Went Flying!

Not as pilot, but I'll enjoy whatever flying falls into my lap. I went flying with my friend Mike, as safety pilot, while he polished up his instrument skills at Front Range airport (KFTG). He flew the the ILS and Localizer approaches to Runway 26, ILS and Localizer approaches to Runway 35 and NDB approach to Runway 26, and practiced holding patterns and tracking.

I had a blast, just riding along and watching for traffic, which was my primary job. I snapped a couple of pictures on this severe-clear day, with Pike's Peak easily visible off to the south. I also played traffic controller, and gave him vectors (magnetic headings to fly) to each initial approach fix.

Every once in awhile, I would glance down, and check our progress on the Foreflight aviation app's moving map display on my iPhone. Very cool. Except, the regular access to the phone's GPS device, and the frequent screen updates, rapidly drained the battery, until I decided to shut it off at 30%, only halfway into the flight.I was kicking myself, for not bringing K's cool iPad 3 along, since it has a much bigger screen, and a longer battery life.

Even considering the iPhone's nice high resolution color screen, my old trusty Garmin GPSMap196 handheld aviation GPS is probably a more appropriate flying companion. It does a better job of providing aviation situational awareness, with real-time course and vertical guidance for most IFR approaches, and the batteries last far longer, even though they're not rechargeable.

Note to self: Need to either plug the iPhone into the cigarette lighter to keep it charged when flying, or investigate one of those smartphone battery life extenders. Maybe the Mophie Powerstation XL would be the Christmas present I should be getting myself. Or maybe the Hydrogen Reactor I heard about recently. Or maybe even the PowerBag that my friend's wife likes.

Mike did the driving as well as the flying, and that gave me the chance to see his new (to him) 2011 VW Jetta TDI, a turbo diesel with 6-speed manual transmission. It's a very nice car, comfortable, with good safety considerations, a smooth ride, a few fun gadgets, lots of oomph when the turbo kicks in, and awesome fuel mileage the rest of the time.

Just to add to the enjoyment, we stopped and had a delicious lunch at Racines restaurant, on the way home.

Happy Thanksgiving!

Wishing everyone safe travels, and a wonderful Thanksgiving! Judging  from the weather synopsis charts for the next 24 hours, it looks like everyone traveling around North America has a good chance of missing any serious weather. Crossing my fingers for our traveler friends...

Cheery white stuff

No snow in the forecast. What's all this white stuff, falling from the sky??

Lear 35 crash

Drat. Yet another general aviation crash last night. This one was a Learjet model 35, registration XA-USD, departing Ft Lauderdale at 7:50 PM for a return flight to Cozumel, with a medical team aboard. The flight crew reported engine failure shortly after takeoff, and they turned back, but were unable to make it to the airport. They impacted the Atlantic Ocean near the shoreline, in the darkness of night, and it appears from news articles and pictures that the aircraft at least partially broke up, since 1,000 pounds of floating debris had already been recovered. It's puzzling, that a very capable twin jet couldn't return successfully after an engine failure. Some failures will take out both engines, but most will leave one running, in which case it should have been "easy" to return safely. I really wonder what happened. 

News articles: from Aviation Safety, Miami Herald, Sun Sentinel, CBS Miami

Launched AV038_MAVEN

Today we launched AV-038, an Atlas V rocket, carrying the MAVEN spacecraft, bound for Mars. MAVEN's mission is to probe the Martian upper atmosphere, in hopes of learning how Mars transformed from a warm, wet planet, into the barren world it is today. Flight time for the gas-sniffing sleuth is ten months, with arrival scheduled for next September.

MAVEN's next milestone is a December 3rd engine burn, to adjust the probe's path toward Mars, the first of four course correction maneuvers planned during the mission's 10-month cruise.

Ground controllers will start activating MAVEN's eight science instruments for tests this December, and some of the payloads will take data during the voyage to Mars. MAVEN's ultraviolet imaging spectrometer will observe comet ISON in December.

Once MAVEN is at Mars, the probe will drop into an operational elliptical orbit, and begin collecting scientific data in November 2014.

See the full story and more pics at SpaceFlightNow.com.

Home after a crazy day

I checked in with K's nurse at 7:30am this morning, and discovered that a blood glucose (BG) hypoglycemia emergency was brewing, and they didn't even know it yet. They had given her a total of 32 units of Humalog (a fast-acting insulin) during the night, while chasing a high BG that only required 4 units. By my calculation, that would have driven her blood sugar down to negative 4,200 over the next few hours! An impossibility, for sure, but also surely enough to kill her, if left unchecked, by taking BG down to zero, and holding it there.

