Author Archives: Greg Moore

Unknown's avatar

About Greg Moore

Founder and owner of Green Mountain Software, a consulting firm based in the Capital District of New York focusing on SQL Server. Formerly, a consulting DBA ("and other duties as assigned") by day, and sometimes night, and caver by night (and sometimes day). Now, a PA student working to add PA-C after my name so I can work as a Physician Assistant. When I'm not in front of a computer or with my family I'm often out hiking, biking, caving or teaching cave rescue skills.

Freeing Myself

Posted on by
1

If all goes as “planned”, sometime this afternoon I’ll hop in the Subaru and head “west”.

Why the scare quotes and what is the plan?

Well the plan is sort of no plan. I have some goals, but not a strict schedule. This includes even when I’m leaving.

But let me back up a bit.

I’ve kept mum for various reasons, but now I’ll give the details on the PA program I accepted an offer to attend. I’m proud to say that on May 27th, I will be starting my orientation with my fellow PA-S1 (that’s the lingo for first year PA students) at the Christiana Delaware campus of Arcadia University. I already met a few of them at the open house a few months ago, but on the 27th I’ll meet the rest. On 28th, we buckle down and start classes. I mention specifically the Christiana campus because Arcadia is one of the few (may be only) schools to run to simultaneous programs in a parallel manner. The other cohort of PA-S1s will be at the main campus in Glenside, PA (outside of Philadelphia).

Now, the savvy reader who is hip to their geography have probably figured out that I won’t be easily commuting on a daily basis between Delaware and upstate New York. The solution is that I’ll be renting a place for most of the duration of my time in PA school. This is an unfortunate added expense to deal with. So, one of the things I have planned before the 27th is to sign a lease (I have an apartment complex picked out already).

So what to do between now and then?

The biggest step was putting in notice with my current employer; Albany Medical Center. May 8th will be my last official shift as a full-time equivalent. I am looking to continue in a position where I’ll be able to pick up a few shifts over my rare breaks but that’s just to keep my skills sharp and for the enjoyment of it.

In the meantime, I’ve decided to take a bunch of my banked vacation days and travel a bit.

The original plan was to start yesterday morning right after my shift. A delay in my car repairs and because they really needed techs last night, I moved my start to later today (after I pick up the car and pack it.) The goal, to see some of the country, visit some national parks, hike, relax, etc.

Those who know me well would understand when I say that at times I can be a control freak, even over myself (perhaps a better way might be “self-disciplined”?) If I set a goal, I do my best to meet it, or often to exceed it. This can be good if I’m setting a goal to study or exercise. But it can also add stress when I’m attempting to reach a goal I set for no specific reason.

As I planned my trip, I initially set out specific goals for each day’s travels etc. Very quickly I realized how unappealing that was becoming and how rigid it would be (as shown by the fact that I’ll already be leaving probably 32 hours behind schedule!)

So I decided, since my next 2 years will be rigorously scheduled for the most part to turn my vacation into a loose set of goals with a loose timeline.

The biggest goal, get to the Grand Canyon and ideally do an overnight or two in it. And visit Bryce and Zion canyons.

After that, we’ll see. I’ll probably head north, but who knows how far. I’ll probably check out a few more national parks. Eventually I’ll have to head back east in order to make my May 1st scheduled PA shift. So how long will I spend “out west”. We’ll see.

I’ll post updates as I see fit. But no promises. Again I want to relax for a change.

mRNA Vaccines

Posted on by
Reply

I was planning on writing a more detailed post, complete with images and citations, but I’ll be honest, I don’t have the energy or time right now, so this will be simpler than I’d like.

One of the claims some people have made about the mRNA based Covid vaccines is that they alter your DNA. This basically isn’t possible. But I want to delve a bit into why.

We’ll start with something often called the Central Law or Dogma of Molecular Biology. I’m going to paraphrase it at first: Information passes from DNA to RNA to Proteins and never in the opposite direction. I’ll explain why this is mostly true and why it is vitally important to understand when it comes to the mRNA based proteins. But first, some definitions.

We’re all probably familiar with DNA, the double-helix first observed and described by Rosalind Franklin and later better described by Francis Crick and James Watson. This is where genetic information is stored. In computers, we think of data as stored as bits, 1s and 0s. DNA is similar, each “lattice” in the ladder is made up of a pair of AT (Adenine/Thymine) or GC (Guanine/Cytosine) molecules know as base pairs. Whereas in computers we’re often dealing with bytes which is a group of 8 bits, DNA is grouped as three base pairs at time.

