A Drug with No Antidote / Uphill Battle

Wednesday June 22nd -
Today was presentation/projects day meaning at 2pm we headed to the conference room at the AFB to show our IM and SQ injection videos to the the other students and pharmacists from the base. It was hard for me to watch/hear myself on screen but they all seemed to like the videos. After the other students presented, Captain brought us cake to celebrate and our Sargent agreed to teach us a dance (apparently from some childhood show I did not watch). We have video and pictures of this floating around somewhere. Overall, it was a fun and random afternoon at work.

This evening we went to Kinley's Restaurant and Bar for a Pharmaceutical Rep dinner. Here, we were educated on Pradaxa (anticoagulant drug) which after his presentation I'm still weary of. There is no known antidote to the drug unlike Coumadin/warfarin which has Vitamin K as an antidote. Regardless of the presentation, the steak I enjoyed was delicious. We also had crab cakes and bacon wrapped dates that were also quite tasty. After dinner, Captain took us out to play foosball, billiards, and table shuffleboard. Mallory and I dominated at shuffleboard probably out of pure luck rather than actual skill. It really was a great night to spend outside of work with the other interns.


Thursday June 23rd -
Today Becca and I had the day off, so we decided to hike Mt. Baldy which was recommended to us as a fairly easy hike with some harder spots. Since our classmate Kyle has a rotation here in July, he flew in early to explore Alaska, so he also came with us on our hike. Boy, we didn't know what we were getting ourselves into. It was an uphill battle that I was not ready or in shape for. Kyle, on the other hand, had no problem traversing the side of the mountain. Last month he spent some time in Utah hiking the Blue John Canyon same place Aron Ralston, 127 Hours, was trapped and had to amputate his arm. Therefore, he was more prepared than Becca and myself. When we finally made it to the top, the view of Eagle River was beautiful! I still like when we hike further away from the developed cities where you can't see/hear the highway though, but it was still nice. We went beyond the peak some to Blacktail Rocks where we abandoned the trail to play in some snow. I pitched Kyle a couple of snowballs and he used his walking stick as a bat. After that, we decided to go back a different way than we came up the hill, so we found a downhill path that was pretty fun for trail-running. By the end of the hike, I was really ready to rest my legs while working on a paper for my Honduras trip.

Summer Solstice: 24 Hours of Daylight

Yesterday I was scheduled to spend the morning in the inpatient pharmacy which I have definitely enjoyed doing so far. Instead, I was told to go to Labor and Delivery and scrub up! I started out the morning by being introduced to the staff. They were really awesome and made me feel welcome in their unit. We worked on dosing iron sucrose for a pregnant woman with iron deficiency. Luckily, this question had come up on rounds the week before so I was able to contribute to the discussion and calculating of the dose. 

Next, we had a couple women come in to be induced into labor, so I brushed up on my oxytocin knowledge in order to weigh in on the conversation. (Sidebar: I'm realizing how much I need a phone upgrade since Epocrates was removed from Palm phones. And Lexi-Comp for phones is a tad pricey. Okay, enough with my rant. Back to the good stuff.) After they were induced, we had an odd array of patients that had fallen or weren't feeling well come in to get checked out and stay a while for monitoring. Also, a couple moms-to-be came in for tours of the L&D unit. 

One of the moms was to receive an epidural so the anesthesiologist walked me through each step describing everything in full. He then quizzed me on my ropivicaine, epinephrine, and lidocaine knowledge. Afterwards, he allowed me to ask him any questions I wanted to know the answers to. Overall, I learned a lot about epidural administration which I'm glad for. 

After the epidural, we continued to monitor the baby's heart rate along with mom's contractions until it was time to push. So I gloved up and headed into the birthing suite with the OBGYN and supportive nursing staff. Instead of watching from the head of the bed, I took a place next to the doc for a up close viewing of the live birth. Everyone’s first question to me afterwards: “You still want to have children?”

That evening I went for a walk around the lake while making a couple phone calls. So the following occurred while on the phone with my mom. Between the trail and lake, there was a dog staring at a baby moose. The owner of the dog called for it to try and get it to move away, but the dog only crept closer to the moose. Advice: if you see a baby moose, mama is not far behind. When the dog began to bark, the mother moose flew out of the trees over the ridge. At this point, eight other people and myself were stuck in a stalemate with a baby moose and its mom. Mama was definitely upset that we were so close to her baby. Looking back, we probably did not have the best reaction, but we all decided to run away in different directions weaving in and out of trees. Everyone was able to make it away safely when the moose began to charge at us.

