Dandy in Afghanistan

Hi Gang,

You obviously know we can’t drink here. At least we’re not suppose to, but it happens all of the time. Just the other day Security Forces (the AF military police) brought a young Army private in to have his blood tested to see if he’d been drinking alcohol as he blew a positive Breathalyzer. Apparently, this young man pissed on his sleeping bunk mate. The bunk mate woke unpleasantly to the stream of warm urine hitting him and got out of bed and drug the kid to the police to turn him in. He’s lucky the bunk mate didn’t beat the tar out of him. The private was suppose to go home on his R and R on the very next day. Sure enough, he’d been drinking. Why on earth, he couldn’t wait until he got home is beyond me, but I’m sure he got in kinds of trouble for it.

So what does drinking have to do with a runner’s high you might ask? Well, obviously I’m smart enough to stay away from the alcohol- so the next best thing is a runner’s high. It’s legal, free, and ethical. What is a runner’s high? According to Wikipedia “the pituitary gland and hypothalamus produce endorphins, which are endogenous opiod polypeptide compounds, in vertebrates during strenuous exercise, excitement, pain, and orgasm.” Although it’s an unproved hypothesis among scientists because it’s not feasible to perform spinal taps on athletes before and after workouts to measure the endorphins, athletes will tell you it exists.

I will tell you it exists. Just today I was running and when I had ran 3.5 miles at 6.5 mph, I suddenly turned into a video game character! I was jamming out to Tunnel Alliance’s “Sandstorm” (a techno song) while I ran through the dessert picking up men and throwing them over my shoulder. I jumped into my rugged jeep and started shooting giant spiders and killer wasps with my machine gun. Then I ran into a Ninja fight where I dominated the enemy with my deadly kicks and punches. The next thing I knew I was hitting home runs, kicking field goals, and sending a golf ball into the greens at the driving range. It was pure euphoria!

A couple of times it’s felt like an out of body experience where I felt like I could leave my body and float around. I know it sounds like utter madness, but it’s really the way I felt. All I know is that I’m going back for more. It’s a positive way to deal with the sandbox.

BLUF- Get off of the couch and go find your runner’s high!

Dandy will hit her first 100 miles next week Aaron

What’s going on Gang?

The trauma bay is where all of the action takes place. Our patients are brought in on NATO litters from either hellicopters or fixed wing aircraft such as C-17s and C-130s from various Forward Operating Bases (FOBs) scattered throughout Afghanistan. If the injury happened locally then they might be brought in via ambulance or on occasional an MRAP. The trauma bay is designed to take care of most life threatening injuries and stabilized the patient initially to get them to CAT scan and then the operating room.

We can accommodate up to six trauma patients at a time in the trauma bay, but on average we get about three patients at time. As soon as they are wheeled in a brief report is exchanged between the medevac and the ER physician. While that’s going on one AF medic is taking a manual blood pressure and the other AF medic is unstrapping the patient and getting them ready to transfer to the stretcher and the physician is beginning their initial assessment. Once the initial blood pressure is called out the patient is moved. Once on the stretcher, the patient is hooked up to the machine blood pressure cuff, telemetry (heart monitor) and pulse oximetry (monitors the 02 saturation). They are also put on oxygen if their condition is severe enough. On the other side of the patient, the other AF medic is obtaining IV access and drawing blood. Almost all of our trauma patients require two IV lines; one for fluids/blood products and one CAT scan contrast access.

Once the monitoring and IV access is completed the techs will complete whatever tasks the physician may need done to the patients. It may be starting a foley catheter or setting up for a chest tube insertion or cutting off clothes or controlling bleeding on injuries. The most severe the trauma, the more interventions are required.

The nurses are also instrumental in the trauma process as one documents all of the physician’s physical exam findings, the vital signs, and anything else done and the other nurse assists with pain control by administering medications or hanging blood products if needed.

We also have respiratory therapy (RT) technicians close at hand for patients that are intubated or need to be intubated. They are responsible for the patient’s airway and hooking them up to the ventilator. The patient may have oral secretions that need to be suctioned or oxygen therapy through a mask or nasal canula. If the patient is intubated, the RTs follow the patient from the ER to CAT scan to the OR or the Intensive Care Unit (ICU) depending on the plan.

We have a pharmacist and a pharmacy technician that helps distribute medications during the trauma and accounts for all of the narcotics given. The lab technicians labels all of the blood tubes taken from the patients and runs all of the urgent tests that need to be ran. They also process all of the blood products that need to be given. The radiologist and the radiologist technicians shoot portable xrays right at the trauma bedside so the surgeons can get instant feedback on the patient’s injuries. Once of all of the x-rays are shot, the rad techs go to the CAT scan room at the other end of the hospital to get ready to receive the trauma patient for more studies.

We also have the “Trauma Czar”. They are the top trauma surgeon on call for the night who oversee all of the patients status and determine which patients need to go to the operating room in which order. We have several general surgeons that take turns pulling call and also evaluate the patients for further surgical procedures. We have orthopedic surgeons for the extremities injuries and an opthalmologist for eye injuries. Not too mention, we have surgery technecians, OR nurses and anethesiologists waiting to prepare the OR for a no notice surgery.

The other night we had three trauma patients and I counted 37 peoples not including the patients in the trauma bay. Once the patient finishes their CAT scan they will either go to the OR for surgery, or admitted to the Intensive Care Ward (ICW) for less severe or the ICU for more severe conditions.

