Wednesday, February 29, 2012

Mark Young: Heroes Among Us 2/2

Today, we're continuing with Mark Young's posts that reflects how a personal experience provided fodder for the opening scene of his latest novel, Off the Grid. A great read for a great price!

Welcome back, Mark!

They seemed to vanish as we neared where I last saw them. We followed the trail they made for quite a ways without any further sightings. Finally, orders came through to break off and head toward our main camp. Just as we veered off, enemy soldiers opened up. Our machine gunner was the first man hit. My adrenaline kicked in. As I reached for another magazine of ammunition, I realized that I had been hit. Someone yelled “medic” as the jungle around us seemed riddled with enemy fire. I saw a lone corpsman crawling through the brush, working his way toward our position amidst heavy enemy fire. With little regard for his own safety, I watched this man move forward and began to treat each of us who had been hit.

He worked with speed and compassion in what seemed like an impossible situation. Nightfall soon descended and we pulled back a short distance. We could hear movement all around us that night as we waited for morning light. Air support could not reach us until daybreak, and for the moment we were cut off from the rest of our troops. The machine gunner lay mortally wounded, but it took most of the night for him to die. That corpsman stayed with the dying Marine, trying to comfort the injured man at great risk to himself. The dying man occasionally screamed out in pain, and the noise threatened to give our position away. The enemy might have easily lobbed a grenade or fired a shot in our direction, using the howls of pain to locate our position. That brave medic, however, stayed by the dying man’s side until the very end risking his own life.

That corpsman was my idea of a hero.

As I came back into the present and began to write, I tried to remember those moments and make the memory of that corpsman, and others I met on the battle field, a part of what my main character would become—a hero. In this world, we need to witness the courage and bravery lived out in the lives of those around us. We need to find those heroes among us. We saw it in the lives of others when the events of 9/11 changed us forever. Today, there are heroes living among us, normal everyday folk whose bravery might never be known—a nurse comforting the injured, a doctor easing the pain of others. And a corpsman braving a foreign battle field to provide aid and comfort.

Our world needs to see that there are more heroes. That is why readers will always find a hero somewhere in my novels. These main characters will not always be perfect—but they always come through in the end regardless of the cost.

*****************************************************************************
Mark Young is an American novelist. His second novel, Off the Grid, is his first international thriller. Mark was a police officer with the Santa Rosa Police Department in California for twenty-six years; an award-winning journalist; and a Vietnam combat veteran. He served with several law enforcement task force operations, including the presidential Organized Crime and Drug Enforcement Task Force targeting major drug traffickers, and the federal Organized Crime Task Force charged with identifying and prosecuting prison gang leaders. He lives in the Pacific Northwest with his family. Visit Mark’s blogs for further information at Mark Young: Arresting Fiction… or at his mystery blog site Hook’em & Book’em.

Monday, February 27, 2012

Mark Young: Heroes Among Us 1/2

Mark Young is a good friend and talented writer. I have read the opening scene of Off The Grid and it is gripping! I highly suggest you pick this novel up.

Welcome, Mark!

One of the bravest people I ever met was a navy corpsman who came to my rescue on a battlefield many years ago.

As an author, creating fiction sometimes forces you to relive moments of your own life that you might otherwise suppress—maybe even try to forget. As I began creating my main character, Gerrit O’Rourke, in my latest novel, Off the Grid, one of these moments came crashing through from the past.

I began creating Gerrit as a lieutenant in the U.S. Marine Corps in the opening prologue. The scene opens during a military operation in Iraq, dubbed Phantom Fury, one of several hard-fought operations to gain control over the city of Faluja, in 2004. It was an intense fight between Marines and enemy combatants. Many military veterans likened these battles to the conflict to gain control of Hue City, in Vietnam, more than forty years ago, door-to-door firefights that by their very nature create heavy casualties.

As this character developed in my mind, I brushed aside the cob webs and relived moments of my own experience in the Marines during the Vietnam conflict. It was 1968. Our company had sustained 120 percent casualties in the battle over Hue City. I and my fellow Marines, fresh from the states, became replacements for those killed or injured in that conflict.

We were moved from that battlefield to the mountain tops along what was dubbed the Ho Chi Minh trail, a jungle pathway weaving through the countries of Laos and Cambodia, along the Vietnamese borders. This network of jungle trails, beneath heavy jungle foliage, was being used by the enemy to move troops and equipment from North Vietnam into South Vietnam. We were charged with providing protection to engineers, as they built mountaintop landing zones (LZs) to allow helicopters to land troops and equipment into the area.

One day my platoon was sent out to scout the mountain slopes around this LZ. It had been raining, and fog hugged the mountains in a chokehold. At times, it seemed visibility extended to the end of my nose. I had been selected to walk point that day. We worked our way quite a ways from the LZ, and it was getting late in the day.

At one point the lieutenant directed us to start heading back home. Leading our platoon down the mountain side, I saw movement further down the slope, figures like gray ghosts working their way through the fog. These ghosts turned out to be North Vietnamese and Chinese soldiers. I was ordered to start following them to see if we might locate their main body of troops....

