Discount Workout!

    It always amazes me that no matter how convenient it is to work out (example: complete 24 hour gym less than 5 minutes from my house), I want it more convenient. Hence, my slow accumulation of various workout equipment over the years. We have exercise balls, weights (ankle and dumbell) in various sizes, a small collection of workout dvds and at one time, a large treadmill that took up a huge amount of room.
    The treadmill has been consigned to dumpster land after I tried to put it in the storage position, forgetting that I had left the incline up. OOPS! No matter how hard I tried, or how many people I got involved, it just never worked right after that.
    My workout video collection was expanded during my deployment by the addition of the P90X videos on my laptop. It was great when I was right there and could set my laptop on the counter in the little tent gym right outside the hospital in Bagram, but I just couldn't picture it working at the big gym here on base, or any other gym I might have access to.
    My solution was to get all the weights I would ever need, and a weight bench, and I could do the workout at home. Sounds great, right? Have you ever priced dumbells? Not the type you might find sitting on a couch in front of the T.V., but those weights designed to be lifted one handed? If you can find them for a dollar a pound, you are doing pretty good. Considering that in just one P90X workout I might use the 10s, 15s, 20s, 30s, 45s, and 50s, I was going to need a lot of weights. I only had the 15s, so how was I going to afford all those weights? I wasn't. 
    Someone very smart had a solution, a weight set that was completely adjustable from 5 to 90 pounds, and much more affordable than 1 dollar per pound. They are called PowerBlocks. But, they still ain't cheap. According to the website www.powerblock.com, "The Elite 5-90 set comes with plates 1-8, and has a weight range of 5-90 lbs per hand. The Elite 5-90 lb equals/replaces 28 pairs of dumbbells, or 2565 lbs of free weights while taking up the space of just 1 pair (90 lb dumbbell is just 16" in length) This set is expandable to 130 lbs per hand using the 8-11 Elite Big Block Kit. The dimensions of the Elite 90 are; 16"L x 6" W x 6" H. Ships in 4 boxes. Made in USA." Price: a measly $588.00 per pair, plus $89.00 shipping and handling.
     Hard on the bank account, but I was willing to do it, especially since we are moving to the land of snow and ice and other cold weather phenomenon. I was still going to have to find a weight bench as well.
    And then Mrs. Penguin happened to check the Travis yardsales e-mail one evening a week or so ago. Lo and behold, a weight bench and the PowerBlock Elite set for the low, low, low price of $350.00! Immediately Mrs. P sent an e-mail saying we were interested, and I went and picked them up the next day, plus the safety mat the seller had the weight bench on. Half price! 
    I rushed them home, set them up in the garage, and . . . there they sat until the movers packed them up on Tuesday. We will be reunited in Anchorage, where I intend to get my money's worth out of my discount workout equipment!

A Day in the Life at Craig Joint Theater Hospital (Warning: May be considered graphic)

This is the final article I wrote about Afganistan, also intended for publication in the newspaper. This is not for the kiddos.

    The alarm clock begins beeping, signaling the start of another day. It’s only been a few hours since he closed his eyes, but for Capt. Robert Austin of the U.S. Air Force, there is no sleeping in, no matter how tired he is. “Service Before Self” is one of the three key tenets of the Air Force, and this deployment has provided an exceptional opportunity to live that tenet. 

Austin, a Nurse Anesthetist deployed from Travis Air Force Base in Northern California is a Nurse Anesthetist with the 455^th Expeditionary Medical Group at Craig Joint Theater Hospital, Bagram Air Base, Afghanistan. 

He says, “On paper, we only work 8 hour shifts. I’m usually at the hospital 12-14 hours a day, minimum. So many of our patients require so much that we often have 2 providers in the room, or we are busy enough that we end up staying over to help cover the cases.” He is referring to the nearly 300 anesthetics he has provided or helped with in the past 6 months.

“My last day off was the day I got here, December 21^st,” He smiles and jokes, “My next will be the day I go home.”

The hospital cares for a large majority of the American troops wounded in theater, as well as Afghan National Police, Afghan military, and local nationals. He explains, “Bagram is the primary hub for evacuation to Germany. No matter where in country you are injured, you will most likely come through this facility on your way out.”

Accurate numbers were not available, but Austin estimates that the facility averages 10 surgeries a day, ranging from laparoscopic appendectomies and gall bladder extractions to multi-specialty, multi-hour cases. "We have specialties here that you’ll only find at large hospitals stateside. Neurosurgical services, pediatric orthopedics, vascular surgeons, ophthalmological surgeons. We have it all. Often we’ll have one surgery with 4 or 5 services scrubbed in. It can be very hectic." 

