Life Is Fleet-ing

Being at the water rescue house has its perks some days. This year we were assigned to be part of Fleet Week. Several other agencies and ourselves were assigned to create the perimeter for the flyover zone in the bay, keeping any other vessel traffic out. Basically we formed a large rectangular floating blockade. It makes for a long 6 hours on the bay, basically station keeping (maneuvering the boat to stay put against the tide and current) and keeping vessel traffic moving in the transit lane. But it is absolutely the best seats in the house for that show.

 

The jets are flying right over you and less than 400 feet in front of the boat as they scream across the water. None of our pictures or videos do it justice but we were close enough to smell the jet fuel when they passed by.

And my god is an F18 Raptor LOUD!

At one point they brought out a 747 and had it banking turns around Angel Island and flying right over the GG Bridge. When that thing first made its turn over the bridge I just hoped that it was part of the show. Otherwise I was about to be intimately involved in what would undoubtedly be an infamous incident when a 747 crashed into Alcatraz.

I honestly don't know how people spend months at sea because 6 hours on the water in the sun is seriously tiring despite how much fun it was to take part.

So, after we got back to the station and cleaned up the boat, got everything back into service, and picked up some dinner I was really hoping for a quiet night.

But...
shortly after dinner we got a medical call. En route to the call we got the update that it was for a full code blue for a male in his mid forties.
Wait did they say 43?
Yep. They did.

We arrived to a frantic and distraught woman who pointed us to the living room where our patient was sprawled out over the ottoman. He was pulseless and not breathing. We moved him to the floor and went to work. His wife/girlfriend(?) was able to keep it together long enough to tell us that he had some kind of heart condition that had apparently already taken another of his family members about the same age a year before.

He was in asystole from the get go. We got the Lucas on for compressions, dropped an ariway and started breathing for him, I got an IV and started pushing meds. The ambulance arrived and went for
an ET tube. The ambulance medic got the tube and we had already run two rounds of meds and some just in case meds as well when the ambulance medic supervisor arrived. We had already decided to transport due to the patients age and the fact that he could be an organ donor. Normally a patient that is in asystole from the beginning gets cpr and three rounds of medication and if there is no change or improvement then we call it and declare a death in the field.

The supervisor agreed and we moved to the ambulance where I took over bagging the patient (rescue breathing for him). I had to move his head back to neutral and saw that there was  blood running from his mouth down into his ear. I told the ambulance medic and began to suction. My guess is that his tongue got nicked while putting in the tube. The tube was good still so it wasn't compromising our work. Just meant that I spent the rest of the ride bagging and suctioning out blood.

He was pronounced dead in the ER before we had restocked and left the parking lot.

The next morning we got on the boat and headed back out to the bay to watch jets and biplanes and 747s go screaming over our heads again. It's not quite as thrilling on day two but still really cool and maybe there was a just a little more appreciation for a beautiful day spent on the water as part of your work day.

(Missing Man formation)

Mr. Hughes And The Hipsters

You meet and care for all sorts of people on this job.

 

 

This tour the first response of the day was for a male subject unable to move. When we arrived on scene our elderly and bearded patient was standing outside his front door leaning on his cane. Well, unable to move seemed a bit of a stretch since he made his way out to the front and closed the door behind him. I would learn in a few minutes that I was likely to be very glad that he met us outside. As it was the first thing I noticed was that he was barefoot and had Howard Hughes toenails.

 

Like this except pointier and more dragon like.

He said that he had arthritis really bad and that he couldn't walk. He slid down the stairs on his belly to get to the door and then get outside. He said he had no other complaints but my observation was that he was pale and didn't smell great. We got some vitals and realized that he was extremely sweaty and had a rapid pulse. He was so sweaty that the ekg lead stickers would not stick to him at all. We undid his sweatshirt which turned out to be the only thing he had on to wipe him down and try to get the leads to stay. It was at this point he stated that he had not had a shower in over a month and "could we tell?". Well yes we could. 

Even wiping him down didn't do the trick and I had to hold the leads to him in order to get a reading. His heart was racing along at over 155 but he had no cardiac complaints at all and no cardiac history.

When the ambulance arrived we had a moderately tough time getting him to shuffle his way to turning around and then get on the gurney because he couldn't really bend which also explains why he can't take care of his toenails. His heart was still racing and the ambulance crew asked again if he had any cardiac or other significant medical history. Again he said no. As they wheeled him away I asked the overlooked obvious question: "When was the last time you saw a doctor?" His answer was, "Six years." Well there you have it then. 

This way to the ambulance Mr. Hughes.

