Sunday, September 30, 2007
Saturday, September 29, 2007
Tomorrow at 0700am the E.R. (and the entire hospital for that matter) close, and the new hospital opens. After eight years of construction, the new hospital and 130 acre campus opens in Wyoming off of M-6 and Byron Center Ave. (Mental note to self: Don't drive to the Boston Campus Sunday night for work... No one will be there.)
That's it. Nothing mind blowing today to post about. This morning after work, I temporarily fixed my "Vintage" (Code name for "junk" or "old") 1985 Magna motorcycle to finish out the season and squeeze the most out of every bit of gas mileage that I can. -And it's now time for bed.
Last minute prayer request for all you prayer warriors out there; Our interim Sr. Pastor, Pastor Steve went into the hospital (not mine) for chest pain again. It seems his stents are becoming blocked again and will require a double or triple bypass early this upcoming week after the cumadin is out of his system. -Please keep him, and his family in your prayers this week. Thanks!
Have a great day today. It's suppose to be beautiful out.
Friday, September 28, 2007
Thursday, September 27, 2007
If you've ever seen the "Home Improvement" television show, the knockoff tools they used were called "Binford". During the show Tim and Al screwed up. A lot... Well, I pulled a 'Binford' the other day and need some "Home Improvement" advice.
I was working on my motorcycle sprockets the other morning, and somehow managed to step in a wad of grease in the garage. -Needless to say, there is now a small grease smudge every 24 inches (as in, every step I took into the house until I realized I was the one that made the dreaded 'marks' on the carpets).
--Anyone have any advice on how to remove grease from carpets before Tess realizes that I have no idea on how to get it out?
All sane comments are hastily welcome.
This past seven days we've had some really good cardiac interventions in which we were able to get our patients to the cardiac cath lab in some really good time. Positive outcomes also, which always makes for a good experience.. and a 'feel good' for the entire team.
We've also had a few brain bleeders as well. One, (a fictional fellow of course,) a 25 y/o recently discharged from the military. He's been in town for only a few weeks and was to start college this week. For whatever reason, he found himself in the worst imaginable part of town at a inner city party store at 3am where he was assaulted with a beer bottle, fists, and stomps to the head. Yeah. It wasn't a pretty picture.
He was somewhat alert upon his arrival but deteriorated quicky. During the CT he started demonstrating some inappropriate behavior indicative of a severe head injury and we had to settle him down with some IV meds. Back in the E.R. he was put down (sedated),intubated, and given additional meds for sedation and to decrease the intercranial pressure created by his head injury. I don't know how the surgeon got there so fast, but its a good thing he did. We got him to O.R. for an emergency craniotomy. Last I heard he was stable and in the ICU. Hopefully, he'll be able to walk in the future. Statistically, due to his closed head injury and possible brain damage, only time will tell.. and the numbers are against him.
This is another fella I'd like to ask you to keep in your prayers
Wednesday, September 26, 2007
Although we are much more politically correct in our verbal delivery during situations like this in the midwest, THIS is a PERFECT example taken from an East Coast Doc of an every-third-day occurrance in any E.R. across the country.. in my fictional hospital, we just run the tests instead of being as direct as below.. Just insert any chief complaint such as: Boil, toothache, headache, sore foot, chronic back pain, or simple drug seeker, intoxicated person looking for a place to sleep, ect.. Repeat the scenario mulitple times a week with various complaints; You get the point..
cc: "I think I'm pregnant again"
HPI: 22 y/o sexually active WF LMP "last month" c/o possible pregnancy. Denies pain. Denies vag. bleeding. Have not performed home pregnancy test.
ROS: 9 points ROS o/w neg.
POB/GynHx: G4P4Ao, all NSVD w/o complications, no STI's
PE: WDWN, AAOx4, NAD, ambulatory, drinking bottle of Sunkist soda.
HEENT: NCAT, EOMI, PERRLA, nonicteric
Neck: No LAD/mass/JVD/thyroidmegaly
CV: RRR, no m/r/g
Chest: CTAB no crackles/r/r/w
Abd: +BS, soft NT/ND, No HSM/masses. unable to palpate fundal ht.