Image courtesy of Wikipedia.

But what’s the purpose of these three base pairs? I’m going to overly simplify, but an entire strand of them makes up a chromosome. (Humans have 46, 22 “identical” strands and then a set of XX or XY strands. Identical is in quotes because sometimes when replicated, errors can creep in creating a mutation. And of course some people have more than 2 of each, such as Trisomy 21, aka Down Syndrome, or even XXY, or can be missing one of the pair, such as X0. But that’s beyond this post.)

But three base pairs together can encode later for amino acids. Amino acids make up proteins.

Within each chromosome are multiple genes. Genes are what make you look like you and be human. You have genes for example that control your blood type, hair color, and more.

That said, two things can happen to DNA: Replication and transcription.

Replication is necessary when a cell divides and basically the entire chromosome is duplicated so each cell has a copy. This is extremely interesting in and of itself, but again, beyond the scope of this article.

What we care about here is transcription. This is when part of the chromosome, specifically a specific gene is accessed in order to make a protein. This can get fairly complex and honestly, we’re learning new details about how genes can be activated and used all the time. (For example, so called “Junk DNA”, i.e. areas that don’t encode for genes, turns out that can be very important too and it’s not junk.)

So, before I can get into why mRNA vaccines can’t alter your DNA, let’s dive into a bit more how a protein is made and how this related to vaccines.

An important detail to keep in mind here is that in what are called eukaryotic cells (which is what makes up almost all multicellular creatures, including you) chromosomes are within the nucleus of the cell. It’s difficult for anything to get in or out. Basically there’s a wall around them with closely guarded gates.

That said, the nucleus receives a signal that a particular protein is needed. So, the particular chromosome, which is normally very tightly wound unwinds at the location of the gene needed for that protein. Then a special enzyme (and they are different between eukaryotic and prokaryotic cells i.e. single cell bacteria and the like) called RNA Polymerase that starts to “walk” the gene and create what’s known as Messenger RNA or mRNA (see we’d get to this eventually).

When it’s done reading, this new strand of mRNA leaves the nucleus and goes into the cytoplasm of the body of the cell. There, “molecular machines” known as ribosomes will latch onto it. These actually come in two sizes, large and small. You have millions of these in each of your cells. When a piece of mRNA is floating around a large and small ribosome will clamp to the “start” end and start to read it. As they read it three base pairs at a time, they will attach the amino acid that matches that 3 base pair encoding. This amino acid is brought to the ribosome unit via something known as Transfer RNA or tRNA. Once the end of the mRNA is read, the ribosomes come apart and the mRNA may be read again or destroyed. (I won’t get into the signaling factors that control this, but the key part is eventually all mRNA gets destroyed and its base pairs typically used for other purposes.)

The created protein may undergo other transformations and be moved to other locations within the cell, to the surface of the cell, or even ejected from the cell.

And that his how a protein is made. Notice the direction matches what I said above DNA->RNA->Protein. It’s one way.

But what keeps it from going the other way? That’s really the question here.

Let’s start by stating up front that your DNA DOES in fact contain genes that apparently came from viruses. So that central law obviously has an exception. But what makes that exception?

Specifically it’s an enzyme known as Reverse Transcriptase. Humans sort of have a form of this, but it’s used for a very specific (controlling telomere length during replication). There are a few other weird things that could do something like this, but basically for the mRNA Covid vaccines they don’t. The simplistic reason is that the mRNA vaccines don’t include the encoding that is required for Reverse Transcriptase to start its work. It’s sort of like a guard asking for the password to get into a military base. If you don’t have it, you’re not getting in.

Moreover, an mRNA vaccine encodes for a specific protein or proteins. That’s it. It doesn’t contain enzymes like Reverse Transcriptase, nor do the mRNA segments contain the encoding to allow for any form of reverse transcriptase. Even if somehow DNA was formed from them, it would then have to make its way into the nucleus (which is very difficult to do) AND the be incorporated into an existing chromosome. This just beyond the point of believability.

But, let’s say somehow it DOES happen. You know what the most likely result is? Nothing. Your body has no reason to activate such a gene. It would sit there like other inactive genes doing nothing.