Mark concludes on Wednesday!

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Mark Young is an American novelist. His second novel, Off the Grid, is his first international thriller. Mark was a police officer with the Santa Rosa Police Department in California for twenty-six years; an award-winning journalist; and a Vietnam combat veteran. He served with several law enforcement task force operations, including the presidential Organized Crime and Drug Enforcement Task Force targeting major drug traffickers, and the federal Organized Crime Task Force charged with identifying and prosecuting prison gang leaders. He lives in the Pacific Northwest with his family. Visit Mark’s blogs for further information at Mark Young: Arresting Fiction… or at his mystery blog site Hook’em & Book’em.

Saturday, February 25, 2012

Up and Coming

Hope everyone is having a fabulous week. Thanks so much to all my new followers/subscribers! So glad to have you here.

This Week:

Monday and Wednesday: My good friend, Mark Young, drops by to talk about how real life military experiences influenced his current novel, Off the Grid. This is a great book for a great priced. Please, check it out.

Friday: An all important topic for writers-- maintaining the chain of evidence. What is it and what does it mean if it's broken?

What interesting things have you researched lately for your current work in progress?

Jordyn

Friday, February 24, 2012

Medical Question: Brain Surgery

Today, Amitha concludes her thoughts on surgery with some specifics about brain surgery.


-->>Note: If you're squeamish stop reading here!<<--

As far as what would exactly happen during the brain surgery, it's hard for me to say because I don't really know what kind of surgery your fictional patient is having. But most basically, the surgeon first cuts into the patient's scalp, exposing the skull. They drill open and remove a portion of the skull, then cut into the dura (a membrane surrounding the brain) to expose the brain. Then the surgery is performed (depends on the type of surgery). At the end of a craniotomy, the skull is reaffixed using screws or other techniques (though in a "craniectomy" it is not replaced).

This website: http://www.brain-surgery.us/12_open_surgery_postop.html goes into some specifics about what's involved during different brain surgeries. Make sure to scroll down to the bottom for some nice images.

Search YouTube for craniotomy:

If you have an idea what specific kind of surgery your fictional surgeon is performing, there's probably a video of it on YouTube.

But as far as things that would make your story believable, I think this video of an awake craniotomy is excellent. You get views of the room, the equipment they use, the patient, the doctors and others in the room, and the surgery itself.



This video isn't quite as self-explanatory, but shows a surgery where the patient isn't awake and where a special microscope is used during the surgery.



When writing, I'd try not to get too bogged down in research and details. You'll bore yourself and your readers to tears. I'd focus on getting the overview of things right. What people are wearing. What people are doing—rather than specifics of the surgeries.

It's the simple things that will make your reader question your credibility as an author. For example, knowing that your surgeon will already have her face mask and hair coverings on before she enters the OR and that she'd keep these on the entire time she’s in there is something that anyone who has seen a surgery would notice. Whereas, choosing the wrong type of scalpel, or the wrong kind of anesthesia, would be overlooked by most people.

******************************************************************************


Amitha Knight is a former pediatric resident turned writer of middle grade and young adult fiction. She’s also a blogger, a book lover, an identical twin, and a mom. Follow her on twitter @amithaknight or check out her website: http://www.amithaknight.com/.

Wednesday, February 22, 2012

Medical Question: Surgical Timeline

I'm pleased to have Amitha Knight back who will be hosting a medical question today and tomorrow about surgeries. Today, she covers the general surgical timeline and what the patient's process is through the OR. On Friday, she'll cover more in depth about brain surgeries.


RB asks:

In the book my one lead character, a Brain surgeon, will be performing two major surgeries during the life of the book, one on (an animal), and the other she will be performing a radical operation on the male lead.

Could you, in as short as possible, give me an overview of what happens during such a surgery. The big picture and any suggestions you could give me that would make the scenes believable.
Even if you can point me at a website where I can read up about brain surgery – any videos would help as well, I am not squeamish about blood etc… so don’t worry about that side (more fascinated by the whole process).

Any help would seriously be appreciated.

Amitha says:

While I saw lots of surgeries during my 12-week surgery rotation in medical school, ranging from cholecystectomies (gall bladder removal) to liver transplants to cardiac surgeries to breast implants, I didn't see any brain surgeries. I especially didn't see any veterinary surgeries so I can't comment on that part of your question.

The reason I didn't see the brain surgeries was that the surgeons wanted you to be there for the entire surgery and brain surgeries can take a long time. For example, I heard of one brain tumor removal taking 6 hours. A quick search of the web reveals people who report their brain surgeries having taken more than 12 hours--not sure if they're counting recovery time. Performing and assisting surgeries for long periods of time requires stamina, dedication, and patience. Alas, our hospital didn't have a surgical theatre like on Grey's Anatomy where people could eat lunch, gossip, and come and go as they please while watching surgeries.

