From one nurse to another: Ebola

Hi.  For those of you who don't know me or follow the blog, my name is Eric.  I've been an ER nurse for the past 6 years.  For the last 4 years I have been traveling between different ER's across the country.  It has been a privilege to work alongside many of you.  I want to take a second to talk about Ebola.

Right now we are nervous, just a little.  Ebola is still a punch line with our grim sense of humor.  But there is a real chance that it will get a lot less funny.  It is not yet probable, but all too possible, that we will see a large number of cases in our country and in our departments. I want to be ready.

As nurses we have a few responsibilities.  First and foremost is the safety of ourselves and our patients.  I think that begins with education.  Education is a primary duty of nurses.  I am asking you to educate yourself about the virus and disease and help educate everyone else.  There is misinformation everywhere and we are singularly able to combat it.  There are enough of us out there that we can turn the tide of ignorance. 

For instance, Ebola is not airborne.  Yes, technically you could catch it through transmission of a sneeze if you were close enough, but that isn't airborne.  The distinction is important.  Droplet isn't airborne. We all know people will get an idea in their heads because they heard someone say something not quite right.  You hear someone say it is transmitted through the air and look up airborne diseases and next thing you know, people stop going to work for fear of catching Ebola.  I don't know about you, but I would like the grocery stores and gas stations and myriad other services to stay on in the event that this gets worse before it gets better.  Panic never helps.  The enemy of panic is knowledge. If you look at the early problems with this outbreak in Africa, much of it was caused by the spread of misinformation.  People refused to seek treatment because they believed the people in the hazmat suits were bringing the disease.  There is a website going around now that says Ebola was planted in Africa as a method of population control.  That type of misinformation can further the spread and keep people who might need it from seeking treatment.  Even a claim such as that which doesn't stand up to basic scrutiny, can cause massive problems if left to perpetuate unchecked.  Please correct misinformation when you see it. 

That knowledge includes us.  We need to know how best to deal with this disease if it does show up.  Look around your department and your isolation carts.  This is what you have and what you will deal with.  Not everyone will get issued full hazmat suits and gear until well after the initial patient encounters are done.  Look at what you have and practice with it.  A fellow nurse and I did that recently amid the snickers and comments of our coworkers.  I sincerely hope it remains a joke, but will be prepared if it isn't.  Our current gear leaves something to be desired and has weaknesses.  If you haven't practiced and examined and thought about this in calm times, it won't be there for you when stress arrives.  You don't want to be trying to figure out the vulnerabilities in your PPE when you are covered in possibly infectious material.  Now, when all is calm, take a look. 

Nurses and doctors have dealt with this disease safely before and we can again.  Having been all around the country, I know the nurses in our hospitals are strong, capable and dedicated beyond most people's ability to understand.  If anyone can beat this, we can. 

I want to leave you with a quote I picked up from my dad.

It is what we do now, when we don't have to do anything, that makes us what we need to be when it is too late to do anything about it. 

Now, back to your regularly scheduled pretty pictures and frivolity.

Mt. Hood Railway

I did something weird today.  It was something normal for some people, but definitely weird for me.  I woke up early...voluntarily.

And I mean early.  Before the sun.

Why? 

Well, we had planned to go to the Mt. Hood Scenic Railway today and that was going to require us to get up a little earlier than usual anyway and I had been eyeballing this picture that I thought would look best right around sunrise. 

So I actually set an alarm I didn't have to to do something I thought might be cool. Of course, it could have been cloudy or foggy and ruined it all for me, but it wasn't.  It was cold though. 

So, here it is. 

At least one version of it.

I took several shots, not sure which is my favorite yet.  The above is the leader at the moment.


I took a couple more, because it is boring when you are waiting for the sun to rise.  One or two even came out.

Morning looks cool, maybe I should do...Nah.

Farmers get to work early

Mountains are big, the sky is bigger.

Then it was home for coffee, blessed coffee, before we walked the dog and set out for the town of Hood River. 

When we arrived we found something very amusing.  The train cars are old Holland America train cars from their Alaska train tours.  They have painted over logos everywhere.  Pretty funny.

I'll be honest, the train ride was long and boring.  They played taped narration that was about five minutes off from what we were seeing out the window and it was accompanied by some of the worst music I have heard in some time.  The kids seemed to have fun though.

Happy kids, just starting out.

Still enjoying the scenery

It is pretty.

Yep, thumbs up for the train.

Trying to capture passing scenery.

And now they are just interested in their toys.

