When I went camping last weekend, I had to pull out some way to (reliably) cook food! Fire is an option, but we were getting in late, wouldn't have time to collect much kindling, and I didn't want to be hungry.  So out came the camping/backpacking stove!

Yesterday, I spent a lot of time thinking about hands.  Mostly because I spent a lot of time looking at hands.  Not how you and I normally look at hands though.  I was looking at a hand with no skin... the naked, impersonal, functional, stripped, insides of a man's hands.  It was strange.  And made me think.

I'll give you a little background.  Remember that big burn I talked about in my last post?  The one we spend 8 hours operating on on Monday?  Well, we took him back to the OR for another 8 hours yesterday, to finish excising (removing) his burns to start the healing process.  Like any other damaged, dead, or dying organ, the damaged skin has to be removed or it will continue to wreak havoc on the body and make him very sick.  So, we worked on removing the burns from his chest and arms while the plastic surgeons removed the burns from his hands. 

I spent a good amount of time holding his hand to lift his arm off the table so we could get to all the parts we needed to.  And it was strange.  You can tell a lot about a person from their hands;  how hard they work, if they smoke, if they nervously bite their nails, if they use lotion, if they have had a lot of sun exposure.  But when you take all the skin off, you can't tell any of that.  A hand with no skin is depersonalized.  But you can see what a hand can do, how it works, where the muscles and tendons and veins go. 

Before surgery, his hands were still and leathery, immobile.  Once the skin was removed, they were pliable and mobile, like normal hands.  You could imagine them doing things again, feeding himself, scratching an itch, holding someones hand.  And while they were depersonalized, there were no judgements or stigmas attached.  Just a hand, a person's hand, who was injured, whose life is totally different than it was a week ago, who needs our help to live.  There's no difference between a perfectly manicured hand that spent it's life playing the piano, and the dirty hand of a homeless man, when there is no skin left. 

By the end of surgery, his hands, and every other part of his body where we'd removed skin, were covered with a synthetic dermis that will hopefully allow for him to heal, and eventually we will graft new skin onto them.  And then they will be hands with scars, suture lines, and skin.  Right now, they are just hands, stripped down, exposed, and waiting to be turned into something new. 

In burn surgery, it is important to hydrate.  With something other than coffee.  While not ALL burn surgeries take place in sweltering operating rooms, some do.  Especially for patients with big burns, regulating their body temperature is near impossible (no skin = no barrier to heat escaping...).  So since they can't keep the heat in, we have to make the room their body temperature... or warmer.  Usually warmer.

I mentioned that last week, we got a big burn patient.  He's a gentleman who caught his shirt on fire while welding, and has full thickness burns to basically everything except his face from the waste up.  On Monday, we did the first of two surgeries to remove all the burn eschar (all the dead burned tissue).  Tomorrow, we will do the second half.  Because of the extent of his burns, he definitely falls into the category of poor body temperature regulators.  So, when we went to the OR with him Monday, the room was HOT.

And by hot, I mean they have to super-heat the room (above what the normal heat system can do), tape the doors shut so that no one opens them and lets the heat out, and bring in a fridge with water for us (breaking all OR no eating/drinking rules), because passing out in the OR is not cool.  When I asked, somewhere in the middle of the 8 hour surgery, what the room temp was, I believe we were in the 102-104 degree range. 

At some point, everyone took a break (as it should be!).  When I took my break, I went to change scrubs because mine were SOAKED, and before I even left the locker room I changed again because they were already sweaty again!  Maybe it'll be the latest in fad diets... I swear I lost like 13 lbs during that case!

We have another case just like it tomorrow morning...  so tonight I am drinking lots of water :) 

Maybe we'll be able to hang out in the less than 100 degree range tomorrow....

Last summer, I was getting ready for a trip to the US/Mexico border that would involve "camping" like living arrangements, and I realized that I basically had NOTHING of my own at my apartment that resembled camping equipment.  I'd always had access to stuff at home, but most of it didn't make it south with me.  So I set out to collect the things I would need for the trip (a tent, a sleeping bag, other odds and ends), and realized that I needed some light.  A head lamp to be precise.  I have a few flashlights, but when I'm camping I always prefer a head lamp because it's hands free! 

When I worked at Eastern Mountain Sports through high school and college, I would demo the head lamps for people interested in buying one.  We'd check out the brightness, different settings, comfort, weight, etc, etc, etc.   The things I was looking for in my new headlamp were comfort, brightness but multiple settings(didn't want to go blind just reading a book in my tent...), light weight, single head strap (vs one around and one over the top), and easy battery replacement. 

One of my favorites when I worked at EMS, and the one I decided to get this time around, was the Tikka Plus.  It's a 4 bulb LED headlamp with an adjustable angle to you can point it towards the ground and not have to look down to light up the path in front of you.  It's got three brightness settings and one flashing setting (in case you get lost in the woods or stuck on the side of a cliff, and need to attract the attention of a rescue helicopter...).  And unlike when it first came out (while I was still working at EMS), it not comes in MANY color options!  This is the one I got...


Adventure on,
Kari

The coffee shop in the hospital gets pastries fresh every morning from a local bakery.  One day, I discovered the cheddar basil scone.  I never knew that you could make a savory scone, but ohhhhh can you.  It was potentially a defining moment in my life.  Since then, I've wanted to recreate them (or try to) at home.  But it's taken me a long time to get all the ingredients in my apartment at the same time!  I went out and bought cream and then basil, but then realized I didn't have any eggs, then I bought eggs, but used too many, then I bought MORE eggs, but my basil was bad, but luckily my little basil plant I bought with Sarah had grown into a big basil plant, and had MORE then enough to offer for this recipe... then I didn't have time.  Until today.

Today, I made basil cheddar scones.  Lots of them.