One of the surgeries that stands out in his mind is a Polish patient early in the deployment. “I started his case one evening and took it back over and finished it the next day. He was in surgery for over 18 hours. He had Ortho, General Surgery, Neuro, and I believe, Urology, all working on him.”

Such extensive surgeries are the exception, not the rule, fortunately. Unfortunately, the signature injury of the war, amputation of both lower extremities and one hand with or without groin injury are seen almost daily, and are increasing in frequency. “These patients are the hardest,” says Austin. “Usually we are not the first to see them. By the time they get to us, they have already sustained not only their original injury, but the first of what will be multiple surgeries. They are the recipients of massive transfusions.”

‘Massive transfusion’ refers to when a patient receives more than 10 units of blood products. The average circulating volume of the human body is 5 liters. 10 units of blood products comes close to completely replacing that volume. 

“We recently had a patient who had received 70 units of packed red blood cells (pRBCs), 64 units of Fresh Frozen Plasma (FFP), 21 units of whole blood, 4 10-packs of cryoprecipitate and 5 6-packs of platelets before he got to us. He had the equivalent of 14 people’s entire blood volumes for one surgery. We took him back to surgery, gave him another 8 units of whole blood, 8 pRBCs, 13 FFP, 3 10-packs of cryoprecipitate and 5 more 6 packs of platelets, or about another 4 blood volumes, just for the revision and washout of his injuries. He’s facing probably another 20 or more surgeries over the next few months, and then years worth of recovery and physical therapy.”

Austin says he wonders about how well these patients will do. “We’ll never see these guys again. I have no idea if they will recover and adjust to life without three limbs, or if they will die of infection, or what. It’s hard.”

Some patients exhibit a spirit that reassures him. “We had one guy who had lost a leg. He had to go back to surgery for a washout of his injury. After surgery he was in a lot of pain, both physically and emotionally. He was really struggling with accepting his injury. One of the ICU nurses told me the next day he was gonna be ok. I asked her how she knew and she shared a joke with me that he had told her that night. 

‘Where does a man with only one leg go for breakfast? IHOP!’ If you can joke about it, you’re probably going to be all right.”

There are other patients that Austin will never forget either, the ones who didn’t survive. Speaking of the first patient who died while in the operating room under his care, Austin says, “I carry a lot of guilt,” he says. “They died under my care. While I can know that I did everything right, that we all did, it doesn’t change the fact that we lost him. We tried until it was apparent that he wasn’t going to make it, and then we kept trying. There were four anesthesia providers working on him and six surgeons. At one point there were over 20 people in the room, all contributing to try and keep this soldier alive. He had the best of the best giving it their best, and it wasn’t enough.”

Austin says he is glad he’s going home soon. “I have been privileged to care for our troops, but it’s someone else’s turn. The cost is of caring for these boys is high, mentally and emotionally, not just for me, but for my family as well. I’m looking forward to being reunited with them, and to my upcoming PCS.” Austin will be moving to Elmendorf AFB in Anchorage later this summer.

What are the odds?

This is actually the first article I wrote, before I found out about Davin and Dan being there. This was also intended to be published as a Newspaper article

     It is approximately 6500 miles as the crow flies from Homer to Bagram, Afghanistan. That distance was bridged in an incredible way this spring. Sometime in Mid-April of this year, a chance conversation at the local CarQuest between Mariah Thomas-Wolfe and R.J. Austin led to the discovery that both of them had sons deployed to Bagram with the 455 EMDOS, serving in the same unit.
    Mariah’s son, Senior Airmen Zach Schindler is a 2004 graduate of Homer High and works in the Contingency Aeromedical Staging Facility or CASF as a medical technician. R.J.’s son, Captain Robert Austin, graduated Homer High in 1994 and is a Nurse Anesthetist working in the Operating Room inside the hospital. The two met a about two weeks after their parent’s encounter, during a IDF or Indirect Fire attack, when the CASF was evacuated into the hospital.
    “It is incredible. No matter how far away we get, I always run into somebody from home. My last deployment (To Balad, Iraq in 2005-2006) I worked with a guy from Kenai. There are a couple of docs here from Alaska as well. I am impressed with how well represented Alaska is in the Armed Forces.” says Captain Austin.

    Coincidentally, only a couple of nights before Austin and Schindler met, Capt. Austin snapped a picture. He explains, “People back home make and send blankets and pillows for the wounded troops to use on their flight out to Germany. The litters that the patients travel on are lined up in the hall a few hours before the flight. That night, I happened to notice the embroidery on the blanket said “Homer, Alaska.” I don’t know who sent that blanket, but I hope they read this article and know that it did indeed keep a wounded service member warm on a long flight, and that it cheered up another service member, seeing that reminder of home. Whoever you are, thank you.”