GU/Pelvic: deferred since patient denies pain, VB or d/c
Back: No MT, no CVAT
Ext: 2+pulses throughout, no c/c/e
Skin: warm, dry, no obvious rashes
Neuro: grossly intact, no lateralizing signs, nonataxic gait.
Assessment: Young female requesting pregnancy test. LMP last month. Denies pain. Denies VB. PE benign. Abd. without pain on palp.
Plan/Dispo: Patient instructed to go to local pharmacy and get a home pregnancy test. If pregnant, f/u with her Gyn MD.
The above is the actual medical record documentation. The following is how things really transpired.
Me (after reading triage sheet and rolling my eyes): Hi, I'm Dr.____. I'm the doctor in charge of the EMERGENCY Department tonight. I see that you came by AMBULANCE. What was so bad that you had to call 9-1-1 at 3 AM to be rushed to the EMERGENCY ROOM by AMBULANCE? What is your MEDICAL EMERGENCY? What is your LIFE OR LIMB THREATENING problem??
Patient (clueless to the sarcasm): Oh, I think I'm pregnant again.
Me (thinking that this clueless girl still don't get it): You must be in a lot of pain or bleeding severely to come in by ambulance, huh?
Patient: No. I just didn't have a ride.
Me: So you're not having any pain or vaginal bleeding?
Patient: No, no pain. No bleeding.
Me: Did you take a home pregnancy test?
Patient: I didn't have one.
Me: You know they sell them at Walmart. They're open 24 hrs.
Patient: Well I couldn't go to Walmart in the middle of the night.
Me: So you took an ambulance?
Patient: Yeah, but my insurance will pay for it.
Me: Insurance? It says here that you've got Medicaid.
Patient: Yeah, that's my insurance.
Me: No, dear. Medicaid is not insurance.
Patient (quickly interupting me): Yes it is! That's my insurance!
Me: No, dear. It's only called insurance if you're paying for it.
Patient: Well, what ever! Medicaid will pay for it.
Me: Good grief! You didn't have to take a $400 ambulance to the hospital for a simple pregnancy test.
Patient: But I didn't have a ride.
Me: You could have taken a cab. Surely you got $20 bucks for a cab. And those pregnancy tests are under $20 bucks at Walmart ya know. $400 bucks ambulance ride versus $20 bucks...You could have save us tax payers a lot of money, ya know.
Patient: My insurance will pay for the ambulance.
Me: Good grief! How many times do I have to tell you that Medicaid is not insurance? And it won't pay for nonemergent problems.
A quick 5 seconds physical exam. Push on the belly, no pain. Scribbled the discharge instructions and handed to patient to sign:
Go to local pharmacy and buy a home pregnancy test. Follow up with your medicaid assigned gynecologist if positive. If having pain or vaginally bleeding, return to ER.
Patient: So you're not gonna run a test to see if I'm pregnant?
Me: No, a possible pregnancy is not a medical EMERGENCY.
Patient: But my insurance will pay for it.
Me: Not if I don't order it. And even if I did order it, Medicaid...Oh never mind, just go to Walmart or any drug store and get yourself a home pregnancy test, alright. They're the same urine pregnancy test that we use in the hospital anyway, and it's much cheaper, too.
Patient (indignantly): So how am I gonna get home now? I got 4 kids at home.
Me: Well, you should have thought about that before you took an ambulance. Surely you didn't think that we would admit you to the hospital for a possible pregnancy, did you? Your kids are not at home by themselves are they?
Patient: You're a mean doctor!
Me: No I'm not! If I was, I wouldn't have ask about your kids. They're not home alone by themselves are they?
Patient: No, they're with a friend of mine.
Me: Alright. I'll see if the charge nurse can help you with a cab voucher home. There's also a cop here from your part of town. Maybe he can let you hitch a ride home in a while.
It's so frustrating trying to convince the local EMS folks to be not so fearful of litigation to call their on line medical control and get a refusal to transport order for all these silly nonemergent problems.
Adden: I must issue an apology to all of my EMS brethens regarding the above statement. The problem is not with the heroic folks pounding the streets because they are only following orders and protocols established by their administrators and medical directors who are the real ones fearful of lawsuits.
