Wednesday, April 27, 2011

“No running with tonsillitis!”

These were Pavel’s words to me when I left him at the hospital last evening, seeing now that he is my “personal doctor” and all, he apparently feels entitled to give me such advice…and he also knows that I will be off for the next twenty-four hours and naturally inclined to do something silly like that. 

Damn.  He knows me so well.

The funny thing is that despite my resurgence of feeling fatigued and miserable for the last couple days, I felt well enough all day today that while looking at yet another sunny day outside I said to myself “Maybe if it is still nice tomorrow I will take myself for a run.” 


I’m stuck by this strange power play between my brain chemistry and immune system…for once brain chemistry is loosing to my other physical needs…but she is not going down without a fight damn it. 

A few days ago, after a few days of antibiotics and a totally insufficient amount of sleep, I woke up and felt the urge to go for a run…despite the fact that I had slept for only four hours, had been given my tonsillitis/sinusitis verdict two days prior, and that it was raining.  I just was feeling energetic…so I hit the road for about an hour…maybe four miles?  And I totally got caught. 

“I saw you!  From the van, going to the hospital to check babies… and you were RUNNING…in the rain!?! Crazy girl with tonsillitis!”

What can I say?

And of course, I felt awful again for the following two, three days.  Seems that my compulsion to move may actually be bordering on pathological at this point. 


Tuesday, April 26, 2011

I swear the nurses hate us here

I can’t say that I can blame them honestly though; they are all very good at their jobs and have extensive experience working with adult heart patients of all sorts (this hospital is devoted  entirely to heart patients).  The other guest nurses agree that we feel like we are invading their turf.  A few are friendly; most seem indifferent if slightly annoyed at times…and then there are a few who are outright cold. 

But it must be difficult and frustrating for them; they all work very hard and are arguably overburdened.  We come in and all of the sudden they have even more work to do because of the increased volume of cases plus they have the added annoyance of having us get in the way and ask them tedious questions like “what med is this?” or “when did you start this drip?”  Nothing is labeled in English, med-wise which at times is scary, especially considering that we have caught several medication errors already.  There also seems to be a general indifference about learning anything new; it feels like every time I make a suggestion I am met with an emphatic explanation of “this is how we do it.”  The physicians are just as bad; I don’t even want to bother making suggestions at this point so unless I feel like a decision is going to potentially harm the patient, I just let it go. 

This experience, though not really that much different from my first Siberian ICHF trip, stands in such stark contrast to my Iraqi trip.  The nurses needed so more much help but they were at least somewhat appreciative of our presence…and it felt like we were doing something.  Teaching, caring for patients, modeling good practice.  And everyone was so friendly. 

Not the really the case here…at least not clinically.  Which is a bummer.  And frustrating. 

Cutey Pie hanging in the ICU post BT shunt
SO, for the most part, I just try to stay out of the way: do data entry for our trip, catch up on emails and reading…and try to enjoy the fact that this isn’t a total clinical nightmare.  
This little guy has AV block and is stuck in the ICU on a pacemaker...I think he is over it.

Monday, April 25, 2011

Had my first “proper” banya experience.

It was rad. 

One of the local doctors who are hosting us has a little country home (Pavel called it a “bungalow” which prompted a discussion about the differences between simple tropical houses on the beach and rustic cabins in the woods).

This country home is about an hours drive from Kemerovo and situated in the Taiga forest; I was told that this is the larges forest in the world, though this is a fact that I have not been able to substantiate as of yet.  It was beautiful though…an expanse of birch trees and tall firs. 

Our hosts provided us with a generous spread of food, primarily of the type that appeals to hard-core carnivores…I counted nine different varieties of cured meets and three of cured fish (we are certainly not lacking for protein or sodium).  And of course, bottles and bottles of vodka.  And fresh beer (you can take your recycled two liter bottles to beer dispensaries that have a wall of taps and you can have your plastic bottle of beer filled over and over…and novelty aside, the beer itself is quite tasty). 

After our salty, meaty meal and libations, we headed out to the actual banya.  It was a little log building behind the house, with a toasty common area with a large sectional vinyl couch for lounging in between rounds in the sauna.  We lazed about in our swimsuits, drinking fresh beer and sparkling water and took turns in the absurdly hot dry sauna…by far the hottest sauna I have ever been in. 

Then they busted out the birch branches. 

