Memorial Day Illness

Ugh. Spent the past 18 hours or so feeling quite poorly.

I am attributing it to the questionable leftover chicken I had for dinner last night.

Or maybe it's the Ebola virus.

Whatever it is, it's laid me down pretty hard and I've spent most of the day in bed. Not at all what I wanted to be doing today.

Tuck man has been pretty darn good today, Aims had to work and so he was stuck with me. The Rodman siblings came over to play for a few hours this afternoon as well, so it was a pretty full day for TJ.

I'm rambling now. Guess I need more sleep.

Long weekend ahead

So Memorial Day is almost here. A time to reflect on those who have gone before us, and those who serve today.

In Yellowstone, it's time for late season snowstorms that close all the roads. They re-opened this morning around 10:00, so all those tourists are out there on questionable road surfaces. All of them are, I'm sure, very competent drivers who are not distracted and have great tires. Should be an interesting day.

I'm stuck on monster patrol this weekend. Aims headed down to open Grant Village food and beverage, so it's me, Tuck, Dozer, and Eddie together again. I do have a secret weapon, though. I bought "Lego Universe" for the Tuck man and he would play it 24 hrs a day if possible. We will try to get out hiking a few times if the weather will cooperate. I'm sick of being stuck in the apartment (aka "The Cave") so any chance to get out is welcome. Even if it's just up to the ambulance bay to clean out the cabinets.

We may have a line on a bigger house. I'm guardedly optimistic that we will be in bigger digs in a few weeks. It's hard not to get excited about the possibility of a bigger/better place, but we've had several disappointments this year so I'm holding back. Keep good thoughts on this one, folks!

My EMS volunteer work is going OK. I've been on four ambulance runs - 2 with Gardiner and 2 with the NPS. I rode shotgun on the 2 Gardiner runs, drove for one of the NPS, and got my first patient contact on my last run. And made so many mistakes, it was ridiculous. Forgot to pick up the patient's medication list at their house, froze up trying to fill in the run sheet, asked questions out of order and poorly. It was a mess. I have so much to work on.

As is typical for me, I've assembled a small library of EMS books and am reading through them as I have time. Most are gleaned from the EMS Newbie podcast/blog per the suggestions of Kelly Grayson. I've asked a couple of the paramedics here for a reading list as well. Here's the list of books I'm working through:

Textbooks:

Anatomy & Physiology for Emergency Care (2nd Edition)

Bryan E. Bledsoe, et al

My new constant companion. In my backpack wherever I go.

Anatomy & Physiology Paramedic

Bob Elling, et al

Started going through this one, but decided to work through Bledsoe's book first.

Anatomy and Physiology Coloring Workbook: A Complete Study Guide (10th Edition)

Elaine N. Marieb

Haven't read it yet.

The 12-Lead ECG in Acute Coronary Syndromes - Text and Pocket Reference Package

by Tim Phalen (Paperback)

Haven't read it yet. Borrowed this one from Joe.

Rapid Interpretation of EKG's, Sixth Edition

Dale Dubin

Haven't read it yet.

First Responder (8th Edition) by J. David Bergeron, Gloria Bizjak, Chris Le Baudour and Keith Wesley (Paperback - Jun 12, 2008)

The book from our course this winter. Ok, but not really well laid out.

Reference:

Keys to Student Mastery of EMT Training

Arthur Smith

This is actually helping me. Along with A&P for Emergency Care, this book rides with me in my pack. It's great for students who want to hone their study skills, or for lapsed learners who need a refresher. Who knew baroque music played lightly in the background, actually helps you study more effectively?

Taber's Cyclopedic Medical Dictionary, 21st Edition (Thumb Index Version)

Donald Venes

At my bedside (well, next to the couch, anyway). I look up words constantly - has a CD version packaged with it which is nice.

EMS Field Guide ALS Version- 19th edition

Paul LeSage, et al

In my pack. Good guide, outside my scope of practice, but has med. names listed. Which helps when you can't spell. and don't know what they are used for.

