FOH: A Week In Pictures.


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On 4/16/2020 at 7:39 AM, SigmundChurchill said:

No, I am an Anesthesiologist.  Here in the US, intensive care is a sub-specialty of Anesthesiology.  

And since basically the entire hospital is now an ICU for COVID patients, we dont have nearly enough Intensive Care docs to cover all the patients, so the anesthesiologists are treating them.  This is not just in my hospital, but in all of the ones that are overrun with COVID patients.  After all, there are only emergency surgeries anyway, so they dont need us in the operating rooms.

We commandeered these Stryker space suits from the orthopedic department.  We retrofitted the air intake with hepa filters, and we wear them when we intubate covid patients.  Intubating these patients is extremely dangerous for both the doctor and the patient.  We are right in the mouth, and the process of intubating aerosolizes the virus, so we wear these suits and make everybody else leave the room and we close the door, in case the patient coughs during the intubation.  

It is dangerous for the patient because we dont mask ventilate them.  Mask ventilating them REALLY aerosolizes the virus.  The entire room would be filled with virus within a minute or two.  So we have no way of getting oxygen into the patient after we paralyze the patient.  We have to find the vocal cords and get the tube in quickly before the patient dies.  Strange times we are in.

Curious if you are having high success with your vv-ecmo covid patients.  Not a single death for us, such an amazing stat given our usual 50% mortality rate.

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Great wedding weekend! My dad turns 90 in July, my mum 85 this year. They danced away until closing time.  Ben and Hattie were magnificent. My youngest Brother Rick (left) went "to town

Had a good fall steelhead trip recently. Went 13 for 13 on steelhead in 2 and a half days. Excellent weather! The young angler James was successful as well!

Went to Cuba, smoked good cigars, ate good food, saw cool stuff.

25 minutes ago, Monterey said:

Curious if you are having high success with your vv-ecmo covid patients.  Not a single death for us, such an amazing stat given our usual 50% mortality rate.

Our ventilator mortality rate is dropping.  Started at 90%, but as the weeks went on, the people who made it past the initial 2-3 weeks without dying, are being successfully removed from the ventilators at weeks 6-8.  Last I checked, we were at about a 70% mortality rate and dropping.  I think by the end of all this we will be down to 50%.

As to ECMO?  In my opinion, that is the best way to go for these patients.  It allows you to oxygenate them without the barotrauma of the ventilator.  It gives severely ill patients the best opportunity to survive.

But it is not exactly practical, is it?  I mean, we only have 2 machines at my hospital.  And most hospitals don’t even have 1 machine.  Plus, keeping people on ECMO is very expensive, which also limits it’s use.

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9 hours ago, SigmundChurchill said:

But it is not exactly practical, is it?  I mean, we only have 2 machines at my hospital.  And most hospitals don’t even have 1 machine.  Plus, keeping people on ECMO is very expensive, which also limits it’s use.

2 is the minimum.  You always have to have a backup when one is in use.  The machines themselves are not that expensive, at least in comparison to other equipment.  Roughly 130k per machine.  The cost is the nurse.  2:1 nurse to patient ratio is a high cost.  We bill on average just over 1 million per case.  Pricey stuff.  We have 5 machines, though in normal times we will go all summer without seeing a patient.

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I'll trim my beard when I am dead and gone!

JK, probably when we go to the beach in a couple of weeks....

 

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3 hours ago, Habana Mike said:

I'll trim my beard when I am dead and gone!

JK, probably when we go to the beach in a couple of weeks....

 

Nooooo!!!!!! Keep the beard till Christmas!!!!! :lol3:

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On 6/6/2020 at 10:25 AM, GVan said:

As requested by MoeFOH; from my post 

H Upmann Mag 50 (ESL SEP-18) / The Who - Who's Next (FCFARW)

By GVan, 13 hours ago in Cigars Discussion Forum "the water hole" 

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Rather than just repost the pictures here, I thought I'd show some of the pictures from my "Smoking Porch".  

The back-story -- when I built my retirement home the architect designed a covered second floor porch.  My brother told me to delete it from the plan as every second floor porch he'd ever seen was never used (My brother takes care of peoples second homes in FL as his business).  I didn't delete it thankfully, but, for the first 3 years he was right - we did not use it.  Just before all of this COVID-19 shutdown, I decided to take this on as s a "project" and convert it over to my smoking porch.  Of course, I had to come up with a design that my wife would approve which meant it couldn't be just a "guys place to smoke and joke".

You've seen many of my Daily Smoke pictures from here at night.  The area has two ceiling fans and overhead speakers.  My (FCFARW) post was taken here while listening to The Who's Next ... below is really the smoking area with a homemade concrete and epoxy table and cast iron rocking chairs (it gets pretty windy here as we are on an inlet off the Atlantic Ocean) as everything on the porch needs to be heavy!  The Padron 64 box contains 2 torch lighters, 2 credo cutters, cigar matches, the remote control for the ceiling fans and a PerfectDraw.  What more does a cigar smoker need?

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I also included a 110" teak bench that doubles as extra seating that can be moved around when we have guests -- but, is really my afternoon golf napping area -- notice the pillows that are really old bedroom pillows.  My wife picked the colors and pillows.

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Lastly, this is her area where she will join me when I'm smoking a cigar.  With the small light she often just reads a book as she relaxes in the lounger.

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The daytime view which is often hard to see at night with my cigar pictures.

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Absolutely beautiful setting for a smoke! 

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1 hour ago, StogieSteve23 said:

@Habana Mike @JohnS Keep them! Although, if the lady doesn't like the facial flow, it's hard to keep.  I've got a pretty good mustache going right now myself but the fiancé loves it.  Dirk Diggler? Tom Selleck? I'll let you all be the judge.   

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Haha, Tom Selleck...definitely Tom Selleck!

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Not as good of a weekend as planned.  Yesterday morning it looked like the boat was riding a little low - we had 12" of rain two days before - this is what I found! Spent the last two day, pumping, vacuuming and drying out the boat.  Battery Charger died and took the batteries and bilge pumps with it.  No major damage - just a PITA -- We all know what BOAT stands for ......

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On 6/6/2020 at 5:47 PM, Habana Mike said:

Working on the Dr. Guano look. Need a cat on my shoulder....

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Haven't seen the barber since February!

Love this Brother! You are getting close. Another 20 years without a hair cut should do it.

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