Done It!!

Well, it's all over. Except, that is, for the pain, the tiredness, and the wonderful sense of achievement. There is something very special about crossing the finish line of a your first 10K. The whole day was very exciting. We woke up early, and had a light breakfast, then met up with the rest of the team at Green Park. I cannot begin to tell you how it feels to be standing in a sea of people, all waiting to set off.

Scissors was by my side the whole time. He has run 8 marathons, so this wasn't going to be a challenge for him. He kept shouting at the crowd, urging them all to cheer us on - very amusing!

MrsRRD is there, at the 2km mark, along with the rest of the support team. I probably looked quite fresh at that time! Not so later on, as I wind my way through the streets of London, onwards, ever onwards.

And then I reached the 8K mark - uncharted territory for me. The pain in the hips was slowing me down, and my leg felt like jelly. Scissors turned to me (running backwards as he did - show-off):

"Do you want to spend a whole year, until the next BUPA 10K, wishing you had got in under your target (1 hour 20 minutes), or do you wish to spend the next year being pleased you did?", he asked me. Hmmm, tough one. My brain told my legs to speed up. My legs told my brain to sod off, then grudgingly stepped up the pace.

I have a GPS watch. I bought it with money from my birthday (yes, I still get money for my birthday, what of it??) It tells me exactly how fast I am going, how far I have gone, what my pace is. I have been using it to plan my race, and to optimise my training. I charged it up, so that it would be ready for race day, so that I could keep to just under 8-minute kilometres.

I left it at home.

So, I was dependent on Scissors to keep me on pace. If he is telling me I need to pick it up, then pick it up I will. And I did. Somehow, I managed to find those extra few muscle fibres, the ones that hadn't given up the ghost, and put them to work. I pass MrsRRD again, pushing myself harder and harder.

And there it is in the distance - the finish line! I have 400m to go, and I start to sprint, with Scissors muttering, "There's no grey - it's either black or white." No idea what he meant by that, but the sight of the finish line getting closer and closer spurned me on, faster and faster.

And I'm through!! I turn to Scissors, gave him a big hug, then asked the question? Was I in or was I out? He looks at his watch, and tells me the news: 1 hour 16 minutes 1 second!

And then, in true form, we meet everyone else, and have a picnic in Green Park.

And what of Princess RRD and Ginger? Did I beat them? No. 1 hour 5 minutes. No training. Nothing. Big Neph? 57 minutes. No training. Ah the joys of being young.

What's next? Something very exciting, but I'll keep that for another day!

Thank you to all of you for all your support. Without you watching me, I would never have managed this.

Race Day!

Well, the day is finally upon us.  After almost 140km of training, tomorrow I am running for BASICS.  I feel quite proud, to be honest.  I have often seen on the television the runners as they cross the line, and tomorrow that will be us!

I'm supposed to have had an early night.  It's nearly midnight here, and I'm not quite ready for bed.  After all, life doesn't stop at Chez RRD, not even for a 10k run.  There are children to get to and from parties, wallets to find (mine), and hair to be trimmed (mine).

And, of course, the preparations for the race day itself.  Ginger, one of Princess RRD's friends who is also running tomorrow, is staying over tonight, and the girls had a very giggly time.  They spent the afternoon decorating the back of their running shorts with the BASICS logo.  Oh, and the Union Jack on the front!!  Mrs RRD has been making the food for the after-run picnic.  Lots of food!!  Camera batteries have been charged, so I will be posting the evidence here tomorrow evening...

Shrink will not be running tomorrow.  An over-exuberent dance session over the weekend has left him hobbling on an injured ankle, so he will have to watch from the sidelines.  Scissors, a veteran marathon runner, has elected to keep me company all the way.  So, his time won't be any good, either!!

I have set things up so that any of you can follow my progress, inch by painful inch.  If you go to www.sportstracklive.com, and search for me, rapidresponsedoc, you should be able to find a live, as it happens, track.  My aim is to keep my speed as close to 8 minutes per kilometre - see how well I do and cheer me on.  Start time will be about 11:20, UK time.

Right, I am off to bed.  See you at the starting post!!!