How to Become a Straight-A Student: The Unconventional Strategies Real College Students Use to Score High While Studying Less

Cal Newport

Haven't read it yet.

Light Reading:

A Paramedic's Story: Life, Death, and Everything in Between

Steven ""Kelly"" Grayson

I really enjoyed this book - Kelly has a good style and experience working in a suburban/rural EMS.

Rescuing Providence

Michael Morse

More urban EMS - great writer and an easy read

The House of God: The Classic Novel of Life and Death in an American Hospital

M.D. Samuel Shem

OK, this book is very weird. So weird I had to read some Stephen King after the first chapter to achieve some sense of normalcy.

Guardians of Yellowstone: An Intimate Look at the Challenges of Protecting America's Foremost Wilderness Park

Dan R. Sholly, Steven M. Newman

Haven't read it yet.

Paramedic: On the Front Lines of Medicine

Peter Canning

Canning's first book - a bit preachy - first year as a medic.

Rescue 471: A Paramedic's Stories

Peter Canning

Canning's second book - his next 3 years as a medic - currently reading this one. Not bad - better than his first book IMHO.

Doctor on Everest

Dr. Kenneth Kamler

Pretty good so far - he's a hand microsurgeon who also climbs - he's got a great writing style.

Ambulance Girl: How I Saved Myself By Becoming an EMT

Jane Stern

Don't bother reading this one. It sounded good, but I had to force myself to finish it.

So, quite a large list for a lowly First Responder! In order to prep myself for EMT-B class, I decided to go through Bledsoe's book, A&P for Emergency Care first. I was pinging around 12-lead interpretation books, EMT-B textbooks, you name it, but I lacked a focus and a background. I need to understand A&P first. A lot of it is re-hashing high school biology, but I'm getting into it. The study guide "Keys to Student Mastery of EMS Training" is also a big help to get me focused. The rest of the books are on the shelf for now until I master the basics.

Unless a very convenient EMT-B course pops up within driving distance, I am going to go through the EMT Basic Certification Course.

I wouldn't consider doing this course without being able to have access to the classroom here at Yellowstone. Basically, the course is mostly online. They send you the book, study guide, video lectures, have instructor support online, and you work through the course at your own pace. Then you go spend a week at their training center and do 10 hours a day on psychomotor skills. You can either do your clinicals there (before or after the week-long class) or do them in your local area - you need 10 patient contacts, I think. After that, you do your NREMT certification. I've looked at several courses, and this one looks like it will fit in well with my schedule. It's not too expensive ($2,500) and includes everything but transportation to the resort on Hayden Lake. (I can visit my parents & old friends in Spokane after the course.)

I could probably convince the training staff here to let me use the equipment, or do some of the practical work on our regular training days.

This feels like the right decision.

Now I just need to decide when to start.

I'm writing...

TOO

MUCH

METADATA...

ARGH!!!!

Monday Update

For those of you complaining that I don't keep you updated (ahem, TC2...), here is the short update:

Volunteering for EMS - LOVING IT

Working at GIS - tolerating it

Studying EMS - very cool and at times all-consuming

Graduate school, GIS - struggling through mind-numbingly boring coursework

Aims, Tuck, and Dozer at the house - spending more time away from the house ;)

Hiking, writing, sketching when the weather is not against me.

Missing friends who are far away.

Ramping up for summer operations - the tourons have arrived.

That good enough, Thomas?

:)

The Couch

A bit weird to be blogging on a couch, but bear with me.

You see, I have an awesome couch. It's a hideous shade of green leather, bought at an upscale garage sale in Spokane a few years ago. That couch is super comfy, though, and long enough for me to sleep on. It's a lovely thing. In fact, when Eric left for Fairbanks he said it was OK 'cause he left his ass print on my couch.

