Tuesday, July 29, 2008

EARTHQUAKE!!!!! 5.4 or 5.8?

I had just left the house to drive to check on our rental house. As I pulled up to the stoplight and waited for the red light my SUV started rocking back and forth. I looked around and at the car next to me thinking that it might be a souped up car that rattles everything within 50 yards of it when at a stoplight but it didn't seem to be that problem. My car rocked and rolled for the entire length of the red light and I was relieved to get going.

After crossing the intersection I pulled to the curb to use my cell phone (you know we have a new law that we can only talk on hands free phones while driving now! and I haven't gotten a headpiece yet - does anyone making the laws know what mothers do when driving their kids around?) and when I stopped my car was still rocking from side to side. This had to have lasted for 30-40 seconds. I tried calling my daughter for another matter and the call would not go through. Only when I finally reached her did I find out that the problem had been an earthquake. We are very happy that the dishes are still in the hutch, mirrors, clocks, and pictures are still attached to the walls and all of the food is still in the cabinets and most of all we are all safe.

Life is back to normal, well, sorta, because every movement that you're not expecting stops your heart for just a moment until you confirm that it's an okay movement and not the dreaded earthquake movement. We're going to be okay.

Friday, July 25, 2008

NO SEWING

There has been no sewing in our house for the last couple of weeks...sad to say. We have had store issues to deal with and have spent many, many hours working on solutions to some of the recent problems. It is always a fun time to get together with my husband and search for the best answers for a retail business. (of which we have absolutely no experience!)

It seemed like week after week I just couldn't get myself together to do anything, that all I wanted to do was just sit and vege. One day I happened to pay particular attention to my medicine bottle that contained my prescription of thyroid medicine and thought to myself that the dosage didn't look quite right. I finally called my physicians office to check what strength he had written the Rx for to compare with what the bottle said. Well, my bottle said .05 mg and the Rx was for .15 mg.

With that information I called my pharmacy and told them that there was a discrepancy in my dosage and would they please check the Rx against what was dispensed. They put me on hold and were gone quite a while before coming back and telling me that it should indeed have been the .15 mg dosage and they would call the doctor and have a new Rx of the right dosage waiting for me. AND I would have to have new blood tests run and it would take about 6 weeks to get back to feeling normal. I have been taking the wrong dosage for at least 6 months and you wouldn't believe how sad my poor body is!

So, it may take a few weeks for me to get enough energy to get up off the couch, but I am looking forward to getting back in the swing of sewing things as soon as possible. Until that time I will live vicariously through all of you others sewers who are just churning out wonderful garments.

Wednesday, July 16, 2008

MORTALITY

From James:

The strong young man's body is covered with goose bumps. His eyes are rolled up in his head staring blankly into nowhere. The mourning wails will begin shortly. It's hard to believe that just 15 minutes ago I was standing by his bedside and he was looking at me. Although I shouldn't be surprised considering ever since he came last night and we opened up his abdoment to suck out liter of stool and inflammatory fluid from a perforated small bowel from Typhoid Fever, ever since then he's been hanging on despite being in septic shock. What's sort of weird is to look over at the bed next to him and see a young woman who just 10 days ago was operated on for the same thing and just 8 days ago also stopped breathing but miraculously came back to life.

I can still remember it clearly...

It was while my cousins, John and Jenny, were visiting Bere along with my sister, Chelsey, and a radiology tech named Brian.

It was a Sunday and I was rounding late. About 1:30pm I find myself at the bedside of a 25 year old woman operated on Friday for intestinal perforation secondary to Typhoid Fever. We'd taken out a small section of her small intestine and sutured to bowel back together.


She looks weak and shaky but is looking at us as we ask how she's doing and examine her. There is no bowel function yet and we are keeping her NPO (nothing by mouth) and on IV fluids. She has a quinine perfusion running in slowly. John and Brian are with me as is Abel and two nursing students. It turns out to be the perfectly assembled team for what quickly transpires next.

I am in the midst of talking to the nursing students about Typhoid Fever and its complications when I glance down at the woman and see that she has stopped breathing and her eyes are rolled back in her head. I check her pulse, nothing. My first instinct is to do nothing since I've tried to resuscitate patients here before without success, but something makes me decide to try one more time. I start doing chest compressions and call John over to take over. As he continues CPR, I stop the quinine perfusion and switch to a bottle of 5% Glucose solution that is there at bedside. I think that maybe the Quinine has caused hypoglycemia. I send Abel to the OR to get some Adrenaline. I send Brian to get a pulse oximeter. John keeps pumping valiantly on her chest. I remember something else and send one of the nursing students to chase down Abel and make sure he brings some Atropine as well.