So the practice, which I became acquainted with courtesy of one of the local ICU doctors (PS, this is a hilariously incredible departure from the customs of Iraq where men preferred not to touch women or even look them in the eye) goes something like this: You lay prone in the sauna and a beefy Siberian dude in a Speedo hits your repeatedly along your back and legs with steamy branches of birch leaves…after getting you “warmed up” a bit, he throws more water on the hot rocks, heating the tiny space up even more, wets the branches again, places them on the hot rocks and goes for the second round.  THEN they throw snow all over you…and in my case, being the first victim and subsequently having the privilege of experiencing the fresh enthusiasm of our hosts, I was so overheated that I could barely breath the scorching air and tried to escape…so they had to restrain me in the sauna while they rubbed snow all over my body. 

There was a great deal of squealing and screaming to say the least. 

The other first timers found the volume of my good natured protest to be a bit unnerving…though no one else seemed to have quite the same intensity of experience that I did…except our surgeon, but I think he asked for it. 

So once I finally escaped, I emerged form the sauna soaked with sweat, completely lobster read and covered with birch leaves…and I think I must have looked pretty shocked and disoriented by the experience…which made the other first timers just that much more nervous.      

Despite all my caterwaul, it was actually kind of great.

Sunday, April 24, 2011

Did I mention that the weather has been absolutely beautiful?

Like so much nicer than it had been in Seattle when I left. 
Spring in Siberia. 

It is much cooler today, but I am still so taken aback by all the sunshine of the previous week. 

I was in the woods yesterday (another story, I’ll get to that later) and there were these little purple flowers sprung out of the dead grass.  My translator told me that they were the first flowers of spring. 

Our hotel is situated next to a walking path that runs along the River Tom.  All week there were people strolling along this path, roller skating, strutting around in their fancy spring threads…teenagers flirting, young couples pushing babies in prams (like the old school kind…pink, four wheels and a  little bonnet; the kind where the baby is in a little mobile bed looking back at you…you never see those back home, except in books and old movies). 

And the other morning, I was falling asleep in my room following my night shift with the window open and the birds were singing.  They sound just like the birds back home in the spring. 

So birds sing the same in Russian as they do in English.

Thursday, April 21, 2011

Tonsillitis and sinusitis…

That is Pavel’s diagnosis for me this morning. 

I have had this yucky cold since I got back from my ski trip in Canada (over four weeks ago now)…god forbid I just take care of myself and recover right?  I mean, I have to drive all over the state, fly to California, pack up my place, socialize and climb at every opportunity, right?  Duh. 

After two weeks I stiff felt awful, so I did a round of antibiotics, felt better after a few days and then a few days later I have the same symptoms come back.  But like I said, god forbid I actually chill out for more than a day. 

So, of course I jump on a plane and travel to the other side of the world again, three or so days on planes and in airports with crappy sleep, then I pull a couple night shifts and low and behold, I feel like shit again. 

So today, I tell Pavel that I am sick and he is totally skeptical…then he looks in my ears and throat, etc and says “Eeeeewe.  You have tonsillitis and sinusitis maybe.”  So, he tells the locals, they send me to the lab for a CBC, give me antibiotic fluid to gargle with, one of the girls on the team supplies me with antibiotics, and I am promised some sort of nasal spray…Pavel has to go to the pharmacy to figure out what he can give me. 

And they all assure me that coupled with my scheduled trip to the banya and a little vodka, I will be better in no time. 

So they are taking good care of me…but they instructed me to not kiss any of the children in the ICU. 

Wednesday, April 20, 2011

I fear that this trip may not be as interesting to read about as the last one…

Which is actually kind of nice from my end, I must admit.  I will  not miss recounting tales of clinical horror and equipment malfunction like the ones I had for Iraq. 


Tonight I am working with two excellent Russian nurses whom I worked with during the last trip: Yulia and Irina.  Lovely women who are incredibly skilled and knowledgeable but are still happy to ask questions and take any information I have to offer.  So mostly, I am here tonight to stay out of their way and answer questions if they need me too.  Plus, I have an ICU full of stable patients and I am hoping it stays that way since I am flying solo.  We have brought a very bare bones team on this mission: one other nurse, a respiratory therapist, a perfusionist, a surgeon, a cardiologist, my darling intensivist friend, Pavel and myself.  ICHF teams are typically closer to 14 people. 

SO, during the day everyone but me is at the hospital…and I hang out in the ICU with the locals and my interpreter during the night just in case with Pavel a phone call away. 

