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I am Sam: EMS 2.0

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When I should have been sleeping Thursday night, I was watching “I am Sam” on TBS. I actually tried to walk away from it a few times, but I guess I’m a sap for that kind of thing. Well, not really, but whatever. This post IS a little bit rambling and a lot scattered. Mostly because I’m a LOT emotional about it. I’m sick of watching “EMS Professionals” treat patients with complete disregard for the most basic of human needs.
backtop_iamsam
It got me thinking about the countless parenting lessons the Main Character “Sam” offers us. As a mentally handicapped dad with an IQ around 70, the struggles WE all face on a daily basis are compounded–yet somehow he does it better than most parents could imagine. So… Because it is what I do, I TWEETED it. Next @EMS2Foundation asked me a simple question, that made my mind spin out of control.

do you think there’s any good lessons from “I am Sam” for EMS personnel?

Obviously I am Sam is full of Life lessons in general, but I think that the overwhelming theme is about compassion and understanding. I’m not sure what it was about this question that really got me going, but it did. I actually got frustrated trying to write this post–not because I can’t find the words or ideas, but because the basic concept–one we ignore all too often–is so easy. It is almost easier to follow this concept than what most of us do, but yet we still continue on.

What is this concept? Treat our patients with Respect, Integrity, and Compassion. The EMS Blogosphere is abuzz with EMS 2.0 discussion. Seems as though every one of my fellow bloggers has written an EMS 2.0 post–so I guess I HAD to follow.

For those of you who are living under a rock in West Texas, EMS 2.0 is:

EMS 2.0 is the global effort to reform prehospital emergency care. We are an open community that includes members of the general public, medical professionals, and policy makers. All of us are committed to reforming prehospital emergency care world wide.

Personally, I think it should start on a much more basic level.

Respect. Integrity. Compassion.

Respect.
It seems to me that medics have this God Superiority Complex that justifies the way they treat others–Our patients are scumbags, bums, drunks, and thugs. Our patients DESERVE what they got. Our patients don’t deserve good care. Our patients don’t deserve critical thinking. Why should I respect someone who doesn’t respect me?

Sure, we see a lot of bad eggs. Part of why we see them is the nature of BEING a Bad Egg. Bad Eggs do stupid shit. Bad Eggs make bad decisions. But…. Bad Eggs are still people. Do we expect the bad eggs to magically un-rot if we treat them like crap? Right…. Don’t get me wrong–I am not suggesting you coddle drunks and seekers. I AM suggesting that you don’t disrespect them. I AM asking that you don’t maliciously maltreat them. I AM asking that you give your patients a chance–now when they take that chance and piss it away by swinging at you, that is a new discussion.

I think that if we treat patients with respect, the image of EMS will only get better. Often we have this public persona that we are lazy, dirty drunks–much like the patients we hate–yet we don’t do anything to improve this image. It is OUR responsibility to ACT professional, and Respecting our patients is the foundation of that.

In the Movie, Sam doesn’t shove anyone down. As a matter of fact, it is striking how much he tries to NOT disrespect anyone. Our patients deserve to have a care provider with this dedication–yet often they end up with far less.

Integrity.

adherence to moral and ethical principles; soundness of moral character; honesty.

I think the easiest way for EMS professionals to honor the integrity of our patients and act with integrity ourselves is to Follow the EMT Oath. What you say? We have an Oath? Yup, and while we might not put our hands on a bible or be sworn in like some public servants, we are still obligated to uphold this Oath.

Be it pledged as an Emergency Medical Technician, I will honor the physical and judicial laws of God and man. I will follow that regimen which, according to my ability and judgment, I consider for the benefit of patients and abstain from whatever is deleterious and mischievous, nor shall I suggest any such counsel.

Into whatever homes I enter, I will go into them for the benefit of only the sick and injured, never revealing what I see or hear in the lives of men unless required by law.

I shall also share my medical knowledge with those who may benefit from what I have learned. I will serve unselfishly and continuously in order to help make a better world for all mankind.