They didn't allow for (and didn't even want to consider) the time it takes even fast-acting Humalog to be metabolized. Someone must have fooled these people into thinking that insulin takes effect immediately. I had told them that each unit of Humalog will drive her BG down by 150, at a rate of about 60 per hour. In this case, they started at 719 BG at 1145pm, so after giving her the correct 4 units of Humalog to bring it down by 600, it would have taken about 10 hours, to get to a normal number in the 100 range, sometime around 10am. Instead, they measured periodically, and treated the number they saw each time. So they gave her 10, 10, 8, and 4 units throughout the early morning.

They had measured a BG of 419 at 4am, and I guess they felt confident that they would need even more insulin soon, and weren't even a little worried that her BG would be going too low. I warned her Nurse and the Charge Nurse that she'd be crashing soon, and that they would probably need IV dextrose to stop it. I recommended that they measure her immediately, even though they were in the middle of the RN shift change. Sure enough, they measured a BG of 58, way too low. They measured again, to be sure, and got a BG of 34, critically low.

Luckily they were in a hospital, and had easy access to intravenous dextrose. They gave her a shot of 50 mL of D50 push, which raised her BG to around 240 over the next hour or so. Amazingly, her BG didn't drop below that later, as I feared it would, but instead hovered at 240 for several hours, then started trending up, after she ate lunch. The D50 had completely offset the excess Humalog. We've gotta get ourselves some of that stuff! If only we could.

They tried very hard to get her discharged during the day, but she wanted to wash up, and have dinner before she left. Then she wanted to peruse the hospital gift shop windows, even though the shop was closed, and I had locked myself out, by going out the automatic doors after 8pm when they stop letting people in that way. I didn't finally get her out the door and into the car, until after 9pm.

Surgery went OK

They took her from her room to pre-op around 130pm. Dr Atkins came and took her from pre-op toward the operating room at 350pm, estimated 30 min to complete. The O.R. called me in the waiting room around 430pm to say that the surgery went well, and they were putting on the bandages. Then the Doc stopped by to give me a quick recap, basically "it went as planned, couldn't close all the way, leave the bandage on, expect bleeding - we want that, don't use ice, and see her on Tuesday." They said her BG was heading down through 89, after surgery. They moved her to recovery for an hour, which gave me time to run off and eat at the Copper Pot again. Nice place. Then they took her to her room without telling me, but I found her pretty quickly. She was sleeping like a log, and I couldn't imagine them discharging her that night, but they didn't figure that out until later. When she woke up, so was starving! And in pain! Figuring her BG was probably low by then, I got her to drink some Apple juice, and the RN started working on pain meds. Food Service still had her with the "no food" order that was in place before surgery, and that had a really big impact on her, since she hadn't eaten since the night before. After an hour, things started getting better, as the doc returned the RN's call and canceled the no food order, and she finally got her breakfast/lunch/dinner, and some pain meds. They finally realized she was going to have to stay overnight, and I headed home to see how the dog had fared. She was fine, and welcomed a late night walk around the block.

Surgery today

So, the "wound removal and ankle bone scrape" surgery should be today. They decided to dialyze her this morning 8-12, so the morning caregiver Maureen didn't get to be very helpful.

I had to giggle to myself last night (in a slightly hysterical way), when the nurse said she was going to give her 10 units of Humalog before bed. I mentioned that ten was *way* more than we would've given her, especially since she's been taking Tradjenta, ten units would bring her BG down about 1500 mg/dl, and since her BG was only 402, that seemed problematic to me. You'd rather *not* have a negative blood glucose, after all. I said we would only have given her two units for the BG, and another unit for the food she was about to eat. To her credit, the RN went with our recommendation. This morning, her BG was 149, a very nice number. It's *so* scary to think about how that would've gone, if I'd already left for home by then.

Surgery deferred again

This morning, I woke up to find K with an extremely high BG. Her glucose meter reads "HIGH" instead of a number, which means it's over 600. I fell asleep last night, before she and the caregiver finally got home from dialysis, and apparently she fell asleep on the floor of her closet, before she could think about taking any insulin for her glucose, which was already going up. I've no idea if we can get it down into an acceptable range for them in time, without crashing it. If it goes too low, with no food intake allowed since midnight, she won't be able to recover without canceling the surgery due to food in stomach. This is unbelievably frustrating.

