First Day Back

It was my first day back to work in the Urgent Care Clinic. I actually didn't see my first patient until 1100, but then it started to get a bit busy- smashed hand from door slam, hypoglycemia, severe nausea and vomiting turning out to be pregnancy, known miscarriage with heavy bleeding, abd pain from constipation - you know, the usual. I felt very slow getting any work done. It will definitely take some time to get back into the swing of things, but I'm sure I'll get there eventually. Thank goodness I have tomorrow off.

So many stories still to tell from Afghanistan. I think I mentioned earlier a brief visit from Afghanistan's president, Hamid Kharzai. I'm hoping I'll be able to post a small video. I also wanted to mention my two Afghan mandibular reconstruction patients. Both of these men were had their lower jaw blown out by gunshot injuries. They arrived maybe a week or two apart. I take very little credit for the care of these men as it really was our wonderful ENT doc who did some amazing, but rather unsuccessful surgeries on both of them. They both originally had a piece of their hip bone removed and grafted to reconstruct their lower jaw and then a free flap from their abdomen placed over the bone. Sadly neither of these took very likely to the poor nutrition of the Afghan population. The first one, who I would refer to as the nice one, as the other was a bit high maintence and stubborn, had a second jaw reconstruction done with a bone graft from his fibula (lower leg bone) complete with skin flap. It looked good at first, but it just didn't take either. I think the ENT doc was seriously considering somehow getting some leeches which are apparently fairly common place in these types of surgeries in the States. I just have to commend my dear surgical colleague here though because the hip graft surgeries each took between 7-8 hours in the operating room. The fibular flap was upwards of 14-15 hours. CRAZY! But he still did it. It was very frustrating, however, to see these men spend so much time with their jaws wired shut and when finally removed still unable to eat for fear of infection from any oral contamination. Hence both these gentleman were on tubes feeds for weeks. Nothing by mouth except moistened sponges on a stick to keep their mouth moist. My dear nice Afghan male appeared to become rather depressed and he was eventually transferred to a FOB (forward on base) who happened to have a highly specialized ENT physician trained in jaw flaps. He didn't return before I left, but I do hope all is well. The other gentleman appeared to resign himself to a long stay at the hospital and became much less stubborn.

I might have to tell the crazy bomb maker story next.

Delayed

So I'm sitting in Chicago's O'Hare Airport waiting for my flight back to Japan. So far we are 2 hours delayed. I can't really complain as I have no crabby tired children. I have no medical ailments and I'm not hungry (as I just treated myself to a gourmet carmel apple- fruit right? And an iced latte). I'm hoping the Ambien will still work once I finally get on the plane.

One part of coming home that I forgot to put in my last posting was my arrival in Baltimore and being greeted not only by my beautiful sister and nieces, but a whole welcoming committee from the USO at Baltimore. Before I left of Afghanistan, I always felt a little guilty when random people would thank me for my service after they found out I was in the Air Force. Going through the line of the welcoming committee and shaking hands with all there made me feel like I really had done something finally. Granted many more have sacrificed a whole lot more than I did while I was there, but now I've experienced the war zone to some extent, walked in the blowing dust with my teeth crunching on the dust that got through, carried my M9 around with my like it was my cell phone and have woken suddenly in the middle of the night from rockets or mortars dropping (usually relatively in the distance) and now have some right to be called a veteran.

My arrival into N.KY was not a military greeting, but it certainly was a great reunion with my parents, aunt, sister and nephews. (I love being Aunt Sally). Balloons and signs. Dad even posted a big sign in our front yard welcoming home Doctor Sally (which they called me in Afghanistan). So many people at our church festival the next evening knew I had just returned and greeted me a warm welcome home. I wasn't used to all the attention, but after a couple of beers at the festival I was quite comfortable chatting about the last 6 months. I did see a lot while I was there and have several specific stories to tell, but thinking about the whole experience is more of a feeling than a memory - good and bad. It is a bit difficult to convey in words and not every story is something I want to share, but I have no problem saying it was - well not a life changing experience, but a life learning experience.

Looks like we might actually be boarding soon so I better get off my computer and start listening to any new announcements. More to come later.

Home Sweet Home

Finally back home- well that kind of depends on how I'm defining home at this time, but back in the States nonetheless. I've been thoroughly enjoying time home with my family - parents, siblings, nieces and nephews who have all grown up so much since I left and are so incredibly cute (the nieces and nephews that is).

I have so many stories yet to tell from my days in Afghanistan as well as pictures to post. The internet at Bagram was so slow and spotty that I finally just gave up. Now I don't know where to start. First I think I might describe my homecoming a bit. July 2nd, 2010 was literally the longest day of my life. We left Kyrgystan at around 0730 with stops in Turkey and Germany and finally arrived in Baltimore around 2100 (please add about 9hrs time change). We, meaning all the other soldiers and I, were in a large chartered plane with minimal comforts. My seat did not recline, but the one in front of me sure did and it stayed reclined pretty much the entire trip. It didn't help when food was served as my tray table did not unfold completely with the seat reclined. I slept very minimally and was relatively warm and sweaty in my ABU's. Now the exciting part of the trip came with about 3 hours left before hitting BWI when I was tapped on the shoulder by the chief OR nurse who I knew well, a Lt Col, telling me that a pregnant woman was likely having some Braxton Hicks contractions, but I should probably check her out. So yes, there I was with a 34 week G2P1 pregnant female whose first child was born at 36 weeks now having regular, low grade, but persistent contractions that were not remitting with rest and water. No blood or fluid, but slightly concerning. Thank the Lord for our OB nurse who sat with her and timed her contractions which improved slightly by the time we reached BWI and were met by medics. The poor girl had traveled to the States to spend her husband's deployment with her family (very understandable), but flying at 34 weeks on such a long flight from Germany (she had boarded in Germany) maybe not such a great idea and with child number one in tow. Obviously things worked out fine, but I was slightly concerned for a bit that should she have any bleeding or fluid loss that I'd have to check her cervix with nonsterile gloves behind the curtains of the airline stewards' bay. Not fun for me, but certainly not fun for her.

Pictures shown are a few from my last days in Bagram as well as my first meal at my sister's house- Fresh asparagus and corn-on-the-cob from the farmer's market, amazing mushroom pasta and some steak all washed down with some good red wine. Couldn't have asked for anything better.