Day One Trauma Call: Kicked My Ass!

If you don't like the title, stop reading. This is a blog by ME, so if you don't like the language or my opinions, don't read.
Yeah, I've had one of those days!  It started yesterday, on my BIRTHDAY, trying to get a pager from the hospital so that I could take OMS and trauma call.  Ha! I've been here 3 weeks and things still aren't working, more to come later in my post.  They handed me an old fashioned pager, yep, the one that gives you a phone number to call. No message or anything. I didn't think it would be that big of a deal, right, just call the number that shows on the pager. WRONG!  My pager went off at 5am this morning, scaring me out of some pleasant dream of having Mitch here with us as a family. Thanks ASSHOLES for separating us AGAIN!  I thought it was the smoke detector and jumped out of bed. Nope the pager, that doesn't have a light when you hit the button, so I had to stumble into the bathroom and turn on the light to find a 643-XXXX number on the screen.  Ok, call the number and find out what is going on, right? Ha ha! As I wrote above, my cell phone doesn't get service in my house and I don't have a home phone yet.  I also know that you can't call the above number from the Japanese cell phones. I went downstairs and dug through my office bag to find the codes on how to call the number. Not on any of the papers they gave me. Nice. My pager then went off again and it said NAVHOSP ER call 643-XXXX. Ok, now I know it is the ER, but can't page them back and still don't know how to call the 643 number. Back upstairs to google NAVHOSP Okinawa ER. Luckily I found a number  (090-xxxx-xxxx)  I wrote it down, because I can't get the wireless router to work so I am teathered to the modem etc. went back downstairs out the back door to the patio and called the number. It gave me an operator and listed the number I wanted to call. YES! It worked!
The ER physician quickly described the trauma patient, "guy with a mandible fracture, mobile segment, handing secretions ok and can send him to your clinic in the morning."
Ok, this gave me some time to figure out what to do with Cooper and Mackenzie. I told him, have the patient come to the clinic at 8:30 and we will go from there. At this point I was planning to see the patient, admit him to the hospital and do the case on Monday. Didn't seem urgent and the hospital doesn't do many cases on the weekends, and this is what the OMS surgeons have done in the past.

