Ramping Up

Ok - I didn't finish the story about the Block Party: The kids were in that jumper until we pulled them out around 9 (2 hours past their bedtime, but at least an hour earlier than the other kids wound up staying up), and they both passed out quickly... The weather got colder and colder, and so in the middle of July, we had a fire pit going, passing around hot coffee and Bailey's. With the kids down, I was on house duty while Pamela hung out, rolling in after 11.

The next morning, the moonwalk was inflated at 9am (the family hosting the jumper set that time as the earliest, even though their 3 kids had been up since 7 demanding more bouncing). The whole neighborhood of kids was BACK out at 9:01 jumping again, but there was exhaustion... a little less pep to the bouncing. By 10, they were all just sitting in and on the jumper, getting on eachother's nerves, but unwilling to leave the space, because hey, it's a MOONWALK. By 11, when the men with the truck finally came to take the moonwalk, there was a brief flurry of frantic jumping, but then general relief that no more jumping would be required.

There were widespread reports of rubberlegs, aches, and general grumpiness. Our whole house took a NAP. Even Bella. It was good. We had the semiannual neighborhood progressive dinner on Sunday night (ramped back from quarterly - I love my neighbors, but my time is ever more precious at home), and had a good evening of catching up... Rita and Jeff are seeing an increase in business, which means they've weathered the downturn well: We've been so concerned and hopeful for their design-build operation...

Now I'm in Philly, and will be for quite a while. Last week out in Jersey was frankly so stunningly taxing that I had a hard time getting my head on straight Monday, which was fine, since the first few days of a gig are always just ramp up time. My boss Ken handed me a thick manilla folder filled with notes to get caught up on, and I've read the whole stack thrice now - once each day. By today, it was all making sense, and I was hitting the internet to get more info on some of the esoteric things they're doing....

This is a cardiology project, but a very very different one than I did a couple of years ago: In a traditional cardiology unit, you're dealing with arterial plaque and coronary blockages, mostly older people, and 95% of the time, you can clear things up with some drugs, angioplasty, or inserting stents. Maybe 5% of the time you're dealing with something genetic. In PEDIATRIC Cardiology, it's 95% genetic anomalies.

So the needs of the doctors are very very different, and you get to realize that these tools have all been built around the 95% adult cardio model. My job is to help figure out a solution that will actually work for the Pediatric world. And it may not actually exist yet. It's very exciting.

Today I was doing research on the most common heart defects and the sorts of procedures that are used to treat them. Also, I did some deep diving into some of the procedures that I hadn't really seen much of in the past. Today I learned about Electrophysiology - the study of the electrical system that works the heart. Seems some people have overactive nerve clusters in there which lead to the heart twitching rapidly and being inefficient in its job as a pump.

There's a procedure called Ablation where you guide a wire up into the heart, and literally zap tissue in the overactive regions to disrupt the electrical feedback loops. There's a a surgery called "The Maze Procedure" which is more invasive - they actually go in and cut patterns into the heart with a scalpel and then sew it back together, and that scar tissue is less likely to have the electrical storms. And finally, if a person has an out of control arrhythmia they do a "Cardioversion" which is basically using the Defibrillator paddles to shock the heart back into sync.

This is all very cool and interesting stuff. It's not really very common to think of yourself as an electrical being, but every muscle twitch is an electric process.

Can you tell I'm happy to be back in the clinical world, learning about things again? Much more fun than trying to figure out how to get the assistant of the CIO of that one health system to pass a message along about how we have the best consultants if only they'll give us a chance. Much more fun.

Anyway, the point is that after a few days of drinking from the firehose, I'm starting to feel like I might just know what I'll be doing, and am having the pieces fall into place. Add to this that I am totally loving this city (more on that in posts to come, but you can be assured food probably factors in to this), and this will be a very good gig for me. VERY good.

And now I'm going to switch gears and do some work for the Jersey client... a promise is a promise.