Just beneath the surface

Small talk. One of my less favorite things to do in the world. My standard answer to the ubiquitous question, "So, what's new with you?" is pretty standard: work and dancing. Really, that's it. Not even any international travel plans this year.

But dig a little deeper, and there's tons going on.

At work this past week, I took care of a patient with his guts in a sac outside his body. I've taken care of patients with opened chests, where the heart is visible under a transparent betadine patch, but I don't think I've ever taken care of a patient with a surgically extruded organ. Bizarre. Anyway, eight year old patient with a malrotation and volvulus. MD Spaniard, came back with the patient from the OR and said that they couldn't close the abdomen because of the major swelling of the entire small intestine, so they piled the small intestines onto the abdomen, covered it with a plastic sheet, and sutured the sheet to the edges of the incision. It looked like a six inch, bloody stack of cd's on his belly. Good thing I'd put the egg crate on the bed before they took it to pick up the patient, because we weren't even allowed to turn the patient ... which could have kinked off parts of the already injured bowel.

The next day, they took the kid back to surgery to see if they could salvage any of the small intestines, but it was a no-go. They had to resect all of it, leaving only a small portion of the duodenem to save the insertion site of the head of the pancreas. Poor kid will need a small bowel transplant, and maybe even a liver and pancreas if they can get it.

Another day, I taught NM how to work the hemofiltration machine. Hemofiltration is like hemodialysis, except slower. What dialysis does in a matter of hours, filtration does over days. Filtration is gentler, and a better choice for unstable pediatric patients who have temporary renal issues. We've had a run on renal failures lately. Lots of kids on hemofiltration, peritoneal dialysis and even those who get bedside hemodialysis. We're only missing the kidney transplants, which is a shame, since I really like those types of cases. Anyway, it was lucky that my (different) patient needed a circuit change that very day. We'd discontinued the hemofiltration earlier in the day to trial the patient off in preparation for dialysis, but the patient became too unstable, and the lytes were going crazy. So, the didactic class instructors were able to have the class prime and initiate a new circuit. Good timing, since sometimes it can be months between hemofiltration cases, by which time the class members have lost a lot of the info they learned in class.

So, I taught NM how to run the circuit. After the first two hours, she was able to assume total patient care, and used me as a backup. Busy kid. Some baseline neuro-cognitive deficits that will be exacerbated by the lithium overdose that bought her to the hospital in the first place. Nasty stuff, lithium. They had to start her on hemofiltration to remove the lithium. When her levels got down to below detectable, they took her off the circuit. But since lithium is stored in the tissue, her levels shot up after a few hours. The neurology team is pretty certain that she will have some permanent functional deficits after her acute symptoms resolve. At least she will be followed by our team from now on, not the crackpot local team that had her on too many antipsychotics in the first place.

ECMO staff meeting the other week. We may be starting use of a new pump specifically for the post-op heart patients. Which will mean cross-training for the CTICU and PICU ECMO nurses.

And, dancing ...

Wonderful night of dancing at Lindy Groove. An almost perfect dance with StretchJ. He really excells at the faster tempos, which I tend not to like. But, there are songs that are just at the higher end of my tolerance, and at the lower end of his, where our dancing is just superb.

A great, break-laden song with Sociologist. He uses a lot of weight behind many of his crazy lock-turns, etc. And I love those moves because he maintains firm-but-painless connection. And because he especially loves doing those moves with me because he likes the way I counterbalance. So good, especially if the music is more moderately tempo'ed.

And lastly, my favorite new leader of the night, D-Roca. Really, he looks like Mo Rocca (who I find adorable), except with a really bushy head of hair. D-Roca was celebrating his birthday this week, and his style was so funky that I had to jump in on his birthday dance. Later, we grooved a little to some alt-swing music, and it was a blast. Finding new, danceable leads is such an A-Ha/discovery moment.

And, more dancing ...

Tivo failed to record SYTYCD on Wed and Thu. What a tragic disappointment. Spent Friday morning scavenging info and dance clips on the net to appease my inner demons. In the process, I decided that, instead of swing or salsa, that I would teach Nightclub Two Step for the mid-singles FHE in July. I just can't stand teaching east coast swing anymore. Besides, NCTW is super easy, and much better suited for contemporary music. And, I found this clip of Jeremy and Monica doing NCTS. Jeremy is one of my favorite leads to dance with in Utah, and it made me curiously happy to see him dancing NCTS and West Coast Swing. In the WCS clip, Jeremy even does those he-goes-she-goes travelling turns that he's so good at leading. Utah is a long way to go for NCTS and WCS, but I generally can't make it out for WCS on Thursday because I go to Lindy Groove, or Sundays, when there's dancing at Memories, but I choose to stay home. Anyway, seeing people at the Murray Arts Center made me realize how much I miss dancing there.

Incidentally, Jeremy reminds me of His Vickness. Neither are flashy dancers. They don't stand out because of crowd-pleasing moves. They stand out because they are fantastic leads that interpret the music well, are very ogranized and clear in their lead, and allow the follow to just relax and enjoy the dance.

So, I've decided to teach NCTS, and am putting together a lesson, and I've recruited a friend to help me teach. Fun!

Also, there's just a ton of dancing during the summer! The LA and SM YSA's are doing a summer dance series on Wed nights. Dancing Under the Stars in Pasadena on Fridays and Saturdays starting in July. Camp Hollwood at the end of July. And Paladino's in open every Tuesday in the summer. I feel like dancing all summer!

Yes, there's really only work and dancing occupying me nowadays. But there's plenty going on just below the surface.