Super bugs and New designs. Ooh sexy, sexy!

Room 6 is a lady with an MRSA (Methicillin-Resistant Staphylococcus Aureus, a.k.a., the super-bug) infection in her pannus.  Outside her room is a cart full of an assortment of gloves, gowns and masks. Ostensibly, so that we, as health care providers, don’t acquire that nasty little bug.  And more importantly, so we don’t spread death and disease to the rest of our patients.   I dutifully don the gloves and mask each time I go into the room.  Half the time, I do all that, don’t ever lay hands on her, but still feel the need to scrub my mitts with toxic cleansers.  Sometimes, I just speak loudly from the doorway so I don’t have to go through that silly charade.   After she has completed her stay in the ER, the room will be deep cleaned and scrubbed with an antimicrobial cleanser that claims to kill 99.99999% of germs.   The joke, you see, is that when she leaves the hospital, she’ll go directly to the King Soopers to squeeze the tomatoes, sample the deli meats, and rub up, down, and all over the donuts.  She’s not the only offender.  Those bulk bins of granola and dried fruit?  I can’t tell you how many times I’ve seen some snot-nosed kid playing sand box in those things.  And a couple of times, they weren’t even my kids.  Yeah, I know.   I also test out a grape or two to make sure it’s up to snuff.  I am certain that I’m already colonized.  So my paranoia has it’s limits.  But I do lay down some squares on the seat before I pinch a loaf in a public bathroom.  I don’t have the quad strength to levitate above the toilet seat.  And it’s nice to relax when you take care of business, even if a thousand other assholes have sweated over the same spot.  But yeah, I still take comfort in that paper thin Scott tissue repelling the layers of evil underneath me.  No doubt, my MRSA patient, and all her family, have been violating the public toilet seats at Arby’s too.

A couple new design are now available for purchase.  Walt Works Team and Alchemist Wings

are now ready to throw down with the likes of Patagonia, J.Crew, and Ralph Lauren.  So if you happen to know those guys, let em know we’re a comin’.

Claire strutted the Alchemist threads at the latest Louisville Farmer’s Market.  It went over great.  Lot’s of lookers, and yes, some of them were buyers too.   Alchemist Tweets and Facebook will have a shout before the next booth, so all you crazies can go by the booth to check out the action.  Special Market pricing and giveaways in the future.

Defibrillators, Burgers, and Super Hall

In follow-up from the follow-up from the last post.  Mr. “I-died-and-lived-to-tell-about-it” had clean coronary arteries on his heart cath.  But he did get an internal defibrillator.   So the next time he spontaneously goes into a lethal rhythm, he’ll get a heavy dose of electricity directly to Grand Central Station.  It boggles the mind that you can be out shopping with your wife, laughing and joking, and the next thing you know, you’re dead.  Whose twisted sense of humor is responsible for that?

Have you received your latest issue of Mountain Flyer in the mail?  If you haven’t, borrow or steal it from a friend, or you can just go buy one.  I’ve said it before, but I’ll say it again.  It’s the king of bike porn.  When you get your hands on that silky stack of prose and photos, turn to page 97.  You see it?  Oh yah, U betcha!  It’s the most beautiful right-side-of-a-page I’ve ever seen too.

Last week, Team Alchemist rode out to Super Hall.  Left from my garage in the ghettos of East Boulder, rode to the Boulder Res, through the trails of Boulder Valley Ranch, up 36 to Left Hand Canyon, Over Heil, down Picture Rock, up the back side of Hall, around the lollipop, down the front side, then back the way we came.  Some of us on 27 gears, some of us on one.  Finished at Reuben’s Burger Bistro for a decadent feast of gourmet burgers, beer , and fried foods. That area behind the fence is actually a bike stable where you can park your steed before stepping into the eating area.  We rolled in with dirt on our legs, salt in our hair, and sweat in our chamois.   But it was cool.  Reuben’s burgers are tributes to monuments of cycling, with names such as the Paris Roubaix, Alp d’ Huez, Eddie Merckx.  So grungy, spandex clad folks like us were welcome to saddle up.

Excuse the mess of photos, but it’s just easier that way.  4th pic is with Nejla and Dave, who are from Austin, TX.  They joined the Super Hall ride without any idea of what they were getting into.  Big props to them for crushing it.  Amazing.  The last is a vid of me rockin’ the technical terrain of Hall Ranch.  No doubt, it will remind you of a Danny MacAskill video.