So, for those who read this far, or who skipped the end, your cells and the mRNA vaccine for Covid simply does NOT possess the mechanisms to incorporate the the vaccine into your cells and even if it did, the net result if anything would be nothing.

The Next Decade

Posted on by
1

This past week I visited an open house at the PA school I’ll be attending starting in late May. It definitely made things feel very real. It almost reminded me that I’ll be the oldest there by far. This gives me a feeling of cognitive dissonance.

On one hand, often when I’m at work, or when I was taking classes, I feel very young, often decades younger than my chronological age. One of the best compliments I received from a fellow tech was, “Greg, you run the techs in their 20s into the ground.” The tech saying it was herself in her 20s.

And the idea of going back to college makes me feel pretty young.

That said, the reality is, I’m entering a career that while will probably last me the rest of my working life. But I at most probably only have a decade in it or so.

I’ll be 57 when I enter school. I’ll be in the didactic phase for 12 months.

That makes me 58 when I finish the first half and start my 12 month clinical phase.

This means I’ll be 59 when I graduate and take my PANCE (the certifying exam that officially makes me a PA and allows me to practice as one.)

Many people plan on retiring at 65. I have never really had that as a goal. I figured I’d want to keep busy beyond that, even if I ended up working at a more relaxed pace.

But the real limit may come when I’m 69. PAs have to basically take an exam every 10 years. The honest truth, as I approach that date, I’ll have to give it some thought if it’ll all be worth it. Perhaps it’ll be the sign to retire. But also, working in the ED (as is my current plan) requires a certain physicality that at 70, I’m not sure I want to deal with. And while PAs can make lateral moves, I’m not sure what other specialties I’d enjoy.

So, we’ll see. Do I make it the full 10 before retiring? Do I re-up? I can guarantee I won’t be re-upping when I’m 79! (Unless someone discovers the fountain of youth!).

So if I have one regret about my approach PA career, is perhaps I should have done it decades ago.

But in the meantime, I’m going to enjoy the living hell out of the time I’ll have for it

ED Teching vs My Future – A Step Forward?

Posted on by
1

Over the coming weeks I’ll probably cut back on my hours as an ED Tech. And I have mixed feelings about that. The main reason being is I’m picking up some IT consulting work that pays a lot better and well, I’ll be honest, the money will help pay for me being in PA school.

Originally I had two goals when I tried to get a job as a tech in the local Emergency Department. The first was to gain the Patient Contact Experience that most PA schools require in order to apply. The second was to confirm whether I really wanted to be in Emergency Medicine. I was able to confirm the second goal fairly quickly.

As for the hours, every school had different requirements, from as few as 200 hours to as many as 1000 hours. Of course the minimum is different from the average and most schools only accepted students who were closer to the average number of patient contact experience hours.

I was able to quickly surpass the 1000 hour minimum within the first 6 months or so of me working in ED (this despite being in theory only a .6 FTE). Obviously that wasn’t enough for my first cycle (and most likely other factors). By the time I applied for the second cycle, I was at over 3,000 hours. I’m now at over 4,000, probably 4,500 hours and odds are I’ll be at close to 5,000 by the time I leave the job. (Edit: I looked through my old pay stubs, and turns out I’m actually over 5,000 hours now, so probably will be over 5,500 by the time I leave.)

In his book, Outliers, Malcom Gladwell cites a “10,000 hour” maxim which basically states to become an expert at something, one needs to spend approximately 10,000 hours of training for it. If it’s accurate, there’s a lot of question about the accuracy of this rule, then I suppose I’m half-way to being an expert. That said, I’m not really sure what being an expert tech means.

However, looking back, I definitely think my extra time in the ED as a tech was well worth it. I’m a far better tech (at least in my mind) than I was 1 year ago, let alone 2 years ago. (Though strictly speaking 2 years ago I was just off orientation). And that extra experience I think will go a long way to helping me in PA school.

Partly it’s a matter of confidence. Partly it’s a matter of skill. I appreciate that my place of employment is a teaching hospital and encourages a team approach. I’ve been in cardiac codes where the attending will run through what we’ve tried and ask, “anyone have any suggestions.” And they truly mean anyone, even a tech can speak up if they feel inclined. In other situations I’ve offered advice and had it accepted. I’ve actually had nurses and providers ask for my input or to help with some more advanced procedures.