While I continue to keep this oath unviolated, may it be granted to me to enjoy life, and the practice of the art, respected by all men, in all times. Should I trespass or violate this oath, may the reverse be my lot.

So help me God.

A big part of Integrity is Pride in one self, pride in your profession, and pride in what you do. If you are missing one of these parts, maybe this profession isn’t for you. Maybe someone a little more disconnected is your cup of tea. These aren’t optional parts of doing our jobs the RIGHT way. If we can’t act with honor, why bother?

Compassion.
Likely the most underused tool in our “kits”. To do this job for a long time you almost have to disconnect from your patients. The things we see and do are hard on the strongest of hearts, let alone one who allows them to eat you up. What that doesn’t mean is that we should disregard the significance of the moment for our patients. Our patients are in pain, dying, sick, or injured and it is our job to assess, treat, and transport them to the next level of definitive care.

DSCF2108 Young and Elderly handsAssess, TREAT, and transport. Treating our patients doesn’t have to involve and IV, medications or the LifePak 12. It could simply mean providing a compassionate ear to calm them down. More often than not, my patients don’t need any “medical” care, yet few people outside of medicine are prepared to offer them what they need. They need someone who has “seen it all” and able to reassure them, comfort them, and be honest with them.

BE HONEST. Compassion doesn’t mean making false promises. You should all know better than to go all TRAUMA on me and yell at your patients for dying or promising they’re gonna live. If they’re gonna die, you don’t have to say “Look, you’re dying”, but you NEED to make them aware(obviously if lucid) of the severity of the event. You MUST be compassionate and part of that is being honest. Tell them what they NEED to know. Tell them in a way you’d expect me to tell your mother.

Sure, EMS 2.0 is about a lot more than all of this “simple” crap, but what point is there in wasting the effort to improve the rest of EMS if we aren’t doing the bare minimum for our patients. The smartest, best groomed medics can still disregard the simple basics of patient care.

In the end of the day, if you aren’t treating your patients the way you’d expect me to treat your 85 year old mother, step back and ask yourself WHY? Then fix it.

If you haven’t seen I am Sam, you should. Sure, it’s sappy and silly, but honestly there is little excuse for us to not all live with the same Love and Care for others that Sam does for his daughter Lilly. Either we decide to do our jobs with Honor, Respect, Integrity and Compassion, or we’ve decided to insult our patients AND our colleagues. What point is there in improving the rest of EMS if we can’t address the most important part?

A day in the life of medicTHREE’s twitterbrain

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A day in the life of medicTHREE’s twitterbrain

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A day in the life of medicTHREE’s twitterbrain

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Cause…

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I couldn’t have said it any better, I’ll just Let EPIJUNKY do it for me.

We should all follow her lead. I think this is really what we should focus EMS 2.0 on. If we can’t stand up for our patients, what business do we have THINKING for them…

EMS LODD RSS

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loddI’ve always found it important to inform my readers of EMS LODD notices. I use an email alert to do so, but found this wasn’t always easy when I was away from my computer. Thus, I contacted Kris Kaull at ems1.com and asked them to add an RSS feed for their LODD notices. I’ve added it to my site at left, and here are the links you need for them. There is both now an LODD page and and LODD RSS feed.

Share, use, and most importantly thank ems1.com for their help on this. They always seem to have the most up to date notices.

http://www.ems1.com/DutyDeaths/

http://www.ems1.com/ems-rss-feeds/duty-deaths.xml

EMS-ambulance-thx

A day in the life of medicTHREE’s twitterbrain

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A day in the life of medicTHREE’s twitterbrain