 

Six years since a doctors visit and over a month since a shower. This is why I was so glad that he met us outside. I can't imagine what the inside of that place looks like and I don't want to.

The following two calls were for hip problems. One lady had an artificial hip that was supposed to be basically bullet proof. Except in her case when she bent over to grab her slippers the thing popped out on her. She was handling it pretty well and I was able to give her some meds for the pain although they didn't help much.

The next lady fell in her kitchen and was very cordial and not in quite as much distress as long as she was laying still. We were able to get her up and on to the gurney without much difficulty. It was hard to say if she had done any real damage as nothing seemed out of place or unstable. But she was also in some pain when we did have to move her so I'm sure her xrays may reveal some damage.

We were able to help everybody we tended to that day but in a district with a primarily older population it can be tough seeing these folks struggle with daily tasks in their old age and especially those who lack the resources to get needed help.

A Light In The Darkness or This Little Light Of Mine

I have a terrible memory for houses. I need to see the people and then I remember why I've been there before. But when I looked at the map as I got my turnouts on I was pretty sure I'd been to that place before, but I didn't know why. It was about 8:30 at night and we were responding to a seizure call.

We pulled up to the house and I put on my hat (more on that later) and started donning my gloves. We grabbed the gear and headed to the front door. It was dark and there was no porch light on. As we got to the walkway we saw a woman moving around on the porch. She had apparently squeezed out the barely open front door and was attempting to clear a path. The entire porch was covered in trash and random things I couldn't even begin to make out. So much so that the front door was blocked - from the outside. Which begged the question: how long has it been that way and how do they get in and out of the house? Or do they?

She shoved some things aside and we were able to make entry. The inside of the house was no different. No surprise. It was a total hoarder house.

Of course the difference between this house and the one above is that in the picture above you can actually see.  The house we went into was super dark.

                   

The only light came from a single battery powered lantern.

 

The lady who had cleared the porch so we could get in mumbled something about the power being off at the moment but it was clear that it had been off for quite some time.

Now back to the hat. I wear a lighted ball cap on all medical calls in case I need both hands and can't hold a flashlight at the same time. My firefighter has teased me that I'm one of only three people in the department who bought this hat when it was approved as an official uniform item. But I love that hat and it has served me well on numerous occasions and he had to admit on this call it was bad ass and the perfect tool.

 

With the light from my hat I made my way to the couch where an elderly woman sat near a man in his fifties who looked in his seventies. He was wearing a hospital gown and was slumped over sideways with his head under the couch cushion. I lifted the cushion and started to ask him questions while my crew tried to move some of the detritus so we would have a prayer of getting him out and to the ambulance. 

I was surprised to find him alert and oriented. He knew he had had a seizure and said it had been a long time since he had one and that he was taking his meds. I got a quick set of vitals on him and asked my firefighter to grab the glucometer for me. He was oriented but I still check a blood sugar as standard precaution after a seizure. I was just getting the sugar when he stopped responding to me. I noticed his head was turned and he was staring off into space. I knew he was about to seize again. I was able to get the fingerstick covered up so he didn't bleed all over me and the glucometer put away just before the seizure began in earnest. I asked for an IV to be flooded and for my firefighter to pass me a start kit. I got the tourniquet on while he was seizing but fortunately he stopped in time for me to attempt the IV. The first vein rolled around on me but with my cap light shining down on his arm I was able to get a vein on the top of his wrist and had a solid line when the ambulance arrived. Which is when he started to seize again. The crew was setting up to administer versed when the seizure stopped and we decided to take the opportunity to get him out of there and to the ambulance and treat him there.

There was no way to bring the gurney or a stairchair or any equipment into the house so we just had to grab him off the couch and do a sit pick carry out to the gurney on the front lawn. The ambulance crew said they didn't need a rider and would give the versed in the back of the ambulance en route. So we cleared and went back to the stations.

The patient would get the treatment he needed and hopefully an adjustment to his meds to keep him from more frequent seizures. The living conditions however are another story. We can only report it to the proper agencies and hope they get some outreach assistance. There is no question that if there's ever a fire in that place we will be pulling dead bodies out of there.

Welcome Back!

So, for those just catching up, I had a baseball sized tumor removed from under my breastbone this year. Best of all possible outcomes, considering: no cancer, no radiation, minimally invasive as thoracic surgery goes I guess. I was recovering and off of work for three months and returned to full duty with no real complications.

As a welcome back present I got a four alarm fire.

Not my first day back but a few tours in. My first fire in a while too. It came in just on the border of our district and the next one over, but technically their first due. It was a grocery and liquor store we knew well.
As we rolled down the street we could see Engine 50 coming the opposite way. The hydrant was on our side of the street but on their side of the intersection. I knew they would get to the building first and figured we would be taking care of the water supply for them.

