Indian River Trail

A little exploring in spite of the rain. 

Sitka's flora.

Merry 1st Christmas in Alaska!

photo credit: wifey

Jam session

Some friends from work invited us over to make jelly from this year's harvest of wild Sitka berries. It was really fun. We're hoping to make some from our own picked berries next year. Here's a shot I took with some creative lighting.

Clockwise from 11 o'clock: blueberry,  red currant, black raspberry, huckleberry. Middle: spruce tip.

One of the things I want to learn while I live in AK is how to cook fish well. There is so much quality fish here so I just have to. Here is my first attempt: pan-seared rockfish with lemon beurre blanc. Note to self: cooking with wine rocks. 

  

pre

reminds me of my other job

post

Mari gave it thumbs up. I'd recommend adding 1/2 the amount of lemon the recipe calls for.
By the way, this place rocks and Sitkans are very generous. This Christmas we've been given 12 jars of jelly, an assortment of baked goods, a bottle of wine, a pumpkin roll, and cookies.  Merry Christmas, everyone!

Bike commuting

Back when I was living in Lancaster one of my co-residents gave a really good talk on the benefits of bike commuting. After hearing him I decided that I would try to ride my bike to work year-round once we moved to Sitka. As you can see, commuting to work safely in a place that gets dark early and receives 80 inches of rain per year requires some extra stuff.

a) Reflective vest

b) Messenger bag to carry my stuff

c) Head light and tail light

d) Reflective tape

e) Rain pants

f) Rain boots

g) Studded tires—for good traction on ice in the winter

h) Front and rear rain fenders/splash guards

i) Rain jacket, of course

5 miles round trip with a few good hills

CPT I

Baby is 4 hours old. I witnessed his birth (by cesarean), suctioned his airway, dried him with a towel, examined him, and saw him make the critical transition from life inside the womb to life outside. Strong cry, good tone, he’s good, I said.
Pager goes off: “Come to OB floor now”.

Problem #1: Hypoglycemia; baby cannot maintain his blood sugars after feeding

Problem #2: Temperature instability; his body cannot maintain his core temperature and it is dropping

Mom is homozygous for CPT 1 deficiency; her body cannot make a liver enzyme that converts fat to energy. Dad only has one good copy of the gene that makes the enzyme. Mom didn’t have any problems with her 1^st baby but here we are.  The problem is that these symptoms could also be signs of a serious bacterial infection—sepsis. Time to multitask.

#1: Place baby under warmer.

#2: Baby needs to get glucose. I tell the nurse he is regurgitating his formula. His small stomach has no more room. We need to get a peripheral line—nurses are good at this, we’ll be fine.

Right arm: fail

Left arm: fail

Left foot: fail

Right foot: fail

Plan B, get an umbilical catheter. My colleague asks for backup. I have never placed one or seen one placed. Medical director to the rescue—masterfully succeeds in placing it. He leaves. It clots.

Plan C, get a scalp catheter. Senior nurse succeeds. I want to give her a hug.

#3: Call Anchorage, this baby may need to be medevac’d to a place that has a neonatal intensive care unit. Hope it doesn’t come to that—process including flight would take 4 hours.

#4: Chest xray, blood work, start thinking about antibiotics if baby doesn’t improve with intravenous sugar solution.  

#5: Breathe.  Note baby’s scalp catheter makes him look like a little unicorn.

Happy ending: baby recovered, he maintained his temperature and blood sugars, he didn't end up being septic. We stopped his IV sugar solution and took out his catheter after 36 hours, then discharged him home 2 days later. Few things are as amazing, beautiful, and stressful as birth. 

Lessons learned:

CPT-1 is a rare metabolic condition that is more common in Native Alaskan Inuit people.

How to place an umbilical catheter.

Carpe diem

I was wrong. All of you who asked whether we would have few hours of daylight during the winters in Sitka may recall me saying that wasn't the case. That is the case. Somehow I assumed that was only further North. But now that the sun is setting at 3:25 pm (and it's setting earlier and earlier) it feels like time is flying (though it is worse farther North). We notice it most on weekends because they seem to fly by so quick. It was starting to really bum us out--we kept on saying "where did Saturday and Sunday go?" I think we figured it out, though. What happens is that you wake up around 8-9, eat breakfast, don't really get out of the house until its close to 11 or 12. Now you have 3 hours of daylight (or sunshine if it's not a typical cloudy Sitka day). In terms of outdoors stuff all you can do in a few hours is a short hike. Then you get home and see its dark at 4 pm and you start gearing down as if it were 9 pm. Your brain does that automatically for you. You don't want to venture outside, you just want to get in your PJs and start winding down. Then your productivity really goes to crap and you're confused because you swear its got to be 10 but its only 7.

One good thing about this is that it makes you try to get more done. We're realizing we can't really lounge around in the mornings--we need to plan our days in advance, see what's going on, try to get out. Yesterday (Sunday) I woke up at 9 and said to myself "ok, you have about 12 hours", and throughout the day I would countdown to bedtime to keep perspective on where time was really going. It's the weirdest thing. Seize the day has never been more real to me. Revenge is sweet though; come summer we've got up to 18.5 hours of daylight.