Not my words, but to answer the question: "Does this type of system abuse really happen?" -Frustratingly, Yep. Every single day.
Monday, September 24, 2007
.....That person would say:
"Man! I'm tired!"
I'll detail just as good as I can, (as I have the next two days off) ....Just not right now.
(I'm not trying to be a, "After this commercial break" kind of person, but, after the long weekend at work, running some errands this morning, and working on a few important home projects this afternoon, it's been about 22.5 hours since I've slept, and I think I owe it to my family to at least get some sleep,- prior to resume being the irritable turd I've been lately.
I know you understand...
Sunday, September 23, 2007
Saturday, September 22, 2007
Betamethasone is a steriod (yes. Tess is taking "roids"). It matures and lubricates a baby's lungs (just in case a premature birth occurs.) She had gotten the shots (two, twenty-four hours apart) with Grace, and Now with Noah, -just in case.
She's been feeling well, and Noah is now 24 weeks and 2 day! 1 pound 12 oz. (almost two pounds!).
That's all for now. -Have to get ready for work.
Friday, September 21, 2007
"This one miraculously appeared on the counter. It just all of a sudden was here - poof!" Friend said.
State Sen. Ernie Chambers of Omaha sued God last week, seeking a permanent injunction against the Almighty for making terroristic threats, inspiring fear and causing "widespread death, destruction and terrorization of millions upon millions of the Earth's inhabitants."
Chambers, a self-proclaimed agnostic who often criticizes Christians, said his filing was triggered by a federal lawsuit he considers frivolous. He said he's trying to makes the point that anybody can sue anybody.
Not so, says "God." His response argues that the defendant is immune from some earthly laws and the court lacks jurisdiction. -It adds that blaming God for human oppression and suffering misses an important point.
"I created man and woman with free will and next to the promise of immortal life, free will is my greatest gift to you," according to the response, as read by Friend.
There was no contact information on the filing, although St. Michael the Archangel is listed as a witness, Friend said.
A second response from "God" disputing Chambers' allegations lists a phone number for a Corpus Christi law office. A message left for that office was not immediately returned Thursday.
Attempts to reach Chambers by phone and at his Capitol office Thursday were unsuccessful.
The other night at work we had a sobering case.. At least for those of us who ride motorcycles..
A seasoned rider was on a 2007 Yamaha V-Star 1100 riding down South Division near 68th when an unnamed automobile driver pulled in front of the motorcyclist. The bike hit the car, flipped three times, and the motorcyclist suffered road rash over both legs, back, and three vertebral 'tine' fractures in the lower back (superficial, but just as concerning considering what could have happened). After four hours of tests, x-rays, and a CT scan, the resident provided some major pain control (a few mg of Dilaudid) in preparation for a huge scrubdown/debridement of the roadrash.
(Sobering mental note: Regardless of how casual or short the ride is, wear Jacket, pants, and full soled shoes). This motorcyclist was wearing a helmet, short fleece top, sandals and shorts...
Prior to dressing all of the road rash with triple, adaptic, telfa dressings and wraps, I coated the wounds with some topical lidocaine to at least minimize the rest of the pain I was about to cause.
The patient did a steller job in cooperating, and actually WALKED out of the Emergency Department after being discharged.. Evidence of the power of narcotics... Unfortunately, once it all wears off, and the wounds begin to ooze and crust, and the muscle pain returns... it's going to really, really, REALLY, suck.. I feel bad for this rider. Years of experience riding, one indiscretion decision to wear shorts and sandals, and one automobile driver not paying attention... Murphy's law.
This all reminds me to not be stupid (like last summer?) when it was 95 degrees out, (too hot for leather jacket) riding into work on the highway with helmet, gloves, paper thin scrubs, backpack, and 'crock' sandals. -Getting 50 mpg isn't worth that kind of pain.
Wednesday, September 19, 2007
So now, it's not that we don't have enough petroleum, it's the fact that since the fed cut interest rates to prevent a recession, the economy MIGHT revive itself, and MIGHT increase the potential demand for energy (petrol)... So they raise the price of a barrel of oil. Nice......
No more bad news from me today. (;-) Just the good stuff.
