tag:blogger.com,1999:blog-88379548753435500262024-03-13T09:49:36.026-07:00Dr. B. Culpdrbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.comBlogger87125tag:blogger.com,1999:blog-8837954875343550026.post-42973415302703932382011-12-12T08:24:00.001-08:002011-12-12T08:24:46.651-08:00MIA<div style="text-align: center;">I can't really say life has been crazy as much as it has been wonderful lately! But that means I've been a terrible slacker with the blog. Soon enough, the blog is getting a makeover and I'm hoping that will inspire me to get some more reader-friendly posts your way! </div><div style="text-align: center;"><br />
</div><div style="text-align: center;">In the meantime, I hope you are enjoying the holiday season! </div><div style="text-align: center;"><br />
</div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-Z6d0hPwneWM/TuYqpU_HGeI/AAAAAAAAAuo/yvRVeqaAcUA/s1600/snow.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="http://1.bp.blogspot.com/-Z6d0hPwneWM/TuYqpU_HGeI/AAAAAAAAAuo/yvRVeqaAcUA/s640/snow.jpg" width="459" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">via pinterest</td></tr>
</tbody></table><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: transparent; border: 0 !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com1tag:blogger.com,1999:blog-8837954875343550026.post-48476880318068313052011-11-28T08:42:00.000-08:002011-11-28T08:42:59.382-08:00Working Out<div style="text-align: center;">I guess Thanksgiving has me feeling guilty. I've been meaning to be better about working out. I started with Camp Gladiator back in September, and it was awesome. The workouts are intense and there's always someone there to keep you going. The only thing I don't like about it is the times/places the workouts are available. While there are a number of locations, the times at the locations closest to me aren't all that convenient to my schedule. While I still do occasional camps, I'm not good about going every chance I get. I've been seeing the Bodyrock workouts on Pinterest for months. Today, I'm getting started. The home workout revolution has swayed me. All of Bodyrock.tv's workouts are fairly short and the results look amazing. Maybe for the New Year I'll consider changing my diet too. Maybe.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Today: I'm starting with some of her older stuff. Today we're starting with the first part of her Rock Your Body group of workouts. Wish me luck!</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Think you wanna join in on the fun? Check it out:<a href="http://www.bodyrock.tv/"> http://www.bodyrock.tv/ </a></div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: transparent; border: 0 !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-2291783336483272182011-11-23T14:37:00.000-08:002011-11-23T14:37:05.953-08:00Happy Turkey Day<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-u2xumZ_mdHE/Ts11D98B41I/AAAAAAAAAug/7Sy_gX7C0Uw/s1600/Thanksgiving+Faux-Burlap+Printable.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://1.bp.blogspot.com/-u2xumZ_mdHE/Ts11D98B41I/AAAAAAAAAug/7Sy_gX7C0Uw/s400/Thanksgiving+Faux-Burlap+Printable.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">From <span class="Apple-style-span" style="color: #228822; font-family: arial; line-height: 15px;">sweet--bits.blogspot.com</span></td></tr>
</tbody></table><div style="text-align: center;"><br />
</div><div style="text-align: center;">It's been a rough year in some parts. But I made it through my 2nd year of residency, my family survived the loss of my parents home, and I've got new people in my life making it a great one. There's so much to be thankful for this holiday season. What are you most thankful for? </div><div style="text-align: center;"><br />
</div><div style="text-align: center;">And on that note, what's your favorite part of Thanksgiving dinner? I think I have to go with my mom's sweet potato casserole. Yum!</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com1tag:blogger.com,1999:blog-8837954875343550026.post-3634500206478873402011-11-17T14:16:00.000-08:002011-11-17T14:16:08.164-08:00All I Want For Christmas<div style="text-align: center;">Now that I've completed almost every bit of my own Christmas shopping, here's the things I'd love to find under the tree for me! What do YOU want for Christmas?</div><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-xVz8NXMaIL4/TsWGYILQbmI/AAAAAAAAAts/L3jSoN7Z2i0/s1600/godoggo.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-xVz8NXMaIL4/TsWGYILQbmI/AAAAAAAAAts/L3jSoN7Z2i0/s400/godoggo.jpg" width="266" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Etsy.com</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-EY5NiXAoqUw/TsWGcmVgbrI/AAAAAAAAAt0/qEiIVVvjS98/s1600/projector.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-EY5NiXAoqUw/TsWGcmVgbrI/AAAAAAAAAt0/qEiIVVvjS98/s400/projector.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Brookstone</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-o_CgixA5z54/TsWGeekpWRI/AAAAAAAAAt8/18fDYbyRgEw/s1600/purple+peacoat.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://1.bp.blogspot.com/-o_CgixA5z54/TsWGeekpWRI/AAAAAAAAAt8/18fDYbyRgEw/s400/purple+peacoat.jpg" width="296" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Victoria's Secret</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-Jzd8S_v9Rm8/TsWGmQKMEMI/AAAAAAAAAuM/n5Zg5fUlsmk/s1600/staffordshiredogs.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="270" src="http://2.bp.blogspot.com/-Jzd8S_v9Rm8/TsWGmQKMEMI/AAAAAAAAAuM/n5Zg5fUlsmk/s400/staffordshiredogs.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span class="Apple-style-span" style="font-family: inherit; font-size: x-small;"><span class="Apple-style-span" style="line-height: 15px;">oneofakindantiques.com</span></span></td></tr>
</tbody></table><br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-x-avzMlSUFU/TsWG3tPTyEI/AAAAAAAAAuU/Wmy5MPTJQMU/s1600/welkerjersey.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://1.bp.blogspot.com/-x-avzMlSUFU/TsWG3tPTyEI/AAAAAAAAAuU/Wmy5MPTJQMU/s400/welkerjersey.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">ProShop</td></tr>
</tbody></table><br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: transparent; border: 0 !important;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-33553435460891427722011-11-16T16:32:00.000-08:002011-11-16T16:32:20.685-08:00A Time For Thanks<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-GB7-GOfu0Bk/TsRV6fmd93I/AAAAAAAAAtk/Pd15ud-K9sA/s1600/Thanks-Tree.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-GB7-GOfu0Bk/TsRV6fmd93I/AAAAAAAAAtk/Pd15ud-K9sA/s400/Thanks-Tree.jpg" width="308" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span class="Apple-style-span" style="font-size: xx-small;">Image courtesy of: http://chocolateonmycranium.blogspot.com/2008/10/thanks-and-giving.html</span></td></tr>
</tbody></table><br />
Last night, I had the pleasure of enjoying dinner on behalf of my patient's family. Yes, the one I blogged about a while back. The one that means so much to me. His family has become more than just the loved ones of someone I was able to help, but dear friends of mine. Their friends treated me (and my date!) to a fantastic dinner at Lemongrass in Deep Ellum. For you Dallasites, I highly recommend it. Fantastic Vietnamese--and they even kept things peanut free at my request! I'll keep this post short and to the point. My boyfriend (yes, I said it!) and I had a terrific time catching up with the family and friends that I've spent so much time getting to know as their son recovers. I have so much to be thankful for this Thanksgiving season, but nearing the top of the list is my patient's recovery, the new friends I've made because of his course, and the meaning which it gives me for my career. Thank you again to those of you who were so gracious in spending your evening with me. You know who you are. :)<br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: transparent; border: 0 !important;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-25564548858025324482011-10-29T18:56:00.000-07:002011-10-29T18:56:00.910-07:00Happy Halloween!<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-ObYCKSXkIb8/TpuKhLSH8vI/AAAAAAAAAlw/dsG6dlkAPg4/s1600/halloween.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://2.bp.blogspot.com/-ObYCKSXkIb8/TpuKhLSH8vI/AAAAAAAAAlw/dsG6dlkAPg4/s1600/halloween.jpg" /></a></div><br />
<div style="text-align: center;">Happy Halloween readers! While I am on call for the official All Hallow's Eve, I'll be out with the rest of you enjoying my weekend playing up the likes of someone else! I can't wait to see the costumes! Please be safe on your adventures!</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-clip: initial; background-color: transparent; background-origin: initial; border-bottom-width: 0px! important; border-left-width: 0px! important; border-right-width: 0px! important; border-top-width: 0px! important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-59020723710908736172011-10-28T18:49:00.000-07:002011-10-28T18:49:00.844-07:00Small Town America<span style="font-size: large;">New England's Smaller Towns</span><br />
<br />
<em>Massachusetts</em><br />
Average Medical Liability Premium: $20,000 to $107,000<br />
# of physicians/100,000: 214<br />
Average # of disciplinary actions of boards/1,000: 2.6<br />