While I haven't seen a brain surgery, the very basic timeline of surgeries are generally the same:

  • The patient is wheeled into the sterile operating room (OR) and transferred to the operating table. Everyone in the room (besides the patient) is required to wear a face mask, a hair covering of some kind, scrubs, and shoe covers.

  • The anesthesiologist sedates the patient (sometimes this is started in the pre-op area). During some brain surgeries, the patient is kept awake for portions of the surgery (so they can monitor the patient's brain functions by having the patient do different things during surgery) while in others, the patient is intubated and kept under general anesthesia the entire time.

  • The patient is positioned appropriately for the surgery. Parts of the body that aren't being operated on are covered up. The patient's head is shaved (or at the very least the part that they are operating on I should think).

  • Meanwhile the surgical team "scrubs in" (i.e. they go to a separate room attached to the OR to thoroughly clean their hands/arms up to the elbows and then return to the OR where they are helped by surgical technicians and nurses into sterile gowns and gloves, all the while making sure not to touch anything that isn't sterile). Sterile coverings (which are usually all blue) are draped everywhere so that people who are "scrubbed in" don't accidentally touch non-sterile things. People who aren't "scrubbed in" aren't allowed to touch anything in the sterile field. Keeping things sterile and clean is key.

  • The surgical area is "prepped" (i.e. cleaned).

  • Surgeons and surgical techs do a "time out" and double check the patient's name and the procedure being done and the area being operated on.

  • The first incision is made.

  • The surgery is performed. Tools are all counted by the surgical tech. (During long surgeries, this may happen several times throughout.)

  • The surgical site is "closed" i.e. stitches are put in, the wound is dressed.

  • The patient is wheeled to the post-operative area ("post-op").
Have you ever written a scene that involved the operating room?

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Amitha Knight is a former pediatric resident turned writer of middle grade and young adult fiction. She’s also a blogger, a book lover, an identical twin, and a mom. Follow her on twitter @amithaknight or check out her website: http://www.amithaknight.com/.

Monday, February 20, 2012

Medical Question: The Morgue

DV asks: I am writing a thriller right now and need a description of a large city hospital morgue. I haven't tried to secure a tour yet (do they even allow that?) at a city nearby. All I need is to know how they're set up. I've read they're usually in the basement near a loading dock, and they're usually unmarked and secure.
Do they use a wall of refrigerated drawers? If not, what does the room look like? How are the bodies marked? Do they still use toe tags or is it all done electronically? Do they include cause of death? I'm afraid the smaller town I live in wouldn't have the same kind of morgue as a large city (the book takes place in LA). I'd like to have at least a semblance of reality.
Jordyn says:  DV, thanks for sending me your question.
I'm not familiar with a large city morgue either. Just a hospital morgue. I think you could probably call and set-up a tour. I'm sure you won't be the first person to ask. Another thing I would recommend would be to take your local police department’s citizens’ police academy. I took one locally last year and it was a wealth of information. Sometimes, through a venue like this, you might get the chance to tour a morgue.
Considering your question as a medical person, this is how I would research it.
Do a Google search for known medical examiner's buildings and get photos of the structure via the Internet for the outside look.
Next, go to You Tube and search for "morgue tour".
I thought this one was actually pretty good and gave decent enough info to set up a scene.

You could view others as your heart desires. Any other suggestions for DV?

***********************************************************************

DV Berkom grew up in the Midwest, received her BA in Political Science from the University of Minnesota, and promptly moved to Mexico to live on a sailboat.

Several years and at least a dozen moves later, she now lives outside of Seattle, Washington with her sweetheart Mark, an ex-chef-turned-contractor, and writes whenever she gets a chance. You're welcome to email her at dvb@dvberkom or chat with her on Facebook or Twitter- she loves to hear from readers as well as other writers.

Sunday, February 19, 2012

Up and Coming

Hey Redwood's Fans! How has your week been?

This week is all about author questions. I love the challenge of doing these posts. Amitha Knight is joining in on the fun as well.

Monday: The Morgue

Wednesday: Surgical Timeline

Friday: Brain Surgery

Looking forward to seeing everyone!

Jordyn

Saturday, February 18, 2012

Several Days Before Christmas

I'm pleased to host Frank Edwards, MD today as he writes about telling a family about the death of their loved one.

I have been in this position, unfortunately, as well. Sometimes, getting the feelings of a healthcare provider is hard to do. I think Frank has done it well with this poem.

It was a little after noon
when the drizzle began.

A truck skidded sideways on a bridge
and overturned.

The driver wasn't hurt,
but underneath his truck

Lay a car,
roof caved flat,
the driver's head crushed.

Before setting out,
she had firmly buckled her two young sons
in the back seat.

In the hospital
I examine them:
A few scratches from window glass
turned shrapnel.

They do not ask about their mother
who'd gone straight to the morgue.

Her husband,
at work,
was only told
there'd been a wreck,
his wife was hurt.
When he arrives
a silent nurse leads him
to the room we keep for these occasions.

How to do it?

Introduce yourself.
Not by first name--
use your title: doctor.
It's pragmatically superfluous now,
the little good you did,
but this a time for shamans.

