Night Blooming Cereus in Arcadia

Arcadia California is known for its Night Blooming Cereus. I have found that they will continue to bloom during the daylight hours but only if you are lucky. The bloom of the Cereus will only last a day at most two. Jennifer cultivates them for her pressed flower collection. Eventually this magnificent flower will end up in an artwork pressed flower picture fit for the walls of a museum.



Arcadia is a beautiful little hillside city in the midst of the San Gabriel mountain chain. This area was once a smog filled area but in the past 20 years or so the air has gotten much better. During the fall months especially the views of the San Gabriel's are quite nice.

Outpatient Anesthesia

Outpatient anesthesia is the coming thing. Our lecture today given by Dr. Gold at the Keck School of Medicine program of Nurse anesthesia. It was concerned with Surgical Center and Office based anesthesia based practice.



It is estimated that currently 60 to 70 % of all surgical procedures in the United States are done on an outpatient basis (Ackerman, 2002). This is a dramatic change in the last 20 years or so. The main driving forces for this move to ambulatory surgery has been financial incentives. Additional benefits that have come from the outpatient surgical movement is earlier ambulatory of patients, decreased exposure to nosocomial infections and patient convenience.


Anya Bibergal SRNA

Like it or not, having surgery as an outpatient is here to stay. It could easily be predicted that in the next two decades the numbers of hospital based surgeries will decrease and sicker patients will be treated as outpatients in Surgery Centers. These Centers will have overnight stay capability and hospital access for patients that need higher levels of care. Its impossible to stop the move to more decentralized care and this includes surgical as well as medical treatments. Physicians and Nurse anesthetists will be providing this care, working together to ensure patient safety.

The entire lecture and notes can be located for your perusal in the archives.



Happy students after receiving their test scores from the Anatomy exam!

Birthday Week at USC

This week is Birthday week in the nurse anesthesia proram at the University of Southern California. Robert Olson made a great chocolate cake by himself. Robert did admit to burning a yellow cake earlier in the evening before finishing up this great cake we were presented with today. Yummy, thanks Robert.

The birthday people from left to right:
Douglas Brannan, Amy Engelmann, and Elliza Ong ("Little Star")



This little celebration came just at the right time. We are all very tired and worn out from the exam schedule this week. Monday was our midterm Anatomy exam to be followed this Thursday by an Anesthesia Principles exam. This comes on top of a couple of papers that are due and a Pharmacology exam last week. We are all a little under the weather mentally and this little break was really nice.

Just to show you how stressed out we are a little bird was looking in on several of us this morning spying. We get to see what is going on behind closed doors. Before the lights are out on the street lamps students are pouring over books in the study area discussing the finer points of anesthesia practice.



Later in the morning when we all get together just before our lecture for the day on pharmacology several of the students have their stuff spread out. This method of study has been shown in double blinded trials to increase retention by 0.005 %. We use the technique anyway even with the low efficacy rate.




You have to notice that "the boys" have hogged the table. In a personality profile of nurse anesthesia school applicants those that were polite and thoughtful of others, ended up on the alternate list. Actually that is not the case here. This class gets along so well and generally cheers for each other every day. Even as stressful as the last month has been we are all getting along really well. That has been the best part of the whole experience so far.



There are some students that study for other classes during lecture or spend every free moment thinking about what nerve goes where. We have all been studying very hard and some of us are having a hard time relaxing lately. We decided to all meet for dinner and drinks after our Thursday exam just to blow off a little stream. This will give us a few moments where we are not worried about what premedicaiton is appropriate in preoperative management for prevention of nausea and vomiting. After our exam this Thursday we well forget for a few hours HOW MUCH FUN we are having at school at USC. Yippeee!

The little bird will be in the midst of all this fun. Pasadena here we come!

Trust Me

Today's spotlight is on our friend Christy Davis. You know when you are in the presence of greatness when you hear truth. Today was such a day.

"You guys need to trust me more......my roots are naturally brown!"
10/24/2004 Christy Davis




Now I am not one to doubt when I hear such things. You could call me idealistic but there are things that ring true and this was one of them. There was witness to this.

San Francisco Trip Part 2

Last weekend the CANA Fall conference was held in Berkeley California. During the trip we were able to drop across the water to Fisherman's Wharf twice for lunch and then dinner with friends.

Flying in over the San Francisco bay is a beautiful sight on a clear fall day.



The Airbus Express flight from Los Angeles to Oakland Airport was very quick. We barely got into cruising when the decent into Oakland and the landing across the water began. Landing into Oakland Airport is a great thrill because of the descent very close to the water.


Anyone that has been to San Francisco will tell you that these are the steepest streets around. This is a shot of Lombard Street, one of the famous hill climbs in the city. From this lofty height most of the bay can be seen.




The next must see stop for any tourist is Fisherman's Wharf. Between you and me, I have had better sea food in San Diego at the Aqua Blu in the Gas Light district. One of my eatery recommendations for a cafe must see and taste is the Aqua Blu. Life is too short not to visit this wonderful place in San Diego.