Tuesday, September 18, 2007
Regarding what I had mentioned yesterday? I'll update after some sleep.. In the meantime, here are some interesting stories concerning France's latest warning to the European Union regarding Iran..
"The EU should prepare itself for the worst possible scenario.. that, being the reality, and likelihood of war with Iran". Germany seems to be in agreement with France's latest saber rattling. Both of which are expressing a total 180 degrees from their previous stances. (Whaat?)
See these few newslinks for more 'general' information, keeping in mind that 90% of global politics is rhetoric.. (International 'chest bumping').
The World from Berlin
Pentagon "Three day blitz"
Israel's mysterious airstrike in Syria. Nuclear related?
Russia warns on Military action against Iran
Just because as Christians, we are cautioned (instructed) to not worry, for 'certain things will come to pass', we are not told to 'check our brains at the door'. Whatever pans out, is going to pan out. We should never be surprized if the time comes tomorrow, next year, or 50 years from now.
Sound kooky? -Take it any way you like; it's just food for thought.
Monday, September 17, 2007
Tomorrow, I'll outline more "global happenings" that involve Israel, Syria, Iraq, Iran, France, Germany, and Communist North Korea.. -Remember, Russia nearly always plays a behind the scene puppeteer with N. Korea. (You know for sure, if even FRANCE is saber rattling, there must be something brewing...)
It might just blow your mind how tender-a-balance is going on.. And if you are so inclined, might see the correlation from last weeks "heads-up."
I picked up a lot of Global perspective and reasonings from my time in the Marine Corps. It 'Sharing' time.
Have you ever felt the urge to pray for someone and then just put it on a list and said, "I'll pray for them later?"Or has anyone ever called you and said, "I need you to pray for me, I have this need?" Read the following story that was sent to me and may it change the way that you may think about prayer and also the way you pray. You will be blessed by this.
A missionary on furlough told this true story while visiting his home church in Michigan. "While serving at a small field hospital in Africa, every two weeks I traveled by bicycle through the jungle to a nearby city for supplies. This was a journey of two days and required camping overnight at the halfway point. On one of these journeys, I arrived in the city where I planned to collect money from a bank, purchase medicine and supplies, and then begin my two-day journey back to the field hospital. Upon arrival in the city, I observed two men fighting, one of whom had been seriously injured. I treated him for his injuries and at the same time talked to him about the Lord. I then traveled two days, camping overnight, and arrived home without incident.
Two weeks later I repeated my journey. Upon arriving in the city, I was approached by the young man I had treated.
He told me that he had known I carried money and medicines. He said, 'Some friends and I followed you into the jungle, knowing you would camp overnight. We planned to kill you and take your money and drugs. But just as we were about to move into your camp, we saw that you were surrounded by 26 armed guards. -At this, I laughed and said that I was certainly all alone in that jungle campsite. The young man pressed the point, however, and said, 'No, sir, I was not the only person to see the guards, my friends also saw them, and we all counted them. It was because of those guards that we were afraid and left you alone.'
At this point in the sermon, one of the men in the congregation jumped to his feet and interrupted the missionary and asked if he could tell him the exact day this happened.
The missionary told the congregation the date, and the man who interrupted told him this story: "On the night of your incident in Africa , it was morning here and I was preparing to go play golf. I was about to putt when I felt the urge to pray for you. In fact, the urging of the Lord was so strong, I called men in this church to meet with me here in the sanctuary to pray for you. Would all of those men who met with me on that day stand up?"
The men who had met together to pray that day stood up. The missionary wasn't concerned with who they were, he was too busy counting how many men he saw...... There were 26.
This story is an incredible example of how the Spirit of the Lord moves in mysterious ways. If you ever hear such prodding, go along with it. Nothing is ever hurt by prayer except the gates of hell. As the above true story clearly illustrates, "with God all things are possible".
Sunday, September 16, 2007
Saturday, September 15, 2007
Friday, September 14, 2007
-A negative can be a positive if consciously perceived as such. --As long as we remember to take the motive and dedicate it to God. If we don't; it could be just like the picture says: "Agony. Not all pain is gain".