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  • How do I make twitter tools auto post to twitter from wordpress? No worky… #
  • WordPress is rocking my socks off. Glad I made the switch. Let me know what you think at http://www.medicthree.com #
  • What was I thinking picking up this shift? I get to work 12 more hours today… Not off till 1900 tonight… Ugh. 24 hour shift on my bday?! #
  • Pd standby. Subject with a gun. How bouts you call when he does something with that gun. #
  • @911Brent nah. I'm the definition of perfect. Just ask me. in reply to 911Brent #
  • Somebody best shoot somebody else. Thiss is getting old. Fast. #
  • Armored personnel carrier has arrived. Knock the damn foo down so I can get a nap. And if you shoot-3 center mass. Don't make me work. #
  • RT @MedC2: RT @clayfisher: More Vets have commited suicide than been killed in Iraq & Afghanistan since 2001 http://bit.ly/3qcKwn #
  • @JonesyGirl_41 we would, but we're busy. Ya know. Saving lives here in this parking lot. Sans patient. in reply to JonesyGirl_41 #
  • @DrJosephKim I found the imagio to be a complete disappointment. Failed pi satisfy, let alone wow. in reply to DrJosephKim #
  • Is it obvious I'm bored senseless. #
  • RT @CoolBBThemes: RT @mashable Now Use Google Voice With Your Existing Phone Number http://bit.ly/33SZwo #
  • @MsParamedic have fun! I'm a little jealous. in reply to MsParamedic #
  • Patience is not my thing. Two hours of swat standby. Ugh. #
  • Rockstar juiced and string cheese for breakfast. Good thing this standby was in a gas station lot. #
  • Channeling Mortal Kombat: Finish Him! #
  • Finally cleared from biggest waste of time. #

A day in the life of medicTHREE’s twitterbrain

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  • How do I make twitter tools auto post to twitter from wordpress? No worky… #
  • WordPress is rocking my socks off. Glad I made the switch. Let me know what you think at http://www.medicthree.com #
  • What was I thinking picking up this shift? I get to work 12 more hours today… Not off till 1900 tonight… Ugh. 24 hour shift on my bday?! #
  • Pd standby. Subject with a gun. How bouts you call when he does something with that gun. #
  • @911Brent nah. I'm the definition of perfect. Just ask me. in reply to 911Brent #
  • Somebody best shoot somebody else. Thiss is getting old. Fast. #
  • Armored personnel carrier has arrived. Knock the damn foo down so I can get a nap. And if you shoot-3 center mass. Don't make me work. #
  • RT @MedC2: RT @clayfisher: More Vets have commited suicide than been killed in Iraq & Afghanistan since 2001 http://bit.ly/3qcKwn #
  • @JonesyGirl_41 we would, but we're busy. Ya know. Saving lives here in this parking lot. Sans patient. in reply to JonesyGirl_41 #
  • @DrJosephKim I found the imagio to be a complete disappointment. Failed pi satisfy, let alone wow. in reply to DrJosephKim #
  • Is it obvious I'm bored senseless. #
  • RT @CoolBBThemes: RT @mashable Now Use Google Voice With Your Existing Phone Number http://bit.ly/33SZwo #
  • @MsParamedic have fun! I'm a little jealous. in reply to MsParamedic #
  • Patience is not my thing. Two hours of swat standby. Ugh. #
  • Rockstar juiced and string cheese for breakfast. Good thing this standby was in a gas station lot. #
  • Channeling Mortal Kombat: Finish Him! #
  • Finally cleared from biggest waste of time. #

medicTHREE’s pointless tweets

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  • What kind of official OS update doesn't support email link. @blackberry you suck. #
  • Doesn't anyone think an Electric Heater made by the Amish is a little… um… yeah… #
  • Seriously… Thats like buying German Beer made in Iceland. WTF stupid morning infomercials. #
  • Seriously @blackberry This is your version of an official OS? I can't even click links in emails… wtf were you thinking????? #
  • I can finally see. Longest two days ever. Have to go back to work. Geh. #
  • RT @AmboDriver: Monkeys flinging shit at a map: that's our dispatchers making post assignments. #
  • Why yes, I would love to go code 3 to this "headache" in BFE. That sounds swell. #
  • RT @firedaily Update: Can I Be Forced to Take the H1N1 Vaccination? http://bit.ly/1EpapU #
  • @RobRiscoe wasn't even a headache. It was ear pain. 8 day old ear pain. in reply to RobRiscoe #
  • New Diggs – http://medicthree.com/2009/10/new-diggs/ #
  • It's my birthday and I'll cry if I want to. #

Unspoken

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Often times on a call, it is what ISN’T said that is most important. As paramedics we are trained to ask a set of questions necessary for assessing our patients, but more often than not, we know the important answers. We know when our patients are sick. We know when they hurt. We know when they can’t breathe. Those things are usually obvious.