Andre has just shown up, attracted by normally dignified nurses tearing up and down the halls at full speed. I thought about sending for the bag-valve-mask to breath for the dead patient but remember just hearing from my friend, Erling Oksenholt, that chest compressions not only pump blood from the heart but serve to move air in and out of the lungs as well.

I ask Andre if we have any more 10% glucose bottles, He says he thinks we do and runs of to look for them in the pharmacy. Meanwhile, Abel has returned with the Adrenaline and Atropine and Brian has come back with the pulse ox which he attaches to the woman's finger before taking over CPR from John.

Her oxygen saturation is in the low 80's and her pulse is present only with chest compressions. I push Adrenaline and Atropine one right after the other. Still nothing. We continue CPR with John and Brian taking turns. Andre comes back with the 10% glucose which we let run in full bore. Her O2 sats come up to the 90's.

Amazingly, after 20 minutes she has a faint pulse and is taking occasional gasping breaths. We continue to help her with CPR. Finally, after 30 minutes, although her breaths are shallow and labored, she is breathing on her own. Her eyes are closed and her pulse is thready. Without intubation, without oxygen, withous labs, with minimal monitoring and only a couple of medications she came back to life.

All this rushes in upon me as I glance back and forth between the two patients post-op from exploratory surgeries and bowel repair for Typhoid perforations and think about the thin thread that separates life and death. Miraculously for one, all the elements came together so that we were at her side when she stopped breathing (even though I almost never do rounds at that hour) and all the staff necessary were there (Abel is usually in surgery, he only is on the wards occasionally on Sunday but he knew where all the meds were and had the key for the OR where they are kept) and Andre is never on the wards, much less on a Sunday but he is the only one who knew where we had 10% glucose, plus usually we don't have visitors who are familiar with emergencies and CPR like my cousin (worked years in an ER) and enough students to run back and forth to help send messages and find things. So why did it all come together for her and not for the strong young man in the bed next to her?

As I walk away I hear wails and cries of grief pierce the air and my heart as the goosebumps rise on my arms as well.

Friday, July 4, 2008

Finally Catching Up

It was a push to finish the JCC by the Monday midnight deadline but how fun to get past the hump and complete it. It has taken the rest of the week to get caught up on all that I let go in order to have my capsule finished so I haven't posted any of the pics.

I discovered that even after doing my fitting and making changes to the pattern that after the garments were sewn (the top and blouse/jacket) a few fitting problems still remained. This week I think I will see what I can do to refine the fit some more.

How thankful I am for the many sewers that are willing to post how they do different sewing applications and then take pictures to show you exactly what they're talking about. Shannon's blog gave me the courage to WASH the dupioni. I was scared to death I would ruin it but plowed ahead just based on her recommendations. I need not have worried as following her instructions proved the good thing to do and I won't have to think about the cleaning bill.

The next thing that Shannon explained was sewing the underlining to the fashion fabric right sides together and the turning them right-side out to produce beautifully finished seams.

Fitting info and other techniques were from reading blogs by Debbie, Gigi, Ann, Paco, Tany, Carolyn, Cidel, Summerset, Liana and others . Thanks to all who have given of their information - I promise not to hold you responsible for the outcome!

This is the final storyboard for my capsule -



Even though the are neutral they are so peaceful for me and will go with quite a few other garments in my wardrobe. I have enough of the dupioni to make pants so I might think up something else and continue on with the July projects. That is after I make a dress for the granddaughter and teepee for the grandson.....

Jugular Vein

From James:

The dark blood suddenly gushes out of the neck wound like a hot spring bubbling up from the ground. I had hardly slept the night before anticipating the complexities of operating on this man's neck. He had a mass bulging out under his right mandible which looked like a bunch of large grapes with bearded skin stretched tightly over them. The mass was smooth and lumpy and about the size of a large grapefruit.



He'd been to many other hospitals who'd told him there's nothing that can be done.