I didn't get much sleep as it was the Summer Solstice, so basically 24 hours of daylight. Though the sun did set behind the mountains, it still managed a nice twilight glow until it rose again a couple hours later. I'm still not really use to this daylight stuff, and I'm not sure I ever will. 

A Halibut a Day Keeps the Doctor Away

We packed up the Escape and drove down Friday night after work to Homer, AK. We got in pretty late in the evening, but decided to drive the Spit for the others who hadn't been to Homer yet. I felt like a personal tour guide ha. After that we settled in at the hotel and tried to get some rest before the big fishing day.

5 am came a little too early, but we managed to get everyone ready to go for the day. We stopped by Boardwalk Bakery like last time to get cinnamon rolls for breakfast and boxed lunches for the boat ride. The half day halibut fishing trip included myself, Becca, Jenna, Paige, Hana, and Tim. We were joined by the Sherman family along with a father/son duo which made a total of 16 people fishing for the day. We boarded the Whistler, a 50 foot fishing yacht, and hit the water. 

Upon getting on the boat, Becca and I both managed to sit in huge puddles. At that point, I was really thankful for my Columbia hiking pants that dry rather quickly. It made for a funny start to the trip though. It was a BEAUTIFUL day for fishing. The weather was great and the water was perfectly calm, so no one got sea sick.

I caught my first fish fairly early after anchoring and dropping lines in, but Jenna was the first of us to catch one in a couple of minutes. It got pretty crowded and chaotic at points with how many people were fishing. The crew was running around like crazy every time someone yelled "Color" - meaning you had a fish near the surface. Once we got our limit (2), we hung out and got to know the rest of the people on the boat while the remainder of the people continued to fish. Jenna and I explored the boat some which you can see in the pictures I posted. We didn't do a great job at staying out of trouble, but those are stories for another time. 

Around 10 am, we started heading back to the harbor while the deckhands began filleting our fish. We started timing them and it took an average of 55 seconds to filet one halibut. They were crazy fast! I don’t know how they don’t cut themselves. Around 11 am we made it back to the harbor after a really nice ride back. The total fish caught between the 6 of us was 50+ lbs of halibut. We had them cut into 1 lb filets, sealed, and flash frozen in order to take back to Anchorage on Sunday.

Me and my halibut

After fishing, we headed back to our hotel to shower. After cleaning up and washing the fish/sea smell off, we headed to Bear Creek Winery for wine tasting. We sampled a variety of wines, and I was surprised how good they were. My two favorites were Blue Zin and Pomegranate. So I’m going to find a way to bring a bottle of each back home.

After wine tasting, we met up with the whole group of pharmacy students for dinner. We headed to Captain Pattie’s on the Spit. We were able to bring in some filets from Mallory’s fish (106 pounder) that she caught and have it cooked up in various ways. We had more than enough food for everyone and it was delicious! I also enjoyed a glass of Blue Zin which tasted great after fish.

The whole group with our feast from Mallory's monster catch.

After dinner, we hit up the Salty Dawg Saloon. The deadliest catch guys were still not there, and they won’t be back until August. It was definitely great to sit and relax after the long day. I also found that I really like Alaskan Brewing Company’s beer. They have a “summer” that is a wheat; I also tried their “white” and the “amber”. All of which I really enjoyed. After Salty Dawg, we headed to another place that had a live band playing and played some pool. I found out that I’m a little better at billiards than I thought, but still no professional. I think I’ll stick to pharmacy. By the end of the day, I was completely exhausted.

On Sunday, we headed to the Spit to pick up our fish from Coal Point Trading Co. I ended up with 13 one lb fillets. I'm going to be eating a lot of fish once I figure out how to get it back to Kansas City. While on the Spit, we also did some last minute souvenir shopping before grabbing some lunch and hitting the road back to Anchorage. On the way back, we stopped at Indian Valley Meats where they sell Alaska wild game meats basically anyway you want it. You can also bring them what you hunted/fished for and they will process it for you. I’m keeping that in mind for salmon fishing next week!