Thursday, September 13, 2007
Wednesday, September 12, 2007
On a cool note; What an absolutely amazing sunrise this morning!... -If ever there was a "positive" of working nights, the sunrise would be it.
Tuesday, September 11, 2007
- The store owner is going to be p----- off when he learns he lost a days worth of revenue for no reason.
- Playing Chicken little; "The sky is falling" is unAmerican.
- If you see the Army or the Navy fleeing, ask yourself "WHY?" before you follow blindly. If you see the MARINES leaving expeditiously, you now know that there is a REAL situation.. WE would be staying, and doing our job. That is what America expects of us, THAT is what we will do.
I spent the rest of my day rigging up a makeshift antenna out of comm wire so I could get a real news station like NPR to see what was going on in the outside world while our office continued to make it's mission. ...I have to confess.. That night, was the first night in my entire life that I had never seen aircraft gracing the sky. -Not a single one. Which gave for a beautiful, clear starlite night to comprehend was was to come. I can't believe it's already been six years.
Monday, September 10, 2007
It was a long weekend with plenty of busy-ness, but not much acuity. The change in weather (and I presume the drop in barometric pressure) induced alot of labor Saturday night.. Labor, as in, 'women in labor'. We ran out of O.B. triage rooms and had five in active labor at the same time.. -Glad it's not my floor. After I finished my business there, I bid the them 'adeau' and wished them good luck.
E.R. cases were mostly psych, alcohol, and drugs.
Sunday, September 9, 2007
'date'). : )
Grace went to "Little Lambs" for the first time... For the first time, she didn't go to the nursery.. (Sigh..)
I must get some sleep. Weekend update will come later.
Have a blessed Sunday.
Friday, September 7, 2007
Thursday, September 6, 2007
Revelation chapter 9... 13 "The sixth angel sounded his trumpet, and I heard a voice coming from the horns of the golden altar that is before God. 14 It said to the sixth angel who had the trumpet, "Release the four angels who are bound at the great river Euphrates." 15 And the four angels who had been kept ready for this very hour and day and month and year were released to kill a third of mankind. 16 The number of the mounted troops was two hundred million. I heard their number."
**The Euphrates river starts in Syria and runs down Iraq. Iran is Iraq's neighbor to the right.*the only nation which can support an army of 200 million soldiers is presently China*this prophecy is to be fulfilled before the rapture and the Battle of Armageddon take place.
Interesting, eh? If you are one of the people who really like to dig into the old school translational meanings there is a freely distributed program called, 'E-Sword' ..Best of all, it's downloadable free.
Wednesday, September 5, 2007
Kill a bat or find a dead one? Save the head
Posted by Chronicle News Service August 14, 2007 21:16PM
Categories: West Michigan
Should you find yourself chasing a bat around the house with a tennis racquet, experts have a request: Go easy on the head.
The winged mammal's noggin needs to be intact for health department workers to test it for rabies, said Adam London, director of environmental health for the Ottawa County Health Department.
With four cases of rabies found in West Michigan bats recently -- including three in Muskegon County -- experts say they are getting calls about what to do should someone find one lying around the backyard or flying around the house.
A fourth rabid bat was found in Kent County.
London said he understands people want to exterminate a bat in their house by any means necessary, but he needs the brain to perform the test. Rabies is a disease of the central nervous system that can be fatal. The virus is in the saliva of infected animals and can be spread by a bite or a scratch.
"Sometimes people bring in the bats for us to check, but they're all crushed and we can't do anything," he said.
Once the bat is dead, or is discovered in that state, London recommends placing it in a sealable kitchen freezer bag filled with ice, then taking it to the Health Department.
Tuesday, September 4, 2007
Turn on your P.C. speakers and sit back for a few minutes to enjoy our latest brief video!
Life is always better with background music... ; ) -We hope you enjoy our latest HiltonLife video. As always, comments are welcome, and hoped for!
Monday, September 3, 2007
Saturday, September 1, 2007
Don't be disappointed but, 'HiltonLife Web log' is going to be on hiatus for the holiday weekend unless something earth-shattering occurs. Tess is 'nesting' and we are being indentured into forced labor...
We'll resume with a new adventure day video after the work is done.