The surgery started off bad with a difficult intubation. I put the laryngoscope into his mouth only to find myself faced with a looming open esophagus and no vocal cords in sight. I pulled up with all my strength, tried repositioning the head, had someone try and push his voice box down, all to no avail. Finally, I blindly inserted the tube above where I could see the esophagus and pulled out the guide wire. As my cousin Jenny filled up the cuff with air and my cousin John attached the ambu-bag I looked for the telltale signs of vapor on the tube. Then, Jenny verified that there were breath sounds.

Unfortunately, at this time his oxygen saturation started to fall as his pulse jumped up to 172 beats per minute. I listened to his lungs and they were clamped down like a severe asthma attack. I quickly asked Simeon to give him some IV steroids and Chelsey to run to the pharmacy for some bronchodilators. It was about this time he started to grunt and clench his jaw and hands while straining like he was going to burst through some invisible barrier like the Incredible Hulk transforming himself into the Green Monster. I shouted at Simeon who quickly gave him more Diazepam on top of the Ketamine.

Finally, after about 30 minutes, we had him sedated enough, airways open enough and heart rate down enough to start the hard part of the case.

I had dissected the skin off the mass and was working my way around the lateral side underneath the tumor when I got into the jugular vein.

As the blood gurgles into the wound I quickly put my finger over it with a gauze pad between me and the large vein carrying most of the blood from the head. I pause for a moment. What do I do now? I'm definitely in uncharted territory. I calmly ask Johnny to put on some sterile gloves and hold pressure on the wound. As he holds the man's lifeblood from escaping under his finger I continue to methodically and painstakingly dissect the rest of the mass off the mandible, the voice box, the trachea and the carotid artery and other deep muscular neck structures. An hour later, the mass is out.

Johnny's fingers are paralyzed in position and totally numb.

I ask him to gently take off pressure. Blood surges into the surgical field. He quickly presses back down.

It's then I remember my old friend, Erling Oksenholt pulling me into his office in Oregon in May and showing me a short video. In the video, a gloved hand is poised over a pig's groin. A sharp scalpel suddenly lunges down slicing through the porker's femoral artery. As blood spews from the wound the gloved hand quickly piles on gauze and holds down fiercely. Then, just as quickly, the gauze is withdrawn and a white powder is poured into the wound and the gauze and pressure is quickly reapplied. A note on the bottom of the screen says "five minutes later" as the scene shifts slightly. The gloved hand releases pressure and gently pulls up the gauze. There is no bleeding.

I also remember that Erling gave me some packets of this miracle powder (Celox) that I had left with my cousin John to bring with him when he came three days ago.

I yell to Brian to run over and check the bags that he and John brought and see if he couldn't find any. Meanwhile, John and I continue to wait and hold pressure. Brian comes back at first to say he didn't find any. Jenny and Chelsey go to help him look. Finally, Brian comes back with a small, white plastic bag with Celox in big red letters. Brian opens the sack and I say, "ready" and lift off the gauze as he quickly pours in the powder and I reapply pressure. Five minutes later I lift off the guaze and see white powder in the wound but no bleeding.

Johnny has been reading the instructions and says that now I should irrigate the powder out of the wound which I do. At the end I am trying to wipe out the last fragments and the blood gushes forth again. We repeat the process and the second time I'm a little gentler.

It holds and I close the muscles and skin, wrap his head and neck in a loose ace wrap and then send him off to ICU attached to a ventilator (whoops, dreaming again). Instead, I take out his endotracheal tube and send him out to the hot, sticky wards where his family will fan him with homemade woven fans and we'll hope he wakes up and his throat doesn't swell up too much so that he can't breathe.

Two days later he's complaining of a sore throat but sitting up, breathing normally and taking liquids. His neck has virtually no swelling at all.

Tuesday, July 1, 2008

Storyboard


Well, this is how my JCC actually turned out. I know that the white pants look goofy on this board, but I really like it together with the champagne colored dupioni. There is no way I can take credit for this, I just took my cue from the picture already posted from Bloomingdale's with the yellow dupioni top and white pants. To be honest, I had enough fabric to make the pants but just ran out of time and decided to make the pants my purchased item. Pictures of the garments coming tomorrow

I'm Done!!!!!!!!!!!1

I finished my JCC about 11:30 tonight and tried to go online and let Elizabeth know I had made the deadline. My camera is not wanting to cooperate right now and so there are not pictures yet of the finished garments.

I'll quickly try again, but then I am off to bed.............rest is sweet when you finish the project....