Earthquake in Tent City

Apparently there was an earthquake this morning. The quake struck with a magnitude of 5.2 shortly after 11 am. Since we had Thursday off, Becca and I headed downtown to check out some of the shops, so we did not feel the quake while driving in the car. Once downtown, we headed to one of the malls which is multiple levels but a lot smaller than I expected. Gap had a huge sale, so we got a couple things to wear for rotation. I also found kid's Pumas on sale and had to invest in some new ones. Don't worry, Mom, I'll get rid of an old pair back in KC. 

Old (dirty) Pumas and New (clean) Pumas :)

After shopping we checked out the street vendors that were selling Reindeer Dogs, and of course had to try one. They were so good! I now understand why Alaskan's stick reindeer in just about everything.

Reindeer dog with sauteed onions

We then went for the Anchorage City Trolley Tour where we learned a lot of the history behind Anchorage (formerly called Tent City). I'm not even sure our guide took a breath while narrating the tour. She really knew the history of the place well, and we're pretty sure she made up a lot of things too. The most interesting part was driving by Lake Hood Seaplane base where all the small planes are stored on land or water in their slips. They average about 200 flights per day.

After the tour, we hit up some gifts shops to check out what the locals were selling. My brain was on overload as the stores were packed with tourist and even more full of tshirts, hoodies, jerky, keychains, mugs, figurines, etc. At this point, I was tired and ready to head back to the apartment.

That evening Jessica, Becca, and I headed to Horse Trekkin Alaska for a trail ride. I was given Duke, a 16 year old Morab (Morgan and Arabian). Apparently I was paired up with the youngest and most curious of the horses who wanted to run the entire time... a little like myself :) Tina, our guide, took almost 90 pictures of us on the trail so you'll have to check out the other ones. Since there were only 4 of us riding, she allowed us to run the hills with the horses if we liked. This was my favorite part. Once Duke got going, he didn't really want to stop. During one of our uphill runs, Duke sprinted to the top of the hill ahead of the guide and her horse. By the time the others had caught up, all they could see was the back end of my horse between two pine trees off the trail. He definitely liked to "bail from the trail" which I didn't mind too much.

Me on Duke, Becca on Doc, and Jessica on Curly

Once we finished the ride, we headed back downtown to grab dinner at an Irish pub with a live Irish band that seemed to multiply people and instruments each time we looked up.  It was kind of sad to have our last dinner with the four of us as Jess and Celeste leave on Friday. I'm definitely going to miss the two of them. We had such a great time together, and I'm really glad to have met them.

Overall, it was a really fun day off from work. I'm not looking forward to going back to work tomorrow only because Fridays are now like a combination between Monday and Friday, the start and the end. But I guess, when Friday is done, it's the weekend and that means... Halibut fishing in Homer, AK!!

Into the Wild: Denali Adventure - Part II

SATURDAY: Woke up Saturday morning, suited up in our "outdoor" gear, and headed into town for breakfast before our full day. We ended up at Black Bear Coffee House as it was the only other option for breakfast besides Subway. (Tangent: There is a Subway on what seems like every block of Anchorage, and there's also one in every small town).

After enjoying our coffee/juice/egg-ham-cheese muffin, we checked into Denali Raft Adventures where we signed our lives away and were given instructions about whitewater rafting. Though I don't have any pictures of us in our dry-suits and life vests, I think someone out of the 6 of us in our group captured the awesomeness. I'm pretty sure we looked absolutely ridiculous. Once outfitted in our rafting gear, we took a bus down to the Nenana River that runs through Denali Park to get our final briefing from Peacock (one of the guides whose real name we don't know) on proper paddle use and what to do/what not to do while rafting. After that, we jumped in the rafts and hit the river. Becca and I volunteered to be upfront and keep the pace for paddling. I had no idea what I was really getting myself into. Within the first set of rapids I was drenched and very happy to be sporting my dry-suit. Our guide, Nicole from Florida, provided us with history of the river which was pretty interesting. She also let us jump out of the raft between rapids if we wanted to go for a swim, so Tim and I both decided to jump out and the water was freezing cold. Once again, I was glad to have my dry-suit with warm layers underneath. In order to get back on the raft, another member of the team must grab your life vest and pull you up. Therefore, Becca helped me back in. After pulling me out of the water, I laid on my stomach for a second which Celeste took as me still needing help, so she dragged me across the raft. After all the "voluntary man overboards" were back in the raft, we finished the rapids and came to the end when the "involuntary man overboards" occurred. We hit the shore and Becca was tossed out of the raft. A second later Jason was overboard in the water also. It was quite an amusing and enjoyable time - thankfully no one was seriously injured.