As I've gone through in many recent posts, my sis, Tuck, and 2 dogs are living in my one bedroom apartment. I gave Aims the bed since the couch is a bit too short for someone who is 6'1". She's on the road 3 nights a week so I retake my bedroom on Tuesday, Friday, and Saturday nights. The other nights of the week I tend to work late in the park, go hiking, or go off to write. It gives Aims and TJ some time alone, and I get away from the chaos for a while and enjoy my favorite time - night.

Tonight I was joking with Joe that I was in no hurry to go home just so I could surf the couch. You see, although it is quite comfortable, sleeping on it every night is not fun. Particularly since Eddie the wonder dog insists on sleeping on my feet.

I got home tonight after ten and found a dark house, TJ snoring, my sister sleeping on the couch, and fresh sheets and pillows on my bed. Say what you want about family, but that is pure love right there.

Thanks sis.

31 years since May 18th, 1980

The day all of us in the Pacific Northwest will never forget. The day Mount St. Helens blew.

I remember that day because all the adults were acting very strangely. As the day progressed, it got darker. Pitch black at 3 pm. The ash started to fall. We stayed inside. My dad's paint company ran out of respirators and dust masks within hours. Thick ash over every surface. Pure chaos.

USGS page on the May 18th, 1980 eruption:

http://vulcan.wr.usgs.gov/Volcanoes/MSH/May18/framework.html

Current USGS page on the mountain:

http://vulcan.wr.usgs.gov/Volcanoes/MSH/

Happy Emergency Medical Services Week! 15-21 May

Hug your favorite EMS provider!

Or better yet, bake them cookies.

And vote to pay them better.

And get them better gear.

32nd P2P is in the books!

Woot! It's over with. Being the 'safety coordinator' for the race is a bit crazy - trying to organize the volunteer medical folks, county sheriff department, swiftwater search & rescue, Montana DOT, get permits to have the race, blah blah blah - it's a chore but every year it gets done, somehow. I flagged the cattle guard (I'm a certified flagger as well - bet you didn't know that. Is there no end to this girl's mad skills?). This meant I stood on the side of the road and screamed at the bikers to stay on the fog line 'cause that's where the narrow "bridge" of plywood and rubber matting covered the huge gaps between giant steel bars. I held my breath as the first racer went over, and for each of the other 20. They all made it. Whew!

Couldn't have done it without JoJo & Davey taking over the other 2 spots, and the many other volunteers that make this race come together every year.

I was whupped at the picnic afterward. Hauling highway signs & road cones in and out of my car all day was a bit taxing. I left a bit early and grabbed a quick nap before dropping off the signs, etc. at the garage.

Trying to keep up on my EMS reading, podcasts, study, etc. Not much going on in our area, medically speaking, so I'm just trying to be prepared. Reading a lot of things way out of my scope of practice as a first responder, but hopefully not for long. Going to have to bug our folks here about whether or not they are going to offer an EMT-B course this winter. I keep looking at the WMI/NOLS course, but it's 20 days. If it's 8 hrs per day, that puts the course at 160 hours total, which is close to the minimum 150 hours required. I'd rather do a more comprehensive program, if possible. Something cheaper would be nice as well. It would be better for me to do a class concurrently with my work schedule as well - the boss would not be too enthused about me asking for a month off...

Root Canal, part II, and other happenings

So, another busy week.

In part 1 of root canal, they cleaned out what they could, packed in antibiotics, and topped with a temporary filling. 2 weeks on 2 different antibiotics and we were ready for round 2 yesterday. Another hour and a half of drilling and scraping and it looks like the root canal is a success. In 2 weeks get prep work and a temporary crown. Then a month or so later will get the permanent crown. 4 trips to Livingston total, $2640, and about 8 hours in the chair. Ouch all around.

On the plus side, Aims and I went to town to do some shopping and had a decent day. We got a lot of tasks taken care of (returning things, getting a few things we need, etc.) I got a spiffy watch at REI that I really like, after losing the one I've had for many years. Also found a great wall pocket for the Mammoth ambulance protocol book, but I suppose only I would get excited about that (and maybe Joe...).