I find I really enjoy doing the ED Tech work. And it’s made me both want more and not want more. I’ll be taking a two year gap (other than perhaps some per diem work) from working in an ED while I get my PA degree. Once I have that and pass the certifying exam, I’ll be a PA-C and be able to do a lot more in the ED than I do now. I’m excited about that!

But, I also look at the downside: being a tech, when my shift is over, I do about a 5 minute hand-off and I’m done. There’s no paperwork. There’s also no paperwork during the shift. It’s pretty much all hand’s on. Once I’m a PA-C, it won’t be that easy. When my shift officially ends, I’ll be responsible for paperwork and doing a more extensive hand-over. And, of course during the shift, I’ll be responsible for discharge paperwork and a lot of non-hands on work. I’m…. at best ambivalent about that. But, I suppose it comes with the terrority.

That said, I’m still excited about the next few years!

A Thought on My PA Journey

Posted on by
Reply

When leaving work last night, after a long 16 hour shift, a thought crossed my mind. Even if somehow I don’t succeed at PA school (not something I’m actually too worried about, and not really the point of this post), the last 3 years have been worth it. Almost exactly three years ago I was busy getting the paperwork done to start taking classes at the local community college. The first three classes I signed up for were Biology 1, Intro to Psychology, and Anatomy and Physiology I. I was nervous and excited. It wasn’t easy balancing my work and school schedule, but fortunately my consulting job gave me flexibility. Within the first week I realized how much I enjoyed being back in the classroom. I was in my element. I love learning. And I loved specifically learning these topics, especially Anatomy and Physiology. In fact, besides A&P, I really enjoyed Organic Chemistry (a sentence I never thought I’d write or say) and Biochemistry and Genetics. I’m actually thrilled most schools required these in order to apply, since by the time I had finished them, I had a much fuller understanding of how things happen inside our bodies. It’s been a thrill learning these topics.

As I’ve mentioned in the past however, taking classes was the easy part. I simply had to sign up. Getting the required hands on experience took some effort. But I quickly realized I was where I needed and wanted to be. This is evidenced in part by the fact that in 2023 I worked over 2200 hours in the Emergency Department (on top of my consulting work and taking classes) and in 2024, over 2400 hours. I’ve commented before that my IT consulting pays a lot better, and honestly has better hours. But I love what I do in the ED.

The stories I tell (some say bore) others are often the more interesting ones, but even the nights where nothing interesting happens and it’s mostly handing out blankets, performing ECGs and the like are fulfilling. For every shift I do CPR on a patient (and this week for some reason was a busy one, 4 out of 5 shifts I performed CPR compressions on a patient) there’s probably 10 where I’m only going ECGs and finding nothing noteworthy. And I’m OK with that. It’s still patient contact. It’s still making connections with another human being.

Despite biking and hiking less in the last 3 years than I’d have liked, I honestly have been busier and more fulfilled than I have been in years.

I know if I had done nothing but IT for the past 3 years, I would have been richer financially, but been less rich in terms of fulfillment.

The past 3 years have reinvigorated me and made me feel younger. It’s been worth it.

I can’t wait to see what the coming years bring!

So my advice to folks in the new year, especially those later in life like me, branch out. Be brave. Do something different. You don’t have to be drastic like me and change careers, but take a class, start a new hobby or something. It’ll be worth it.

Happy New Year!

2025 A Year in Preview

Posted on by
2

In keeping up my tradition of setting some goals (not resolutions) for the new year, here’s my hopes for the coming year.

  • Succeed at PA school – I managed the goal of getting in. Now the next goal is actually succeeding! I know it’s not going to be easy and I think I’m prepared. As I’ve said to others, come May, my full-time job will be being a student. I haven’t had that “job” in 35 years! So this should be interesting!
  • Travel – I want to get in at least one road trip before school starts. I don’t have details yet, but I hope to figure this out soon.
  • See Friends/Make New Ones – One detail about PA school is that I’ll be 4-5 hours from home. So I’ll be relocating for the next two years (the first year is all classroom room, the second is clinical rotations). So I hope to see some of my local friends, and make new friends among my classmates.
  • Biking – Yes, I definitely hope to get some in. I’ll be bringing my bike with me to school. It’ll just be a matter of finding time to do it. Fortunately I won’t be working night shift, which means I’ll be awake during the day.
  • Get our new septic system – Yes, again a goal.
  • Several projects around the house – this will be limited by the amount of time I have between now and May. So we’ll see.
  • That’s about it. Honestly, as long as I succeed at my primary goal, I’ll be happy and content.