Becca, Jess, and Celeste getting excited before rafting!

We loaded the rafts and paddles up, and hopped back into the bus to return to the town. After getting back, we changed out of the gear and headed to Denali Doghouse for the lunch that was provided in the combo ATV/Rafting deal. After our stomachs were full of hamburger and reindeer (yes, reindeer dogs), we checked out the local gifts shops full of everything imaginable to do with Alaska and Denali. We came across a store that had fresh fudge so of course we tried it. Denali Oreo Dream was really tasty!

Yum! If fudge kept better, I would've brought some back from Alaska.

After perusing the stores, we headed to Denali ATV Adventures to again sign our lives away. Emily, the owner's wife and office manager, was great. She told us about the different guides and explained a little about their business. Mike, the shuttle driver, came and picked the group of us up to take us out to where the ATVs were (which happened to be down the street from our hotel). Upon arrival, we received our "Star Wars" helmets and goggles along with instructions of how to work the ATV. Since I'm prone to wander off trails, I chose to be behind the lead guide, Tim, to hopefully keep me on course. This also prevented me from potentially running into the back of one of my friend's ATVs. They took us to two high overlooks and then down to the creek bed where we got to go through more water which happened to be my favorite part. We also got off the ATVs and walked around the creek bed when Celeste jumped into a the stream like a little kid in a puddle.

Celeste in her storm trooper helmet jumping in the stream.

There was one point in the ride when Tim pointed out a swarm of butterflies on the ground at the side of the trail just before a pool of water which I promptly drove directly into stirring up the butterflies and drenching myself in the process. I'm definitely a kid at heart. Also, I guess I need to work on not smiling and laughing as much as I do since Tim told us that every time he looked back to check on the group I was either laughing or smiling...which apparently was distracting - Oops! The rest of the group immediately chimed in and said it's more like all the time that I'm laughing/smiling. I can't help it! Especially since I was having so much fun. I definitely had enjoyed this part of the day the best, and I can't wait to go again sometime.

At the first outlook: beautiful view, already loving the ride :)

After ATVing, we headed back to the hotel to clean off the days dirt. By this point we were rather hungry and had heard from our guides to try out The Salmon Bake locally known as "The Bake". Unfortunately, I didn't get salmon which I wish I would have. The food was still good though. After dinner, we checked out a local ice cream store which had Moose Tracks (my favorite ice cream). I was glad to find another ice cream shop on the trip as it further reinforces my Alaskan trivia. After the long and exciting day, we headed back to the hotel to get some shut eye since it was an exhausting day. Before heading to bed, I was able to return a couple phone calls and catch up on stuff going on in Missouri while again watching the sort-of-sunset.

Into the Wild: Denali Adventure - Part I

FRIDAY: It was definitely hard going back to work Friday morning after our 14 mile hike the day before. The base was hosting their Family Medicine Children's Health Fair where dependents of enlisted soldiers come to base for physicals. There were children running around everywhere which may have deterred people from coming to the pharmacy as the place looked very busy. Therefore, Friday was a fairly manageable day. I spent the morning in the inpatient pharmacy with Angela, a contract pharmacist, who is really awesome and loves what she does. I believe I get to spend a couple more mornings with her and possibly go on rounds with her as well. As for my afternoon, I spent some time at the kid's health fair where I directed traffic mostly. Towards the end, an airman and myself watched one of the kids while his mom tried to get stuff done at the hospital. The 5 year old was really excited to have his Mountain Dew which he demonstrated multiple times of how he is able to chug it...great. Why do mom's let their kids drink that stuff?