E-50 stopped just short of the building and started stretching hose. I was just rolling up on their position when the front of the store exploded.

https://youtu.be/3FJT2QU-xgM

(something like that but without the people in front)

I literally watched in my side view mirror all this glass and debris flying across the street right behind my engine. My first thought was, "Where is the crew from E-50?". I was afraid they had just pulled hose in front of the explosion. They hadn't. They were setting up to go in the Delta side main door. The debris shot across four lanes of traffic to the gas station on the opposite side of the street.

We made the water supply connection for Engine 50 using our own 5" hose (which would later prove to be a mistake). Then we helped pull a back up line to that door on the Delta side (that's to the right of the address btw). There was quite a bit of flame showing in the Bravo/Charlie corner but visibility was still good and we could still see all the way through the building.

However...

Within just a couple of minutes of the smoke explosion the roof collapsed, the whole interior was burning and there was no hope of fighting this fire from the interior. My crew got reassigned to start forcing entry and checking the exposure businesses on the Delta side. There was some minor damage to the first unit but the others were clear. We ran into some trouble with ventilation though because it was a peaked roof built over a flat roof so the vent groups efforts were pretty much wasted. We wound up just doing some pre-emptive salvage work, covering up computers and electronics, and safeguarding plaques and awards, etc. As we did that, the sticks went up on two sides of the structure and the 'surround and drown' began.

We spent the bulk of our time after that putting out spot fires and several times revisiting whatever was burning in the bravo/delta corner that refused to go out. Whatever it was was buried under the roof collapse so there was no way to get to it yet.

All in all we spent about 13 hours on this fire. We were second in but last to leave. There were a few extenuating circumstances that caused that to happen but one being the fact that E50 was using our 5" as water supply and that was pretty much the last thing to be loaded.

It was a long fire (02:30 - 15:00) but not overwhelmingly strenuous beyond the first ten to fifteen minutes. But, it was still a good test for my return to work post surgery and a pretty exciting fire for a little while.

All of this reminds me of a joke:

A Lama with one L is a holy man.
A Llama with two Ls is an animal.
Do you know what a 3 L lama is?....

One helluva fire.

"I feel like a Kentucky Fried Idiot"

Two examples of why I do this job, both in the same night, both on the same call, both quite different.

At the tail end of making dinner, we responded to a report of a Level 1 Hazmat at a gas station in the district. Most likely a gasoline spill of some kind. We were advised en route to look for a Jeep leaking fuel. Yep. Okay, easy enough.

We pulled up to the station and found the Jeep. A friendly and very apologetic young woman met us and explained that she was filling her tank and the fuel was just shooting through straight onto the ground.

 (Like this but underneath, not out the fill pipe)

So we crawled under the car (now moved from the pump to a parking spot). There was a (maybe) 5" round spot of fuel on the ground and a small spot under the tank that looked like it might have dripped. Not at all the deluge that was described. We inspected the gas cap and what we could see of the fill pipe and all appeared normal. Her gas gauge still read 1/8 tank and the car started fine. It just didn't add up. 

She was afraid of running out of gas if she drove home and was going to call for a tow. We had her pull back up to the pump so we could see what had happened. She went to the same pump she had used before and there was no fuel on the ground. Hmmm.

She got set up and as soon as she squeezed the handle gasoline went flooding out from underneath the car. She stopped immediately of course but I then noticed the gas station attendant standing nearby watching us suspiciously as if to say, "What's wrong with you? Why would you have her do that AGAIN?"  Well, you never unless you try, right? Seems she must have a broken gooseneck between the tank and the cap that wasn't visible. The spill from the first attempt had just evaporated in the meantime. That was a bit surprising considering it was freezing cold that night.

She had called for a tow and was informed it would be over an hour. She was still worried about running out of gas if she tried to make it home. My captain told her that she could try to make it home and hope for the best, wait for the tow here in the freezing cold, or she could drive the few blocks to the fire station and wait there where it was warm. She took option three and let the tow company where to meet her. 

We were about to eat of course and as we finished making dinner, we set a place for her too. She initially declined but as the food arrived and no eta on the tow truck she gladly joined in. So we were able to take a bummer of a situation and unpleasant evening and turn it into a hot meal (udon noodle soup and shrimp, perfect for the cold night) and a pleasant wait for this poor kid. She was very happy and thankful and that's the outcome we want. So, good deed done and superior customer service rendered.

BUT....

