Hectic Couple of Weeks!

These last 2 weeks have been exhausting!  The hospital I work for has undergone one of the biggest (if not the biggest) changes in its history.  We transitioned from paper charts to electronic charts.  I have worked with electronic records before, but I have never been apart of the switch from paper to computer.  For the most part, the switch was a smooth one.  The system never crashed, and patients have been fairly understanding as we muddle along reading a computer screen.  To try and aide the transition we significantly reduced the number of patients we see in one day.  With our old paper system we saw patients in 20 minute appointment slots with three overbooks allowed.  This gave us a grand total of about 16-18 patients each provider a day.  Currently with the new electronic system we see patients in 40 minute appointment slots and no overbooks.  This gives us a grand total of only 8-9 patients per provider a day!  Despite the dramatic decrease in number of patients seen each day, we have all been exhausted with learning each little crevice of this new system (and trust me, there are thousands of little crevices to learn).  Each night I go home feeling more tired than I ever felt seeing twice the number of patients I currently see.  I usually go to bed shortly after the kids go down.  When I wake up the next morning I can remember all the strange dreams I had that night!  I don't know if that means I am sleeping harder or softer. 
One of the most exciting and frustrating parts of doing everything electronic is the radio medical traffic.  I've written about RMT before.  It's where the village clinics send the Bethel based provider an account of a patient they just saw and request a plan for this patient.  What's nice about the electronic system is that when a patient comes in from a village, I can see what was already done.  Before with the paper system, the patient's village chart was separate from their Bethel chart.  Ideally, information got sent back and forth, but this was rarely the reality.  Now it's all one chart!  The frustrating part is that computers rely on electricity, and electricity is very fickle in the villages.  Our email inboxes are ever flowing with up-dates on which village is currently down and reverting back to the old paper system. 
All in all its a good change.  No more misinterpreting something because of bad handwriting.  No more searching for paper notes you know should be in the chart.  No more searching for whole charts!  With time I will hopefully get faster and feel less exhausted by the end of the day.  Who knows, maybe soon I will be able to stay up past 8:30!

Kuskokwim 300

If there is one thing Bethel, Alaska is known for, it is the Kuskokwim 300.  The Kuskokwim 300 is the most well known, mid-distance dog sled race in the world.  It starts and finishes in Bethel on the frozen Kuskokwim River.  This year 21 teams raced for a piece of the $110,000 race purse, with first place taking $22,000.  The race trail follows an old mail route 150 miles up river to Aniak, then back to Bethel.  This year's winner, four time Iditarod Champion Jeff King, completed the race in 40 hours 30 minutes and 10 seconds.  This year's win was Jeff King's 9th Kuskokwim 300 victory; his first K-300 win was in 1991.  

Start of the Akiak Dash

Anxious to run!

Two other, shorter races, also share the weekend with the K-300.  The Bogus Creek 150 is a 150 mile race that starts about an hour and a half before the K-300 and finishes the next day.  The shortest of the 3 races, the Akiak Dash, is a 65 mile race that starts and finishes on the same day.
Everything kicked off Friday evening at 5:00pm.  The frozen Kuskokwim River was lined with more than a hundred cars and trucks.  The temperature was well below zero with the howling wind.  For the Bogus 150 and the K-300, teams start the race individually.  One of the biggest attractions of the Kuskokwim 300 kick off are the fireworks that begin shortly after the last team has left the start line.  Most of the people I talked to watched the start of the race from the warmth of their running cars.

Saturday features the finishers of the Bogus 150 and the mass start of the Akiak dash.  The temperature had greatly warmed up to just below freezing on Saturday, although still cold when you are standing on a frozen river.  
Sunday, Luke and I headed to the river after church to watch some of the finishers of the Kuskokwim 300.  We arrived minutes after Jeff King crossed the finish line.  Luke was all about loving on the tired dogs, patting each of their heads telling them "good boy".  We stayed long enough to see the second and third place teams cross the finish line before heading home.

4 time Idiatrod Champion and winner of the K-300 for the 9th time - Jeff King

The dogs get loved on by fans moments after crossing the finish line

Not even off his sled and
the media are interviewing
second place Tony Browning

Third place went to Peter Kaiser

Another great Alaskan first for the Aickens!

