Sundays

Not sure of why all of the medical emergencies in our family happen on Sundays...even better, Sundays when David is on call. Poor Alec spent the entire morning in a collared shirt and tie and we never made it to church. While I was feeding the baby the three bigger kids made their way into the kitchen to wait for breakfast. I soon heard the customary crash of Anne falling. This is a common daily occurance. Somewhere in the area of 5 to 15 times a day Anne falls...from chairs, tables, couches, and then there are the falls because of pushy siblings, slippery socks and some just plain old for no apparent reason. She always yells as though she is dying (Many women swear that they can tell the difference between their childrens mad, hurt, scared and whining cries. With Anne I have given up trying to interpret them. They all sound the same.). I left Pati screaming indignantly in the bedroom and went to check it out since Jan and Alec were yelling about blood. This morning was a little different - she really had hurt herself and there was blood "all over" the kitchen. It always surprises me how much little cuts in the head bleed. When we got it all cleaned up the wound had shrunk down to a generous inch on her forhead...below the hairline. I thought that I would be traipsing back to the emergency room since the gash was pretty deep and looked to be too wide for the super glue treatment (Which I couldn't do by myself anyway...Anne is a wiggler even when she isn't in pain). There are several Doctors that attend the church that we attend - I tried "my" Doctor first (David). He answered my page but was awfully busy and it looked as though I should only use him if I was completely out of other options. I called the doctor that the kids call "Mr. Steve" who lives right down the street and is married to another doctor who the kids call "Mrs. Heather". They weren't home. I had one other option - the doctor who the kids call "Megan's Dad". He was home and graciously gave up a good portion of the morning to put some stitches in Anne's head.
It has been snowing hard all morning but we may venture outside later to break icicles off of the gutters. We already did this yesterday and stored some away in the freezer, but there is a fresh crop this morning and opening the front door is hazardous because it makes ice daggers come crashing down. I think that it distresses the gutters too.
There is so much snow outside that we have a snowman (he really is an icelumpman since the only way to get snow to pack is to build mounds and pour water over it) and a killer snow fort in the front yard - this last week we built two sledding hills in the back yard and are working on an igloo (although I forgot to pour water over that so it is not ready for excavation yet). People don't expect any sign of spring until April.
If there are no other emergencies maybe we will try to make it to night church this evening.

The big storm

Today I was glad for 4-wheel drive. We were hit with about 16 inches of new snow on top of the 12 that were already there. I had fun off-roading it in the big rig at 5 this am as I zipped past all of the honda civics in the world who were trying to swim down the street. Due to the heavy weather, school and most government offices were closed, doctors and patients cancelled surgery, and that all added up to a fairly light day of work, meaning my senior resident sent me home around 1pm when I got my work all done.

Took the kids sledding at our local park, but due to the heavy snow they were having a very difficult time walking back up the hill, so we just made a few passes and called it quits.
Tried my hand at converting video off from the day and have posted it on google for all the world to see.

http://video.google.com/videoplay?docid=4260019235756321422&pr=goog-sl

If that doesn't work, you can email me and I will send you the link.

I am now going to be on call for a good stretch, so I may be quiet until March.

Getting to do lots more surgery, and getting to be quite the seamstress.

More later.

David

Frozen February

Winter is here, finally. After a December with nere a flake of snow, and a January where it rained as much as it was cold, we now have some winter weather. We have about 4 inches of snow on the ground, that blows around, and for the next 3-4 days it is forcasted to be well below 20 degrees F.
We now have carpet picked out for the office downstairs, someone to come out next week for to tear up our bathroom (they laid linoleum down on top of carpet and now it stinks and will come up) and put down some new linoleum. So, maybe next weekend I will be able to put the office back together and have a place to hide and study and pay bills and such.