State Income Tax: 0%<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-yEbZzvk1xRQ/TqTfCYkZDTI/AAAAAAAAAmw/5wk8jF9CHW0/s1600/Northampton.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="266px" rda="true" src="http://2.bp.blogspot.com/-yEbZzvk1xRQ/TqTfCYkZDTI/AAAAAAAAAmw/5wk8jF9CHW0/s400/Northampton.jpg" width="400px" /></a></div><br />
<u>Northampton </u><br />
Location: Western Massachusetts<br />
Population: 28,978<br />
Ethnicity: 84% Caucasian, 7% Hispanic, 3% African-American, 4% Asian<br />
Median Resident Age: 37.3<br />
Crime Index: 259.1<br />
Average High Jan/July: 33/82<br />
Average Low Jan/July: 13/59<br />
Median Household Income: $50,455<br />
Unemployment Rate: 5.3%<br />
Cost of Living Index: 112.2<br />
Median House/Condo Value: $289,766<br />
Average Home Price in 2009: $325,319<br />
Median Rent: $844<br />
Getting There: 45 minutes from Hartford Airport<br />
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<div class="separator" style="clear: both; text-align: center;"><a href="http://3.bp.blogspot.com/-8l7aGmwXc-Q/TqTmjclKiGI/AAAAAAAAAm4/A6jigZu2Z2M/s1600/newton.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="276px" rda="true" src="http://3.bp.blogspot.com/-8l7aGmwXc-Q/TqTmjclKiGI/AAAAAAAAAm4/A6jigZu2Z2M/s400/newton.jpg" width="400px" /></a></div><br />
<u>Newton</u><br />
Location: Boston Suburbs<br />
Population: 84,600<br />
Ethnicity: 81% Caucasian, 4% Hispanic, 2% African-American, 10% Asian<br />
Median Resident Age: 38.7<br />
Crime Index: 90.0<br />
Average High Jan/July: 34/81<br />
Average Low Jan/July: 18/62<br />
Median Household Income: $108,686<br />
Unemployment Rate: 4.5%<br />
Cost of Living Index: 140.3<br />
Median House/Condo Value: $685,400<br />
Average Home Price in 2009: $745,249<br />
Median Rent: $1471<br />
Getting There: 45 minutes from downtown Boston<br />
<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-b_Ltmz8oWW8/TqTnLOq22fI/AAAAAAAAAnA/TEXBFuHZzkg/s1600/MVOL.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="278px" rda="true" src="http://2.bp.blogspot.com/-b_Ltmz8oWW8/TqTnLOq22fI/AAAAAAAAAnA/TEXBFuHZzkg/s400/MVOL.jpg" width="400px" /></a></div><br />
<br />
<u>Edgartown</u><br />
Location: Martha's Vineyard<br />
Population: 4,067<br />
Ethnicity: 93% Caucasian, 1% Hispanic, 2% African-American, 1% Asian<br />
Median Resident Age: 40.3<br />
Crime Index: 163.3<br />
Average High Jan/July: 39/79<br />
Average Low Jan/July: 22/62<br />
Median Household Income: $68,675<br />
Unemployment Rate: 16.4%<br />
Cost of Living Index: 110.7<br />
Median House/Condo Value: $667,632<br />
Average Home Price in 2009: $875,155<br />
Median Rent: ---<br />
Getting There: 45 minutes from Boston airport or Providence airport to ferry<br />
<br />
<em>New Hampshire</em><br />
<br />
Average Medical Liability Premium: $20,000 to $107,000<br />
# of physicians/100,000: 214<br />
Average # of disciplinary actions of boards/1,000: 2.6<br />
State Income Tax: 0%<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-5Y8ce3AQzwU/TqTn61qFcsI/AAAAAAAAAnI/k9EjjVKh3JY/s1600/nashua.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="280px" rda="true" src="http://2.bp.blogspot.com/-5Y8ce3AQzwU/TqTn61qFcsI/AAAAAAAAAnI/k9EjjVKh3JY/s400/nashua.jpg" width="400px" /></a></div><br />
<u>Nashua</u><br />
Location: Southern New Hampshire<br />
Population: 86,494<br />
Ethnicity: 81% Caucasian, 9% Hispanic, 2% African-American, 7% Asian<br />
Median Resident Age: 35.8<br />
Crime Index: 201.0<br />
Average High Jan/July: 33/83<br />
Average Low Jan/July: 12/59<br />
Median Household Income: $58,789<br />
Unemployment Rate: 5.5%<br />
Cost of Living Index: 118.8<br />
Median House/Condo Value: $248,500<br />
Average Home Price in 2009: $287,823<br />
Median Rent: $1014<br />
Getting There: 40 minutes north of Boston<br />
<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://1.bp.blogspot.com/-YVxC_oJlMyI/TqToKuVkCBI/AAAAAAAAAnQ/O-i5D5FLrEE/s1600/portsmouth.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="256px" rda="true" src="http://1.bp.blogspot.com/-YVxC_oJlMyI/TqToKuVkCBI/AAAAAAAAAnQ/O-i5D5FLrEE/s400/portsmouth.jpg" width="400px" /></a></div><div class="separator" style="clear: both; text-align: center;"><br />
</div><u>Portsmouth</u><br />
Location: New Hampshire Coast<br />
Population: 21,233<br />
Ethnicity: 90% Caucasian, 2% Hispanic, 3% African-American, 4% Asian<br />
Median Resident Age: 38.5<br />
Crime Index: 174.6<br />
Average High Jan/July: 35/80<br />
Average Low Jan/July: 18/59<br />
Median Household Income: $58,492<br />
Unemployment Rate: 4.1%<br />
Cost of Living Index: 136.7<br />
Median House/Condo Value: $309.723<br />
Average Home Price in 2009: $385,926<br />
Median Rent: $1077<br />
Getting There: 55 minutes from Boston airport, 50 mintues from Manchester airport, 50 minutes from Portland airport<br />
<br />
<em>Maine</em><br />
<br />
Average Medical Liability Premium: $20,000 to $107,000<br />
# of physicians/100,000: 214<br />
Average # of disciplinary actions of boards/1,000: 2.6<br />
State Income Tax: 0%<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-_ulcBSlqXWU/TqTq4qRulcI/AAAAAAAAAnY/0UnHO9-LPtg/s1600/portland.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="261px" rda="true" src="http://3.bp.blogspot.com/-_ulcBSlqXWU/TqTq4qRulcI/AAAAAAAAAnY/0UnHO9-LPtg/s400/portland.jpg" width="400px" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Credit: Deborah Andrews <a href="http://www.preservationnation.org/">http://www.preservationnation.org/</a></td></tr>
</tbody></table><u>Portland</u><br />
Location: Maine Coast<br />
Population: 66,194 (516,826 metro)<br />
Ethnicity: 85% Caucasian, 3% Hispanic, 6% African-American, 3% Asian<br />
Median Resident Age: 35.7<br />
Crime Index: 303.0<br />
Average High Jan/July: 31/79<br />
Average Low Jan/July: 13/59<br />
Median Household Income: $42,010<br />
Unemployment Rate: 6.5%<br />
Cost of Living Index: 104.7<br />
Median House/Condo Value: $257,245<br />
Average Home Price in 2009: $304,245<br />
Median Rent: $830<br />
Getting There: Portland Airport<br />
<br />
<em>Rhode Island</em><br />
<br />
<div style="margin: 0px;">Average Medical Liability Premium: $44,000 to $57,000</div><div style="margin: 0px;"># of MDs/100k: 376</div><div style="margin: 0px;"># of cases/1,000: 2.85</div>State Income Tax: 9.9%<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-dZ-4tg1PQqQ/TqTw203VVNI/AAAAAAAAAng/ddDY1YZmCA0/s1600/newport.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300px" rda="true" src="http://2.bp.blogspot.com/-dZ-4tg1PQqQ/TqTw203VVNI/AAAAAAAAAng/ddDY1YZmCA0/s400/newport.jpg" width="400px" /></a></div><br />
<u>Newport</u><br />
Location: Rhode Island Coast<br />
Population: 24,672<br />
Ethnicity: 88% Caucasian, 3% Hispanic, 6% African-American, 1% Asian<br />
Median Resident Age: 34.9<br />
Crime Index: 266.2<br />
Average High Jan/July: 38/78<br />
Average Low Jan/July: 23/64<br />
Median Household Income: $55,916<br />
Unemployment Rate: 12.8%<br />
Cost of Living Index: 117.5<br />
Median House/Condo Value: $408,894<br />
Average Home Price in 2009: $616,510<br />
Median Rent: $1021<br />
Getting There: 45 minutes from Providence, 90 minutes from Boston<br />
<br />
<em>Vermont</em><br />
<br />
Average Medical Liability Premium: $20,000 to $107,000<br />
# of physicians/100,000: 214<br />
Average # of disciplinary actions of boards/1,000: 2.6<br />
State Income Tax: 0%<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-UeSfIZyMt4w/TqTxEw7_QJI/AAAAAAAAAno/gMc4pgpU0oI/s1600/brattleboro.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300px" rda="true" src="http://2.bp.blogspot.com/-UeSfIZyMt4w/TqTxEw7_QJI/AAAAAAAAAno/gMc4pgpU0oI/s400/brattleboro.jpg" width="400px" /></a></div><br />
<u>Brattleboro</u><br />
Location: Southern Vermont<br />
Population: 12,046<br />
Ethnicity: 93% Caucasian, 2% Hispanic, 1% African-American, 2% Asian<br />
Median Resident Age: 39.2<br />
Crime Index: 291.5<br />
Average High Jan/July: 31/83<br />
Average Low Jan/July: 9/57<br />
Median Household Income: $37,382<br />
Unemployment Rate: 5.4%<br />
Cost of Living Index: 98.0<br />
Median House/Condo Value: $196,999<br />
Average Home Price in 2009: $206,378<br />
Median Rent: $704<br />
Getting There: Providence Airport<br />
<br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com1tag:blogger.com,1999:blog-8837954875343550026.post-39235711598608598742011-10-27T18:48:00.000-07:002011-10-27T18:48:00.483-07:00Providence<div style="margin: 0px;"><span style="font-size: large;">Providence, RI</span><br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://4.bp.blogspot.com/-eDihP4j3-yA/TqHeoVIvrFI/AAAAAAAAAmg/27CKyDRWrmQ/s1600/Historic_riverfront-cr-Hal-Barth_mr.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300px" rda="true" src="http://4.bp.blogspot.com/-eDihP4j3-yA/TqHeoVIvrFI/AAAAAAAAAmg/27CKyDRWrmQ/s400/Historic_riverfront-cr-Hal-Barth_mr.jpg" width="400px" /></a></div><br />
The People:</div><div style="margin: 0px;">Population Metro: 1.6 million</div><div style="margin: 0px;">Population City: 178,052 (July 2010)</div><div style="margin: 0px;">Ethnicity: 41% Hispanic, 36% Caucasian, 14% African American, 7% Asian</div><div style="margin: 0px;">Median Resident Age: 28.1</div><div style="margin: 0px;">Crime Index: 440.1 (US average 319.2)</div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;">The Weather:</div><div style="margin: 0px;">Annual Rainfall: 45.5</div><div style="margin: 0px;">Annual Snowfall: 35.9<br />