Then, after an hour or so, the train stops at a tiny little town called Parkdale.  Oddly enough, Sarah and I remembered stopping there once for a sandwich as we were driving around a couple of years ago.  Small town, but pretty with a great view of Mt. Hood and a cute little park.  I took way too many pictures of Mt. Hood, but I will spare you from all of them. 

The park had this cute/weird metal sculpture.

Max had to pick its nose. 

Family portraits.

We can tell the better photographer

Back door of the caboose, sounds dirty, isn't.

Every tourist train depot town needs an ice cream parlor

Genetically forbidden from looking at the camera

That America font looks familiar

OK, now the mountain.  

Only a couple.  Meet Mt. Hood.

Happy Anniversary.

Thirteen years. 

Wow, that's pretty cool. 

I don't even really know how to approach telling you (and anyone else who happens to read this) how awesome you have been over the past thirteen years.  The only thing I can think to do it think back to who I was back when we met.

I was something of a mess. 

I was flitting and floating around the ether with no idea really about what I wanted to be when I grew up.  I smoke a pack or a pack and a half a day.  I was a dedicated, if infrequent, pothead.  When we married, I was working as a AV guy with J&S Audiovisual in Houston.  I lived in a crappy apartment across the street from a strip club I couldn't even manage to visit.  The only thing I was good at was apathy. 

Then you showed up.  And you did things...intentionally.  Where I would fall into some circumstance and try to make a go of it, you would make a decision to do something and then follow it through as though that was just how things worked.  What a revelation. 

Damn you were pretty, still are.  It is amazing how you seem to get better every year. 

Thank you for showing me how to do things, things I want to do instead of whatever is happening.  It has made a tremendous difference.  I owe who and what I am now to you and I am thankful for all of it. 

I love you.

Happy anniversary.

I hope we get at least thirteen more.

MWAH

I beat the Blerch, Part 2.

The pre race activities were fun but, eventually you have to run the distance.

Say goodbye to normal Daddy kids.  Next time you see me I will be agony Daddy!

All the hoopla was over.  In the end it is about the distance.  I lined up at the start line in the 10+ minute mile section.  A man wearing a large, inflated green suit trotted past me to the front.  Turns out it was Mr. The Oatmeal going up to address the runners before the start.

I was at the front of the 10+ minute mile group

The countdown finished and we were off.

The first thing I noticed was the gravel.  I run in the Vibram Five Fingers.  There is no padding in there at all.  The first 1/2 mile or so was on pavement and then it transitioned into gravel, then hard packed earth with a sprinkling of gravel over that.  The old feet were noticing the lack of padding. Oh well.

You know what?  Running a long distance can be a little boring to write about.  I put one foot in front of the other for a long time.

I noticed a blonde woman running in my vicinity who was wearing a Tough Mudder t-shirt.  I asked her about it and it turned out she was from the Netherlands and had done Tough Mudder Amsterdam.  Her name was Ava.  This was her second marathon.  We ran together for a few miles and talked about Tough Mudders. For those that don't recall, I did a couple of those too.  

At this race, the full marathon folks left 30 minutes before the half marathon folks.  The full course ran out and turned left to run for a couple of miles before turning around and backtracking to the original left turn and continuing on.  The timing worked out so that when we got back on the main course, we were behind most of the half marathon runners.  We fought through the traffic for a few miles.  Somewhere around here Ava decided to cut her pace down a little bit.  I decided to press on and try to keep my pace steady for as long as I could.  I bid her good bye and said I would probably see her later.  I was right.

Passing a bunch of half marathon people.

I believe she was asking about the shoes

"Seriously?  What were you thinking?"

"Suit yourself."

See me smiling?  We will see who has the last laugh.  (Hint:  It was her.)

Mile 5 is where the full marathon rejoined the main course.  This is also where the course starts to climb several hundred feet until mile 15, where it turns around and starts down.  The course is tree lined and pretty with the occasional scenic bridge or overlook.  I tried to stop and take a few pictures along the way.  My photography skills were pretty much shot though.  Hard to compose a good photograph with shaky hands on sweat streaked cell phone camera while you worry about stopping for too long.  I tried though.

A fun note.  Starting around 10 miles, the aid stations sprouted a new feature.  They had a couch...and a Blerch.  Yup, someone dressed in a Blerch outfit, complete with large droopy nipples, would sidle up to you and start talking.

"Hey, that looks like it hurts.  You should probably stop."
"I have a couch over here, and cake."

They did indeed have cake.  Large pieces of birthday cake stuffed in cups.  I declined.  But, I did run over and sit for a moment on a sweaty and disgusting couch.  Not for long though, I got back to running.  It was fun though, playing at exhaustion and mocking the Blerch.