Start easy.

Your sons are fine,
Not hurt . . .
But I do not have good news about your wife
(Husband, mother, father, brother, sister, friend).
Then shut your mouth for about ten seconds,
sit, lean forward, take their hand,
allow them to poise,
their grief to ripen.

Do not proceed,
I repeat,
do not continue--
until you feel it yourself.

Only then
give the truth.
and do not be afraid
to use the word death.

And as the floor caves in--
sink with them.

*****************************************************************************

Frank Edwards was born and raised in Western New York. After serving as an Army helicopter pilot in Vietnam, he studied English and Chemistry at UNC Chapel Hill, then received an M.D. from the University of Rochester. Along the way he earned an MFA in Writing at Warren Wilson College. He continues to write, teach and practice emergency medicine. More information can be found at http://www.frankjedwards.com/.

Check out Frank's novel Final Mercy.

Friday, February 17, 2012

Author Beware: Unsecured Narcotics

I was happily reading along one of my favorite best-selling authors when I stumbled upon a troubling set-up. Now, this author makes a lot of money which is why I'm not sure the reason for his not picking up the phone to consult me on his manuscript.

One character had been beaten up fairly well. He was in the hospital on a Valium drip. Huh? That's right, just a bag of Valium hanging and dripping into his veins.


Issue One: Valium is not a pain medication per se. It is a muscle relaxant which can relieve pain from a muscle spasm. However, if you have had the snot beat out of you, let me introduce you to my friends the opiates: Morphine, Fentanyl, etc. These are likely what we would give first for pain.

Issue Two: Valium is not given in a bag as a drip. In fact, I can think of few instances where Valium would be given as a continuous medication. Some shorter acting friends of Valium are-- but you generally have to be in the ICU on a ventilator to get some. This character was not.

Issue Three: Narcotics need to be secure. If a patient needs a continuous amount-- this is what PCA (patient-controlled analgesia) pumps were made for. They are locked IV pumps so that no one can steal the drug from the bag and so that the patient cannot manipulate how much they receive.

Pediatric ICU's do run a lot of continuous drips that are not locked. In these instances, usually a calculation is made at the end of a shift to look at the amount remaining. If the syringe is off by more or less one millimeter-- then generally an incident report is filled out.

So bestselling, multi-million dollar author--- really, just call me up. I'd be happy to help.

Have you read a scene with inappropriate use of narcotics?

Wednesday, February 15, 2012

The Challenge of Caregiving: Rob Harris (Part 1/2)

Today, Rob concludes his first person account of caregiving under crisis. Good news is his wife is strong and well and they are still happily married.

Welcome back, Rob.


The cardiac room was cramped, even without the medical team working over her. I was relegated to the hallway with a nurse that had accompanied us from our oncology floor. She had been on break and was friendly with my wife and me. She was there to make sure I was okay – or was she there to ensure I would not get in the way?

A nurse who was unknown to me walked past with a large syringe.

“Atropine?” I asked as I turned to the nurse who escorted me to the cardiac floor. She nodded in affirmation.

“Just precautionary,” she advised.

In the room, I heard my wife state to the doctors, “I can’t see. Everything is getting dark.”

That’s when I stuck my head into the room and saw it.  By the way in which her head fell to her chest, there was no doubt in my mind that her heart had stopped beating.

For the first time, a doctor acknowledged my presence. “Nurse, please remove him from the room.”

A tug on my elbow instructed me to follow. I comprehended the message.

Though I had no intention of getting in their way or interfering with their efforts to restart my wife’s heart, I was her husband. I had to give it one try.

I pulled away from the nurse’s grasp. “CINDY, WAKE UP!” I screamed at her.

And that is exactly what she did! She came back to life. That is when I agreed to leave the room. Second later, the syringe was dispensed and, after careful and extended monitoring, my wife was relocated to her new home, the Intensive Care Unit of the hospital.

It was 24-hours later before I was spoken to by a cardiologist. Terms that had up to that point been foreign to me were introduced, soon to become a regular part of my ever-expanding medical vocabulary. “Your wife had an episode of what’s known as QT prolongation.   Her electrocardiogram indicated she had a rather unusual occurrence, known as ventricular tachycardia, more formally called Torsades de pointes.”

He then turned to my wife. “You’re very lucky,” he began. “Not many people survive an event of this nature. I’m curious. What did you see, what did you feel when your heart stopped beating?”

My wife smiled, though still extremely groggy. “I was shopping in a mall. I was buying all the purses I wanted and I didn’t need a credit card to pay for them. They were free. I loved it there.”

“What brought you back?” he asked.

“I heard my husband shout my name. It sounded like he needed me badly.”

The cardiologist turned to me and smiled.

In hindsight, I understand why I had been ignored. There was no way I wanted to distract or interfere with the doctors whose mission it was to keep my wife alive.

That said, I would have liked the doctors and nurses who had been working all around me to understand that although I appeared composed, mentally, I was in critical condition. If my wife was dying, so was I. If she was suffering, I was in distress right alongside her.

