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firestarter girl

firestarter girl

firestarter girl

 

 

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Page: http://healingfireisland.com/2013/03/23/firestarter-girl/

Healing Fire Island | <span class=”hiddenSpellError” pre=”Island “>firestarter</span> girl

<meta name=”description” content=”Luke arrived from Miami with the scent of Sophia.  Walter brought a sick hip and ended up with complications.  It was a challenging week for Rocks.  “>

 

 

 

 

It was wild Wednesday for Rocks. Luke got back from Miami with the scent of Sophia all over him and his laundry.   It lingered all night for Rocks to dwell on as they lay together the night he returned. They talked very little and it was a pregnant pause in their life.   Rocks was mad, Luke was sad.

Rocks left for the clinic in a bad state of mind, Luke took the old Jeep in to town. He ordered an egg sandwich at a diner and considered his options. Chaz had essentially offered him a promotion, and he couldn’t leave until the job was finished. He knew his life with Rocks was over. They had lain beside each other without touching, and that was unheard of.  Luke was empty and felt lost.  Rocks wanted him off the boat.

Walter brought in a sick hip replacement on Plavix that Rocks had to cancel.  Her doctor felt that she needed more work up and blood pressure stabilization.  Walter had a hissy fit and took the patient to the hospital.  There were complications and the patient lost 4 units of blood that could have been prevented if she had been advised to stop the Plavix as Rocks had suggested.  Walter had skipped the meeting and snubbed the Cardiology Clearance Guidelines.  Closed door meetings with Vince followed.  Rocks was not included.   She was relieved but would have had plenty to say.

Meanwhile, back on BreakAway, Jet could sense the tension and as the weekend approached, the pair were contemplating the haul out and getaway.  Rocks had been quiet and Luke had been busy working late.  Neither had discussed the obvious.  It wouldn’t wait long, neither was sleeping.  Rocks was distracted at work, and the staff was concerned.  They thought it was about the case that went bad, they had no idea how she handled cases like that.  They were not aware of her personal life, she always kept those issues quiet.   Read about it at Healing Fire Island, by Chery Fee.

firestarter girl

firestarter girl

cardiology clearance

Page: http://healingfireisland.com/2013/02/26/cardiology-clearance/
Healing Fire Island | Cardiology Clearance

heart attack

If a patient comes for surgery and has a heart problem often they get an ECG and a basic heart history and things proceed as expected.  But sometimes the patient has zingers that make people nervous and they end up with a Cardiology Clearance.  Here a few things that tip-off the Anesthesiologist and lead to a Cardiology Clearance.  Chest pain that is escalating or unstable, blood pressure that is uncontrolled, obesity that has been uncontrolled, diabetes that has been uncontrolled, abnormal ECG, recent heart attack (within 6 months), poor exercise tolerance, non-compliance with significant medications.  History of significant complications during surgery, ICU admission postop.

A patient will need a Cardiology Clearance before surgery DEFINITELY if they present for preop with unstable angina, heart attack within 6 months, or cardiac surgery within 6-12 months.  Recent pacemaker or AICD placement would require patients to have pertinent details available to the anesthesiologist for appropriate intervention if required.

Rocks had a Cardiology Clearance for hip surgery that ended up getting life flighted off island because of crushing chest pain during her stress test. She was a star within two weeks of starting her job.  The clinic owner was relieved that the patient wasn’t on the table, almost certainly arresting under anesthesia.  She had already impressed the unimpressable orthopedist Walter, and the owner was sending out a very sick patient for an emergency cardiac cath to the Heart Institute of Miami by LifeFlight.  Rocks had picked it up.

The clinic was going to need some ‘Cardiac Guidelines’ to avoid cardiac cripples from ending up on the schedule and to educate the community docs as well.  Rocks was already working on a document.  She understood the need for education and the value of avoiding cancellation just before scheduled surgery.

Healing Fire Island.  A work in progress!  By Chery Fee

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