Update- They just deferred the deferred surgery. Her BG was coming down rapidly, and at 11, when she was supposed to go into surgery, it was fast approaching the number they said yesterday would have been acceptable. I question their reasoning for canceling. Sounds like they will admit her today, and "get her BG stabilized" before they do the surgery later or tomorrow. But I question their ability to do any better a job with BG, considering recent past experience. I guess if I just stopped sleeping, I could watch it all night for her, and this wouldn't have happened. What a slacker.

Update- She's been admitted to Swedish Hospital. No surgery slots available this afternoon or tomorrow morning. They'll try again tomorrow afternoon, pre-op at 1pm, surgery at 3pm.

And now begins the frantic effort to cancel or reschedule every activity she had scheduled between now and Saturday morning...

Surgery deferred

K's surgery was deferred a day, due to high Blood Glucose (BG) when she arrived today. She had a a really low BG this morning, and too much Apple juice got drank, dealing with it, so it overshot up high.

Surgery Wednesday

K has foot surgery scheduled for tomorrow morning at Swedish Hospital. She has a long-standing ankle wound that has been resistant to various treatments. She says they're going to try scraping the ankle bone, to put less pressure on the skin from the inside, and give the wound a better chance of healing.

Another BG saga

6:30am - I checked in with the nurse, and found out her BG was high (719) last night after eating, which calls for 4 units of Humalog, but they gave her 28 units over several hours! Her BG is 400 now, so that ought to bring her blood sugar down to about minus 3000 in a few more hours! I warned her RN and the desk RN that she'll be crashing soon, and she'll probably need IV dextrose to save her.

8:30am - Sure enough, they measured a few hours later and her BG was 58, then 34. Ack!

9:30am - They gave her 50 mL of D50 push, and it appeared to solve the problem, bringing BG up to 172.

BG stayed above 100 the rest of the day, climbing and settling at around 240 for several hours, then starting up again later.

3:30 - They're trying to get her discharged today. Seems like the BG is doing ok, after the shot of dextrose.

They were ready for her to leave before the RN shift change at 7pm, but we didn't get out of there until around 9pm. Ran into the neighbor as we were pulling into the garage, and chatted for quite awhile. Finally got into the house around 10pm.

Sleep deprived

Nuts. It's happened. I've turned into my Dad, who used to fall asleep every time he sat down in front of the TV with the family. So, we would wonder, was it the TV, or the family, that put him to sleep? Turns out, it was the sitting down part.

Winter weather inbound

Looks like we've got a little snow on the way this afternoon and tomorrow...

Update- False alarm. I sprinkled a bunch of snow melt on the walkways and driveway, and nothing came. So now the walkways are slippery with that stuff. Can't win. Now I'm hoping for snow, so it will melt the snow melt. Ironic.

Happy Halloween 2013!

We had quite the crowd tonight! Mandy even got involved, sneaking out behind everyone, while I was snapping a picture, to go greet a friendly old Pug that one of our visitors' parents had brought with them. I posted the pics on Facebook. See if you can spot her!

Portable Concentrator?

K is seriously considering transitioning from using portable liquid oxygen bottles to a portable oxygen concentrator offered by Inogen. In theory, it would give her a little more freedom. The concentrator battery lasts 3-4 hours, a little shorter than a bottle would, but it comes with two batteries, so in theory she could go 6-8 hours, if she's willing and able to switch the batteries while she's out. Plus, if she plugs it in, when she's in a car, or waiting at the doctor's office, it will run and charge at the same time, in which case, it can theoretically last longer than a bottle would.

The downside I'm struggling with, is what to do when we get four feet of snow, so there's no access in or out of our neighborhood, and the power goes out for a few days (it's happened). Right now, she can tap into the big liquid oxygen storage bottle in the garage, which will probably last for days, at a low flow rate.

The Inogen representative says, "just buy a couple of oxygen bottles to keep around the house for emergencies." But he's dreaming. Each bottle like he's talking about lasts just 3 hours at her flow rate, so we'd need 8 fully-loaded oxygen bottles to last an entire day, or 24 bottles to last three days, and we don't have room for all that stuff. Much less, the time and energy to keep it all. Ugh. I know she is being drawn in by the idea of having more freedom, but Medicare will only pay for the bottles or the concentrator, not both, so we'd have to cover the additional cost ourselves.

Considering we've only been stuck for an extended period without power twice in the past 18 years, once for almost three days, and once for about a day, I guess maybe I'm overly concerned. If she thinks it will give her more freedom, I'm inclined to let her go for it, and figure out how to handle the contingencies as best we can. The concentrator company says to call for a backup oxygen bottle, if the weather forecast seems to call for it, but that is such an iffy proposition, I have to laugh. The reality is, she can survive without supplemental oxygen for awhile, if there's no other option.