Keep in mind; we are all human beings, with all-too-real emotions. Any form of communication, even if it’s a nanosecond of recognition is invaluable to someone whose most valuable gift, the life of a loved one, is in life-threatening distress.

***************************************************************************

Rob Harris is a seasoned/accredited Human Resources professional. He is the author of two books. The first, “We’re In This Together, A Caregiver’s Story” is scheduled for release in the Spring of 2012. The sequel, “We’re In This Together, A Caregiver’s Guide” will follow shortly thereafter. More importantly, he is a seasoned Caregiver. His wife is a two-time cancer survivor (Non-Hodgkin’s Lymphoma and a radiation-induced leiomyosarcoma).  He and his wife are the proud parents of two U.S. Army officers. Presently, his youngest son is protecting our country's freedom in Afghanistan after previously being stationed in Iraq. His brother recently returned from his first deployment in Afghanistan.  

Monday, February 13, 2012

The Challenge of Caregiving: Rob Harris (Part 1/2)

I'm very honored to have Rob Harris here at Redwood's Medical Edge today. He's giving a first hand account of what it's like when your loved one nearly meets death. Part 2 will be posted Wednesday.

Welcome, Rob.

7:24 a.m. The nurse tech entered our hospital room and took my wife’s vital signs. I was awake, dressed and ready to record her findings on my Excel spreadsheet. “Temp: 97.5; BP: 122/61, Pulse: 32,” she said as she turned to depart our room.

I looked up from my laptop, my fingers frozen over the keypad. “Excuse me,” I stopped her in her tracks. “You gave me an incorrect number. You said her heart rate is 32? Is the machine working properly?”


She returned and took my wife’s pulse manually. “It’s 45,” she announced. Again, she turned to leave.

“Could you please ask our nurse to come into the room,” I requested calmly, so as not to alarm my wife. My wife’s pulse rate under normal conditions is high, typically in the mid-to-upper 70’s. Being in the 30’s or even the 40’s was cause for alarm.

She didn’t move quickly enough for my liking. I strode past her and turned the corner. Once out of eyesight I raced to the nurses’ station and interrupted the nurse assigned to our room. She was debriefing the attending physician prior to beginning his rounds. I apologized for the intrusion and explained my concern. They followed me and went straight to my wife.

Thus began a day I will never forget. My wife had received her sixth cycle of chemotherapy for a leiomyosarcoma, a 4-hour dose of methotrexate administered via an IV-drip into her port the previous night. Up to that moment, no unusual symptoms appeared.

My caregiver role began and ended at that moment. It commenced by my alerting the doctor and nurse that I was gravely concerned about my wife’s medical condition. It ended as soon as the medical teams descended upon our room.

To use a sports vernacular, I was “benched.” I was immediately transitioned from caregiver to spectator. As anyone who has ever attended a sporting event in which they are loyal to the home team can attest, a spectator, or fan, can yell, scream, cheer and even insult. Much as they may beg to differ, they have no bearing on the final outcome of the game. In other words, they are powerless.

And so was I. Worse, I was alone. I was ignored. I was invisible.

A crash cart suddenly appeared in our doorway.

“Would someone please tell me what’s going on here? Why is this happening?” I inquired to no one individual in particular.

I didn’t want to bother the medical team, but as low as my wife’s pulse was at that moment, mine was definitely heading in the direct opposite direction. Externally, I remained calm. Internally…Jell-O!

“We need to move your wife to the cardiac care floor, the nurse informed me. “Pack your things. We’ll be going as soon as transportation arrives.”

I obeyed. I didn’t exactly feel useful, but I felt, in some small way, engaged in the process. Someone had acknowledged me. Someone gave me direction.

The doctors, three of them, exhibited a calm demeanor. This comforted me to some extent.

I wish someone would look my way and reassure me; talk to me, provide a morsel of encouragement, I thought to myself. Nothing came, not a nod, a wink, a slight smile or even a glance in my direction. I guess I was invisible after all.

Finally, the nurse spoke. “We’re taking your wife now. You can go with us if you’re all packed.”

“Can you tell me anything?” I begged. Nobody, including the nurse responded.

I understood. I felt like a child in a room full of adults. Caregivers and children are to be seen and not heard. The memories came flooding back. I knew my place. My wife is their only focus, as it should be. Again, I remained composed on the outside, but I was combusting internally as we passed another waiting crash cart in the hallway just outside her newly assigned room.

*********************************************************************************
Rob Harris is a seasoned/accredited Human Resources professional. He is the author of two books. The first, “We’re In This Together, A Caregiver’s Story” is scheduled for release in the Spring of 2012. The sequel, “We’re In This Together, A Caregiver’s Guide” will follow shortly thereafter. More importantly, he is a seasoned Caregiver. His wife is a two-time cancer survivor (Non-Hodgkin’s Lymphoma and a radiation-induced leiomyosarcoma).  He and his wife are the proud parents of two U.S. Army officers. Presently, his youngest son is protecting our country's freedom in Afghanistan after previously being stationed in Iraq. His brother recently returned from his first deployment in Afghanistan.