The San Francisco fisherman's Wharf is more of an event kind of place. The afternoon that we were there, the Snowbirds from Canada were doing fly overs. There were kinda cute with their Red bottoms and while tops. They seemed to be much slower than our Blue Angeles.





The crab was really good and the clam chowder not bad. Nothing like fresh cracked crab to make your day really shine. What makes the crab taste so good is the cocktail sauce that goes with it. If you are a purist maybe its the butter and lemon that you prefer?




The Golden Gate bridge is still standing. With all of the terrorist talk you have to worry. God I hate even thinking about it. The toll for the Golden Gate bridge is still $3.00 per person and I hear that the cost is going up to $5.00 per person. If you have to commute I would hope that you could get a monthly pass or it would break the bank if you had to fork out $10.00 just in bridge fees every day.

Oh my God, the gas prices are out of sight. With the price of oil going for nearly $60.00 dollars a barrel, President Bush has got to be crapping in his pants. How can this administration survive with gas prices this high. Maybe its a communist plot?

Ok, back to reality. Sorry for wandering around but its been a long day and I am preoccupied with thinking about the tests coming up in Pharmacology and Anatomy next week so my focus is not on this writing. If you are new to this sight, trust me, I don't do this wandering thing much at all. I am on a roll now.

My friends were at the airport for the flight back to Los Angeles and reality. Brian Le, a senior nurse anesthesia student at USC and Helen Huynh a first year student, were travel companions during the trip. Brian is such a funny guy, he had all of us rolling for two days straight. Just one thing. You have got to watch this guy when he drives at night. Do you remember the story of The Wind in the Willows and Toads wild ride. Brian reminded us of Toad in the way he drives anyway. Having Brian along was such a great treat for us. Looking back on the weekend now, Brian made the trip for us. What I bring back is great memories and a new friendship. I am humbled and blessed.



The four USC students before take off, tired and ready to start a new week. Brian is off to clinical rotation at the VA or somewhere and the rest of us will be cracking the books bigtime.

Fall CANA in Berkeley California

The Fall conference of the California Association of Nurse Anesthetists was held in Berkeley California this past weekend. The conference brought together students and old friends to participate in a wonderful lecture series dealing with anesthetic implications for the obstetric patient.

First and Second year students from USC were well represented at the CANA Fall conference. The students from the USC program were the best represented of all student groups attending the conference.

During the conference time we were all work. The lectures given by the Army and navy personal was really fabulous. The presentation of Epidural and Spinal anesthesia is an especially strong point for these practitioners. Joseph Pellegrini, CRNA, DNSc gave a terrific talk on the Anesthetic and Analgesic Methods in obstetric Anesthesia that proved to be First rate.



Installation of a new regime was one of the features of the conference. The past president Joseph Burkard and Board was retired at and a new president was installed. Jennifer Woolley from USC was installed as our new president. In the photo that follows are three presidents of CANA; Joseph Burkard, Jennifer Wolley and of course Chris Stein "the legend".



One of the greatest treats for me personally was to meet up with a very old friend and long time CANA Board member Bill Jenkins. Bill was a neighbor of mine way back in the dark ages of the early 1980's when we became friends. It was through Bills example that I changed direction and started on the road to nurse anesthesia school. Many years later and here we are together at a CANA meeting. This is one of the highlights and milestones of my life. It may be a little thing but I have been working at getting here for so long it seems like a monstrous mountain has been crossed. Anyway, Bill is in good health and starting another Surgical Center north of San Francisco. His success with anesthesia and leadership to CANA will always be looked to as an example.



Students get together with old friends that were veterans together in the trenches of the ICU's that they worked in together. You never know who you will run into at these conferences. The next CANA conference is in the Spring and will be held in Huntington Beach, California. All of the USC students as well as a good representation from the Kaiser group should be in attendance. The professional aspects of the meeting may yet to be determined.

You go girl!

San Francisco CANA Trip part one

The Fall CANA conference was held in Berkeley California this past weekend. I was fortunate enough to be able to go and visit friends while I was up there for the conference. The story of the weekend will take a couple of posts so just bear with me for a minute. Today I just wanted to post a couple of pictures of Glen Hurtig and his beautiful wife and graduate RNA, Rosanna is studying for boards as we write.

Glen picked me up at the airport in Oakland on Friday. We went straight to Fisherman's wharf in San Francisco for lunch. It was a terrific day there on the water.



Glen is looking out at his old home there at Alcatraz wondering if they will catch up to him soon.





Rosanna and her mother. Rosanna is a recent graduate from the USC School of Nursing Anesthesia program. She is currently working at Kaiser in Northern California and having a fabulous time. Being a new graduate and studying for boards while holding down a full time anesthesia practice is a tremendous amount of work she tells me, but so much fun!



We had to take a little diversion over to the headlands for a view of the Golden State Bridge. A couple of my classmates and I were ferried over by a Senior. We were so impressed. Mostly we just talked shop and ate a lot.