Too hoarse to talk . . . but alive

Following up from the last post.  Mr. “I looked death in the eyes, and took his candy.” is now hanging out in the ICU.  I went to visit him on post-resuscitation day #2.  He had lasted through the rest of that night and the following day.  Incredibly, when I came back to work, he had just been extubated, and he was now breathing on his own.  When I walked into the ICU, the nurses called out, “Are your ears burning?”

“Should they be?”

“We were just talking about you.”

“uh-oh”

“You were so calm during the code.  We thought you were great.”

“I did what any other doc would have done.”

I walked into the room to find the patient’s wife and sister sitting next to the his bed.  He was sitting upright with an oxygen mask on, but no tube in his throat, and no ventilator pumping away.  I reintroduced myself to his family, who remembered me.  I introduced myself to the patient, who didn’t.

“Hi, I’m Jeff, you don’t know who I am.  That’s okay.  How are you feeling?”

He tried to talk, but his vocal cords were still hamburgered from the trauma of having a large plastic tube shoved through them.  He tried to whisper some words, but then gave up, exhausted.

“No need to talk, you should rest. You looked pretty rough the last time I saw you.”  In fact, his eyes were fixed and dilated.

His wife’s eyes started welling up with tears, and she thanked me.

“I did what any other doc would have done.”

“But it was you.”

I wasn’t sure what to say, so I just wished them well and went back to the ER.  His wife didn’t know that I was on the verge of calling it not long after he showed up at the ambulance doors.  She didn’t know that I gave him little chance of survival, much less coming out of this neurologically intact.  She didn’t know that I can hardly bear to continue to work in the ER anymore.  I suppose that’s all for the better.  But she didn’t know it’s patients like her husband that make what I do just tolerable enough to justify all the crap that comes through the ER doors on most every other day.

Had a great epic ride with Team Alchemist up and around Super Hall. Travis (former “Bachelor Paris” and current star of “The Doctors”) Stork joined us for the ride.  Nejla and David were game too.  Very impressive since they were coming from Austin, Texas, and had no idea that the ride was going to be as big as it was.  More details, video and pics in the next post.  Time for bed now.

-jeff

Cheating Death

It’s 1:30am, and I just got home from a long evening shift. But I need to decompress.  

Fella was out shopping with his wife at the mall. They were laughing and talking when he suddenly collapsed and fell to the ground.  By the time the paramedics got to him, he was pulseless and blue.  After multiple shocks and a bunch of rounds of drugs, he was still pulseless when they pulled up to the ambulance bay in the ER.  They rolled in with a sweaty fireman up on the stretcher doing chest compressions, and a handful of medics escorting him into the trauma bay.

Down time: 30 minutes.

At this point in the game, my job is usually to settle everyone down and confirm that he’s pulseless and has no treatable rhythm.  After that, it’s a formality to unceremoniously announce the time of death and make it official.  I’ll usually take off my gloves, thank everyone in the room, and then go look for family members to have the worst introductory piece of conversation you can imagine.  “Hi, I’m Jeff, I’m the ER doc.  I’m really sorry, but . . . . ”

So 30 minutes is a long resuscitation, and flogging the poor guy anymore would be cruel and a waste of resources, even if it does add some drama to an otherwise mundane shift.  Chances of survival if you’ve been worked for that long are virtually nil.

But this guy had other plans.

He rolled in with V-fib, which is a shockable rhythm.  So we shocked him. He went into V-tach, which is another shockable rhythm.  So we shocked him.  Then he went into a sinus rhythm, which is a . . . normal rhythm.  His rhythm wouldn’t stay there.  He died a few more times, and I just kept calling out for more shocks and more drugs.  Epinepherine, Amiodarone, Bicarbonate, Calcium Gluconate, Atropine, Dopamine drip.  “What the hell am I doing?” is really all I could ask myself.  This guy has died multiple deaths in the last half an hour, and I’m only prolonging the agony.  Right?  But now the guy has a normal rhythm and a decent blood pressure.

The conversation with his wife was somewhat more palatable than having to tell her I couldn’t save her husband.  But I wasn’t sure that he was going to stay alive (or more importantly, ever walk out of the hospital), so I tried to temper any enthusiasm with a “but we aren’t out of the woods yet.” tone.  In the ER, you see the best and the worst of people.  His wife was remarkably calm.  I’d be a wreck.  Somehow, she kept it together.