This arrangement suits me fine so far, though six months ago it would have had me wanting to pee my pants.  Funny how much can change with a little more experience. 

Tuesday, April 19, 2011

Ah yes, tongue salad…and mayonnaise.


Seriously, this was my breakfast when I arrived at the Hotel Tom here in Kemerovo, Siberia.  That and something resembling potato pancakes.  And vodka. 

It is funny to be back in Russia especially due to the fact that it was clear and around 60 degrees today, weather considerably nicer than I left in Seattle.  Who knew that spring in Siberia could be so nice? 

It has been a long stretch of days; Seattle to New York, to Moscow for over twelve hours, then to Kemerovo, and after a short nap, a quick run in the sunshine and a lot of caffeine, I found myself at the Kemerovo Heart Center.  I went with the rest of the ICHF team (aside from the two who missed their flight to Moscow yesterday) to the hospital for meet and greet, said hello to many familiar faces and oriented my fellow ICU nurse (there will only be two of us this trip) to our PICU home for the next two weeks.  And then I gave a brief interview with the local TV news station about the work we are doing here…funny that these little interviews are becoming a regular occurrence, though I  have yet to see any of them so far…which might actually be a good thing. 

And now it is almost 8:00 PM and the sun is still out because it is mid April and we are far north of the equator here. 

I love that.

Sometimes I feel like I could survive on little more than sunshine and caffeine.    

Friday, April 15, 2011

I have been hiding out.

Well, sort of.  I really haven’t been totally reclusive after all…saw a few old friends, got my haircut, wound up getting new breaks for my car, etc.  I also packed up my place in Tacoma and buzzed down to Palo Alto to find a place to live last week.    

But mostly I have been sleeping.  At least for the first half of the week.  I have to do that a couple times a year it seems, what with the usual gallivanting and all. 

But okay, wait…I’ll back up. 

My new job doesn’t start until May 9…well, I could have started earlier but after my wild time in Iraq and the fact that I will be leaving the region, I opted to push it back.  Which is nice because I can be more relaxed about the whole endeavor…and go to Siberia for another heart trip real quick like before I move. 

My mom was pretty freaking delighted since she has a laundry room full of month old puppies and was scheduled for a Mexican vacation this week…so I have been house sitting.  

Hence the unstructured time for sleeping, reading, getting over my cold from hell, and hanging out with some adorable little squeaky fuzz balls.  Puppy therapy is hard to beat. 

So yeah, been pretty chill and boring.  Sorry that I don’t have anything profound or exciting to share.  But I got a lot done…and laid around in the spring sunshine and drank coffee in the hot tub. 

Like I said…not bad. 

Saturday, April 9, 2011

Jeeze, I never wrote anything about Baldface!?!


Holy epic adventure that was.  And such a weird contrast to the month I had just spent overseas. 

I had worked a long, 14 or so hour shift on the last day, gone out for a late dinner and didn’t make it back to the hotel until like 11:00 PM…and seeing how I had to leave for the airport at 3:00 AM, I saw no point in going to bed.  So I packed…and drank.

Got on a plane and flew for two hours to Amman, Jordan at 5:00 AM, then a short layover followed by six hours to London; another short layover and then about ten hours to Seattle.  I had time for a relaxed SeaTac dinner and a couple of latte’s and then hopped on another plane to Spokane where my dear friend and kindred spirit picked me up and we and two new quality dudes all went out for a late dinner and beers.  Then, of course, despite the intermittent, poor quality, drug induce state that vaguely resembled sleep that I experienced on the airplanes during the previous 24 hours, I could only get about four hours of shuteye…perfect. 

Then NEXT morning, we all drove three-ish hours to Canada, got on a helicopter (which, by the way was AWSOME!!!) and flew into this remote ski lodge outside of Nelson, B.C.  

I then proceeded to have the best four days of riding deep champagne powder, freshly served up every day for my riding pleasure.  I also got to hang out with a lovely group of dedicated snowboarders and industry folks, riding, riding in the snow cat, sharing meals, stories, and libations.  To top that off, because seriously, it obviously wasn’t ridiculous enough, among the wonderful people I met up there, I met and rode with for three days my first (and arguably only) snowboarding hero, Jamie Lynn. 

The whole thing was completely surreal.  And it felt like some kind of otherworldly reward for my hard work in Iraq. 

Thank you universe, I feel like I owe you one.