The CANA conference was the reason that we went up to the Bay Area. In the future this conference will be posted here. Stay tuned.

CANA: Training for the Future Fall Conference

The CANA (California Association of Nurse Anesthetists) Fall meeting is being held this weekend in Berkeley. As a student in the USC Keck School of Medicine/Program of nurse anesthesia, I will be going along with a few other of the students.

Some important information about the conference is recorded below:
Location Claremont Resort & Spa41 Tunnel Road Berkeley, California 94705-2429
Driving Directions: CLICK HERE
Resort Main Number: 510.843.3000Facsimile: 510.843.6068
Website:Claremont Resort & Spa
Meeting AgendaCLICK HERE for the Meeting Agenda

The agenda will come up in a pdf that you can view now and also print to have with you while attending the conference.


Sponsorship & Exhibit OpportunitiesClick Here for Details.

You can expect a full update as the weekend progresses. Hopefully with lap top in hand there will be wireless access at the Claremont Resort & Spa Hotel. With any luck at all I will be able to publish some pictures and give an accounting of the events.

During the trip to Berkeley there will be some friends that have moved away that will be visiting. So much to look forward to to. Isn't it great to be alive. God, its so nice to be on this journey.

On Aging by George Carlin

On Aging by George Carlin

Do you realize that the only time in our lives when we like to get old is when we're kids? If you're less than 10 years old, you're so excited about aging that you think in fractions.

"How old are you?" "I'm four and a half!" You're never thirty-six and a half. You're four and a half, going on five! That's the key.

You get into your teens, now they can't hold you back. You jump to the next number, or even a few ahead. "How old are you?" "I'm gonna be 16!" You could be 13, but hey, you're gonna be 16!

And then the greatest day of your life . . . you become 21. Even the words sound like a ceremony . . . YOU BECOME 21. YESSSS!!!

But then you turn 30. Oooohh, what happened there? Makes you sound like bad milk. He TURNED; we had to throw him out. There's no fun now, you're just a sour-dumpling. What's wrong? What's changed?

You BECOME 21, you TURN 30, then you're PUSHING 40. Whoa! Put on the brakes, it's all slipping away. Before you know it, you REACH 50 . ... and your dreams are gone.

But wait!!! You MAKE it to 60. You didn't think you would! So you BECOME 21, TURN 30, PUSH 40, REACH 50 and MAKE it to 60.

You've built up so much speed that you HIT 70! After that it's a day-by-day thing; you HIT Wednesday! You get into your 80s and every day is a complete cycle; you HIT lunch; you

TURN 4:30; you REACH bedtime. And it doesn't end there. Into the 90s, you start going backwards; "I Was JUST 92."

Then a strange thing happens. If you make it over 100, you become a little kid again. "I'm 100 and a half!"

May you all make it to a healthy 100 and a half!!

Humming bird Ranch

The fall season is the time to see humming birds fight it out for the sweet nectar. As many of you may know, humming birds are extremely territorial and aggressive when protecting their staked out spots. What this leads to when you put up a humming bird feeder is all out warfare if your bird populations are high as they are here in Arcadia California next to the foothills of the San Gabriel mountains.



So what is the solution to decrease the fighting? Can't we just all get along, someone pipes in. Well in a word, NO. What I can do is to increase the scarce resources so that instead of one big fight there are lots of little ones and a lot of birds get fed. The way to do this is to put up more feeders. Simple solution to a complex problem. How many feeders you put up just depends on your temperament. Currently we have 7 or 8 feeders up scattered around the front and back of the house. All of them are in front of big windows where we can watch them. In front of the kitchen window we have three which attract a lot of attention.



These birds seem to be tolerating each other at the table so why is that. Well I don't have a scientific answer except for my observations. Manly the birds that get along are the extra females or the immature males. With so many feeders up the dominant birds have a lot of work flying around chasing off invaders to their territory. If you put up a lot of feeders some of them will be open. Seems logical. In practice this is what happens.



The fall seems to be the time when the most humming birds are around here in Arcadia. Maybe that's because all the babies are beefing up before migration time. In any event, we have birds here all year long but the fall late evenings seem to be the busiest times for the nectar maker. Last week I made about 5 gallons of nectar. The 26 ounce jars were empty by the end of the afternoon while the big 32 ouncer that I have was over half empty every night.

I can put up links for feeder infor if there is interest otherwise just enjoy the pictures.

Wedding day at the Los Angeles Harbor

Bob and Freda have been friends of ours for a long time. Freda has been Jennifer's "sister" for almost 30 years now. As a matter of fact, they were childhood playmates in China.

Here is Bob and Freda looking out at the Los Angeles Port of Call from there balcony on the Norwegian cruise ship. They are leaving on a 14 day trip through the Panama Canal and on the Miami Florida.






Jennifer and I on the top deck of the Cruise Ship


The Los Angeles Port O' Call looking sea-ward from the top deck.