Circling Back to Naknek

 

Finally, an update!  I’m 6 weeks into my 8 week stint back at my old clinic in Naknek, and it’s been good.  It has really been heartwarming to keep running into people who are so glad to see me and tell me that they’ve missed me!  I’m so much more comfortable here than I was in McGrath because it’s familiar.  There have been a few changes at the clinic, but nothing major.  And the great part of it all is that the (few) times something has come up that makes me say, “Now I remember why I quit!” it’s followed by, “But it’s not my problem anymore!”  And I can truly say now that although this was my home for 8 years, and it’s still a second home, Idaho is my real home and I’m looking forward to going back in 2 weeks.

It’s been good to see my dog, too, but I’m not allowed to have her in my vehicle or at my cabin so I have spent a couple of nights at my friend Ann’s dry cabin at her house where Kvichak lives  now so that I could spend some time with her. 

She clearly thinks that Ann is now her person, which is good because it’s less stressful for her.  But it’s hard for me!  In May I’m coming up here to help some friends pack their stuff in preparation for them retiring and moving to Fairbanks, and then I will get everything all set to cargo ship Kvichak to Anchorage where I can retrieve her, get her health certificate, and hopefully a BATH before we head down the Alcan to Idaho.  And somehow, sometime, I have to buy a suitable vehicle in Anchorage for the trip.  I’m thinking cargo van, since Kvichak’s crate is so large and we will also have all our camping gear and luggage, so I don’t think it would all fit very well in a pickup, even with a canopy.  My son Cole and my daughter in law Sam are going to be able to drive with me, although Cole will have to fly home from somewhere in Canada after a week.  We plan to take at least 10 days to make the trip and we will see a lot of places I’ve always wanted to go.  Including Banff and Lake Louise.  We plan to camp most of the time but every few days will get a motel if we can find motels that take dogs.

I’m living in the same cabin I started out in in 2014!  It’s 300 square feet, which is fine for just me at least for a couple of months.  

 It will make my new 600 square foot apartment in my Idaho shop seem like a palace, and if I ever get my 1300 square foot “Big House” built, it will feel like a whole Queendom!  My contractor says that the plumbing, electrical and gas lines are all roughed in, and they are starting on the drywall tomorrow.  I don’t know (I’ve been afraid to ask) what the ETMI (estimated time of move in) might be.  I’m hopeful that by the time I go off to Ireland on April 29 that I might be in there, or surely by the time I get back in mid-May.  But there are still a lot of puzzle pieces to put in place, like getting the well working right, getting the septic in, water lines run, etc.

I seem to be the winner of the medevac jackpot this trip (if only there was such a thing!).  It’s not very busy this time of year, but we have had 3 medevacs and I have been the provider on all of them.  We are having a population explosion out here; there WERE about 8 or 10 pregnant women when I got here.  Which is lovely, and they all are wanted babies, and I enjoy prenatal care.  But I don’t EVER want to deliver a baby out here, and especially not a premature one.  So a few weeks ago I had a first pregnancy mom who was at 32 weeks of gestation (40 is a full term) who started bleeding one night.  It was probably around 8:30 PM, so I had her come in and it wasn’t really a whole lot of blood, and she wasn’t in labor, just had kind of an irritable feeling low in her pelvis.  So I called the on-call OB doc at the Alaska Native Medical Center where she planned to give birth (most women go out and stay in Anchorage at about 36 weeks, earlier if it’s a high-risk pregnancy) who listened closely to everything I told her I had observed, and concluded that it was probably OK for her to go home and just see how she did.  The bleeding seemed to have pretty much stopped and the fetal heart tones were strong, the baby had good movement, and mom wasn’t really having contractions.  

 So we all went home for about an hour and a half when she called and said the bleeding had started up again and was heavier.  This time we quickly decided she needed to be medevacked out—but the weather was holding up the flight and predicted to continue to be no-fly weather for another 8-9 hours!  The pilot promised to keep a close watch on the weather and said he would let us know if anything changed.  I had mom and dad sleeping on the two gurneys in our ER room, and was just getting ready to try to call the Coast Guard in Kodiak to see if their big rescue helicopter might be able to get in and out when Guardian Flight called and said, “We have a window and we’re heading your way!”  It takes about an hour and a half to get here from Anchorage, and so by the time we got the patient and her husband to the airport to meet the plane in King Salmon it was about 4:30 AM.  We found out later that she had an almost immediate C-section upon arrival and ended up needing two units of blood.  Miraculously the 32 week old baby only had to spend less than a week in the Neonatal Intensive Care Unit, and weighed almost 5 pounds.  I have to wonder if they really had the dates right—even 36 weekers sometimes spend up to a month in the NICU.  I was so glad to have a happy outcome!

Then a couple of weeks later I had a call around 8:30 PM (seems to be the witching hour for preterm labor) from a mom who was 35 weeks along whose water had just broken.  This was her second baby, the first one having been born at 34 weeks almost exactly three years before, and we had medevacked her out that time too.  Fortunately the weather was great, a plane and crew were available, and we got her out by 11:30 PM.  She too had the baby first thing after arrival, and both mom and baby are doing fine.  This one is still in the NICU but doing well.

Another local baby was just born following the proper procedures, having gone out around 36 weeks and having a problem-free birth at 40 weeks, so that’s one less to worry about!  I still have two weeks left here, so I’m keeping my fingers crossed but also getting a pre-term birth box together with several drugs and concise directions about when to use and not use them, and what doses to give.  I figure if I get it all ready it will ward off anymore preterm labor, but I’m not at all superstitious.

My friend's boot inside a fresh polar bear track in Utgiagvik (formerly known as Barrow)

 

The third medevac was a good friend of mine’s husband who had a snowmachine (snowmobile for all the lower-48 ers) accident on the ice of a small lake by our airport.  It was hard to tell what was really going on because of the way the dispatcher toned it out, but to give you an idea of what a small town this is, I got a phone call from my friend as I was driving to the clinic, and I said, “Sorry I can’t talk right now, I’m on my way to the clinic for an emergency” and she said (tearfully), “I know, it’s my husband, he crashed his snow machine!.”  And she was in Sitka for the weekend! (that's her boot inside the polar bear track). No one saw the accident, and no one really knows for sure how long he lay out there on the ice, but one of our local pilots had flown over the lake and didn’t see anyone around, and when he flew back about a half hour later saw the guy laying on the ice and not moving, about 12 feet away from the snow machine on its side.  No helmet…thick fur hats are better than nothing if you’re going to hit and skid on your face across thick ice, but no substitute for a helmet.  We got him out pretty quickly, thank goodness, and he did have a brain bleed but no other injuries.  Unclear whether he will have permanent brain damage, but he’s talking and seems to be recovering well (still hospitalized).

                                                   My new slippers--leopard seal and beaver

No landscape pictures; the weather has been generally lousy, ranging from 12 below zero to 41 above.  Right now the rain has burnished the snow to a fine, zamboni-groomed finish on all the roads, parking lots, etc.  With water on top.  It's treacherous!  I can't wait to get home.