Oh, and some friends have suggested a generator, which is a possibility, but I think it just brings more logistical complications, to the point of diminishing returns. We'd have to keep enough gasoline on hand to run the generator for a few days, which is dangerous, and gas gets old, so if we don't use it, we'd have to change it out, or hope an additive like Sta-Bil will keep it usable for a few years. Then we'd have to deal with the intake/exhaust venting issue, if we wanted to run it in the garage, or we'd have to move it out onto the well-ventilated back patio. But then we'd be bothering our neighbors with the noise all day and night, and we'd have a long run for the cord through the basement, up the stairs, to the laundry room where the concentrator is.

And of course, I might have the option of blasting through the snow in my CR-V, before it gets too deep, and either taking her and the portable concentrator somewhere (hotel? hospital? friend's house?) that has power. The first time we lost power, it didn't happen until the roads were impassable, so I'm not sure how viable an option this is. On the other hand, that time, we had neighbors on a separate power circuit, that never lost power, and after a day without power ourselves, we just went and stayed with them, after they invited us over. Did I mention, she wasn't on oxygen back then? And she had both of her legs? And she wasn't going to dialysis three times a week? So losing power wasn't anywhere near as much of a concern, more of an inconvenience.

Castle Rock Plane Crash

It seems (from the Flightaware track info) like that Glasair GS-2 (N535SP) that crashed on approach to Centennial airport in freezing fog last night, was consistently operating pretty far below the minimum descent altitudes for the approach. Flightaware thinks she was descending below 7000 feet, when the MDA for that segment of the approach is 8000. Either the rime ice she reported was dragging her down, or maybe she had the airport lights in sight, and was descending to land. The news said she told rescuers she couldn't see the power lines in the fog, so maybe she thought she had things under control, right up until she hit them... fingers crossed for her quick recovery.

Nice memorial

I found it really, really, worthwhile, being at David Segal's memorial this afternoon. Brad and everyone did a super job, putting it together and executing it. The Denver Press Club was a really nice choice, quiet, close, and understated. I learned a bunch of new things about David, and heard a lot of what I suspected were his wild stories verified as truth. He pulled together quite a crowd of wonderful people. I finally got to meet two of the really delightful caregivers he was raving about. It looks like I'll be driving home in freezing mist tonight...

A Gothic Folktale

We really enjoyed "A Gothic Folktale" at Parker Arts, Culture & Events (PACE) center, a birthday gift for K, courtesy of our awesome friend Karen. We especially enjoyed being there, as her kids got to meet some of the cast. Very fun.

Bad day at the Vet

I just broke Mandy out of vet jail, and got her home. Too much trauma for such a sweet little dog as her. She had an annual exam, dental exam, shots, nails, heartworm test, and more. We missed her on our morning walk. It's going to be a long haul recovery. She's had tooth and gum problems since we rescued her, and she lost eight more teeth today. The Vet put her on two pain meds for the next week. Poor little pooch. — at Southwest Veterinary Hospital, P.C.

Another procedure

K checked in for another surgical procedure at Swedish Medical Center, to remove some pre-cancerous tissue this morning, less than 1mm deep. She had a low BG before surgery, and we caught it before she felt it. The surgery went well. They got what they wanted to get. It took several hours before she was ready to leave. Somewhere in there, her BG went low again, even worse than before. By that time, she was awake, and doing OK, so they were able to feed her a bunch of snacks to bring it back up. She was supposed to go in for the afternoon hyperbaric oxygen treatment, but unfortunately, those people never updated their calendar, after she called them last week to reschedule, so they didn't have any openings. Administrative fail. Again. This is perhaps the 4th time they've really messed things up for her. I got her home safe by mid afternoon. She was still awake, but very sleepy. Wasn't able to get her to Dialysis i time, but at least I got her there.

RIP David Segal

Sad to say, I just learned last night from his son Bradley, that our friend David Segal passed away Sunday night, at peace in Denver. I had been meeting him for occasional lunches since way back, when we both lived in San Diego. I regret that I let life get in the way, and I haven't seen him since last year. I met him through my dad, who dated his sister for awhile. I liked that he usually said what he was thinking, the stereotypical gruff old bear with a heart of gold. He repeatedly told Dad, "after you break up with my sister, don't be a stranger." I remember he took us for the occasional but very enjoyable boat ride, and one time invited my brother in law Bob to steer his yacht around San Diego Bay. He seemed excited to see how the details of an actual IFR approach played out, when we flew him to Palm Springs for brunch one time, and I had to shoot the ILS approach back into Montgomery field. More recently, I would occasionally pick him up at his apartment, and drive him to lunch, always at Racines. Rest in Peace, David.