After the patient goes to the ICW or ICU they are registered for an Arrived mission to Germany for more definitive care. After they reach Germany depending on their condition and rehabilitation time they may go to the U.S. or back to duty in Afghanistan.

It’s an amazing process to watch. I think it’s also significant because the hospital is tri-service ran. Not only do we have Air Force, but Army and Navy medical providers, nurses, and techs. A team that would not otherwise work together are drawn to this Emergency Room to reach a common goal – to save lives.

Dandy 228.4 miles to go Aaron

Salutations Gang,

In the military we wear uniforms.  We don’t have to decide what to wear for work each day.  From our covers to the socks we wear, our outfit is all predetermined for us.  We all look the same excluding our physical features, name, and rank.  We start to be divided by our attitude and personalities, but even still you don’t get the full picture.  At work, we often develop this picture of what our co-workers look like off duty.  The most professional, friendly airman might be decked out in Gothic drab donned in all black with chains hanging from their jeans and black lip stick smeared on their lips.  Not quite the Airman “Snuffy” you might have conjured up is it? 

The only permanent expression we can show is tattoos and even then we are limited with regulations on the size, placement, and type of images we can have are tattoos.  Since I’ve been here, I’m simply amazed by the number of service members that have full sleeve tattoos.  From skeleton jesters, “Pittsburg Steelers” logo, Air Force logo, praying hands holding a rosary, eight balls, four leaf clovers, butterflies, roses with vines wrapped a thigh, American flags, spiders, tribal bands, to dream catchers. 

The most memorable so far have been the saying “Pain is temporary” on one calf and on the other “Pride is forever” on the other calf.  I also had a trauma patient come in the other day with a pack of smokes and a flask tattooed on his left upper thigh.  As he was waiting to be brought down to CAT scan the chaplain said to him “so tell me about this tattoo you have here.”  The soldier told him “it’s so I would always have a drink and cigarettes on me, I got this when I was drunk.”  

Their bodies become their canvases for capturing significant moments in their lives.  It’s a choice they make to celebrate their brotherhood, camaraderie, or perhaps get inked on a drunken whim.  No matter what the reason is for the ink, its’ a part of them and it’s who they are.

So what do needles have to do with ink?  Well, obviously when you get a tattoo they stick a tiny needle into the top layer of your skin and repeatedly to allow the ink to enter the skin.  I’ve seen many six foot tall, 200 pound soldiers coming in for various medical problems and trauma that require them to get shots, IVs, or have their blood drawn.  Many of them had at least four tattoos or more.  If you could only see the look on their faces when you tell them you need to start an IV.  They act as if you are going to put hot pokers in their eyes.  They get squeamish and flushed and wiggle in their bed.  They tell  you “I really don’t like needles.”  And I say “But you have like ten tattoos, are they airbrushed on or something?”  “No, tattoos are one thing, but needles are another.”  I’m thinking “okay guy, whatever you say” as I burry the bevel of the needle into his arm and he jumps.

So what’s the morale of the story?  We get tattoos to express ourselves and just because we have ten tattoos we can still have a fear of needles!

Good Day! 

Hey Gang,

 It’s truly amazing how you miss the little things while you’re here.  For example, back home I buy a bunch of bananas and most certainly one or two of them will turn brown before I get a chance, or should I say MAKE a chance to eat it.  So the super ripe banana is casted off into the deep freeze with all of the other victims which will hopefully be made into delicious banana bread someday.  You all know what I’m talking about right?

Since I’ve been here I have really been trying maintain a clean diet.  I’ve been eating plenty of salad, proteins, fruit, and drinking a ton of water.  However, it hasn’t been easy because there is a plethora of sweets here.  Just to name a few, over sized soft, moist, chocolate chip cookies, oatmeal raisin, white chocolate chip, zesty lemon cake, apple caramel cake, cherry pie, pecan pie, sweet potato pie, Baskin Robbins ice cream (chocolate, cookies and cream, chocolate chip mint, butter pecan, strawberry, vanilla) mango and raspberry sorbet bars and incredible ice cream bars.  It is a great feat to make it out of the dining hall leaving the listed above delectable behind.  I swear they cry to me “Dandy, you know you want to eat me.” 

Back to the healthy eating, I really do try to grab a couple pieces of fruit when they have it.  Sometimes there is no fruit to be had so I have to rely on trail mix.  And when they do have fruit it’s usually apples, oranges, and kiwis.  That’s it.  I have rarely seen bananas here and the one time I saw them, they were mushy and overripe.  Yesterday, I went to make my evening trek to get food and walked into the dining hall and they had a long table full of fruit and muffins.  It was a bountiful spread of apples, oranges, grapes, kiwis, and yes bananas with an assortment of Otis Spunkmeyer muffins (blueberry, chocolate, banana nut) nestled at the bottom of the fruit. 

I said “glorious bananas” out loud not meaning to say it, just to think it.  This Army lieutenant looked at me like “wow, you must really like bananas.” and politely said “Yeah, they haven’t had them for a while.”  I grabbed my limit of two.  They were small, but had the perfect sunny yellow color with hints of green at the ends.  I enjoyed them both immensely.  One with peanut butter and one in my cereal.

So the BLUF for this week is to love your banana because it really is a powerful fruit.

Dandy 256.6 miles to go Aaron