Aims got the 10th and last book in the Rangers Apprentice series (Ranger's Apprentice, Book 10: The Emperor of Nihon-Ja by John Flanagan) She and Tuck have been trying to get me to read the series since they got here (it's the only books they brought, and that coming from my bibliophile sister, goes for a lot). But Jessi came over last night and borrowed the first one so I'll wait until she is done. I'm halfway through Kelly Grayson's A Paramedic's Story: Life, Death, and Everything in Between and want to finish it first. I'm really enjoying his writing, blog, and the "confessions of an EMS newbie" podcast (link on my EMS blogroll). He's a critical care paramedic in southwestern Louisiana and the stories are great.

Which segues into my next steps. I'm going to get my EMT-B certification. Don't know when, or how just yet, but I've been thinking about this for almost a year now. I made it through the First Responder class without too many issues but I want to do more. I am very happy spending time in the ambulance bay. I think I would just go hang out there more often if everyone wouldn't think it was weird.

EMT-B is the stepping stone for the bigger leap after that: EMT-Paramedic. Pretty much every paramedic program requires you have your EMT-B and practice for a year before applying, so it's not like I can leapfrog over anything at this point. It would mean leaving the park, and GIS for a while at least, but as a SCEP student I don't have a job after grad school anyway. So what the hell.

I've got family in the health fields in Kansas City (though I swore I'd never go back to live there again) and connections in Spokane and Seattle as well, so if I decide to go all the way to paramedic, I'd likely end up in one of those places. Or maybe I'll just go back to school in Germany again (lol).

Regardless, the first step is EMT-B and a lot of practice. There "might" be a class here in the winter, but I'm not pinning my hopes on that. The fall class at MSU Bozeman closed their applications last month, so no luck there either. I will probably end up going with NOLS/WMI Wilderness EMT course. Twenty days of pain, plus clinicals. At around $4k, it's a stretch, but I could likely afford it next winter/spring if I tighten my belt. We shall see.

Other than those monumental epiphanies, spring is trudging along in it's usual fashion up here in the Rockies. Lovely warm days, cool nights, and always the threat of more snow.

I'm in denial that Park to Paradise triathlon is TOMORROW, but I'm pulling all the necessary safety equipment and people together somehow. Once I get through tomorrow afternoon, I will be so much more coherent and happy. Mostly. :)

This is for me, so I don't forget...

...and for you, if you're interested

http://ambulancedriverfiles.com/2010/04/life-death-and-everything-in-between/

a bit cramped...

So it's me, my sister, TJ, Eddie, and Bulldozer. We are attempting to exist in 500 square feet. Aims reminds me that Japanese families do it all the time. Still, waking up in the apartment this morning...the place looked like 'Jonestown: the morning after'

Dogs splayed out all over the floor, Tuck man groaning about not wanting to go to school, Aims and I trying to get ready for work at the same time. Total chaos. No one got breakfast this morning.

Dozer broke my landlord's dog run fence yesterday so all the dogs were running loose in the yard. In an attempt to fix it I slashed a gash in my leg. Dozer got out again anyway. I'll try reinforcing it tonight again. I think my tetanus is up to date...

I'm tired and worn out. Park to Paradise this Saturday, organizing volunteers, getting sign stands, road cones, paddles, safety vests is a priority. We have our last meeting tonight. Have to meet the MT DOT guy on Friday to see if we can put something over the cattle guard for the bikes.

Trying to finish up the semester of grad school this week, but can't seem to get my paper written. Root canal gets finished Thursday.

Busy week.

More Friday Funnies

"I resolve that, when assessing my patient's mental status, I will actually know the correct date before asking the patient. Nothing sucks worse than having your patient demonstrate that they're more oriented than you are."

The Ambulance Driver in Top 10 EMS New Year's Resolutions

Busy Spring - a quick (?) update

I'm officially calling it. Paradise Valley is greening up. We haven't had a major snowstorm in a couple days. I think spring is here.