I felt good.  I felt much better than I ever had at these distances.  When I passed the half marathon marker, I was at around 1:56.  I was ahead of my pace and still feeling good. My mindset had been to keep my normal long run pace for as long as I could.  This would put me in just shy of 4 hours.  I figured that each mile I ran just under my target pace would be a few seconds slower I could run toward the end.


And I kept running up.  At each aid station I was drinking water and picking up the offered energy gel pack. I wasn't eating the gels, I was just stashing them in case.  I was trying to eat one gel per hour and take one or two small electrolyte drinks at each station.  Things were going well.  I was tired, but who wouldn't be?  I reached the 15 mile mark and started back down.

I was starting to slow down.  This was OK though, I knew I would.  The unanticipated problem was the gravel strewn about the trail.  Every other step was a rock under a now tender part of my foot.  My legs were tired and I was going down hill too, so the steps were no longer light.  It was devolving into something of a stomp, which wasn't helping. That's OK though.  I passed through miles and aid stations.  I ignored the Blerch and the couch and the cake.  I was too tired to mock.

Then, around 20.5 miles in or so, something happened.  It was farther than I had ever run before and my body figured that out.  My run dropped to a shuffle and soon, a walk/run mix.  Everything from the waist down hurt.  If I could just manage a 10 minute mile pace from mile 22 on, I would still break 4 hours.  By the time I struggled into mile 22, the question wasn't so much if I could manage a 10 minute mile, but could I walk?  I stopped to stretch a little and the question became, can I stand?

I'll be honest.  If a taxi cab had driven by right then, it would have been over.  Hell, someone friendly looking on horseback could have made a few bucks.  (Oddly, I had passed two people on horseback around mile 17.)  For some strange reason, I kept shuffling.  Then Ava reappeared.  She looked at me and asked, "What the hell man?"  I told her I was cramping up.  I don't know if that is what was happening, but something nasty was going on.  She decided to pace me for a while.  So, I started running again, albeit slowly and intermittently.  This is when she decided to tell me more about her first marathon.  She had finished in 3:50.  She also lost consciousness at the finish line.  This marathon was to prove to herself she could run the race and no pass out after.  So she was a little worried about me.  We kept at it until mile 23.4.  This is where I started throwing up.

Yup, all that sports gel and electrolyte drink came back up all over the side of the trail.

Tasted about the same.

At the next aid station, the Blerch was actually tempting me.  Screw it.  They have a couch and beverages and could probably give me a ride back when it was over.  But no.

I felt a little better.  I started jogging again and Ava ran with me.  Somewhere around mile 25 she must have decided I would survive and she ran on ahead.  Ava, if you are out there...thanks.  I was going way slow and moistly walking.  Then this guy showed up, he was just shuffling along, barely picking up his feet.  For some reason, the idea of this guy beating me was just too much to bear.  So I ran again.  Briefly, I even got under 10 minutes a mile.

I was getting really hot.  The temperature at the start of the race was around 60.  By the end it had climbed to 83.  That's not too bad if you are used to it.  I am no longer used to it.  The last mile of the course is running by a river with a bank just steep enough that I couldn't get down or I would have been in it for a minute.  So I shuffled along and ran when I felt I could.

About this time I saw another course photographer.

What the hell am I doing with my hands?

I don't look too bad here.

My form sucks, but, whatever.

Can't land on the balls of my feet anymore, they hurt too bad.

This is the picture of a struggling runner

But it was almost over.

So I kept going.

I crossed the finish line in 4:30.  Sarah and the boys were there to greet me, and who else?

Ruthie.  She had worked all night, got 2-3 hours of sleep and driven two hours to come watch me finish the race.  As soon as I crossed the line, I walked off to the side and sprawled out on the ground.  Sarah and they boys and Ruthie all got me water to drink.  I was so dehydrated.  I hadn't had anything since I threw up, my water bottles were empty.  I knew I needed to slow down, but it tasted too good to stop.  That's when I started throwing up again.  Yep, right there at the finish line.

Here I come!

Trying to run, shuffling instead.

Almost there!

Too tired to raise my arms in victory.

Not quite vomiting!

Ruthie congratulated me on being a quiet puker.

The last little bit that came out was probably a berry energy gel I had eaten an hour or so before.  IT was red.  The paramedics came up and said they had a report of someone vomiting blood.  I assured them I was going to survive and they relented.

Eventually I made it back up to my feet and to the truck.  Sarah drove me back to Ruthie's where I sat in a cold tub of water for as long as I could stand it.  I was advised to do so by more experienced runners. 