We managed to get him to the ICU.  But a couple hours later the overhead pager went off, “Code Blue . . . I-C-U . . . room 234”.  Of course, it was our guy.  He was in V-tach, which prompted me to say out loud, “Oh good.  This we can treat.”  Having a pulseless, lethal rhythm is generally not so desirable, but everything is relative.  Asystole, or lack of any rhythm, really sucks.  So hey, V-tach is pretty sweet if you consider the alternative.  We got him back to a normal rhythm again, and I went back to the ER thinking I’d be back in the ICU again.  But I didn’t get called back.  The fella actually opened his eyes and started moving around before I left.  We’ll see.  Time will tell how things turn out.

Got word that the Alchemist plantable tags from Bloomin will be ready tomorrow.  Should add some bling to the shirts.  Big props to Bloomin for the awesome tags.

I have an idea for a future ad too.  Will post next time to get some feedback.

Getting geared up for Outdoor Retailer and Interbike.  I’m going to send Claire to work her southern charm on the buyers and get networking.  I haven’t decided if I’m going to attend.  Maybe I’ll pack up the whole fam for Interbike.  It’s in Vegas, so it could be kinda fun.

-jeff

Open Fractures and Swank New Stickers

WARNING:  If you are a vegan, have heart problems, or just a weak constitution, turn away now.  Do NOT read this post.  If you like to eat your steak rare, watch “When Animals Attack”, or generally enjoy noxious stimuli, then well, read on.

A while back, I saw a fella who was brought in by the medics after a base-jumping accident.  He was billed as a trauma alert by the paramedics even though his only complaint was that his ankle was injured.  Seemed like a pretty innocuous injury, but sometimes you just gotta see it to understand.  The medics rolled in with the guy sitting up on the stretcher with his ankle wrapped up in a wad of blankets and splints. He was the calmest person in the room.

“Hey there, I’m Jeff. I’m the doc here. What’s goin’ on?”

“I hurt my ankle.”

“That’s what I hear. What happened?”

“I was base jumping in Eldo (El Dorado Canyon) when a gust of wind caught my chute and slammed me into the rock face.”

“Bummer.  Can I look at your ankle?”

I unwrapped the layers of blankets and air splints surrounding his foot.

“Um, that looks like it hurts.”

“It’s not too bad.”

“Seriously, that looks like it hurts. Can I give you something for pain?”

“No.”

“Dude, have you seen your ankle?  It’s not right.”

“I know. I’m okay. But they cut my pants.”

“Your . . .uh . . .hmm . . .are you serious?   You have a piece of your leg sticking out the back of your boot. Don’t sweat the pants.  Can I please give you some pain medicine?”

This went on for a while.  Me, begging him to accept some pain meds. Him, just chillin’ out like he was watching Sunday afternoon football.  He couldn’t have cared less that he had broken his ankle so forcefully that it punctured right through the back of his hiking boot. WTF are guys like this made of?  I’d be screaming and bawling and creating unadulterated hysteria.

While we waited for the orthopod to get there, the general surgeon and I pow-wowed about how to remove the boot to check his pulse and neuro status.  Situations like this remind me of that Saturday Night Live skit “Bad Idea Jeans“.  Urban Dictionary defines it as a “Metaphorical article of clothing, the invocation of which indicates the “wearer” is exhibiting spectacularly bad judgement.”  It didn’t help that the x-ray techs were taunting us with threats to our manhood.

“Oh come on.  Just pull it off!  What’s the worst that could happen?

Fortunately, sanity prevailed, and we came to the realization that trying to pull the boot off in the ER would be cosmically stupid.  So instead, we cut the boot down enough to feel his pulse.  Or at least enough to make it believable that we could feel his pulse, for the sake of documentation.  The guy eventually went to the Operating Room to have the boot removed and have his shattered leg fixed.  Another happy ending and another life saved (read, disaster averted).

Check out the Alchemist stickers I made.  I ordered 1000 of each, so yeah, if anyone wants one, I might have enough to go around.

We should hopefully get these in time for Breck Bike Week.  Claire will be setting up shop at the event.  Dates are July 5-11.  Check us out if you are up there.

BTW, Claire will be doing some posting on the blog in the future as well.  She is a professional writer for Elephant Journal, so you will be treated to some of her stellar writing.  Should be a nice break from my slack-ass prose.