Days with Precip: 125<br />
Days with Snow: 19<br />
Sunshine Hours: 2607/yr</div><div style="margin: 0px;">Average Jan/July High: 28/73</div><div style="margin: 0px;">Average Jan/July Low: 19/63</div><div style="margin: 0px;"><br />
The Money:<br />
Median Household Income: $37,619</div><div style="margin: 0px;">Unemployment Rate: 13.3%</div><div style="margin: 0px;">Cost of Living Index: 99.3<br />
State Income Tax: 9.9%<br />
<br />
</div><div style="margin: 0px;">The Homes:<br />
Median House/Condo Value: $227,600</div><div style="margin: 0px;">Average Home Price in 2009: $345,750</div><div style="margin: 0px;">Median Rent: $914</div><div style="margin: 0px;"><br />
The Medicine:</div><div style="margin: 0px;">Average Medical Liability Premium: $44,000 to $57,000</div><div style="margin: 0px;"># of MDs/100k: 376</div><div style="margin: 0px;"># of cases/1,000: 2.85</div><div style="margin: 0px;"><br />
Getting Home:</div><div style="margin: 0px;">Distance to Amarillo: 1897 miles<br />
Airlines: Continental, United, Southwest</div><br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-6187419217497895002011-10-26T18:48:00.000-07:002011-10-26T18:48:00.605-07:00Manchester<div style="margin: 0px;"><span style="font-size: large;">Manchester, NH</span><br />
<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-aIP1N4RBC-8/TqTeO03McYI/AAAAAAAAAmo/-oo7_sL_LwU/s1600/manchester.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="115px" rda="true" src="http://3.bp.blogspot.com/-aIP1N4RBC-8/TqTeO03McYI/AAAAAAAAAmo/-oo7_sL_LwU/s400/manchester.jpg" width="400px" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><a href="http://www.photopro44.com/">http://www.photopro44.com/</a></td></tr>
</tbody></table><br />
The People:</div><div style="margin: 0px;">Population Metro: 400,721</div><div style="margin: 0px;">Population City: 109,395 (July 2009)</div><div style="margin: 0px;">Ethnicity: 84% Caucasian, 8% Hispanic, 4% African-American, 3% Asian</div><div style="margin: 0px;">Median Resident Age: 34.9</div><div style="margin: 0px;">Crime Index: 322.9 (US average 319.2)</div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;">The Weather:</div><div style="margin: 0px;">Annual Rainfall: 40</div><div style="margin: 0px;">Annual Snowfall: 47<br />
Days With Precip: 121<br />
Days with Snow: 17</div><div style="margin: 0px;">Average High Temp Jan/July: 32/82</div><div style="margin: 0px;">Average Low Temp Jan/July: 5/55</div><div style="margin: 0px;"><br />
The Money:<br />
Median Household Income: $48,720</div><div style="margin: 0px;">Unemployment Rate: 5.7%</div><div style="margin: 0px;">Cost of Living Index: 119.5<br />
State Income Tax: 0%<br />
<br />
</div><div style="margin: 0px;">The Homes:<br />
Median House/Condo Value: $230,900</div><div style="margin: 0px;">Average Home Price in 2009: $256,276</div><div style="margin: 0px;">Median Rent: $936</div><div style="margin: 0px;"></div><div style="margin: 0px;"><br />
The Medicine:<br />
Average Medical Liability Premium: $37k-$49k<br />
# of MDs/100k: 275.0<br />
# of cases/1,000k: 2.1<br />
<br />
Getting Home: <br />
Distance to Amarillo: 1971 miles<br />
Airlines: Continental, United, Southwest</div><br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-87918753945033212292011-10-25T18:47:00.000-07:002011-10-25T18:47:00.659-07:00Boston<span style="font-size: large;">Boston</span><br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-oyE_rzYzB8A/TqHdTr7PSsI/AAAAAAAAAmQ/zCWvepD6Sgk/s1600/boston01-300x199.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="265px" rda="true" src="http://2.bp.blogspot.com/-oyE_rzYzB8A/TqHdTr7PSsI/AAAAAAAAAmQ/zCWvepD6Sgk/s400/boston01-300x199.jpg" width="400px" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><a href="http://www.hotelsbostonma.org/"><span style="color: #0000cc;">www.hotelsbostonma.org/</span></a></td></tr>
</tbody></table>The Place<br />
Location: Eastern edge of Massachusetts on Boston Bay<br />
<br />
The People:<br />
Population Metro: 4.6 million<br />
Population City: 645,169 (July 2009)<br />
Ethnicity: 51% Caucasian, 22% African-American, 16% Hispanic, 8% Asian<br />
Median Resident Age: 31.1<br />
Crime Index: 420.5 (US average 319.2)<br />
Politics: 32% Republican, 68% Democrat (2008 Results)<br />
<br />
The Weather:<br />
Annual Rainfall: 41.5 inches<br />
Annual Snowfall: 42.4 inches<br />
Days with Precip: 126<br />
Days with Snow: 22.5<br />
Sunshine Hours: 2638<br />
Average High Jan/July: 36/82<br />
Average Low Jan/July: 22/65<br />
<br />
The Money:<br />
Median Household Income: $55,979<br />
Unemployment Rate: 6.8%<br />
Cost of Living Index: 140.2<br />
State Income Tax: 5.3%<br />
<br />
The Homes:<br />
Median House/Condo Value: $375,700<br />
Average Home Price in 2009: $553,032<br />
Median Real Estate Property Taxes: $2,652<br />
Median Rent: $1,196<br />
<br />
The Medicine:<br />
Average Medical Liability Premium: $40,000<br />
# of MDs/100k: 469<br />
# of cases/1,000: 2.46<br />
<br />
Getting Home:<br />
Distance to Amarillo: 1933 miles <br />
Airlines: Southwest, American, Continental, United<br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-6650846119282368282011-10-24T14:02:00.000-07:002011-10-24T14:02:00.853-07:00Where I'm Coming FromWhile looking into moving to New England, it's only fair to compare it to "where I come from", i.e. Amarillo and as of late, Dallas. Essentially, these are the only places in Texas I'd want to live if I stuck around.<br />
<br />
<span class="Apple-style-span" style="font-size: large;">Amarillo</span><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-TPNiFRvE3bA/TqHYUPAHIOI/AAAAAAAAAmA/IZLNraOx6DY/s1600/Amarillo.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="266px" rda="true" src="http://4.bp.blogspot.com/-TPNiFRvE3bA/TqHYUPAHIOI/AAAAAAAAAmA/IZLNraOx6DY/s400/Amarillo.jpg" width="400px" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><a href="http://www.redwingaerials.com/amarillo.html"><span style="color: #0000cc;">www.redwingaerials.com/<wbr>amarillo.html</span></a></td></tr>
</tbody></table><br />
<div style="margin: 0px;">The Place</div><div style="margin: 0px;">Location: Panhandle of Texas</div><div style="margin: 0px;"><br />
The People:</div><div style="margin: 0px;"><div style="margin: 0px;">Population Metro: 249,881</div><div style="margin: 0px;">Population City: 189,389 (July 2009)</div><div style="margin: 0px;">Ethnicity: 62% Caucasian, 27% Hispanic, 7% African-American, 2% Asian</div><div style="margin: 0px;">Median Resident Age: 33.5</div><div style="margin: 0px;">Crime Index: 533.0<br />
Politics: 56% Republican, 44% Democrat (2008 Results)</div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;">The Weather:</div><div style="margin: 0px;">Annual Rainfall: 19.6 inches</div><div style="margin: 0px;">Annual Snowfall: 15.5 inches<br />
Days with Precip: 72<br />
Days with Snow: 12<br />
Sunshine Hours: 3299/yr</div><div style="margin: 0px;">Average High Jan/July: 50/91</div><div style="margin: 0px;">Average Low Jan/July: 23/65</div><div style="margin: 0px;"><br />
The Money:<br />
Median Household Income: $41,759</div><div style="margin: 0px;">Unemployment Rate: 5.3%</div><div style="margin: 0px;">Cost of Living Index: 84.4<br />
State Income Tax: 0%<br />
<br />
The Homes:<br />
Median House/Condo Value: $102,800</div><div style="margin: 0px;">Average Home Price in 2009: $121,401</div><div style="margin: 0px;">Median Rent: $657</div><div style="margin: 0px;"><br />
The Medicine:<br />
Average Medical Liability Premium: $20,000 to $107,000<br />
# of physicians/100,000: 214<br />
Average # of disciplinary actions of boards/1,000: 2.6</div><div style="margin: 0px;"></div></div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;"><span class="Apple-style-span" style="font-size: large;">Dallas</span><br />
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<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-jnVNvX4zW50/TqHa0oCtKNI/AAAAAAAAAmI/DrfD6sSxCkc/s1600/dallas.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="266px" rda="true" src="http://4.bp.blogspot.com/-jnVNvX4zW50/TqHa0oCtKNI/AAAAAAAAAmI/DrfD6sSxCkc/s400/dallas.jpg" width="400px" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Dallas Convention and Visitors Bureau</td></tr>
</tbody></table><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div style="margin: 0px;"></div><div style="margin: 0px;">The Place</div><div style="margin: 0px;">Location: "North" Texas</div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;">The People:<br />
<div style="margin: 0px;">Population Metro: 6 million</div><div style="margin: 0px;">Population City: 1,299,543 (July 2009)</div><div style="margin: 0px;">Ethnicity: 43% Hispanic, 31% Caucasian, 22% African American, 3% Asian</div><div style="margin: 0px;">Median Resident Age: 30.5</div><div style="margin: 0px;">Crime Index: 546.2 (US average 319.2)<br />
Politics: 35% Republican, 65% Democrat (2008 Results)</div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;">The Weather:</div><div style="margin: 0px;">Annual Rainfall: 33.3 inches</div><div style="margin: 0px;">Annual Snowfall: 2.5 inches<br />
Days with Precip: 79.2<br />
Days with Snow: 1.9<br />
Sunshine Hours: 2849/yr</div><div style="margin: 0px;">Average High Jan/July: 55/96</div><div style="margin: 0px;">Average Low Jan/July: 36/77</div><div style="margin: 0px;"><br />