The hardest thing we often know without a word spoken… we know when our patients are ready to die. The look–or lack there of–in their eyes, their posture, their sound–they all tell the tale all too well.

no_evilThe trouble is that we are trained to prolong life. Little about our training prepares us for letting allowing watching someone die. We are trained to do everything possible to prolong life–whether that is what the patient wants or what is best for them. We are trained to give drugs, artificially ventilate, pace, defibrillate, and otherwise interfere in the dying process. We are not trained to let people die.

So what do we do when the ultimate time comes? Outside of a DNR most systems won’t allow you to cease rescussitation. My system takes the word of a family member very seriously–outside of suspicious circumstances, we honor the wishes of an immediate family member. We also take the time to educate them on what will happen either way. I find it important to make sure someone knows that even if we get them to the hospital alive, they very well might never wake up.

My job isn’t as cut and dry as most think. I rarely save lives. Most of what I do has little to do with medicine or emergencies. Most of my night is spent dodging drunks or other frequent fliers. In the last 6 weeks my partner and I had 4 or 5 really “exciting” calls. Maybe I’m sick/twisted/strange/gross, but the exciting calls are the ones that make you go “aw shit…”. Most of the time we are running call after call of No Ambulance Needed or PD to Transport. But every so often we actually run a “real” call. Every so often we come across a sick patient.

Every so often that patient has already made up their mind that theypain can’t fight anymore. Who are we to decide otherwise? Does what we do make a difference other than to prolong a life of pain and discomfort? Are we doing harm in interjecting in what is the obvious end of the dying process? Are we causing pain? Obviously we are bound by our protocols/guidelines. Obviously we are bound as medical professionals to follow the medical standard. But at what point are we doing MORE harm?

New Diggs

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Welcome to my new (and hopefully last!) home for medicTHREE.com! I’m sure you see a few changes(ads, banners, fireemsblogs.com stuff), and you might be wondering what happened. Well, I jumped on the train of awesome(not me…) bloggers who have joined fireemsblogs.com’s blogger community. A project of Jems.com, this community is a new concept in fire/ems blogs.

It is an outstanding idea that really ties together a set of blogs that are focusing on the same topics. Without rambling to much, I’d just like to say thanks to my readers and thanks to the fine folks at FireEMSBlogs.com for bringing me on! Check out the features, the other blogs, and let me know what you think. I’m in the middle of a real post!

Godspeed, Friends!

Change

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I’ve enjoyed my time here on Blogger for the last year and a half, but like many things, it has come to an end. No! No, I am not closing shop, but shop is Moving! I am moving medicthree.com over to the FireEmsBlogs.com Community. I feel honored to be given this opportunity, considering the bloggers that are there already.

First, redirect your blogroll and bookmarks to www.medicthree.com (if you are using the old dailydo.blogspot.com address). Second, head over to www.fireemsblogs.com to check out the bloggers that are there. I’m sure you’ll know most of them.

What this means: My blog will certainly benefit from more traffic. You all will see advertisements that I haven’t ran to this point. There is a leaderboard ad and another placed somewhere in the sidebar. No, I’m not getting rich! It will be hosted on wordpress and that allows much more control and features for all of us. You will notice “community wide tags” were you can click a tag and get all of the posts with that tag throughout the fireemsblogs.com community.

Hopefully within the next 24 hours the blog will up and running. Those of you coming here at www.medicthree.com will notice no difference. Please check out the other blogs there and spread the word. Thanks!

Cotton Anniversary

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Yesterday was Mrs. medicTHREE and I’s 2 year wedding anniversary. I spent the night working, sadly, but we still managed to make it special over the last few days.

It has been a pretty crazy two years for us, with more changes that I could have imagined. During the past two years, I finished medic school, got my first job, we moved, we moved again, I changed jobs(a few times), we got pregnant, had our son Asher, my wife got promoted, I had surgery, and my wife had a few medical scares too.