In the meantime, check out how I did last year.

2024 A Year in Review

Posted on by
1

As I try to do every year, I look back at goals I set at the start of the year and see how well I did. As usual, this it’s a mixed bag.

How did I do?

  • Well, my primary goal was to get into PA School. Last year I had gotten waitlisted at one and declined at all the others. Close, but not close enough. This year started off rough. I was able to submit what I think was a much better application. I had a few more courses to add to my transcript. This helped bring up my GPA (though not above the magical 3.0 that most schools require for a cumulative GPA). But my last 41 credits were all 4.0 and if I include my last 60 (some schools have look back windows of 30-60 credits), it’s nearly a 3.7. Not too bad if I may say so myself. I submitted fairly early in the application cycle.
    In addition, I think I had a stronger essay for my application as well as better letters of recommendation.
    And then the first rejections rolled in. One was particularly disappointing since it was one of my top choices and they claimed to not have a minimum GPA. After exchanging some emails, I learned that while they claim not to, in fact in the last 5 years, they haven’t accepted anyone with a cumulative GPA under 3.2. That definitely felt like a bait and switch to me.
    However, the very next day I received the email that would change my life. In fact, I had to read it more than once since I was in shock. Even when I got the emails explaining how to put in my down-payment I have to admit I didn’t believe it! That said, for now I’m keeping the name somewhat under wraps as I’m still waiting to hear from two other great schools. But the key point is, regardless of what happens with them, I’m going to PA School in 2025!
  • Another goal I had was to keep working in the Emergency Department and keep my Red Badge status so I could be the lead tech in Traumas.
    • Not only did I succeed with this (as of last night over 2450 hours, including PTO) but I added to my resume the role of being the Tech who taught the Red Badge class to new techs. I’ll be handing that role over in a few months (and am already taking steps to make that happen) but it’s been a great job.
    • I also moved to night shifts for most of my shifts in the ED. Honestly, I love the crew and atmosphere, but it’s done shit for my circadian rhythm and for planning day events.
    • One benefit of another year in the ED is I got to become familiar with a lot more procedures and help out with a lot more than I did in the previous year. These are skills and experiences that will aid me well when I start taking classes.
    • More than once I got to listen in as an attending gave an in-depth “lecture” to a resident or med student. Also very valuable!
  • I definitely cut back on my IT consulting. My largest client and I mutually agreed to part ways as of April 1st. This was refreshing in many ways, even if the drop in income was noticeable. Ironically enough, they approached me just before Thanksgiving asking if I was available part-time starting in January. I’ve agreed to pick up some more time with them. This will most likely result in me cutting back some hours in the ED, but as I don’t need to built my resume there, I think it’s financially it’s a wise choice.
  • Work on me and be a better person – I was intentionally a big vague here, but I think I managed this a bit. I definitely tried to relax more and snap less. I’ll continue to work on that.
  • Hiking – I absolutely failed at this. I think I did one hike this year.
  • Biking – I also absolutely failed at this. Honestly, I’m not sure if it’s a result of age, perhaps some long Covid impact lung capacity (though I’ve never tested positive for Covid) or what, but I just found it harder to do the longer rides I preferred doing, especially at the speed I wanted. I also think the fact I was working nights and sleeping days didn’t help.
  • Caving – Ironically, despite having the NCRC weeklong in NY this year, I didn’t get into caves much this year. The best part was taking a local reporter into a local cave during our mock rescue.
  • See friends – Again, with my schedule, I didn’t do as much of this as I wished. And tonight, when normally we’d have a lot of folks over, I’m self-isolating because of a cold (not Covid thankfully).
  • Travel – this is one that Randi and I did manage to do! We flew out to Seattle and stayed with close friends for a night before boarding the Empire Builder for Whitefish Montana. There we disembarked and spent 3 solid days exploring Glacier National Park. Let’s just say 3 days is not nearly enough. When done we took the Empire Builder from Whitefish back to Chicago where we stayed a night at a hotel and then flew home. I’m already trying to figure out how to get back!
  • Septic system – Let’s not talk about this.
  • Several Projects around the House – well, just one, but it took finally biting the bullet and getting a table saw. But I think I’ll work on a few more before moving away for PA school.
  • Classes – I did take one more. If I had more time I might have taken more, or had I not gotten into a PA school I might have taken more to help with my transcript, but decided to focus the time on relaxing and working nights more.
  • Blogging – well I did blog, and as promised, not as much. So I guess I succeeded on that one.

