failure.  It seems that the thing parents fear the most for the kid seems to happen.  Little Johnny (that's what I will call him) was obviously used to running the show.  The dad had requested that the wound be closed by a plastic surgeon.  One was actually already on his way because this little old lady across the hallway had partially amputated her finger.  (More on this story later.)  When the plastic surgeon showed up, he decided to sew the kid first and get it out of the way, so that he could spend more time re-attaching the finger.  He also had the OR waiting on another partially amputated finger in the ER.  I go in to assist and Little Johnny is throwing a huge temper tantrum.  Again, nothing I haven't seen before.  But what I didn't count on was the dad and grandma allowing him to kick and scream and threaten to bite us.  The plastic surgeon finally told the dad that he refused to sew up Little Johnny.  This was a first for me.  (The plastic surgeon told me later that he could not, in good conscience, waste any time (while dad and grandma tried to placate and bribe) on a non-emergency while he knew two fingers could be lost).  The dad and grandma decided to start blaming me and the rest of the ER staff for causing Little Johnny's behavior because we "made him wait so long".  Awesome.  Now it's our fault for him being out of control.  The ER doctor finally made the decision to sew him up herself on two conditons:  grandma left the room and dad allowed us to hold Little Johnny still.  About 10 minutes later, using three staff members to subdue Little Johnny while ER MD sewed, we finished the job.  Little Johnny, with five stitches in his head, bragged to us how brave he was and high-fived all of us that he had kicked and threatened to bite.

Little old lady across the hall, meanwhile, finally had her finger reattached successfully!  Yeah!

About an hour later, a two year old came in who had fallen and had a deep laceration inside her lip.  You know the piece of skin attaching your upper gums to your upper lip?  Yeah, needed stitches.  She sat quietly, while her parents sang to her, and the ER MD held her lip up and put in four stitches.  Wow!  I don't know many adults who would do that.

Later on, a 3 1/2 year old presented with a cut on his eyebrow.  His name was Charles and his mom told us we could call him Charlie Tuna.  We needed to stitch him but Charlie Tuna wasn't having it.  He fought, he kicked, he screamed.  That's okay.  We put him in a papoose and started our work.  He called us "jerks" and "fat assess".  His parents giggled nervously and told us they let him watch Family Guy.  "I thought it was just a cartoon!", mom explains.  Charlie Tuna continued to launch his verbal abuse throughout the procedure.  Again, totally okay with me.  The little guy is scared.  But just as the doc is about to finish, Charlie Tuna starts yelling "No more!  No more!" and mom says to us: "The doctor needs to stop now because Charlie Tuna says no".  I almost blew snot out of my nose trying to hold in my laughter.  Not to sound harsh but I don't give a f*ck what Charlie Tuna does or doesn't want to do.  He's three!!!  Keep in mind that these are the same parents that seem shocked when we tell them that, yes, there will be a scar.  That's what happens when flesh is torn apart.  It's never quite the same.  

I hope I didn't sound too cynical.  I get that way on my hard days...