Early day

I dropped K at makeup dialysis this morning at 6am. Ugh. We really struggled to get going sooner, but just couldn't pull it off. She had a quiet Birthday yesterday, with a visitor at the house, and part of that included skipping her oxygen chamber treatment, and her dialysis. Mandy's with me at work again, snug in her warm bed, on this chilly 38 degree morning. I'm treating myself to a pumpkin spiced latte, since we were up and moving so early.

Chilly day

It's a beautiful clear sub-freezing morning. And a whole new week. K has another, hopefully minor, surgery on Wednesday. Jen's husband Bob is home from hospital, and recovering from a critical head injury, so she'll be out all week. I'll have Mandy with me, out in the car, since K is planning to be out most of the day. I'm so glad the dog loves going anywhere with me in the car, and doesn't seem to mind sleeping most of the day out there.

Home at last!

FINALLY got K home from the hospital tonight! What a long, arduous process. She and I started talking in the morning, about when to pick her up. By the time they had done a nurse shift change, measured her glucose, fed her, administered meds, and processed the paperwork, the 3pm estimated discharge time had turned into 6pm. Then by the time we got to Walgreens to pick up her prescription, their pharmacy was closed, so we went a few miles down the road, to the 24 hour pharmacy. By the time we got out of that Walgreens, with the usual and various complications, it was 9pm. SO tired...

All hail the great hospital doctor. Their sliding scale for insulin was going to kill her, if they didn't discharge her soon. Would be nice if they paid attention to mine. They were giving her much more insulin than I felt was appropriate for her measured glucose levels. I told them to subtract 150 from Blood Glucose, and divide the result by 150. So instead they gave her 9 units for a BG of 350. No wonder she kept crashing in the mornings.

Procedure complete

The arteriogram (angiogram) procedure on K's left leg is all done. Dr Morin's goal was to find something he could fix, to improve the circulation, and help her ankle wound to heal. He had me wait in the employee's lounge by the Catheterization Lab during the procedure. He called me in after 20 minutes, to show me the pics on the computer. He said he didn't find much, and showed me that most of the arteries looked healthy and clear. He pointed out one very short narrowed section of artery, really just a "kink", and suggested putting in a stent there. It seemed like the thing to do, so I agreed, and he went back in, and installed a short stent. He showed me the "after" pics as well, and the artery looked much better with the stent in it. Hard to tell how big the stent is, from the picture on the screen, but it looked about an inch or two long He wanted to send her home today, but by the time they got her into dialysis, to clear out the dye from the arteriogram, it was 4pm, and she came out after 8pm, so he decided to keep her overnight, with the plan to discharge her tomorrow.

Happy dog

Mandy's a happy dog. She got to drive to work with me today. She gets to sleep under the warm blankets in her bed in the back seat of my car, in the nice cool shady covered garage at work. Then she got to go for a chilly 43° walk at lunch time.

Low morning BG

Stopped by Swedish to give K some strawberries, and found her complaining of low blood glucose symptoms. I remembered that I was concerned about that last night, as they gave her more insulin than I would have, but then I forgot. Got the nurse to measure ("we will soon, after shift change") NOW, and found it to be 45, godawful low, especially for being in hospital. Fed her the strawberries, while they looked for apple juice. Fifteen minutes later it was 40, but that's a normal delayed reading. We took bets on what the reading would be after 30 minutes, and K won, as it was 80, heading back up faster than I predicted.

Today is supposed to be the "safe measures" day... I interpret that as "can you just try to keep her alive, until she can start the procedure tomorrow with a normal blood glucose" day. Fail.

Keeping her until Friday

Katherine at the Cath Lab just called to let me know, they will be keeping K in the hospital until Friday. The dialysis isn't done yet, and there's no time left to do the procedure today. There are no open slots tomorrow, so they will keep her inpatient at Swedish, and apply "safe measures" to ensure that she is ready for the procedure on Friday. It will probably be around 11am, but no guarantee of the time. Heavy sigh...

Procedure deferred

They deferred the arteriogram procedure scheduled for this morning, until after they can dialyze her later today, to get her creatinine level down. It's hard to imagine them getting the dialysis, and then the procedure done, before it's too late to discharge her, so I'm guessing that means they'll be keeping her overnight tonight. So now I'm calling around to cancel her regular dialysis appointment. Probably should cancel the morning caregiver, but they haven't committed to keeping her yet, so the schedule is in limbo yet again.