Kwethluk

This week I made a quick trip to the village of Kwethluk.  Kwethluk is only about a 5 minute flight east of Bethel.  In the winter, when the river is frozen, it's possible to drive or snow machine.  The weather the morning I was scheduled to leave was snowy and windy.  As a result my flight was delayed nearly 4 hours.  Once I got to the clinic, I had enough time to quickly unpack and heat up my lunch.  

Kwethluk from the plane 

The purpose of this overnight was to see home bound patients.  Kwethluk has a population of about 750 (the largest of my 3 villages), with a handful of these patients having significant mobility issues.  Since Kwethluk is so close to Bethel, especially this time of year with the ice road, most patients can easily make it into town, relatively.  Many of the patients on my list to see haven't been seen by a provider for years.  Several of these patients are on hospice care.

No plumbing in Kwethluk.  All water is either
hauled from the river or washeteria.  Homes
either have honey buckets or out houses.

At first I was nervous about seeing only patients with multiple problems, pages of medications and no one to consult with.  That fear didn't last long.  My patients and their families were some of the most pleasant people I have had the opportunity to spend time with.  It was such a unique glimpse into my patients' lives, going into their homes.  I saw some patients over coffee sitting at their kitchen table, some in their living rooms, and several in their bedrooms sitting next to them on their bed.  I had time not only to discuss how they were doing medically, but to also find out who the child in the picture on their nightstand was.

Russian Orthodox church and graveyard

One patient I saw on my first day was hosting Slaviq.  Slaviq is the Russian Orthodox Christmas.  It starts on January 7th and lasts for a whole week.  Members of the church go from home to home throughout the week.  They sing, pray, exchange gifts, and of course eat.  It would be like Christmas morning everyday for a week!  It's a big deal in this part of Alaska as the Russian Orthodox church has many members.  I have been hearing people talk about Slaviq all December and was glad to get the chance to observe the tradition.
It has been several years since any provider has been out to Kwethluk.  I hope my next trip isn't that far off.

 

Kwethluk clinic

My mode of transportation

        

The Kind Of Place We Live

Bethel continues to amaze me.  Not just the crazy weather, but the people too.  Our beautiful snow showers from last week have succumb to warmer temperatures and now freezing rain.  The weather has turned our roads into dangerous ice ranks.  Mark is pretty good when it comes to driving in this stuff, but we have come to realize it might be time for snow tires. 
Earlier today Mark was going into town and slid off the road.  His first go to was to call a good friend to see if he could pull him out.  Unfortunately, his truck just wasn't heavy enough to get the needed traction to pull Mark back onto the road.  Their next idea was to ask the airport bulldozer driver who was sanding the runway if he could pull Mark out.  (Mark just so happened to slide off in front of the sand pile.)  However, that meant waiting for a while till the bulldozer returned for sand.  In the mean time, Mark and his buddy left our car to run a quick errand.  Mark saw no point in bringing our cars keys along so he just left them with the car.  
Here's the cool part of the story...  When Mark returned, 3 guys were hard at work pulling our car back onto the road.  One of the guys was our neighbor and the other two were guys we didn't even know.  Apparently our neighbor recognized our car and got a couple of his buddies to help him pull it out!  I think it's pretty cool, when someone you hardly know, helps you out; not just without you having to ask for help, but without even being there!   

Merry Christmas and Happy New Year!

We hope all our friends and family had a wonderful holiday season.  This was the first year we have been away from family and it was bittersweet.  We certainly missed opening presents with Nana and Papa, Auntie, Grandma and Grandpa, Papa, and Uncle Quint.  But, at the same time, it was nice to wake up in our own home with just the 4 of us.  The snow finally came, enough at least to call it a white Christmas.  It even snowed for a little while on Christmas Eve.  
The week before Christmas we took the kids to see Santa.  He was only in town for that weekend, which surprised me seeing how close we are to the North Pole I thought for sure we would get to see more of him.  Every year since both kids were born I have gotten framed Santa pictures.  This year's didn't turn out so well.  Gianna lost her mind the moment she realized she was in a stranger's lap.  Luke who normally has zero stranger danger just looked shell shocked.  He kept looking from Santa to his sister as if wondering what all the fuss was about.  And poor Santa just looked like he wanted nothing more than for this screaming baby to be taken from him.

