Kaisu

I want to thank all of you for your kind words. The people on this site have never let me down. I wasn't sure what kind of responses I would get. I should have known better.

Gave them one month's notice because messed up as I am, I still know not to burn my bridges. Supervisor told me that when I was ready to come back, come and see them. He said "good medics are hard to find, and one that's a good person is even harder". It felt really good to hear that, but I am sure not counting on it. I have been having a very difficult time since my brother died. The joy of the job is gone for me. I hang on by the skin of my teeth, pulling myself together enough to do the job, and grateful for the fact that I run in a system that has a lot of good medics on the scene. I have done a good job through it all, but the cost is mounting. I am going to Canada for a few months. My mother is very ill and she has no one advocating for her up there. I need to be there for her. I need to be with my daughter for me. Living in the middle of the desert has been great for getting out of the snow and cold - not so great for being away from everyone and everything familiar to me. I feel burned out. I really hope I am not done with EMS.

Would you not worry about CPAP drying out mucus secretions? I thought the rational for fluids in pneumonia was to facilitate loosening of these secretions. Would CPAP not be working at cross purposes to this?

Once again, my betters are educating me. I should have said Ace Inhibitors, not beta blockers.... and the lasix thing.. I was referring to front line treatments in the ED.

Given that scientific research is not the issue here I personally would not use CPAP in pneumonia UNLESS there is an edemic component. If there is water there, the CPAP can deal with that and perhaps give the patient what they need to deal with the pneumonia. You just can't push puss (nor would you want to) into interstitial space. (The lasix is worse than useless and has been replaced by beta blockers as a first line treatment for pulmonary edema in progressive EDs).

congrats..

I have progressive tri-focals. The first zone is clear glass and is to eliminate me having to take my glasses off for close work. I have perfect vision up to about 18". My congenitally elongated cornea means I have always been myopic, and after hitting and passing 50, I now have problems with middle distance. At 650$ a pop, I would totally be interested in looking into these.

I have seen similar situations when people have diastasis recti. The right and left sides of the rectus abdominis spread apart at the midline. It's common in pregnant women, where the uterus pushes out the muscles and I have seen it run in families in the males. Granddad, dad and boy all have it. The naval commonly protrudes as well.

different strokes for different folks..

Check the national registry website. They have a map with each state. You click on the state and it takes you to that state's EMS site, with the requirements, etc. Here's the link https://www.nremt.org/nremt/about/emt_cand_state_offices.asp

... get a room you two

Where'd Ed go?

Welcome young one... beware the jabberwocky

You know doc, you really gotta stop beating around the bush. edited because I couldn't get the YOU RULE emoticon to work

Rest in Peace.

This is offensive. Just because people can do stuff doesn't mean it's right to do stuff. To break a silence to beg for money is demeaning, and to try and justify it by pulling in Rob's death is worse. I understand that today's popular culture gives people the sense that amoral behavior is acceptable, but on this site it is not. Go away.

Strong work! Pat yourself on the big, celebrate a little and then tomorrow, back to the work of learning and growing.

congrats.. welcome to parenthood.

Welcome. It is great to have a remote medic presence on the site, especially as Dwayne is such a reticent, retiring type. I look forward to your posts.

I went to the gym for my bi-weekly torture session. When I got there, the trainers were deep in worried discussion about an 81 year old gentleman, also a frequenter of the gym. I had seen him there several times and had exchanged nods. The fellow had been wearing a bandage on his earlobe for about a month. My trainer said "We have been so worried about him. He refuses to go to the doctor. Would you please look at his ear?" We went over to the man. Initially confused, then embarrassed, he allowed me to look at his earlobe. I saw a nodular melanoma and my heart stopped. It was almost 2 inches in diameter, luridly colored with black, red, blue and yellow. I was quite blunt with the man. I told him I wasn't a doctor, but that it was serious. He needed to go in today. Later, he came over to us to chitchat and told me I had frightened him. I told him good - he needed to be scared. The man nodded to me, promised to see a physician tomorrow and offered me lemons from his tree. I feel like crap. I don't imagine the man's prognosis is very good. He left it too long. I really gotta learn to mind my own business.

I for one admire you for helping. I also had some PM contact with the OP and I think he is at least as deserving of help as any one of us.

Phil... I missed you dude.. I asked you to marry me and you disappear .... I promise to behave...

Reality check big time. Thank you for posting.

Welcome Ed Brown. I am in Western AZ. Are you currently working in EMS?

Welcome. One point tho... it is never "just IFT". These are some of the most challenging patients you will encounter; multiple co-morbidities, acute medical, chronic illnesses, etc. etc. These people need compassionate and effective care. Use your time on IFT to learn. Once again, welcome to the site.