Saturday, February 11, 2012

Up and Coming

Hey Redwood's Fans!

Recently, I was gifted two blog awards by fellow writers and I want to acknowledge them in their kindness.

The first was the Versatile Blogger Award given by Carrie Rubin at The Write Transition.

The second was the Sweetest Blog Award given by Faith, Fiction & Friends.

Both of these blogs are deserving of your perusal so I hope you'll take the time to check them out. I want to give a big shout out of thanks for their generosity and support.

I'm going to modify the requirements a little-- you know healthcare people never follow directions too well as my current physical therapist has been griping to me about-- yes that pesky shoulder dislocation. Instead, I'll share some of the blogs I regularly visit that I think are definitely go to sources for other writers. And then I'll share some fun facts about me!

Blogs:

1. The WordServe Water Cooler: I'm a little biased here as I do administrate this blog but it is a group of agented authors sharing their wisdom and advice to those a little further back on the publishing road. These authors are amazing people-- and so is their writing. Recently mentioned on WritersDigest.com!

2. Michael Hyatt: This should be standard reading for all writers everywhere. Michael blogs on several topics ranging from social media to leadership.

3. Novel Rocket: Again, standard reading for novelists. Author interviews from debut to bestseller and everything in between. I mean, it was started by an RN so how could it not be good!

4. Suspense Novelist: Musings from the writing world.

5. Mike Dellosso: Mike's a suspense novelist and all around great guy. Wears his heart on his sleeve and blogs the same.

Five things about me:

1. I recently bet my personal trainer that I would cut out caffeine and diet pop if he would keep getting his six-month-old immunized. That's what I'll do for a child and if you knew how much I liked those two things you'd be amazed!

2. I am a little cranky about having done the above-- but do feel better.

3. Favorite shows: Biggest Loser (which I often eat ice cream in front of), Flashpoint (though not for its medical accuracy by any means) and Castle (love him!).

4. Favorite authors: Dean Koontz hands down. Though I have recently discovered Harlen Coban, Linwood Barclay and Karin Slaughter (who has the best suspense novelist name of all time) and am loving their books.

5. I cross stitch and quilt-- when not mothering, working, reading, blogging and writing fiction.

How about you? What's one interesting thing I should know? Leave a comment!

Now back to business...

This Week:

Monday: Rob Harris guest blogs about caregiving and the real life drama of almost losing his wife.

Wednesday: Rob Harris concludes about caregiving. It really is a sweet story. No Valentine's tears.

Friday: Author Beware. My favorite posts to write where I examine a published work of fiction and the medical error in the ms. This post deals with unsecured narcotics.

Hope everyone has a great week and a fun Valentine's Day.

Jordyn

Friday, February 10, 2012

Medical Question: Pneumonia

Elaine asks: You've come highly recommended by quite a few author-friends and I'm hoping you can help me out with a medical question for my story.

I have a high school senior who comes down with a severe case of pneumonia weeks before her graduation. She is hospitalized in the ICU, pulls through, but doesn't make it to graduation.

Plot wise I need her to miss the fall semester of beginning college & have her family keeping her home during the summer for extra rest while she recuperates more fully. I'd like to know if this scenario is feasible-- that a case of pneumonia, if bad enough, could weaken someone enough that she'd postpone starting school in the fall and take it up again in the spring?



Jordyn says: Elaine—thanks so much for sending me your question. And thanks for the compliment! That means a lot to me.

As far as your question—there are a few issues with your scenario. In a previously healthy young adult, it wouldn't be that feasible for her to be sick so long. Medical treatment for pneumonia is antibiotics for 5-10 days. Then maybe residual cough, easily fatigued for a couple of weeks. This is of course if it is a one-sided simple pneumonia. So, considering those factors, if she were sickened in May I would think she'd be able to attend school in the fall.
Also, people are rarely admitted to the ICU for pneumonia unless they need to be intubated on a breathing machine. So, say she had bilateral (both lungs involved) pneumonia, had to be intubated, popped a lung (called a pneumothorax), needed a chest tube, etc. Again, these might sicken her for a couple of weeks but if she's generally healthy she should be able to overcome this, rest up for several weeks—back to school in the fall.

My suggestion would be this-- give this character a chronic illness that puts her lungs in a more vulnerable state (broncho-pulmonary dysplasia, asthma, cystic fibrosis) and the pneumonia got to the point where she had to be admitted to the ICU on a ventilator and she blew a lung which complicated her situation. Considering her history of chronic disease—it would be more feasible that she'd have a long recovery time and she'd take the fall semester off.

Asthmatics on the ventilator are very hard to manage and get off and often have a complicated course. Most often, they have to be medically paralyzed and sedated. The patient is high risk for developing a pneumothorax. This would be my pick.