But we got through it, and are better off because of it. Without her, I couldn’t have done any of it. I couldn’t have made it through medic school, and I most certainly couldn’t do the job I do now. It is so incredible to be able to come home and have someone who understands me and can help me cope with the stress of this job.

The most exciting part of it all for me is the future. Who knows what and where it will bring us, but together, I am sure we can get there.

Thank you, babe. I love you more than you will ever know.

Irony

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Three Pigs May Be the First in the U.S. With Swine Flu

The virus does not seem to make pigs very sick. Of 103 pigs tested at the Minnesota fair, in St Paul, only three were found to be carrying the virus, and all appeared healthy. They probably caught the virus from infected people, researchers said.

Um, seriously?!?! Damn people, infecting poor pigs with the SWINE flu

Compression only CPR

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In the time since the American Heart Association has begun advocating Compression Only Layperson CPR, I haven’t really heard and stories of confirmed success. While we all know that layperson CPR tends to be inadequate and layperson CPR breathing tends to end up in the stomach, there has been little to indicate that the outcome was any different than before.

Well, JEMS has a story that might just give us some hope that the AHA did the right thing. CNN has the full story. There are some interesting facts to consider in this story. First, the patient was a 33 year old female–not a likely case for sudden cardiac arrest, under most circumstances. Second, she was otherwise healthy, with no known cardiac history. Third of importance to me is that her husband is a Sheriff’s deputy–While he says that it was “different” that being at work, there is little doubt in my mind that his training and experience helped in some way. Fourth, but maybe the most important thing here–a skilled dispatcher walked him through CPR–Compression Only CPR. All of these factors are important.

Lets examine what we can–33 year old women rarely experience sudden cardiac arrest. When they do it is usually caused by other (known or unknown) serious medical conditions–cancer, immune disorders, cardiovascular disease, etc. Initially it was uknown what caused Kathie Harden to die for 18 minutes that night. Kathie being just 33, her husband actually waking up just prior to her losing pulses, outstanding Dispatch direction, quick EMS response, and skilled hospital care can all be thanked. After her initially recovery it is found that she contracted a flu-like virus that attached itself to the left side of her heart, deteriorating heart muscle and function until the Right side of her heart could no longer function. She now lives with an internal cardiac pacer/defirilator.

After arriving at the hospital, Post-Arrest Cardiac Hypothermia was used to cool Kathie’s body to abnormally low temperatures. This is useful in protecting heart and brain function. It allows the body time to repair and recover before trying to fully “restart”. Initially neuro exams did not look good, but after just a few hours Kathie had started to show signs of improvement. After 18 hours Kathie was back from the grips of death. Theraputic Hypothermia was discontinued. She was soon on her path to recovery and “life went on”.

So here’s the thing: what saved Kathie? Was it Compression only CPR? Was it her skilled husband? How about fast EMS response? Her age? All signs indicate that all of these factors were essential to her survival. Most Certianly the Flagstaff EMS Calltaker that helped Scott pound on his wife’s chest that night deserves more than just a little credit. Arizona has worked hard to increase Cardiac Arrest Survivability and this is proof they are winning the battle. Keeping callers calm while giving them the tools to prolong life until destination care can be provided is no easy task and the fine people in EMS call centers everywhere need to be given credit.

Does this mean Compression Only CPR is the end all of Cardiac Arrest Care? Obviously not. Kathie recieved several rounds of CPR and several shocks from the AED brought by EMS. In the end cardiac drugs(epi) and defibrilation saved Kathie. But without early Compression only CPR it is certain that the tools EMS brought with would have had little chance to obtain ROSC.

I’d like to congratulate Flagstaff EMS Dispatch, Scott Harden, and the men and women of Flagstaff Medical Center EMS for providing outstanding care to Kathie that night. Every one of them did their part in saving a life–something that sadly most of us rarely get the opportunity to do, despite our profession.

Chocolate

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Also posted at BBQGUYBLOG.