</div><div style="margin: 0px;">The Money:<br />
Median Household Income: $39,829</div><div style="margin: 0px;">Unemployment Rate: 8.6%</div><div style="margin: 0px;"><div style="margin: 0px;">Cost of Living Index: 94.4</div><div style="margin: 0px;">State Income Tax: 0%</div><br />
The Homes:<br />
Median House/Condo Value: $135,600</div><div style="margin: 0px;">Average Home Price in 2009: $210,881</div><div style="margin: 0px;">Median Rent: $784</div><div style="margin: 0px;"></div><div style="margin: 0px;"><br />
The Medicine:<br />
Average Medical Liability Premium: $20,000 to $107,000<br />
# of physicians/100,000: 214<br />
Average # of disciplinary actions of boards/1,000: 2.6<br />
<br />
Getting Home:</div><div style="margin: 0px;">Distance to Amarillo: 363 miles (Southwest, American Airlines direct flights 1 hour)</div></div><br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-89446900758496542462011-10-23T18:39:00.000-07:002011-10-23T18:39:00.739-07:00Could I Make the Move?<div style="text-align: center;">I'll admit. When I travel, I often come home thinking "I could live there. Forever." But no where does that really feel more true than when I visit the northeastern coast and New England. So where am I headed when residency is over? These days, I'm looking to call New England home. My biggest problem is figuring out WHERE. New England isn't easy, and leaving Texas isn't either.</div><div style="text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-Dd97jegVDB4/TpuJCW8SOtI/AAAAAAAAAlo/eEC3nok8RdY/s1600/new+england+map.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400px" src="http://2.bp.blogspot.com/-Dd97jegVDB4/TpuJCW8SOtI/AAAAAAAAAlo/eEC3nok8RdY/s400/new+england+map.gif" width="260px" /></a></div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Yes, it's colder than Texas. I'm welcome to that change after this year's miserable summer. </div><div style="text-align: center;"><br />
</div><div style="text-align: center;">New England's cost of living is much higher than here in Texas, even Dallas. </div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Besides Boston, New England proper doesn't have a lot of really BIG cities. </div><div style="text-align: center;"><br />
</div><div style="text-align: center;">New England has a lot of medium sized cities and thousands of small towns.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">I have no clue what hospital does what, where, etc.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">I have no clue what it's like to commute up there or even if it's worth commuting.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">What I do know is that I love the architecture, the weather for 9 months a year, most of the people, and overall sense of infatuation I have when I'm there.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">So, New England show me what you've got. Over the next week, I'm going to examine some of my top prospects for the next step. Feel free to chime in!<br />
<br />
Also, if you have advice for moving to the Northeast, it's much appreciated.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-clip: initial; background-color: transparent; background-origin: initial; border-bottom-width: 0px! important; border-left-width: 0px! important; border-right-width: 0px! important; border-top-width: 0px! important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com1tag:blogger.com,1999:blog-8837954875343550026.post-1341979233669726662011-10-21T17:00:00.000-07:002011-10-21T17:00:03.346-07:00New England: A Place in My Heart<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-eTD8iqvsn50/Tpt_XCo4nZI/AAAAAAAAAjY/eNzUcqRt2JE/s1600/IMG_0712.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://4.bp.blogspot.com/-eTD8iqvsn50/Tpt_XCo4nZI/AAAAAAAAAjY/eNzUcqRt2JE/s640/IMG_0712.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Maine Coast</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-PNdO482JNm8/Tpt_bbODhhI/AAAAAAAAAjg/TofXp800Vnw/s1600/IMG_0723.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://3.bp.blogspot.com/-PNdO482JNm8/Tpt_bbODhhI/AAAAAAAAAjg/TofXp800Vnw/s640/IMG_0723.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Maine Coast</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-22T3C4rSdXs/Tpt_fG2rAfI/AAAAAAAAAjo/J5ig1SK8TUs/s1600/IMG_0728.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://2.bp.blogspot.com/-22T3C4rSdXs/Tpt_fG2rAfI/AAAAAAAAAjo/J5ig1SK8TUs/s640/IMG_0728.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">York Beach, Maine</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-jl6JMf8Fj7s/Tpt_hDRN_dI/AAAAAAAAAjw/0_1wYS9S3VQ/s1600/IMG_0734_2.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="425" src="http://3.bp.blogspot.com/-jl6JMf8Fj7s/Tpt_hDRN_dI/AAAAAAAAAjw/0_1wYS9S3VQ/s640/IMG_0734_2.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Oqunquit, ME</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-nOntTs6nUcY/Tpt_nLUjsvI/AAAAAAAAAj4/PKfItfrzwkc/s1600/IMG_0739.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://1.bp.blogspot.com/-nOntTs6nUcY/Tpt_nLUjsvI/AAAAAAAAAj4/PKfItfrzwkc/s640/IMG_0739.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">God Bless America</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-BADlxJ4xET4/Tpt_rEUgsHI/AAAAAAAAAkA/m6CQ2cSB7ys/s1600/IMG_0750.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://1.bp.blogspot.com/-BADlxJ4xET4/Tpt_rEUgsHI/AAAAAAAAAkA/m6CQ2cSB7ys/s640/IMG_0750.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Taking in the breeze on Marginal Way</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-SjuncLMMuWg/Tpt_uBuC2qI/AAAAAAAAAkI/uHxjrBO_4xQ/s1600/IMG_0765_2.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://4.bp.blogspot.com/-SjuncLMMuWg/Tpt_uBuC2qI/AAAAAAAAAkI/uHxjrBO_4xQ/s640/IMG_0765_2.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Catching the sunset in Kennebunkport, Maine</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-QpwHIBW16J0/Tpt_w9_WsBI/AAAAAAAAAkQ/G4OXaOCXSmc/s1600/IMG_0766.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://3.bp.blogspot.com/-QpwHIBW16J0/Tpt_w9_WsBI/AAAAAAAAAkQ/G4OXaOCXSmc/s640/IMG_0766.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Seriously good sunset.</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://1.bp.blogspot.com/-O6ThsvjDaYs/Tpt_1UInquI/AAAAAAAAAkY/1p4A2nfihBQ/s1600/IMG_0837.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://1.bp.blogspot.com/-O6ThsvjDaYs/Tpt_1UInquI/AAAAAAAAAkY/1p4A2nfihBQ/s640/IMG_0837.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Luxurious night in Stowe, Vermont</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-MftCvFMMyGE/Tpt_65UKsII/AAAAAAAAAkg/WL4L4K5IlqA/s1600/IMG_0852.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://3.bp.blogspot.com/-MftCvFMMyGE/Tpt_65UKsII/AAAAAAAAAkg/WL4L4K5IlqA/s640/IMG_0852.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Playing tourist in Killington, Vermont</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-k3ru3YIhFD0/Tpt_96_MsVI/AAAAAAAAAko/LeeTQmztAco/s1600/IMG_0856.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://2.bp.blogspot.com/-k3ru3YIhFD0/Tpt_96_MsVI/AAAAAAAAAko/LeeTQmztAco/s640/IMG_0856.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Capturing history. You can't actually use this bridge except as a pedestrian or on a bicycle these days</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-thZuscG-XH8/TpuCVxK64_I/AAAAAAAAAkw/QCDJItdnxQ8/s1600/IMG_0791.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="529" src="http://3.bp.blogspot.com/-thZuscG-XH8/TpuCVxK64_I/AAAAAAAAAkw/QCDJItdnxQ8/s640/IMG_0791.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Moose. Always Brake for Moose.</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-oGgx1YGdP_8/TpuCc_Wkw2I/AAAAAAAAAk4/2Wb92aXM54c/s1600/IMG_0792.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="329" src="http://2.bp.blogspot.com/-oGgx1YGdP_8/TpuCc_Wkw2I/AAAAAAAAAk4/2Wb92aXM54c/s640/IMG_0792.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Essentially a watercolored landscape</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-Gy-go_Q23LU/TpuCkABwHoI/AAAAAAAAAlA/jbGeynDPhkk/s1600/IMG_0805.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="http://2.bp.blogspot.com/-Gy-go_Q23LU/TpuCkABwHoI/AAAAAAAAAlA/jbGeynDPhkk/s640/IMG_0805.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">More beautiful trees starting to turn</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-8SEMddTjK24/TpuCoyosPGI/AAAAAAAAAlI/RHUBvABL718/s1600/IMG_0806.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="449" src="http://3.bp.blogspot.com/-8SEMddTjK24/TpuCoyosPGI/AAAAAAAAAlI/RHUBvABL718/s640/IMG_0806.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Can't get enough of fall</td></tr>
</tbody></table><br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-66rQjZL5gmY/TpuDOn5CGsI/AAAAAAAAAlQ/5-wRmFxTQH8/s1600/IMG_0796+-+Version+2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="http://3.bp.blogspot.com/-66rQjZL5gmY/TpuDOn5CGsI/AAAAAAAAAlQ/5-wRmFxTQH8/s640/IMG_0796+-+Version+2.jpg" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">I love oranges and reds.</td></tr>
</tbody></table><br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-89096947532491406262011-10-20T13:51:00.000-07:002011-10-20T13:51:16.694-07:00Oh The Places You Will Go<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-mFynUAYDQds/TqCIfC0YTpI/AAAAAAAAAl4/lENtbkxTwL8/s1600/how+far+you+have+come.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="400" src="http://2.bp.blogspot.com/-mFynUAYDQds/TqCIfC0YTpI/AAAAAAAAAl4/lENtbkxTwL8/s400/how+far+you+have+come.jpg" width="400" /></a></div><br />