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Elaine Stock is a former RWA member and has presented several writing workshops. Presently involved in ACFW, she was a 2011 semi-finalist in the prestigious Genesis Contest in the contemporary fiction division. She is also active on several social networking groups. Her first short story was published on Christian Fiction Online Magazine. New to the blogging world, Elaine started a blog this past April, Everyone’s Story. Since then, the blog has been graced by an awesome international viewership that totally pings her heart. Everyone’s Story features weekly interviews and reflections from published authors, unpublished writers…and just about anyone who wants to share a motivating story with others that may lift their spirit. She has also been the guest of several other blogs, helping to further grow her presence on-line.
She and her husband make their home in an 1851 Rutland Railroad Station they painfully but lovingly restored.

Wednesday, February 8, 2012

Author Beware: Hallmark's Christmas Magic

There's nothing more charming for me than a Hallmark Christmas movie. Several I loved this past Christmas season-- particularly Trading Christmas written by Debbie Macomber. Hilarious if you're a writer.

Some I didn't like as much-- and you guessed it-- had to do with a medical reason.

Christmas Magic was a Hallmark movie where a young PR exec was involved in serious car accident.

Spoiler alert!

Most of the movie, you're led to believe that she has died and is doing some angel work before going to heaven. At the end of the movie-- you learn she has been in a comatose state and the climatic scene is where the man and daughter she was trying to help, come to her side at the hospital, to sing her back to life before her father "pulls the plug."

My first issue: You should actually look injured if you've been in such a devastating car accident that you've been lying in a hospital bed for the better part of a week. In her "death" scene, her hair is clean and styled. Nary a scratch on her pretty face. Exactly what was her injury? Supposedly brain trauma. Well, she should at least have a bruise on her head.

My second issue: Pulling the plug generally denotes that you are on a ventilator. Discontinuing the ventilator-- pulling the plug-- means a patient's breathing is no longer being assisted, they then cannot oxygenate their body, and the heart will stop beating when it doesn't have oxygen.

In this scene, she was on a heart monitor (which is merely a monitoring device) and an IV bag of fluids hung at her bedside. She was not on a ventilator. Therefore, no "plug to pull".

To denote discontinuing "life support" the nurse in the movie turned off the IV solution where then the heart began to slow down. Okay, you will die if you are in a comatose state from dehydration (think Terri Shiavo's case) but it will not happen in a few minutes. It will take days.

But, this patient was able to comply and nearly died in a few short minutes.

Next season, Hallmark Channel, hire me as a consultant. You might be surprised at how inexpensive I am!

Monday, February 6, 2012

Micheal Rivers: Altered Mental Status

I'm pleased to host guest blogger Michael Rivers today as he discusses the EMS perspective on altered mental status.

Welcome, Micheal!


EMS handles thousands of calls every year especially in the larger cities like Chicago. There is one kind of emergency call that can take the life of a Paramedic or EMT very quickly, or leave him or her with serious injuries. These calls are either for domestic or institutionalized people with altered mental status.

These calls are handled differently from other calls even involving shooting because the medical personnel have no idea what they can be walking into. Although he is there to help, the sight of the uniform alone can cause a very violent reaction from the patient. The ambulance personnel must not only be wary and insure the safety of the scene, but he has to be inventive when handling his patient.

Depending on the scene you never want the patient to hear your siren or see the flashing lights of the ambulance. It frightens them and they automatically become defensive. If you are running code 3(emergency) stop the siren and the lights a block or more before you arrive on the scene. If at all possible gather all the information on your patient and turn this to your advantage. These are some very good examples that work. This knowledge was gained through experience.

The patient was a 320 pound female confined to a psych facility for homicide. She was known to go through fits of rage even when under the influence of her medication. Arriving on the scene she was found in the nurse’s station sitting in a chair brooding. An armed security guard from the Sheriff’s department stood close by her. Due to the experience of the EMT’s, one stayed at the entrance while the attending EMT walked by the patient basically ignoring her while visually accessing her as he passed by. This assessment tells a great deal about who he is dealing with.

With a better knowledge of the problem and a few personal facts you begin to communicate with your patient. They want to be heard. Listen to them and find a way to get them on the stretcher without a fight. You may have to become an accomplished actor, but you have to convince them you are genuinely concerned and you are their friend, their guardian. In this case the attending EMT was able to get the vitals and convince her to get on the stretcher on her own when in the beginning she refused to be touched. If they had tried to force her, there would have been someone taking a lot of body damage. She was strapped x4 thinking it was for her safety.

Knowing the patient was not diabetic and was allowed sweets was a plus. With a simple cookie and the promise she would not be harmed, (history of physical abuse) she co-operated fully. She was even able to display sympathy for the EMT when he said he would get in trouble if she did not let him take her to the hospital. The call went smoothly and the patient was able to receive treatment without causing further harm to her.

These EMTs were very experienced. Experience cannot always let you see the unexpected coming. They specialized in the Altered Mental Status calls and knew exactly what to look for. Yet, Ambulance 04 was retired one year later after nearly being destroyed as the driver was attacked by a street person from inside the ambulance with altered mental status. This was an incident where the driver’s window was down to answer a man’s question. The street person dove through the window attempting to kill the EMT. At the time they had another patient inside the ambulance also with altered mental status.