So overall, us usual some hits, some misses, but the biggest hit is one I really was working for, so I’m content.

57 and 1

Posted on by
1

I’m a day late on this blog, my usual day is Tuesdays. And my birthday fell on Tuesday this year. So you’d think I’d have written this yesterday, but, well I guess I just didn’t feel like it.

The honest truth, for some reason, my 57th birthday was a bit of a mixed bag, and I’m not really sure why.

It started off fairly well. My daughter continued her tradition, since attending college, of calling me just before midnight so she can be sure to say Happy Birthday at midnight. (Technically my wife wished me happy birthday before she went to bed, but that was before midnight, so my daughter wins on the “first on my actual birthday”). My son then came up to my office wish me a happy birthday. And finally the next morning my wife was the third to wish me one.

And of course all the Facebook posts that came in. I really appreciated those. Though, despite trying this year in advance to setup a charity (which in the past has worked well to raise money on my birthday) again, it just didn’t show up. I’m not sure if Facebook changed how they did birthday charities or what. I suppose that’s one reason my birthday was a mixed bag to me. I wanted to spread a bit more joy and didn’t.

But really, I think part of it is, my birthday is a bit of a reminder of something I realized several years ago: statistically I have fewer days ahead of me than I have behind me. That bothers me. I don’t fear death per se. It’s part of life. It’ll happen eventually. And I’ve certainly seen enough of it at work lately. But damn it, I’ve got so many things I want to do! I need multiple lifetimes to do even 1/2 the things I want to do.

And it’s not only lack of time, but the fact that I’m seeing my body age. Yes “age is only a number” but in this case that number is 57 and I notice it. For example, wounds, even as simple as a scratch take longer to heal. My stamina has slowed down. And well, as any guy can say, their refractory period at this age, even with drugs, isn’t like what it was 40 years prior!

There were definitely some nice upsides though.

One was an unexpected gift: an email from the PA school I’ve been accepted to with an academic calendar, so I can start to plan my life in 2025 and 2026 (hint, not much time off).

And then my wife and I joined coworkers at trivia night (and folks, while I was 100% wrong about the USS New York, I think their answer was “wrong” too (in the sense that they made an assumption based on its later historical significance)) and had a lot of fun at that.

So overall, my birthday was fun, but I don’t know. Perhaps the weather didn’t help. The thoughts of aging, who knows.

And 57 is sort of an odd number. I mean it’s not a big milestone like 60 or something.

I don’t know.

But here I sit, at 57 years and 1 day thinking about life.

But not for too long because I ended up deciding to go into work last night and picked up an 8 hour shift. And then sat in on a lecture on poisonous mushrooms given by one of our attendings. So… on my 57 and 1… I’ll spend most of the daylight hours sleeping!

Tools

Posted on by
Reply

One thing that makes humans rare among species is our ability to shape and craft and use tools. This was on my mind last night as I went to bad.

A couple of years after my dad died, I wrote a post about using his Milwaukee right angle drill. I still have that drill and while I rarely use it, it still brings back memories.

Yesterday I added a new tool to my toolbox. Well, to my set of tools: a portable table-saw. When I first moved into the house, decades ago, my dad gave me his old table-saw as he had upgraded to a much heavier duty one so he could build cabinets and the like. When he passed, I decided to keep the larger one, but had no place for it, so I gave it on “permanent” loan to a friend who went above and beyond the call of duty to help me during my dad’s illness. He had the room I didn’t.

In the meantime, I had gotten rid of the original one, for a variety of reasons, including that it had some bad memories. You see, back in my senior year of high school I was using it to cut some cedar shingles and it kicked back on me. I’ll be honest, I’m lucky to still have all 10 fingers. And that’s in part because of receiving some sutures at the local hospital.

As for the new table-saw, it had been on my bucket list to obtain for awhile and I finally bit the bullet and bought it on Sunday, assembled it yesterday and used it to start finishing some projects that really needed what a table-saw can offer. And so far, I love it. It has a number of safety features my old saw didn’t and it’s much easier to adjust. I think it’ll be a very useful addition to my toolbox.