Since I chatted briefly with Thomas and he was out of the loop about what was going on, thought I'd give a general update

For those of you who are not up to speed, Aims, Tuck, and their dog Bulldozer have moved on up to the GMGM. We're all sharing my 1-bedroom basement apartment. I complain a lot about my lack of personal space and the insatiable appetite of a 13 month old black lab, but I've missed my family and really have never been happier.

Had round 1 of ? at the dentist yesterday. Nasty marble-sized abscess about 1 cm superior to my upper left bicuspid on the medial side. Dentist thought it would drain out with the root canal, but nope. So instead of finishing the root canal, they popped in antibiotics and put a temporary filling in. Hopefully that and the penicillin I've been taking will nail down the infection so we can finish next week. Ho hum.

What else is going on? Trying to get hiking in every good day - been out on Blacktail north of Frog Rock most nights after work just enjoying hiking in the park again. My favorite off-trail hike up on Swan Lake Flats is still under 3+ feet of snow, so I won't be doing that anytime soon.

Getting ready for the 32nd annual Park to Paradise Triathlon that's now (gulp) 10 days away on Saturday May 14th. No, I'm not in the race this year, just the safety coordinator again. I still need to dig up a flagger and a couple safety boaters to fill out the crew. Spoke with the Park Co. Sherrif IC yesterday and we aren't going to get as much help this year from them. Need to call the MHP and see if they can send a patrol car or two to help keep traffic in order. Maybe see if the park wouldn't mind sending someone out between town and Devils Slide. The lovely cattle/bison guard in the middle of the highway is giving me a headache as well. We're still not sure if they are going to remove it and put the concrete plug in, or if we are going to have to deal with it at race time. MT DOT has been wonderful, though. They are fabricating a plywood "bridge" that will cover 4 feet of the southbound lane if the guard isn't out. Just seems like we're having to deal with more things later this year. Fingers crossed for good weather and a safe race!

Other than that, I've been getting my EMS fix, helping with the Mammoth ambulance and working on inventory with one of the ranger/paramedics. It's been a learning experience, and I've gotten to ride along on a couple Gardiner ambulance runs. But I still feel pretty useless and ignorant of the whole process. Both the Gardiner and Mammoth EMS folks are incredible. I'm in awe of their mad skills and just don't know if I will ever be close to as good.

I've been practicing taking vitals - poor Tucker is going to be sick of me taking his pulse really soon. I know the dogs are.

So, what started out as a quick update post has turned onto way more than that! Life is pretty damn good. The days are long, TJ is loving school and his friends, Aims is enjoying her new job, and we are continuing to look for a bigger place to live in for the summer.

Busy but content.

things you don't want to hear when the dentist looks at your tooth...

"Oh, wow!"

"You must really be in pain..."

"We need to do an emergency root canal."

Ugh.

So I'm on 'cillin to try to quash the infection, painkillers to sleep, and am scheduled for drilling Tuesday.

Don't be surprised if I'm in a bad mood.

:/

Three Cups of...crap?

http://humanosphere.kplu.org/2011/04/ten-points-from-three-cups-of-deceit-starting-in-seattle/

http://www.byliner.com/

I missed the 60 Minutes special on this, but you have 72 hours to freely download John Krakauer's "Three Cups of Deceit"

Decide for yourselves.

I read Mortenson's first book and was inspired (duped?) by his story. It is a shame that an inspiring idea can be so corrupted. Too sad.

Happier Day

Congratulations on successfully earning your national EMS certification.

Certification documents will be mailed to the address provided in your account profile by first class US Postal service within three business days.

National certification is not a license to practice. You should contact your state EMS office for information on licensing requirements.

Brandon James Renkin (1993 - 2011)

Brandon left us peacefully on Thursday, April 7, 2011, in his mother's arms, and was surrounded by people who helped care for him. This was the end of a lifelong struggle with congenital muscular dystrophy.