This is a perfect example of the symptoms of altered mental status not being displayed by a person you are speaking with. If you are an EMT or Paramedic you already know the question; “Is the scene safe?”

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Micheal, born in 1953, is an American author. He served his country as a United States Marine during Vietnam. Born in North Carolina, he lived in the Chicago area in the past and furthered his education there and served the community as an Emergency Medical Technician. Micheal returned to the mountains of North Carolina where he resides with his wife and his Boxer he fondly calls Dee Dee. You can learn more about Micheal at http://michealrivers.com/.


Saturday, February 4, 2012

Up and Coming

Hey all! How has your week been?

Mine-- three thoughts: blizzard + snow day = kids running amok. I'll let you infer what kind of mood I might be in.

This week will be an excellent week at Redwood's.

Monday: Micheal Rivers will be guest blogging from the field. How does EMS handle the challenge of the "altered mental status" patient?

Wednesday: Author Beware! These are my absolute favorite posts to write. This one, there will be some mild skewering of a recent Hallmark Christmas movie. Can you guess which one?

Friday: Author Question. These are my second favorite posts. Elaine Stock stops by with a question about pneumonia and how long it could debilitate her character. See what advice I offer to make her scenario plausible.

What's up with your writing this week?

Jordyn

Friday, February 3, 2012

Florence Nightingale Diagnosis Henry VIII: Part 3/3

This has been an amazing series by JoAnn Spears. I've enjoyed having her and I hope you learned something new about medicine during Henry VIII's time.

Baby blues
Nursing Diagnosis:  Sexuality Pattern, Ineffective
Nursing Diagnosis:  Role Performance, Ineffective
In Tudor times, one of the main imperatives on a king was to father sons. Henry’s inability to achieve this goal was the impetus behind the Reformation in England, and has been made much of in fact and fiction. The fact is, though, that his full complement of male children was two legitimate sons, and one illegitimate son. One of the legitimate boys died in infancy and the other, Edward VI, died in his teens. The illegitimate Henry Fitzroy died shortly after he was married, at the age of seventeen. Henry also fathered two healthy girls, Mary I and Elizabeth I. He was in his mid-forties when he sired his last child.
Rhesus or Kell issues, in which incongruent parental blood types can cause a stillbirth or compromised infant, have been suggested as causes of the many miscarriages suffered by Henry’s first two wives. However, his first healthy daughter was born subsequent to his first wife having a succession of pregnancies, which is quite the opposite trajectory to that usually seen with such incompatibilities.
Syphilis, which, untreated, can lead to mental health problems in both parents and offspring, is an embedded but unlikely part of Tudor medical lore. Henry’s impulsive and violent propensities were not described by contemporaries in a way associated with the dementia and deterioration typical of tertiary syphilis. Also, none of Henry’s surviving children exhibited symptoms of congenital syphilis.
Henry’s first three wives each conceived quickly after marriage and, in the case of the first two, conceived multiple times. None of his subsequent three wives conceived. Henry’s symptoms of substantial weight gain and compromised circulation became noteworthy around the period between Henry’s third and fourth marriages. Erectile dysfunction is another potential side effect of both diabetes and poor circulation, and would account for a lot of the personal history of Henry and his last three wives.
Exit strategy
Nursing Diagnosis:  Mobility: Bed, Impaired
Nursing Diagnosis:  Risk for Compromised Human Dignity
Henry VIII’s last years were anything but majestic. The handsome, charming, 6’2” blond athlete of earlier days was a bloated, irritable, sickly being who was largely confined to bed and chair. A mechanical hoist was required to get the king onto a horse once he donned his outsized armor. The purulence of his leg ulcers caused a nauseating stench. His very last days, in which he was confined to his bedchamber, were spent hammering out a succession plan for the progeny he and his sisters would leave behind.
Henry was in his mid-fifties when he died. During the era he lived in, his would not have been considered an advanced age, but a death at that age was certainly not considered untimely. The actual cause of his death is unknown. An embolus to the heart or lung has been suggested. However, either of these would probably have killed Henry quite quickly, and there were days’ worth of succession planning and priestly officiating before the death. Stroke has also been suggested, but the tenor of the deathbed activity around him is not entirely congruent with the suddenness of a cerebrovascular event. Given the circumstances, the eventual succumbing of a once-healthy body to years of chronic disease seems as likely an explanation as any of Henry’s death.
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JoAnn Spears is a registered nurse with Master’s Degrees in Nursing and Public Administration. Her first novel, Six of One, JoAnn brings a nurse’s gallows sense of humor to an unlikely place: the story of the six wives of Henry VIII.  
 Six of One was begun in JoAnn’s native New Jersey. It was wrapped up in the Smoky Mountains of Northeast Tennessee, where she is pursuing a second career as a writer. She has, however, obtained a Tennessee nursing license because a) you never stop being a nurse and b) her son Bill says “don’t quit your day job”.