Christmas day poor Mark woke up with a fever of 102!  He managed to make it through opening gifts before disappearing for the next three days!  The kids and I went over to a friend's house for an excellent dinner.  We had ham and turkey, potatoes, green bean casserole, deviled eggs, homemade rolls and great company.  The kids all played together and I got to relax some.
New Years Eve we spent with the same good friends.  We got so involved in our Scategories game that we missed the ball drop!  The new year has treated us well so far.  The hospital here is getting ready to make the gigantic switch from paper charts to electronic medical records.  It will be great having electronic records, but I am really not looking forward to making the switch.  
We hope the new year is a blessed one for all who are reading this.  Ours, so far, has no complaints.  Warmer temps have meant more chances to play in the snow!

Extreme Cold!

Sunset over the snowy tundra

We are defiantly starting to experience temperatures lower than I have ever experienced before.  The other morning we woke up to -23 degrees, factor in the 15-20 mile per hour winds and the temp was about -45.  With these low temps comes a plethora of new experiences for us.  Here are just a few:
* Despite the fact that we have double pane windows there is a thick layer of ice on the bottom INSIDE of all our windows!  On several of our windows we taped plastic shrink wrap to the inside in an attempt to keep the cold out and the heat in.
* The other day I went to visit a friend and she had to use a hair dryer to defrost her door before she could let me in.  Her outer door had actually frozen shut!!

Snow drift

* There is a phenomenon that we have not yet experienced since we are able to park our car inside our heated garage, but I know several people who have... square tires.  That's right, square tires.  The temperature gets so low that the pressure drops in the tire and they flatten a bit.  Then the rubber freezes in the flattened shape.  The only way to get your tires round again is to warm them up, the only way to warm them up is to drive your car.  At first the tires and car clunk along, but apparently it doesn't take too long for them to warm up, round out and ride smoothly.  I almost want to leave our car outside one night just to see if our tires are square in the morning.
* Lately whenever you walk outside, after just a couple of inhalations through your nose, the inside of your nostrils start to freeze!  Its a very strange sensation.  The first time I experienced it I kept breathing in just to feel my nose.

Frozen Kuskokwim River

* A few nights ago, I took a walk out on the tundra to view a beautiful meteor shower and try to catch the northern lights.  It was about -45 with the wind and after about 10 minutes I could feel icicles on my eyelashes.  I didn't last too long outside that night, I don't have goggles yet and it didn't take long before my cheeks and bridge of my nose were burning.
* Lastly, we got a chance to take a drive on the river.  We didn't go very far, it was a much rougher crossing than I thought it would be.  Plus the wind was blowing the snow so much that it was quickly covering the previously made tracks.  Since we weren't at all familiar with the smoothest route we turned around rather than risk a flat tire in the middle of the river.

Driving on the Kuskokwim

Ice fishing

Blowing snow over the frozen river

So maybe its just the novelty of our first Alaskan winter that makes all the above so interesting, but if that's what it takes to help us get through the coldest winter we've ever experienced then we'll take it!
  

Becoming More Alaskan

Just one of the hind quarters we got

Back in the beginning of September moose season opened.  In that first weekend friends of our friends got not one but two moose!  It was kind of a sad story actually.  The two moose seem to have been brothers.  They were both wondering the tundra together.  The first moose got shot and the second moose didn't want to leave him there, so he got shot too.  (If it makes my animal loving friends feel any better, those two moose filled more than one freezer.)  Mark was asked to help quarter and pack the moose back to Bethel.  In exchange for his labor we would get to keep some of the moose.  It took the whole weekend.  The first day both moose had to be gutted and quartered.  Each moose probably weighed 700-800 pounds and had to be moved away from the gut pile to keep bears off their sent.  Mark didn't get home that night until about 3:00 am, got a few hours of sleep then headed back out to finish packing the moose back to Bethel.  In the end we got two hind quarters.  
We brought the meat to a processor here in town.  It took a little bit of time, but we finally got our moose back.  One hundred pounds of moose sausage, moose hamburger, moose roast... Our freezer is full of meat that will save us hundreds of dollars this winter.  

Our freezer full of moose!

Moose stew.  Yumm!

Tonight I made moose stew for dinner.  We had our good friends over to enjoy it with us.  (Dinner get-togethers are a way of life here.)  It was pretty delicious, if I do say so myself.  Not too gamey as I was afraid it would be, and very lean.  I do feel just a little bit more Alaskan now that my freezer is full of moose meat and I successfully cooked an enjoyable moose dinner.