We’re celebrating our 2nd wedding anniversary tonight. It is actually Tuesday, but I work, and can’t get off. We went out to dinner, which went well and came home and put the boy to bed. We the proceeded to go all choco-crazy. My wife loves Chocolate and, to be honest so do I. We decied to try some Europa ChocoVine Chocolate wine, Green and Black’s 85% Cocoa Dark Chocolate, and my wife’s favorite Chocolate Covered Espresso Beans.

ChocoVine pairs dutch Chocolate with a red wine. At around 10 dollars a bottle it isn’t outrageous by any means. In total, this treat was about 20 dollars. The ChocoVine is rich, with a similar bit of chocolate liquor. I’m not sure we’d drink it every weekend, but as a special treat it is great. The Green and Black’s chocolate is a touch bitter, like all good dark chocolate and leaves you craving more. The Espresso beans are not too soft, not too crunchy, and are by far my favorite part of this little treat.

Recovery: Part II

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First of all, I’m feeling great. I’m 10 days out from my surgery and I’m almost eating like normal. I’ve had tortilla chips, soda, enchiladas, and even pizza once or twice. Am I supposed to have eaten these things? No. But my surgeon doesn’t seem too bothered by it either.

I saw the surgeon today and he seems to think this is his best one so far. I hope he is right. There is always the risk of this procedure failing later on, and right now the life expectency of this surgery’s success is anywhere from 10 years to lifetime. The procedures that are 10 years old are starting to fail, but the process is much different than it was 10 years ago. It isn’t done nearly as tight as it once was and much regard is placed on making sure the patient can burp and potentially even vomit.

Those things might not sound all that exciting to the average joe, but to me they are. I have been reflux free for 10 days and I am ecstatic about it. I never imagined I’d feel this good 10 days out, but I do! My incisions need a few more days of good heeling, but for the most part, I’m in heaven!

To celebrate I am smoking salmon and a pork loin.

On the Clock

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The time has come for my 9 glorious days of time off/recovery to be over. Sadly it wasn’t the vacation you’re all envisioning, but it was a nice distraction from the world of work. Now that I’m back and on the clock, I’m hoping for an easy night or two but not optomistic…

We’ve been getting snow for the last few nights that, while gone by mid day, is a real pain in the ass for us competent people in the moring. See, incompetent people don’t seem to understand that just like last year and every year before, snow comes, causing the pavement to get wet and sometimes slick. This means you HAVE TO ADJUST YOUR DRIVING APPROPRIATELY! Seriously people.

Much of our job is the result of stupid people doing stupid things. Often times these stupid antics cause innocent people to be hurt or worse die. When you roll out onto the roads this winter(yes I know, it is only Fall, but Mother Nature changed her damn mind this year and I can’t control that) please take your time getting where your going. Worse than you getting hurt, is you hurting someone else. To my EMS/LEO friends: Watch your backs. Wear those stupid vests. No one can protect you like you can.

Godspeed friends.

Back to work…..

New Blog/theme/bleh

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As you can see I’ve changed things up here. I’ve also started another blog(cause I am already so good at posting here…) about my obsession with bbq’ing! Check it out at www.bbqguyblog.com and let me know what you think. I am still trying to sort out the theme for BBQ Guy Blog, so I’d love some ideas there, too. I’m guess I’ll end up with a “magazine” style.

Let me know what you think of the theme here, please. I’ll get the blogroll back up in a bit!

Recovery

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I’m alive(sorry…)!. I’m now 3 days post op(just about to the minute) and I’m surviving. It is definately a challenge. I left the hospital on Wednesday morning after a good report from the doctor. Initially he was concerned as my vitals were all over the place. My first BP in recovery was 170/110, and my pulse ranged from 60 to 130. I am not the type to run 60 OR 130, so this was a bit troubling. Fortunately, I was drugged enough to not care. Once pain settled and a few fluid boluses went through, my pulse stabilized and my BP came down to a little higher than normal, but acceptible 138/84. I was on a morphine PCA pump during my stay and burned through about 60 mg of MS during 14 hours. Not terrible, not great. Mostly I was trying to get sleep, which didn’t happen during my entire stay.

