Monday, October 29, 2012 - Upper Winter Creek Trail

Took a little stroll on the Upper Winter Creek Trail to Hoegee's (5 miles round trip). Took a few pictures. Can't beat the California weather. Sunny and in the 80's while there's a hurricane coming down on the east coast.

Had a 78-year-old female patient with a BUN of 81 and a creatinine of 6.2. She has a history of HTN, CHF, anemia, CKD, and DMII. She was only in the hospital a week ago and she was back again this time for pneumonia and increased swelling in her legs. She looked miserable and was getting worse with nausea, vomitting, and inability to keep any of her food down. She needed dialysis, but she had refused previously. When I spoke to her, she refused dialysis because she was scared that it would be painful. When I asked the family why they refused dialysis, they also thought it was painful and somehow involved inserting something straight into the kidneys from the back. I explained to them how dialysis works and even showed them the machine and where the tubing and catheter would be going. After that they understood much more and consented to the dialysis. Simple education. Educating the patients is the key so they can make informed decisions. I don't think anyone really took the time to explain it to the patient or the patient's family. I was able to make a difference. The little things that make this job rewarding despite the stress.

Addendum: Saw the patient today (10/30/12). She was smiling, talkative, doing well. Transferred her from the ICU. Felt good.

Thursday, October 25, 2012 - Mt. Wilson Trail via Sierra Madre

Missed hiking. Did 11 miles round trip on the Mt. Wilson Trail from Sierra Madre in about 4 1/2 hours. Made it to the Mt. Wilson Junction and turned back. Approximately 3,500 ft elevation gain. It would have been an additional 4 1/2 miles total if I had gone all the way to Mt. Wilson. Maybe next time.

 Map of the trail.

Good morning. Around 8:45 am, shot from the trail.

 Fall leaves.

 Fall leaves.

 More leaves.

 Mt. Wilson Trail Junction sign. Turned back from here back down to Sierra Madre. 

Came up from Chantry Flat to the top of Mt. Wilson last year.

 Another shot of the city down below. Higher up this time. Looking back the way I came.

 I liked the green on the rocks.

Nice to have some week days off now. Almost nobody on the trails and no trouble finding parking. A bypassing stranger said to me on the trail, "It's a beautiful day." Indeed it is.

Saturday, October 13, 2012 - Endeavor at the Forum in Inglewood

Saturday morning with the Shuttle Endeavor at the Forum in Inglewood.

 Street lights down.

 Street closed.

I had a patient the other day, a male in his 80's who was in the hospital for acute gastrointestinal bleeding. We drew some of his blood for a CBC and other lab test, which showed severe anemia from blood loss and required a blood transfusion. As I was explaining it to him, he says, "You guys take blood away from me and now you want to put it back in? Hospitals are crazy!" He then laughs and shakes his head.

Friday, October 12, 2012 - Rio Hondo Bike Path

It was a tough past 4 weeks. Glad that's over with. Took a little bike ride today along the Rio Hondo Bike Path. 

 Looking at Washington Blvd. from the bike path.

 One of the bridges to cross the river.

 

Bike path along the "river".

Horse trail next to the bike path. A few houses near the trail own horses and chickens.

Not something you would expect to see in LA, but people ride their horses on this trail everyday. 
You wouldn't be able to see this driving in your car.

Another view of the Rio Hondo Bike Path. In the summer time there is no water.