But I wasn’t done with saws with with memories of my dad’s tools. Turns out I needed to cut out a notch in the piece of trim I had just cut on the table-saw. There’s no real safe way of doing all the necessary cuts on a table-saw. But that’s ok, I realized I needed a coping saw, something my dad had. Sure enough going to his toolbox in the basement I found it and got my cut started. (I’ll admit I cheated for the rest, once I had enough started to fit a jigsaw blade, I used my jigsaw to finish it.)

But I want to circle back to sutures. One of the skills I’ve watched a lot of in the ER is doctors and PAs putting in sutures. The overall mechanics didn’t seem complex, but I wanted to get in practice before I had to PA school in May. Fortunately one of my members of the Council of Moore was able to set me up with some of the items needed. A quick shopping trip on Amazon got me a practice suturing pad. I’ve had the items for a couple of weeks, but finally last night decided to pull them out and pull up Youtube.

And I was right. The hand motions are just as I thought. Pierce the “skin”, rotate the wrist to drive the needle through, pull the suture mostly through, wrap the suture twice around the needle driver, grab the end pull through and voila, the first knot.

Or so I thought. My suture kept unravelling. I watched more videos, they all showed the same thing. I was baffled. I kept trying, suddenly I had something that looked right and didn’t slip. But I had no idea what I had done, so I didn’t count that one.

After getting fairly frustrated I decided to hand-tie one to see confirm what it should look like. That was easy. Back to using the needle driver. No luck.

Then it hit me. While the videos talked about wrapping in two different directions, clockwise and counter-clockwise, there’s really two other directions! The first, which is what I had been doing was wrapping the suture with the tip of the needle driver pointing towards the wound (and hence the free end). The second, was angling it the other way so effectively the tip of the needle driver is towards the needle end of the suture. It’s subtle but once I did that, I was able to create the knot I wanted.

The clockwise/counter-clockwise comes in when tying the knot twice to ensure it’s correctly tied (strictly speaking it’s what’s called a surgeon’s know which is much like a square knot, but with an extra wrap on the bottom half.

I’ll admit I’m still working on getting this part right, lest I end up creating the surgeons knot equivalent of a granny knot. But that’s honestly a minor issue and one that I’ll soon solve with muscle memory.

There’s obviously a lot more to learn about suturing, but getting this part down is a huge win for me.

So in one day I’ve come full circle, from a table-saw, to a coping saw, to a suture. But this time the suture was simply practice by me, not necessary on me.

One last comment: my statements above are not endorsed by my employer, Albany Medical Health System nor do they reflect the views of my employer.

Another Regret and Another Milestone

Posted on by
Reply

I blogged a few weeks ago about a few regrets I’ve had since leaving behind being a DBA but I was reminded of another just over a week ago. It’s an event that combined two of my favorite things: SQL (or more accurately #SQLFamily) and trains! And that’s… SQL Train!

No, it’s not a new Microsoft product or something. It’s an event when a bunch of SQL DBAs and others take the train from Portland Oregon’s SQL Saturday event up to Seattle in prep for the PASS event. So you already know it’s a great group of people. And of course I love riding Amtrak and that’s one segment I haven’t ridden yet, so I would have enjoyed it. It’s something I have been meaning to do for years but never got around to it. That said, I’m sure if I showed up in a future year, I’d be welcomed by my SQL Family, it’s how they role.

That said, this weekend I did something new: I acted in a movie. Technically it’s not my first, but it’s by far the most involved I’ve been. A bit of acting, my daughter is in her senior year of film school and needed a “dad like person in their mid 50s” for a role. After not being able to find someone local to fill the role, she asked me. This involved me leaving work at 3:30 AM Friday after my shift ended, driving a bit, napping for several hours, getting gas, a bit more of a drive, napping again, driving, getting some food, I finally showed up on set. Total, I spent about 6 hours on set on Friday, and 10+ hours on Saturday and 8+ on Sunday.

I’ll admit between short notice (less than a week) and little time (5 12 hour shifts in that week) I wasn’t as prepared as I’d like, but I managed to get most of my lines right.

I’ll say this, as much fun as it was, I do hope I’m a better PA than I am actor! I’m not about to give up my night job.

And that’s it from here this week.