My first memory in recovery was being able to burp. This is a godsend. I’m honestly not sure how people who can’t burp survive this surgery. The bloating that I’m feeling now is insane. As this surgery has progressed over the last 15 years, they have made the “wrap” looser and looser. Ideally it should prevent reflux and regurgitation, while not restricting swallowing and the like. Hopefully that is what we have done here. Obviously at only 3 days post op the swelling is high and it is hard to judge, but I AM reflux free so far. I haven’t been 3 days sans reflux in years.

Once my intestines get moving a bit more, I imagine things will be much happier in M3 land. Hoping to return to work on monday. Sorry for the rushed post, but will keep you updated!

The Knife

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Yup. Made it to today. I go under the knife at 1030. I woke up this morning around 5am(which depending on the day is good/bad) and was just resteless so I had to get up. I’m anxious, but not apprehensive. More so I’m just anxious to be done. I’ve lived with reflux for a long time, but over the last year or two it has really started to control my life. When you wake up with reflux, have it all day, and then go to bed, only to have it wake you up during the night several times, you won’t be sad to see it go!

Wish me luck, folks. Hope you are all well and I’ll bring you a status update as soon as I possible can.

Nissen Fundoplication

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For those of you who have missed it or don’t know, tomorrow morning I go in for surgery–Nissen Fundoplication. I’ve struggled with acid reflux(heart burn) for the better part of 10 years, and no medications have successfully controlled it. Further, lying on my stomach almost always causes regurgitation. I’ve tried everything–cut out caffeine, quit smoking, sleep on a wedge, tried every PPI on the market.

The “wrap” as it is often referred to acts to serve as a replacement to the lower esophageal sphincter(LES). The top of the stomach is pulled up and around the LES and sutured in place, forming a wrap around the esophagus that helps to reinforce the closing the of the LES. The procedure is performed using laproscopy with one large incicsion just above the navel and 2 incisions on each side of the abdomen. If any sign of hiatel hernia is indicated, that will be repaired during the procedure as well. The whole process is expected tot ake 1-2 hours, with 1 night in the hospital.

Recovery is going to suck. Initially swalling will be very difficult. Most people don’t relize, but your esophogus actually moves food down to your stomach. Gravity doesn’t do the work. Because of this, my body has to learn how to move food and liquids through the new valve created by the Nissen. I will be on a strick liquid diet for at least 1 week, up to 3, followed by a soft food diet sans bread for up to 3 months. Now let me make this clear: I love red meat. I love pork. I love meat. I eat meat daily. Steak, ribs, pulled pork, hamburger, roast. Mmmmm Meat. This is going to be the HARDEST part for me. I have done it before–in the past I had a mandibular osteotomy where my jaw was wired shut for 6 weeks… But I know this will be harder. The simple fact that I can open my mouth will make it so much more tempting.

The risks of this surgery are limited. Primarily the inability to swallow or an ineffective wrap. Both are corrected by a repeat Nissen and are fairly uncommon. I have made the decision that I can not tolerate my symptoms any longer and it is time to do this.

I’m all kinds of scared, anxious, and excited for this surgery. Hopefully it will be life changing. Acid reflux has controlled part of my life for at least 10 years and it is time for it to be over. Going into a procedure like this is not an easy task. The process is long and complicated-having multiple EGD’s, an E-Motility study(esentially an NG tube, while concious), and Bravo PH testing done prior to being approved for this procedure. The risks are there, obviously. As with any general surgery, risks range from complications up to death. With a wife and son at home I won’t take that lightly. I am confident I have found a good surgen who will take the best care possible.

Wish me luck and keep my in your thoughts/prayers(if you’re that sort).

I’ll try to keep you posted. For more frequent updates check my twitter feed.

Blogroll

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Check out Pre-Hospital Blog, if you haven’t. I just found him through the EMS1.com blog network. If I’ve missed you on the most recent blogroll(make sure to click “show all”) please let me know. Click the contact lick above or comment here.

During my pre-op screening…

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The nurse asked if I had fibromyalgia. I ROFL’d. A lot.