<br />
So, until I know I won't ever be liable for HIPAA stuff, I don't want to mention my patient's name on my blog...even though it has been referenced on their Caring Bridge website. But I know many of you are wondering how he's doing these days...he is now 70 days out from the crash. I also know many of you know all the details of his days with his mom at his side. She is a great writer herself.<br />
<br />
He was transferred from the skilled nursing facility to the rehab facility right before I went on vacation. Since that time he has made DRASTIC improvements.<br />
<br />
1. He no longer has a wound VAC on his abdominal wound.<br />
2. His cervical collar for his neck fractures is OFF.<br />
3. His tracheostomy tube is out and the hole it left behind is healing well.<br />
4. He spends a vast amount of his time in a wheelchair, not the bed.<br />
5. He is working on the treadmill with physical therapy.<br />
6. He has to have his achilles tendon released on the left side so that he can start walking a bit better. This will happen tomorrow or early next week.<br />
7. He can feed himself and will likely have his diet advanced from pureed to ground/chopped foods in the next couple of days!<br />
8. He is talking more and more clearly every day.<br />
9. He says "thank you" all the time. If you listen to him intently enough you can catch him say things like "thank you" (which he has already said to this person a number of times) followed by "thank you for everything".<br />
10. He's reading as well. His mom finally had the chance to introduce us earlier this week, and she introduced us again today. As I was standing there talking to him, at one point we heard him say "Brittney" and asked what he said and he repeated it. He was reading my name tag!<br />
11. I'm not quite sure how many shirts he has now, but the surrounding fire departments have been amazing in getting him shirts from each of the departments in his county (and beyond). Yes, he's training to be an EMT and finished fire school in May. That's why his bracelets say "Keep Fighting".<br />
<br />
I can go on and on about how cool it is to watch him. I always try to go say hi and plan on a quick 30 minute visit or so. I used to stick around to talk to his family for hours, now I stick around to watch him progress. We rarely get to see this side of it. The recovery, the therapy, the going home. I've been given a great opportunity to see what it's like once they are discharged from the hospital and what the long road to recovery really means.<br />
<br />
Besides the outstanding amount of support that's showered upon him and his family, I think I'm most impressed by his family's strength. I know they have their weak moments, sometimes I'm there to witness them and sometimes I'm not. It makes my heart hurt to see them worry (especially his granddad), but I can always feel the love between all of them. His mom has dedicated so much time and effort to his recovery and making sure he's always on schedule, keeping nurses on their toes, and helping him to understand the process of what he's going through. I know everyone around him is doing the same, but his mom is the person I see the most. (And somehow she's still managing to get some work accomplished during all this too.) I constantly compare this to watching grass grow. If you stand there and try to watch your grass grow, you'll never notice any difference. Even if you check on it every day, it doesn't seem to make much progress from one day to the next. But if you leave for four days and come back, it's grown like a weed! I used to be the one checking on him every day, then he was transferred to the SNF. Now I check on him once or twice a week depending on my own work load. I imagine if I was still seeing him every day it would be hard to really notice the big improvements, but it is so amazing to see how much he progresses in the span of only 3 to 4 days. His words are clearer, his motions more controlled, his thoughts more coherent, his memory improving, his weight gain, all of it. I admire that his family can see him every day and still notice the progress he's making.<br />
<br />
I can only imagine what it feels like for them 70 days out. He's come so far. He obviously still has a long ways to go, but some of the biggest hurdles have already been jumped. Soon enough, he'll be doing too well for rehab and he'll be off the next place which I'm fairly certain isn't a place that's going to be easy for me to keep checking in...at least not in person. But the pictures and texts from his mom, his Caring Bridge, and his spirit will keep me updated I'm certain.<br />
<br />
<div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-7726599139443994222011-10-19T08:00:00.001-07:002011-10-19T08:00:07.421-07:00Winning Bets<div style="text-align: center;">Dear New England Patriots,</div><div style="text-align: center;">Thank you for winning the game in the last couple minutes against the Cowboys. While a native Texan, I am huge fan of the Patriots (and Wes Welker in particular). Because you sent the Girls back here to Dallas with another loss, I am reaping the rewards of betting on the Pats. Next Friday, my good friend is treating me to dinner at The French Room here in Dallas. I made a good bet! Jealous anyone?</div><div style="text-align: center;"><br />
</div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-ks-qsi6sNHY/TpuG1OwWbiI/AAAAAAAAAlg/yXlcm17ntXs/s1600/welker.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://4.bp.blogspot.com/-ks-qsi6sNHY/TpuG1OwWbiI/AAAAAAAAAlg/yXlcm17ntXs/s400/welker.jpg" width="263" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">All because of 83 I became a fan...</td></tr>
</tbody></table><div style="text-align: center;">And now look what I get!</div><div style="text-align: center;"><br />
</div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-vcGRpiXvjtQ/TpuGJclHaWI/AAAAAAAAAlY/PxNna2LTIL0/s1600/french+room.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="http://2.bp.blogspot.com/-vcGRpiXvjtQ/TpuGJclHaWI/AAAAAAAAAlY/PxNna2LTIL0/s640/french+room.jpg" width="542" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><br />
From: http://www.hotelfandb.com/biol/july-aug2009-hiring-practices.asp</td></tr>
</tbody></table><div style="text-align: center;"><br />
</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-17900819747538321552011-10-16T17:59:00.000-07:002011-10-16T17:59:44.675-07:00The Real OutfitDear Readers,<br />
<br />
I've been on quite the hiatus. You can thank my day job for that one. Anyhow, last time I talked about my pinterest-inspired wardrobe for my fall vacation. Here's what it really turned into:<br />
<br />
For the Maine Coast: Cute, fun, ready for pictures, and a jacket to keep cozy.<br />
<br />
<div style="position:relative;width:500px;height:500px;"><a href="http://www.polyvore.com/bee/set?.embedder=1914163&.svc=copypaste&id=38299503"><img width="500" alt="Bee" src="http://embed.polyvoreimg.com/cgi/img-set/cid/38299503/id/CM5i6yj44BGdYcYSz_Fyxg/size/x.jpg" title="Bee" height="500" border="0" /></a></div><br/><div><small><a href="http://www.polyvore.com/bee/set?.embedder=1914163&.svc=copypaste&id=38299503">Bee</a> by <a href="http://drbculp.polyvore.com/?.embedder=1914163&.svc=copypaste">drbculp</a> featuring <a href="http://www.polyvore.com/long_sleeve_shirts/shop?query=long+sleeve+shirts">long sleeve shirts</a></small></div><br />
Driving Thru New Hampshire/Vermont: Comfy and autumnal.<br />
<br />
<div style="position:relative;width:500px;height:500px;"><a href="http://www.polyvore.com/vermont_drive/set?.embedder=1914163&.svc=copypaste&id=38299612"><img width="500" alt="Vermont Drive" src="http://embed.polyvoreimg.com/cgi/img-set/cid/38299612/id/gqdLOyn44BGxUzxK-dLi-Q/size/x.jpg" title="Vermont Drive" height="500" border="0" /></a></div><br/><div><small><a href="http://www.polyvore.com/vermont_drive/set?.embedder=1914163&.svc=copypaste&id=38299612">Vermont Drive</a> by <a href="http://drbculp.polyvore.com/?.embedder=1914163&.svc=copypaste">drbculp</a> featuring <a href="http://www.polyvore.com/high_waisted_jeans/shop?query=high+waisted+jeans">high waisted jeans</a></small></div><br />
Cheering for the Longhorns in the Midst of a Bunch of Yanks: Burnt Orange and Boots!<br />
<br />
<div style="position:relative;width:500px;height:500px;"><a href="http://www.polyvore.com/poor_ut/set?.embedder=1914163&.svc=copypaste&id=38299343"><img width="500" alt="Poor UT" src="http://embed.polyvoreimg.com/cgi/img-set/cid/38299343/id/-GVreij44BG0suMRz_Fyxg/size/x.jpg" title="Poor UT" height="500" border="0" /></a></div><br/><div><small><a href="http://www.polyvore.com/poor_ut/set?.embedder=1914163&.svc=copypaste&id=38299343">Poor UT</a> by <a href="http://drbculp.polyvore.com/?.embedder=1914163&.svc=copypaste">drbculp</a> featuring <a href="http://www.polyvore.com/old_navy_shirts/shop?query=old+navy+shirts">old navy shirts</a></small></div><br />
Hanging out in Boston Common: Relaxed but Put Together<br />
<br />