After work, we quickly packed for Denali National Park and hit the road. About 2 hours North of Anchorage is Talkeetna where you can take a plane ride to see Mt. McKinley. Since the cloud coverage is so thick up in the mountains, you can only see McKinley about 20% of the time. On our drive to Talkeetna, I'm pretty sure we saw a glimpse of it beyond the town! (This is still up for debate though). While in Talkeetna, we stopped for dinner at Twister Creek Restaurant, Home of Denali Brewing Co where I departed from my usual fish and chips and tried a prime rib sandwich with au jus. Celeste and myself also tried a couple of the locally brewed beers: Cleopatra's Kiss (earthy flavor) and Agave Gold (sweeter flavor). After dinner, we checked out the place next door since it was advertising "homemade ice cream". This was my favorite part of Talkeetna: homemade pumpkin cheesecake ice cream! I guess in answer to my Trivia Tuesday question, up North is where the Alaskan's are consuming all their ice cream.

We hopped back on the highway and headed up to Healy, AK just North of the Denali Park entrance where our hotel was. We got in a little around 11:30pm which meant daylight, so driving that late really wasn't too bad.

This was the office of the Denali Park Hotel (really motel).

I wish I would've taken a picture of the entire front of the Escape as it was covered in a ridiculous amount of bugs. I'm pretty sure the mosquitoes took revenge on us the rest of the weekend after killing so many of their kin.

After unpacking/getting settled in, I stood outside the hotel and watched the sunset behind the mountains which was really beautiful. (I tried to get some pictures but I just couldn't capture how awesome it really was with my point-and-shoot.) And it almost got dark! But the midnight sun didn't completely set and so it remained rather light well into the morning. I also got eaten alive by mosquitoes as I only had shorts and a t-shirt on which wasn't smart on my part. I learned to wear pants and long sleeves no matter the temperature outside. Though I stayed up later than I should have on Friday night, I really didn't get much sleep that night as the excitement for Saturday's adventures kept me awake. Check out Part II for more on that.

Ducks, Dogs, and Bear-Dogs

Our preceptor gives us each a day off during the week, so that we can explore and enjoy Alaska. Majority of people have Friday or Monday off and get 3-day weekends. Becca and I have Thursdays off which I was honestly pretty bummed about at first. But then we realized our weeks consist of: 3 days of work, a day off, then only 1 day of work before the weekend - not too bad to have the week broken up a bit.

For our first Thursday off Becca and I planned to sleep in and then go for a hike! I learned this morning that sleeping in is harder for me to do than I thought while in Alaska. So after waking up at 6am, I forced myself back to sleep for a couple more hours. After enjoying a leisurely morning of getting ready, we jumped in the Escape and did just that. We headed up North past Palmer to Matanuska Valley in order to hike Reed Lakes Trail. Unfortunately, the road to that specific trail was closed for another couple weeks. Therefore, we ended up at the next trail over called Golden Mint Trail. We started hiking around 1:00 with no real idea where this trail would take us as it wasn't in our initial plan. The first couple of miles were rather easy and the scenery was beautiful. We enjoyed the lunch Becca made us next to a great part of the river where the rapids pushed the crystal clear water right by us. We both agreed that we wanted to swim in it, but after testing the water temperature realized it was a cold idea. So we continued on the trail passing a few people as we went. After reaching the 5th mile it started to get pretty muddy and at the 6th mile the trail was pretty overgrown. I was really happy to have my Columbia pants on in the overgrown parts, but I was not as fortunate to have my running shoes on when we reached the mud. I really need to buy some hiking shoes/boots while I'm up here. After completing our 7th mile it was time to turn back in order to make it to the car and then drive in to town for dinner. Our roundtrip hike of 14 miles took us 5 hours which was pretty decent. 

While on the trail, we didn't see many animals except a couple of ducks floating down river, dogs hiking with their owners, and best of all, a Bear-Dog. This "dog" was HUGE! I'm not sure what kind it was, but he was massive. I wish I would have taken a picture of him, but instead I only got his print. This picture doesn't do this print any justice. I should have put a size reference next to it. Just imagine my hand, and it'd be almost equal in size - not joking. 

Bear-Dog

The overall day trip was great, though I'm pretty exhausted despite the extra sleep. Hopefully our Friday at work will go by quickly... I even cleaned the mud off my tennis shoes in the sink tonight, and stuffed them with newspaper to hopefully dry them out before the weekend. Next adventure: 19 hours until we depart for Denali.