We had planned to meet the Joo family at the Hagestrom swimming pool on Kadena Base at 10:00am and then play at our house. I loaded the kids in the car with our swim gear and drove to the hospital. I brought the DVD player and toys for them to play in my office. I also thought the hospital kept a dental technician there during the weekend, NOPE, no one there. Luckily, or not, the ER had sent the patient to the dental clinic on Camp Foster, and he was able to get a panorex radiograph.  My access to that system was working and I was able to view the fracture, symphyseal and left low subcondylar. The patient, special forces Army, and his friend an Army Medic came to the hospital clinic. Mackenzie helped me examine him while Cooper watched a movie. He had significant mobility of his symphseal mandible fracture and in a lot of discomfort. To complicate maters he is supposed to PCS in a week back to the US and his family. He started crying in the chair that he didn't want this to delay his PCS back to his family.  How could I not help the guy? I apologized numerous times about having my kids there, and they both thought it was great, having kids of their own. I also apologized for not knowing the system well. No idea how to add a patient for the OR on a weekend or what was available! As we were coming up to the clinic, EVERYTHING in the hospital was closed! I had promised the kids a snack when we got there, NOPE!
I found some numbers and got word that I could take him to the OR today to fix his broken jaw. Great! Now, what to do with the kids!  I called Jae Joo and explained the situation. He just finished his OMS residency at Balboa Hospital and is in the process of getting checked into the command and get housing. He doesn't have credentials at the hospital yet, so he couldn't help me out in the OR, but agreed to bring the family over to the hospital and meet us there. We then caravanned over to our house on Kadena. Cooper and Mackenzie seemed happy and were ok with me leaving.
Jae mentioned that John Malan, another OMS here on Okinawa, was at the hospital seeing his own patient and would help out. YES!!!  I called him immediately and told him I was on my way back to the hospital. He had already taken care of some of the paperwork and was helping get the case into the OR. When I got back to the hospital, things were ready to go. I tried to input some of the H&P and orders into our computer charting system, but couldn't get it to work right. I left my desk and went up to do the case.
John and I worked well placing the arch bars and wires, the plan was to do a closed reduction since the patient was PCS'ing in a week, but that wasn't working in the OR. We had to open the symphyseal fracture and plate it. Of course, we had an older plating system that wasn't the easiest to use. Overall the surgery went well and we were both very happy with the result. The surgery was the easiest part of the whole event! I did leave him in MMF or maxillomandibular fixation because of the subcondylar fracture. He was taken to the ICU after the case, because it was the weekend and the APU and PACU aren't open on the weekend. John left once we had him in the ICU and I talked with his Medic friend and the nursers there about the patient.
Ah, all done, now to finish paperwork/computer entry and go home. It was about 1pm and I had received a text from Jae that they had ordered pizza and were playing in the pool and sprinkler outside.
Door to the Dental/OMS clinic was locked! What! I know I left it unlocked and in my hurry, I left my keys inside. I called John, but he had already left the hospital and suggested I go to the Quarter desk and ask for help.  I walked down to the front of the hospital and asked for assistance opening the "Dental/OMS clinic."  "Ma'am all the doors have a code above the door and that is how the keys are labeled."  Perfect! I walked back upstairs to the clinic, YEP right above the door C209W and C211W. Walked back down to the Quarter Desk and recited the code. After about 10 minutes he came back with about 20 keys.  "Ma'am all of these keys say C211W."  Huh? "Try C209W."  He found a key with C209WK so I took that key and walked back upstairs to the clinic.  No luck. SERIOUSLY!!!  I walked back downstairs and asked him to hand me the pile of keys. He then said "What about this one that says Dental?"  Yes, that is what I asked for the first time!!!
The key worked. Now to just type the prescriptions into CHCS for the patient and finish up the Essentris note.  Hum, my CHCS code isn't working. This is the ONLY way to enter medications for the patient.  Let me call the ITD and help desk. No one there!  Let me see if a pharmacist is in the pharmacy and if they can help! Yes, I was given a good ole fashion prescription pad. I wrote out the discharge medications for the patient and hand walked it back to the ICU and handed it to the nurse. Finally done! I walked the Dental key back down to the Quarter desk and heard the guy say on the phone "Dr. Eisenberg." Yep, that is me!  The nurse on the ICU says the patient requested an antiemetic. Yep, I forgot. A very nice Corpsman came down with the script so that I could add in some Zofran for the patient. While I was waiting the new guy at the Quarter desk asked if I wanted a slice of pizza. HELL YEAH! It was 2:30pm and I was starving! My bowl of cheerios was long gone.

When I got home the kids were changed from playing in the water and having a snack. They were happy but tired and wanted to go to the swimming pool as I had promised. Not at all what I wanted to do, but I had promised and been gone most of the day. Jae had to leave to get ready for the Dental Corps Birthday Ball. Good thing I didn't pay to go!  Kana and I loaded the kids in our cars and dove to the local swimming pool.  While we were there my pager went off again and again I had a difficult time calling the number back.  I finally got through and it was the ICU nurse, one of the medications that I wrote for isn't carried at the hospital. Crap! He then said Dr. Malan is on his way to help change the medication, since we couldn't reach you. What! I looked back at my pager, must have been the quick time I was in the pool with the kids. I called John, he had no problem changing the medications as he was out trying to get uniform things ready for the birthday ball too. He said he should have told me that the hospital didn't carry the medication.
Frustrating day to say the least, but it all got taken care of and now I owe my friends Jae, Kana, and John some BIG FAVORS!
Some may say, you knew you were on call, why didn't you have someone planned to take care of the kids? Well, because I didn't have time to find someone and the guys that have been here taking call said they haven't had a trauma call in 3 months! Just my luck.  However, if Mitch and I were co-located here together, it wouldn't have been an issue! 
Ah, it felt really good to get that all out, and one day it will be funny, just not today.