<div style="position:relative;width:500px;height:500px;"><a href="http://www.polyvore.com/boston_common/set?.embedder=1914163&.svc=copypaste&id=38299202"><img width="500" alt="Boston Common" src="http://embed.polyvoreimg.com/cgi/img-set/cid/38299202/id/pHAZXyn44BGIyTOKTcxMqg/size/x.jpg" title="Boston Common" height="500" border="0" /></a></div><br/><div><small><a href="http://www.polyvore.com/boston_common/set?.embedder=1914163&.svc=copypaste&id=38299202">Boston Common</a> by <a href="http://drbculp.polyvore.com/?.embedder=1914163&.svc=copypaste">drbculp</a> featuring <a href="http://www.polyvore.com/black_leggings/shop?query=black+leggings">black leggings</a></small></div><br />
Leaving on a Jet Plane: Simple and All Packed Up<br />
<br />
<div style="position:relative;width:500px;height:500px;"><a href="http://www.polyvore.com/simple_home/set?.embedder=1914163&.svc=copypaste&id=38299565"><img width="500" alt="Simple Home" src="http://embed.polyvoreimg.com/cgi/img-set/cid/38299565/id/mi0zFSn44BGChsMSz_Fyxg/size/x.jpg" title="Simple Home" height="500" border="0" /></a></div><br/><div><small><a href="http://www.polyvore.com/simple_home/set?.embedder=1914163&.svc=copypaste&id=38299565">Simple Home</a> by <a href="http://drbculp.polyvore.com/?.embedder=1914163&.svc=copypaste">drbculp</a> featuring <a href="http://www.polyvore.com/straight_leg_jeans/shop?category_id=310">straight leg jeans</a></small></div><br />
More about the trip coming soon!<br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-62831652536104953302011-09-27T17:58:00.000-07:002011-09-27T17:58:41.721-07:00Getting Excited!<div style="text-align: center;">With my trip just a week away, I can't help but get excited to wear some of my fall favorites for the first time all year.</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Thanks to Pinterest for all the inspiraiton!</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;">On The Way Up:</span></div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-p7_r_I82ba0/ToJwAXkGVfI/AAAAAAAAAjU/3GnM2bP5N0g/s1600/Fall+Outfit2.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-p7_r_I82ba0/ToJwAXkGVfI/AAAAAAAAAjU/3GnM2bP5N0g/s400/Fall+Outfit2.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Comfy jeans, simple cardy, and red flats for the ride up to Boston!</td></tr>
</tbody></table><div style="text-align: center;"><br />
</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;">Fall Foliage Tour Day #1</span></div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;"><br />
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<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-gPVzU3trdH8/ToJv-ubTz-I/AAAAAAAAAi8/SN_QI8Wlqr0/s1600/Fall+Outfit+.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-gPVzU3trdH8/ToJv-ubTz-I/AAAAAAAAAi8/SN_QI8Wlqr0/s400/Fall+Outfit+.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Driving through Maine with some good riding boots, jeans, and classic black and white stripes.</td></tr>
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</div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;">Headed to the Mountains</span></div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;"><br />
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<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-6cX1w1CFyWU/ToJwAKlB-mI/AAAAAAAAAjQ/F_NT3g2TdvM/s1600/Fall+Outfit+a.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://4.bp.blogspot.com/-6cX1w1CFyWU/ToJwAKlB-mI/AAAAAAAAAjQ/F_NT3g2TdvM/s400/Fall+Outfit+a.jpg" width="266" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Warming up with some layers...and sticking with riding boots...less to pack!</td></tr>
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</div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;">Driving Back to Boston</span></div><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-9IYiye2nxS0/ToJv-bj3cgI/AAAAAAAAAi4/3hl5JTjekc0/s1600/Fall+Outfit.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-9IYiye2nxS0/ToJv-bj3cgI/AAAAAAAAAi4/3hl5JTjekc0/s400/Fall+Outfit.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Recurring theme of jeans and boots!</td></tr>
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</div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;">Hanging Out in Boston</span></div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;"><br />
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<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-mf50MWYRrU8/ToJv_ETEQZI/AAAAAAAAAjE/Mz3d_A-uvlg/s1600/Fall+Outfit+4.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-mf50MWYRrU8/ToJv_ETEQZI/AAAAAAAAAjE/Mz3d_A-uvlg/s400/Fall+Outfit+4.jpg" width="260" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Easy to pack!</td></tr>
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</div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;">Coming Home</span></div><div style="text-align: center;"><span class="Apple-style-span" style="font-size: large;"><br />
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<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-HG49c3uBeSQ/ToJv_Sfr0LI/AAAAAAAAAjI/-x_5vKoy2tc/s1600/Fall+Outfit+5.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-HG49c3uBeSQ/ToJv_Sfr0LI/AAAAAAAAAjI/-x_5vKoy2tc/s400/Fall+Outfit+5.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Comfy, cool, and ready for fall back in Texas!</td></tr>
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</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: transparent; border: 0 !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com2tag:blogger.com,1999:blog-8837954875343550026.post-36858051717991651162011-09-19T07:00:00.000-07:002011-09-19T07:00:00.665-07:00Fall TV<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://3.bp.blogspot.com/-b5spyYMAWSg/TnQCD5PgyDI/AAAAAAAAAi0/iUqhJ9S5JQI/s1600/TV.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://3.bp.blogspot.com/-b5spyYMAWSg/TnQCD5PgyDI/AAAAAAAAAi0/iUqhJ9S5JQI/s400/TV.jpg" width="338" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">via pinterest</td></tr>
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</div><div style="text-align: center;">I've seen a number of posts about the fall TV premieres and couldn't help but relay my own TV watching schedule for this fall. My DVR will be busy as usual, seven hours of TV a week is plenty!</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><b>Sunday</b></div><div style="text-align: center;">9pm Pan Am</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><b>Monday </b></div><div style="text-align: center;">8pm Gossip Girl</div><div style="text-align: center;">9pm Castle</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><b>Tuesday</b></div><div style="text-align: center;">7pm Glee</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><b>Wednesday</b></div><div style="text-align: center;">9pm Revenge</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><b>Thursday</b></div><div style="text-align: center;">8pm Grey's Anatomy</div><div style="text-align: center;">9pm Private Practice</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Only one more week until most of the premieres! </div><div style="text-align: center;">What shows are you most excited about? </div><div style="text-align: center;">Do you and your friends have certain shows that you get together to watch weekly?</div><div style="text-align: center;">Mmm...fall TV, just another reason I love the season so much!</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-8794554952634051072011-09-16T19:05:00.000-07:002011-09-16T19:05:50.340-07:00Pull Yourself Together<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://2.bp.blogspot.com/-CtEr2nO3s2o/TnQAQ63JynI/AAAAAAAAAiw/RCRTjWDEOOc/s1600/pour+yourself.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="http://2.bp.blogspot.com/-CtEr2nO3s2o/TnQAQ63JynI/AAAAAAAAAiw/RCRTjWDEOOc/s400/pour+yourself.jpg" width="400" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Via pinterest</td></tr>
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</div><div style="text-align: center;">So even though my second year of residency is over and I'm currently not working at the county hospital, life still seems hectic. Just about the time I think I'm all caught up, I realize I've fallen behind in another area. Over the last 12 days, that "area" has obviously been my blog. With crazy hours, bigger cases, and more to read, I'm still not as free as I'd like to be most of the time. I also haven't had a day off that I spent at home trying to get caught up since August sometime. Thankfully, I am off come Monday and can start playing that game of "catch up". While my blog may be lacking, I've accomplished quite a bit over the last couple of weeks...everything from deep cleaning from floors in my house, logging more than a dozen cases, reading for residency, reading through more than 300 blog posts on Google Reader that I had yet to read, perusing more than a dozen catalogs and another dozen magazines, welcoming a best friend's new baby girl, eating brunch with friends, getting back to working out (3 times in one week!), walking the dogs, etc...</div><div style="text-align: center;"><br />
</div><div style="text-align: center;">Has your September been so productive? </div><div style="text-align: center;">What in your life are you "caught up" on? </div><div style="text-align: center;">Do you still need to some "pulling together"?</div><div style="text-align: center;"><br />