Brandon was born on Jan. 18, 1993, to Roy and Diane (Ihle) Renkin. He lived his whole life in, and was embraced by, the Gardiner/Mammoth community. At the time of his death, he was a proud member of the 2011 graduating senior class of Gardiner High School.

During Brandon's preschool years, it became evident that he could adapt to any challenge he faced. He mastered the art of operating a power wheelchair at age 3. Brandon demonstrated a tremendous amount of inner strength, energy and maturity that would help him succeed throughout his school years. He also met many influential people in the medical community, and began to build social friendships that lasted for the rest of his life.

School was important to Brandon. He took advantage of the environment to excel academically and demonstrate he could be everyone's friend. He earned the love and respect of his teachers and schoolmates. Despite his challenges, physical education was his favorite class. Brandon became a member of the National Honor Society in 2009, and received the 2011 "Yes I Can!" award from the state of Montana which recognizes academic achievement among students with diverse abilities. He was accepted to attend Montana State University, where his goal was to earn a degree in computer science.

At the age of 6, Brandon joined the family of the Muscular Dystrophy Association (MDA). Through his participation in summer camps, telethons and other MDA-sponsored events he met many supportive, loving, and caring people. Brandon served as the 2000 and 2001 MDA Goodwill Ambassador to the state of Montana. In 2000 he received the Brett French Memorial Award presented by the Montana Professional Firefighters for the camper "who had the most fun." He leaves behind many lifelong friends in the MDA community.

Brandon's favorite pastime was hanging out with friends, playing video games, listening to music, and socializing on Facebook. In his earlier years he enjoyed dressing up in costumes (especially Batman and Zorro), camping, carrying his sword, and playing hide-and-seek. Brandon's first job as a movie critic had the townsfolk eagerly awaiting his weekly reviews. Later he enjoyed board games, poker nights, school dances, Steelers football and Penguins hockey, summer camp, and going on summertime "walks."

Brandon was preceded in death by his paternal grandfather, Roy Renkin; and by his maternal grandparents, Homer and Charlotte Ihle.

He is survived by his parents; sister, Caitlin; paternal grandmother, Lucille Renkin; very special friend, Jennifer Palecek; and many close friends and relatives.

Everyone who came in contact with Brandon developed a unique and lasting relationship. He was as much a teacher and role model as he was a student and friend.

Cremation has already taken place. In lieu of flowers, donations may be made to the Brandon Renkin Memorial Scholarship Fund established at First Interstate Bank, P.O. Box 810, Gardiner, MT, 59030.

A Celebration of Life will be held at 1 p.m. Saturday, April 23, at Gardiner School.

Brandon was truly an amazing and inspirational young man who will be sorely missed by all.

Condolences and memories may be shared with the family atwww.dahlcares.com.

Published in Bozeman Daily Chronicle on April 13, 2011

The Forecast (this one's for you, sis)

Forecast for Gardiner:

And for Yellowstone Lake:

Still excited? Hehe. Soak up that sun while you can!

The Tuck man goes camping & fishing

One day, one fish...
Camping on the bayou...

...and comatose this morning lol

Monday

"One final paragraph of advice: Do not burn yourself out. Be as I am-a reluctant enthusiast... a part time crusader, a half-hearted fanatic. Save the other half of yourselves and your lives for pleasure and adventure. It is not enough to fight for the land; it is even more important to enjoy it. While you can. While it is still there. So get out there and mess around with your friends, ramble out yonder and explore the forests, encounter the grizz, climb the mountains. Run the rivers, breathe deep of that yet sweet and lucid air, sit quietly for a while and contemplate the precious stillness, that lovely, mysterious and awesome space. Enjoy yourselves, keep your brain in your head and your head firmly attached to your body, the body active and alive, and I promise you this much: I promise you this one sweet victory over our enemies, over those deskbound people with their hearts in a safe deposit box and their eyes hypnotized by desk calculators. I promise you this: you will outlive the bastards.”

Ed Abbey (I think)