From January 07

While we were at Home Depot picking out carpet last night, the lady in the carpet section told us that Home Depot has a craft day every Saturday from 9-11:45, so I took the three older kids to Home Depot and we put together race cars, visited their bathroom, and then made it out of there, but not before they hooked me with their discounted snow sleds. Jan wanted the Red one, and was nearly in tears when I said "no." She got over it. Alec really wanted the Orange one and was in tears because he said "I don't know how to use the other one." Actually, he doesn't know how to use any of them, but he got over the answer I gave Jan just a few seconds earlier.
I got the fancy one that looks like a wakeboard, and we went to the park just past our house, where there is a sledding hill. Actually, it is a pretty nice sledding hill, and is sort of like a bowl, so they sled down and then sort of slide around in the bottow until friction overtakes gravity, or big slow kid doesn't get out of the way fast enough. I decided to take them down with me, and that worked well until about 3 times into it Jan says to me, "can I go by myself?" I started to say no, but I thought about that turtle Crush on Finding Nemo who says "it's time to see how Squirt does flying solo," and I said "uh, sure."
After some instruction which mostly included repetitions of "hand on tight" in various flavors, Squirt flew solo, and actually did very well, except I forgot to tell her not to walk back up the middle of the hill, where everyone else slides down. Oh well, that's how you learn, I guess. Next, Alec wanted to go down by himself too, and so both Squirts did very well flying solo. So much so that by the end of the time I decided to add some speed and put them on together. I almost bowled a perfect strike, where they nearly took out a pack of about 8 14-year old girls at the bottom, who were talking and joking until Jan and Alec came blasting through the pack.
We will have to go back and bowl again, and maybe I will bring my camera, so I can share it with you all.
At many of these parks here, there are ponds that are converted into ice rinks... Which we decided maybe we will plan on doing next year, after a year of solid shopping for ice skates for the family. I had some old russian hockey skates, but gave them up a while back. Actually, we could most likely find some skates quite easily, but I need a good year to get stretched out so I don't pull something trying to help the kids learn to skate. I have visions of my dear Father, trying to avoid a wild 4 year old, as well as a hazard marked with cones, and then slipping on a "slippery spot on the ice" nearly made himself a wish bone. Actually, maybe kids learn faster if they just go out there by themselves and figure it out. That sounds good, maybe I can watch the baby and keep the hot chocolate company or something.
This month I am back to the land of general surgery, which is nice, actually. My first day on was Thursday, and I was on call. I got to take out two gallbladders with an attending I have barely met, and the second one he let me do practically the entire thing. I helped put in the gas port and then put in two ports on my own, and held the gall bladder for him while we did cholangiograms (injecting the cystic duct to image the bile ducts and confirm we have the correct duct, as well as look at the specific anatomy (there are plenty of variations to the "normal" bile duct anatomy).
After this point, we started the actual operation and he let me operate the camera as well as do the dissection, isolate and clip off the duct and artery, cut them, and then use cautery to dissect out the gallbladder itself and then put it in a bag and pull it out, followed by careful inspection for bleeding or oozing and then irrigation and quick inspection of the bowel and then taking out and suturing up the port holes.
It was my first real abdominal operation where I was the primary operator, and it was great. Helps to confirm to me why I am here and what I am trying to get out of it.
Well, that is about it for this time. We left the sledding hill just perfectly: everyone had a good time and was upset to leave. Maybe we will let mom go back with them tonight and sled again while I keep the baby and Anne company here in the warm house.

I looked up the park website and there are at least 4 parks here that have sledding hills, and 3 that have ice skating ponds. Fun times.

Dr. Meat

From February 2007

January

From January 07

January was busy.

Starting off we had vacation the first week of January, where my dad and Maria came out for two weeks and were a tremendous asset to us with a new baby and three other children. God knew we needed them here, because one of the first days back to work, my dad came and told me at about 6am that the basement was flooded. Seems the roots are growing into our sewer and with the extra rain we had, our drain couldn't keep up and we backed up. Had to tear out half of the carpet, rip up the pad and then my dad bleached everything and we set it out to dry.
Insurance had a carpet guy come out and he sprayed some cleaner into everything and then re-laid the carpet. Next, a cleaner service comes to actually clean the stuff, and then I have to figure out what to do in the office as we threw that carpet out and are not sure what to replace it with...

So, I have no office to work from or be inspired to blog from, which is fine because we have been busy this month with work (I have been on Urology) and sickness. All of the kids have been sick this month, Kristi included. Mary Beth is now out here with us for two weeks and she is sick too. She was well on her way to recovering from a nasty bug when she arrived and I think that we have succeded in giving her a little too much to do. More than we intended, anyway. Last weekend we were in the Children's Hospital for Friday night through Sunday afternoon with Pati, who had RSV bronchiolitis and was having a very difficult time managing secretions. Mary Beth held down the fort with the three sick bigger kids for the whole weekend while we parents were at the hospital. We don't know what we would have done without her.

All is now well, and we even have our recycling trash bin here. The city just distributed new trash cans to us, well, about 4 months ago, and we finally have the special one for recycling so we can save the planet. Phew! sure feels better now.

Urology has been pretty fun. If you like genitals and their pathology. Actually, I like the bladder scopes, and after the second week I was doing scoping people's bladders and shooting dye in their ureters and laser blasting kidney stones with a vengence. Pretty fun, and they make a killing and have a good life, to boot, but there is something that tells me I would grow to hate it, and being so focused on a single organ system would drive me nuts and make me wonder why in the world I got into medicine, anyway. Nice to know that.

Actually, one of the residents a year ahead of me just switched to Urology, so next year he will be an intern again and start all over. Good for him, but bad for us because he is such a good surgeon and guy. Oh well, I hope they find a good replacement, since he and I were supposed to be senior and chief residents together. I am just trusting God for the replacement.

No new pictures at the moment, since my hard drive is tucked away out of water's reach and all of my pictures are on that drive... .Also because I just finished taking my annual American Board of Surgery In Training Examination today. This is a yearly exam we take which is sort of like a "see where you compare with all of the other surgery residents in the country" as well as a "better study more or else we won't let you pass on to the next level" whip.

I will see if I get a chance to throw some pictures up for you all. Since it has been colder and snowy lately, we have not been taking that many pictures, but we will see what we can do.

Hope all is well with you and the new year brings closeness with Him.

David