</div><div style="text-align: center;"><a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-16727959110259885862011-09-04T08:00:00.000-07:002011-09-04T08:00:03.452-07:00Keep FightingSo, I'm going to avoid any HIPAA violations and not mention anything personal about my patient that you've read about for 3 days. But here are the sweet moments of his stay with me.<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="http://2.bp.blogspot.com/-IQ542vl-iMw/Tl7rTBVW3CI/AAAAAAAAAio/qmjpdVyPKi8/s1600/photo-2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="175px" src="http://2.bp.blogspot.com/-IQ542vl-iMw/Tl7rTBVW3CI/AAAAAAAAAio/qmjpdVyPKi8/s400/photo-2.jpg" width="400px" /></a></div><br />
1. Hugs from the family about a week into everything<br />
2. Being asked for by name by his family members<br />
3. Chocolate chip walnut homemade cookies brought by his family<br />
4. The patient's mom's ensuring my AC gets fixed or else she's sending someone out to do it herself<br />
5. Having the neurosurgeon tell me he's going to wake up, that he can survive<br />
6. Knowing he never even got a whiff of a pressor<br />
7. The bracelets his friends made for support and being provided one to wear proudly myself (see above, they mention his name but that would be poor HIPAA form)<br />
8. When he tolerated tube feeds<br />
9. When he looked me in the eye for the first time<br />
10. When he tried to stop me while I was changing his gastrostomy tube<br />
11. When his grandpa told me "I know you won't bullshit me. But you'll still be upbeat."<br />
12. Making it off the ventilator<br />
13. Fist bumps with his Dad when I had good news, or met goals I had set for us (like his TBili being less than 1.5...it was 1.4 on the day he left)<br />
14. Sweet elbow bumps and waves from them as they walked by when I was working on notes<br />
15. Visits with his family in the waiting room (about my own personal life too)<br />
16. Having an attending stand up for him in conference by saying he wouldn't be a vegetable and that he would wake up (I wasn't the only one that believed!)<br />
17. Presenting him in trauma conference and OWNING him as my patient and being proud of my management<br />
18. Giving updates to the OR staff on his condition/disposition (especially calling to tell them he had been transferred out!)<br />
19. Lingering in his room a bit longer to catch more Looney Tunes while I was working with him<br />
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And my most favorite:<br />
The day he was transferred out, I had worn bumble bee earrings. Most of you know, I collect bee things. (Mom and Dad always called me Miss B...which turned into Miss Bee...Dr. Bee...and a love for bee stuff). I hadn't worn bee earrings in at least a month. One of the ICU nurses commented on them, and then Dad's eyes started to well up. Apparently, there is a motivational speaker out there (I couldn't repeat her name even if I tried) that uses the bumble bee analogy that I used for a previous blog post title. She speaks to the fact that aerodynamically speaking, a bumble bee should not be able to fly. Yet, they go on flying anyway. I've always enjoyed that little fact about bees myself. It's part of the reason I've never been hesitant to adopt them as my personal "symbol". On August 30 (the day I put those earrings on for my last call on the rotation), this motivational speaker had called the patient's mom with full knowledge of the situation and to offer support--out of the clear blue. And my precious little Kate Spade bumble bee earrings served as a reminder of that we can overcome things that shouldn't be possible. Maybe my patient shouldn't be alive, but he goes on living anyway. And maybe he shouldn't be doing as well as he is, but he keeps on doing it. That makes me proud. Proud of my patient, and proud to be Dr. Bee.<br />
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<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com3tag:blogger.com,1999:blog-8837954875343550026.post-26585755803179359292011-09-03T08:00:00.000-07:002011-09-03T08:00:05.398-07:00Sweet EscapeWith the help of attendings, ICU nurses and ancillary staff, ICU interns, and the patient's family, he kept improving. He was tolerating more and more tube feeds all the time. His blood pressure was better controlled. We were weaning off pain meds. We were even weaning off the vent, to the point that he didn't even need the ventilator during the day!<br />
<br />
We were doing less, and HE was doing more.<br />
<br />
Finally, three weeks to the day, my patient was transferred to a skilled nursing facility! Yep, that means he had improved enough that he no longer needed our ICU. He still needed very close monitoring and still has some issues being addressed (but not life-threatening). But he's better, and he's alive, and he's got a long (but likely successful) road ahead!<br />
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On August 31, he was discharged. And on August 31, my current rotation at the hospital was over. I had succeeded. HE had succeeded. I had saved a life! I don't think I really took credit for it until I spoke with the accepting physician at the new facility. The day prior to his leaving, I discussed all of his injuries, current treatments, etc with his soon-to-be primary physician.<br />
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<blockquote>I had to relinquish care! If you only knew how territorial I had become! I even told my chief when I had my days off to avoid messing with him too much. This was MY patient. My chief never had to see him until four days into his stay, and only saw him a couple more times while he was in our hospital. Otherwise, it was me and the ICU team (attendings, interns, consultants, RTs, RNs, etc) getting this guy through.</blockquote><br />
After relaying all of his primary injuries and findings during our initial visit to the operating room, her response was "So basically, he should have died?". At that moment, I realized, had we not intervened on time, had my attending not helped me through his first ex lap, had neurosurgery not placed the bolt, had we not watched him like a hawk night and day...he would have died. He could have died. But, the only thing I'll correct about what the new physician said, is that he certainly SHOULDN'T have died. And he didn't. Personally, I count this as MY first big save (obviously not something I could do by myself but you get the gist). I feel proud. Most of all, I'm reminded why I gave up a life in dermatology (working maybe 40 hours a week with minimal call) for surgery (working 60 hours a week plus with frequent, stressful call). It's those moments that your patient's father's eyes well up with tears and all the ICU nurses come by to say their goodbyes as your patient leaves for the next step. That's why I became a surgeon.<br />
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<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-65534554418199181832011-09-02T08:00:00.000-07:002011-09-02T08:00:00.380-07:00Bumble Bees Shouldn't Be Able To Fly, TechnicallyThere he was in the ICU. Pressures good. Heart beating away. On a ventilator. An open belly. And a heart of gold. His drug screen was negative. Not a drop of alcohol in his system. New lab results coming back that I was extremely happy with--considering. So we scanned him. Had we just done a big time surgery to find out he had a devastating head injury?<br />
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A list of his injuries:<br />
1. Intraparenchymal cerebral hemorrhages (multiple and terrible looking)<br />
2. Large scalp laceration<br />
3. Left clavicle fracture <br />
4. Bilateral pulmonary contusions<br />
5. Left hemothorax<br />
6. Left diaphragm injury<br />
7. Shattered spleen<br />
8. Grade IV liver laceration<br />
9. Left retroperitoneal hematoma<br />
10. Left acetabulum fracture<br />
11. Left pubic ramus fracture<br />
12. Left sacral ala fracture<br />
13. L1-L4 left transverse process fractures of spine<br />
14. C2 fracture of neck<br />
15. Large amount of <a href="http://en.wikipedia.org/wiki/Pneumomediastinum">pneumomediastinum</a><br />
<br />
Then I spoke to his granddad. Sweetest man ever and obviously aching over his prized grandson. And grandma, the smallest, cutest, and soft spoken woman doing her best to maintain a hopeful smile. And Dad, the most fit middle aged man I've seen, doing his best to act as the backbone for the group when deep down he could use just a moment to have his own breakdown. And Mom, energetic, outgoing, and totally in love with her son. Then the girlfriend, they've been dating for 3 years and this was going to be the biggest growth spurt they could ever take as a couple--you could see she was up for the challenge. And girlfriend's mom who obviously cared for him like her own son. I remember telling Dad, "I just want to meet one mean person in the family. Then I know he'll walk out of here in a week." No such luck.<br />
<br />
The next day, his pneumomediastinum appeared to be increasing. So an emergent bedside <a href="http://en.wikipedia.org/wiki/Tracheostomy">tracheostomy</a> was placed with significant improvement. Neurosurgery and orthopedics came by. A "bolt" to monitor intracranial pressure was placed. He was started on medications to keep his blood pressure down and to keep fluid off his brain.<br />
<br />
A couple days later, he returned to the OR. The sponges were removed and everything appeared ok. No more bleeding. So his belly was closed and he was again sent back to the ICU.<br />