That seemed to be enough.  I took 4oo mg of ibuprofen that day and the same amount the next morning.  I was a little stiff and sore, but nothing too outrageous.  I guess that means I could have pushed harder.  :-)

I will likely do another one some day.  I want to break 4 hours.  For now though, I will be satisfied with my race swag.

It was a great event in a beautiful place on a gorgeous day. I feel lucky to have been a part of it. 

I beat the Blerch. Part 1

Now I get to tell you all about it. 

The best place to start is with Ruthie.  You know, I could spend the next few hours blogging about Ruthie and her family and not run out of nice things to say. 

See, we had a doctor appointment in Seattle for the Thursday prior to the marathon.  We had planned on staying at a hotel for two nights prior to the race, but the sudden appearance of this appointment changed our plans.  Who steps in to save the day?  Yup, Ruthie.

She generously opened her home to an invasion from the Adventure Nickel and invade we did.  To make it even more altruistic and amazing, the home was a new purchase and she was still moving in.  We tried to help, but I think mostly provided a distraction from the overwhelming tasks of moving your home and life to a new place.  On the other hand, I did hang up two shower curtains.  She also took time to go out on a 3 mile pre-race run with me.  We made our appointment on Thursday and planned to take Satchel to our pet friendly hotel with us.  Instead, Ruthie offered to keep him there with her.  Turned out to be a wonderful idea.  It was difficult enough to wrangle everything without adding the poor pooch to the mix. 

On Friday we left Ruthie's place and headed toward Seattle for packet pick up.  The race was originally going to be held on Sunday, but when demand grew much larger than anticipated, they added a second race day on Saturday.  Packet pick up was at a running store near Seattle.  The creator of the webcomic which inspired the marathon was there selling and signing books.  When we drove by, there was a line extending half a block out of the store.  Awesome.  Also, no place to park.  Luckily there was a park nearby.  We parked there and the Sarah watched the kids at the playground while I went to pick up my stuff.  Turns out the line was for book signing, there was no line for packet pick up.  I got my stuff, bought the book, and went to see how fast the line was moving.  The people in line were saying it was about a two hour wait. 

Normally, I would never wait in a line that long.  I'm not sure why I decided to wait.  Maybe it was because this was a neat add on to my first marathon.  Maybe I just liked the comic that much.  Maybe I wanted a souvenir of the first running of this event.  For some reason I suspect it will grow to at least an annual event.  Whatever.  I waited in line for around two hours while Sarah watched the kids.  She thought I was crazy for waiting, but suffered along because she is awesome and for some reason she loves me. 

As I got almost to the end of the line, I called Sarah and they all came up to check out the scene.  Michael had read the original Blerch comic and loved it.  So, while the line shortened, Sarah took the kids around to look at all the merchandise.  She ended up with a Blerch stress relief squeeze doll for Max and another book of Oatmeal comics called "How to Tell if you Cat is Plotting to Kill You" for Michael.  For some reason, Michael had been inspired to draw a comic while sitting at the park with Sarah.  He overheard some comment in a conversation Sarah was having with another parent and it struck him as amusing so he decided to draw it as a single panel cartoon. 

When we got to the head of the line and met Mr. The Oatmeal himself, I asked Michael if he wanted to show his cartoon.  Michael did and Mr. The Oatmeal (A.K.A. Mathew Inman) asked if he could keep it.  Michael said yes and then we got our books signed and Max even got his squeeze doll signed.  In Michael's book, Inman even drew a little picture for him.  I think The Oatmeal has a new fan for life.  Thank you Matt Inman. 

He looks nothing like his self portrait.. 

Then we went to the hotel. 

If you ever find yourself in need of a hotel in the Bellevue area, may I recommend the Embassy Suites?  It is pretty sweet as far as non luxury hotels go.  It has an open atrium design, comfy beds, a pool with a waterfall feature and a hot tub.  Here, we spread out and relaxed.  This was a much needed break for everyone. 

I think that cat is plotting to kill us.

It's an original Inman darling.  Priceless in the art community.

Max carried that thing everywhere for days.

Rested and relaxed, I was as ready as I was going to get.  The night before the race I didn't sleep much.  I think that is pretty normal.  The start was at 0900 on Sunday.  I got up at 0645 and got something to eat before we drove down to the surprisingly idyllic and bucolic town of Carnation, WA.  If it weren't for some of the traffic, you would be hard pressed to realize you were that close to Seattle.  The plan was for Sarah and the kids to watch me start and then head back to the hotel for breakfast and to get packed up and checked out.  That way they wouldn't be stuck sitting around county park waiting forever for me to finish. 

As for me, I started the race.  I you want to hear about that though, you will have to wait for the next post. 

Heading out to the starting line. 

Yes, those are pajama jeans.