Before we could leave the gas station and lead her back to the firehouse we had one other situation to deal with.

We were heading back to the engine and noticed a lot of brake lights just before the overpass by the gas station. The firefighter suddenly said, "That's a turkey!" And sure enough, a HUGE, wild turkey was running around in traffic jamming it all up. This is in the middle of a very urban area by the way.

My captain said, "Hang on let me get this thing off the road." He headed off to go chase it away and I went to the rig to grab a flashlight and deal with traffic to make sure he didn't get run over while in pursuit of the turkey.

The turkey, as you can imaging was having none of it. It easily evaded the captain and continued trotting through traffic, not leaving the roadway. The captain gave chase for a bit and then figured that it just wasn't going to happen.

He radioed into dispatch and gave a report of the turkey and the traffic issues and that it was last seen trotting North on Hardin in the left lane. Dispatch responded that they were aware of the turkey and that PD had been attempting to corral it all day long (which was awesome). As Rocky's trainer Mick said, "If you can catch this thing, you can catch greased lightning." Well, apparently no one could.

Routine, that's why I love this job.

Near (But Not So Dear) To My Heart

So I recently had my yearly physical for work. Over the age of forty you get a chest x-ray every two years as well as all the rest of the battery of tests and bloodwork they do. Well I was due for an x-ray as it turns out. Okay, no problem. Quick and simple and done. I actually got my blood work results emailed to me before we had even competed the physical and left the building. And my cholesterol was down thirty points from last year. Woo hoo!

So, I was a bit surprised when I found a voice mail on my phone a couple days later saying the doctor wanted to talk to me about my test results. Usually they just nag me about the cholesterol and all the rest is good. Well it was about quarter to five on a Friday when I called them back. The nurse put the doc on the line and she told me that the chest ray showed a mass in the hilar region of my right lung.

Yeah.

That's what I thought.

She said I needed to follow up with my personal doc and that they recommend a CT scan asap. Hmm...ya think?

 

Of course it is now five oclock on a Friday and I cant do anything about it. I emailed my doc just to get a jumpstart on the process and he actually responded on Sunday with an email that said he already scheduled me a CT on Tuesday. Right on. Way to go.

Went for the CT. Also quick and easy and painless. And then the waiting began.

I had just picked up my kids from school the next day and was driving away when my phone rang. I saw it was Kaiser and pulled into a parking lot, gave the kids the shush signal, and answered the phone. The news was not fun. He told me the scan confirmed a 3" mass in my chest. Not in my lungs fortunately but in the mediastinum.

He said I needed a biopsy (again asap) and that he had made the referral and they would contact me hopefully by weeks end. If they didn't call by Monday I was supposed to call him back. I adjusted that to Friday. No way was I waiting through the weekend.

Fortunately they called on Friday (late on Friday) and had me scheduled for the following Friday. It took an interminable five days to get the results late Wednesday afternoon. The good news was it did not appear to be cancerous, won't know for sure until it is analyzed after removal.

Which brings us to removal:

I need a thymectomy (the tumor grew out of the thymus) which could be minimally invasive but has a whole host of potential complications that can't be seen until they are in the midst of the procedure.

 

For example if the tumor has adhered to anything like my lung or pericardium or phrenic nerve they mav have to remove a small section of whatever it adhered to. In the case of the phrenic nerve that would mean permanently paralyzing the right side of my diaphragm. I was assured this was okay because the left side will still work just fine. Also the tumor is large and has to come out intact which means having a big enough hole to take it out of. This means possibly rib spreaders or taking a piece of rib out or worst of all a sternotomy (splitting my sternum and wiring it back together after). Really hoping it doesn't go that route.

So stay tuned folks. Same tumor time. Same tumor channel.

The Duke Boys Ride Again!....Almost

"E-51 respond to a report of a traffic accident at Oak and Mercator. PD also en route."

We jumped on the rig and headed to the residential neighborhood intersection we'd been given. We expected to see a minor accident between a couple of suburban commuters coming home from work. But what we found in the middle of the street at the end of a long set of skid marks was.........
The General Lee.

Yep. A perfect recreation of the famed General Lee from the Dukes of Hazzard. Apparently this guy had spent the last 3 years restoring it and a half hour ago finished rebuilding the transmission. So, he and his buddy decide to take it for a test run. Somewhere in this test run he and his buddy (in a separate car) wound up colliding. And 5 minutes into owning a bad-ass replica piece of television nostalgia it looked a little closer to this:

 

Well folks, that's how it is sometimes in Hazzard County, when even the best of intentions and the purest deeds don't always turn out the way you planned 'em to. Life is funny that way. Isn't it?