<br />
Over the next few days, he remained status quo. Multiple <a href="http://en.wikipedia.org/wiki/Eeg">EEG</a>s were done to examine brain function with no devastating (but really not hopeful either) results.<br />
<br />
We started tube feeds and the next day we was noted to have what looked like gastric contents coming out from around his trach. More concern for a possible esophageal injury arose. The following day, we took him to the operating again. With a scope, we confirmed that no esophageal injury. We opened his belly again and placed a <a href="http://en.wikipedia.org/wiki/Feeding_tube">gastrostomy tube</a>. We placed an <a href="http://en.wikipedia.org/wiki/IVC_filter">IVC filter</a> for prophylaxis, in hopes of avoiding any kind of clot traveling to his lungs. And we closed his belly again.<br />
<br />
Over the next few days, he didn't tolerate tube feeds too well. So he stayed on TPN and we watched as his liver function tests and his pancreatic enzymes trended down as his pancreatitis improved. He remained on antibiotics for pneumonia. But otherwise, he wasn't deteriorating but things weren't moving rapidly either.<br />
<br />
Then his bolt was removed! No more prongs sticking out of the head making us anxious with roller coaster like numbers. After that, things really started changing. He was overbreathing the vent. He was moving his arms more. Each day, something more happened. His eyes were open wider. He had purposeful movement. He was tracking with his eyes. And on occasion, many of us swear he was following commands. On a number of neurostimulants, he was coming around. Just as I felt he would. With love and age on his side, he was going to get out of here.<br />
<br />
To Be Continued...<br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-28532041493121895402011-09-01T10:26:00.000-07:002011-09-01T10:26:37.785-07:00How to Save a LifeIt's not everyday that we get reminders of why we agreed to work 80 hours a week and 30 hour shifts to "someday" have a better paying job with more freedom. Like most residents, I'm pretty jaded. Most days I'm convinced that 75% of our patients are really just a drain on the system rather than real people needing real help. When it comes to trauma, the rule seems to be dealing with jerks who were legally shot by Texas homeowners during attempted break-ins. On top of that, they throw out four letter word after four letter word in the trauma bay and then go on to treat our nurses like another four letter word. It's annoying and disheartening. One easily loses their faith in people. And just when you think these jackasses make residency completely worthless, something amazing happens to reel you back in and convince you to keep going. <br />
<br />
On August 10, I was on call. My chief resident and I were in the middle of a case when the trauma pager went off letting us know a Level 1 (the most serious kind of trauma requiring a response from the team within 15 minutes) was coming in the door. My chief looked up and told me to go down to the trauma while he went on with a grueling ventral hernia repair. I scrubbed out and ran downstairs to the ER. <br />
<br />
EMS relays the story. This was a young male found down at the scene after a wreck. He had been t-boned on the driver's side and was unresponsive at the scene. EMS <a href="http://en.wikipedia.org/wiki/Intubation">intubated</a> him before bringing him to us. He never lost vital signs, but his blood pressure had been persistently low--an ominous sign in trauma. I ran through my ABCs, his endotracheal tube was in good position, confirmed in multiple ways. He had good breath sounds on both sides. His chest xray showed some significant bruising to both lungs and a fracture of his left collar bone. He had a large, deep, bloody scalp laceration on which we placed a gauze dressing. On <a href="http://en.wikipedia.org/wiki/Focused_assessment_with_sonography_for_trauma">FAST</a> scan, he had a small amount of fluid around his spleen. He had a small pelvic fracture on xray too. After 2 liters of IV fluids and 2 units of blood, my attending decided if his next blood pressure wasn't more than 100, we were going to the OR. I watched as his belly grew, bloody urine filled his<a href="http://en.wikipedia.org/wiki/Foley_catheter"> foley</a> catheter tubing, and his reading came back...still in the 90s. More blood was hung on the IV pole and off to the OR we went for an <a href="http://en.wikipedia.org/wiki/Exploratory_laparotomy">ex lap</a>.<br />
<br />
When we got upstairs, my attending and I stopped in OR 8 to tell my chief we were now in OR 12 with the trauma. While putting on our shoe covers, he jokingly asked, "You wanna go scrub him out and finish that ventral hernia so he can come do this?" I laughed and said "Heck no. He can join us later."<br />
<br />
Prepped and draped, my attending and I opened him up--a long midline incision from his chest bone down to his pubic bone. Once we got "in", at least four liters of blood poured out. We cleaned up the blood and in typical trauma fashion and packed all four quadrants. Then we went exploring. His spleen was shattered. Out that came. His left side had a large hematoma surrounding his kidney and <a href="http://en.wikipedia.org/wiki/Retroperitoneal_space">retroperitoneum</a> that was controlled with more packing. We looked in his pelvis. Thankfully, his pelvic fracture wasn't causing much bleeding. Then we looked at his liver. The capsule was torn in at least 7 places, he had a large hematoma on the left lobe, and two deeper lacerations towards his back. We used the <a href="http://en.wikipedia.org/wiki/Argon_laser">argon</a> laser to help control the bleeding. He continued to ooze so we packed the liver with laparotomy sponges. Still oozing. At this point, I noticed a hole in the left side of his diaphragm. He was somewhat stable at this point, so we repaired that. The bleeding seemed to be controlled for the time being. We placed a wound VAC and got out of the belly. My attending went to the head of the bed and repaired his scalp lac while I put chest tubes in on both sides. Stabilized, we sent him to the ICU. He received 27 units of blood and an additional 37 units of other blood products by the time he got there. And one whopping dose of <a href="http://en.wikipedia.org/wiki/Factor_vii">factor VII</a>. The best part is that anesthesia had done a fantastic job of helping to resuscitate him so he NEVER received one dose of a <a href="http://en.wikipedia.org/wiki/Vasopressors">pressor</a>. <br />
<br />
And that's all in the first couple of hours. To be continued...<br />
<br />
<br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background: none transparent scroll repeat 0% 0%; border-bottom: 0px; border-left: 0px; border-right: 0px; border-top: 0px;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-3690739174761420402011-08-31T12:00:00.000-07:002011-08-31T12:00:04.498-07:00Pinterested in Antiques<div class="separator" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: center;"><a href="http://2.bp.blogspot.com/-s7NLN9i41mI/TkwTx1If6WI/AAAAAAAAAiU/5-XG0oZ3LGw/s1600/antiques.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"></a><a href="http://3.bp.blogspot.com/-Gzpgxfjah0Q/TkwTrCMAKdI/AAAAAAAAAiM/3JY2iinwE5E/s1600/104309707_Px2lMdED_c.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"> </a>While most of the "antique" finds on pinterest are really only vintage (rather than antique), I'd find it hard to pass up any of these great pinspirations:</div><div class="separator" style="clear: both; text-align: justify;"><a href="http://1.bp.blogspot.com/--uPAkLVSkbY/TkwciyXDc9I/AAAAAAAAAiY/2r9xciIqIPU/s1600/OB-Pinterest+Antiques.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="580" src="http://1.bp.blogspot.com/--uPAkLVSkbY/TkwciyXDc9I/AAAAAAAAAiY/2r9xciIqIPU/s640/OB-Pinterest+Antiques.jpg" width="640" /></a></div><div class="separator" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em; text-align: center;"><br />
</div><div class="separator" style="clear: both; text-align: center;"> <a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a></div>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0tag:blogger.com,1999:blog-8837954875343550026.post-31895693902616290112011-08-27T12:00:00.000-07:002011-08-27T12:00:02.274-07:00Weekend Wags: The Man Too PleaseBefore summer is just completely over, I'd like to find a man just like this one:<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="http://4.bp.blogspot.com/-d3WR_kIi6TA/TlHBtMwNHKI/AAAAAAAAAik/Mgjc5AM7WTw/s1600/ManDog.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="http://4.bp.blogspot.com/-d3WR_kIi6TA/TlHBtMwNHKI/AAAAAAAAAik/Mgjc5AM7WTw/s640/ManDog.jpg" width="456" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Via Pinterest/<a href="http://awelltraveledwoman.tumblr.com/post/5134520512">Well-Traveled Woman</a></td></tr>
</tbody></table><br />
<a href="http://www.mylivesignature.com/" target="_blank"><img src="http://signatures.mylivesignature.com/54489/101/C99886A5DADAF5CCEC393F253D39A265.png" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-width: 0px !important; border-color: initial !important; border-left-width: 0px !important; border-right-width: 0px !important; border-style: initial !important; border-top-width: 0px !important;" /></a>drbculphttp://www.blogger.com/profile/01672902448283170452noreply@blogger.com0