Death

I see death every day.  Not many people can say that.  Not many people understand what it is like to be confronted with the fact of one's own mortality so often.  It's part of what I do, it goes with the territory.  That's not to say I don't get affected.  I believe if you don't get affected, then you are in the wrong profession, and it is time to move on.  But that makes it hard.  Hard to sit and watch the widow, the son, the father, after you have given them the worst of all possible news.

Death comes in many forms.  There is the expected death, often a blessed relief for all, patient included, perhaps after a painful, drawn-out illness.  There is the unexpected death, home just two weeks following a successful heart bypass, then found lifeless in bed one morning.  There are the deaths from trauma, car accidents or stabbings.

And then there are those that deal the fateful blow themselves.  Those that I get called to are invariably the more violent: the blade, the rope, the train, the 5 storey fall.  These cases affect me more than anything.  They leave me numb.  That anyone could want to end their life is one thing - to end it in such an aggressive manner is another.  They drain me, both the the act itself and the intent behind the act.  They often leave me empty and low for days after.

I had two today.

Countdown

In two weeks time exactly, I will be in agony, having successfully completed the BUPA 10k.  my legs will be on fire, and I will be falling asleep on my feet.  My time?  Only time will tell.  Less than 1 hour 20 minutes will make me happy.  Getting all the way round before I collapse in a heap will make me happy!!

And what about the sponsorship?  Well, so far, with two weeks to go, I have managed to get just over £1000 of pledges!!  How much will it be before the end?  That's up to all of you...

Thank you to everyone who has sponsored me and supported me.  And thanks to all who are going to before the 30th May.

The Fallen - Take 2

My cat sleeps on our bedroom floor, in a bag.  We try to discourage him, mainly because being woken up at 4:30am is too much like having a new baby, and not at all conducive to happy living.  But he likes his bag, and he likes our floor.

04:30, and the gentle miaow wakes both of us from slumber.  It's MrsRRD's turn, and she disappears downstairs to open a pouch, the diminishing tinkling of the cat's bell signalling the fact he has chased after her.

04:35, and the insistent ringing of my phone drags me back from sleep once again.  Can I attend a man who has fallen out of a 4th storey window, and now has a Glasgow Coma Score of 3.  After falling out of a 4th floor window, I would be surprised if he was walking around uninjured!!  I take the details while I pull on some clothes (socks!!)

MrsRRD is a bit surprised to see me downstairs and dressed, but quickly kisses me goodbye, and I rush to my car.

Sasha, my Sat Nav, seems to be having trouble waking up this morning - when I look at the overall map of where I am going, it shows me going round 3 sides of a square.  I set off along what looks like the shortest distance.  The no right turn at the end of the road doesn't stop me, but does explain somewhat why Sasha was sulking.

The ambulance is moving!  They are off without me.  The police look surprised to see me, and hesitate before lifting the police tapes to let me through.  The Station Manager bangs on the side of the ambulance and they stop to let me on and see the patient.

He is around 50 years old.  The crew had been called to a person who was threatening to jump out of a window in a block of flats. They were forced to watch him as he fell, despite the efforts of the police negotiator.  It cannot be nice watching something like that - usually we get there after the incident has occurred.  He's in a bad way, with signs of a serious head injury.  There is no doubt that he needs tubing and ventilating, and I look for a vein to put a line in.  There is nothing.  There are marks of intravenous drug use, which has caused all of his veins to become damaged.  I look at the veins in his neck - even these are looking difficult to cannulate.  The paramedic suggests we go for a needle straight into the bone of the leg.  Sounds bad, doesn't it.  But, an intraosseous needle, as we like to call them, is a great way of getting drugs and fluids into a patient when there are no other veins available.  We have what is essentially a cordless electric screwdriver, which we use to drive the needle into the tibia, just below the knee joint. I ask the para how many he has done.  He tells me that he has so far inserted three.  I tell him to make it four.  The shaking is barely perceptible, as he drives the needle home.

Just as I am unzipping my intubation kit, the door of the ambulance opens, and there are two more men in orange jumpsuits.  Great!! The HEMS team have arrived.  We have a little chat about where we are and what has occurred, and I maintain my authority over the case (I got there first) as I tell the HEMS medic that I will be intubating the patient.  She suggests that we regroup, with patient, outside the ambulance, as there isn't enough room for everyone.  No, not now you are here!!

As we are wheeling the patient back outside, I hear the grumbles of the ambulance crew, suggesting that it might have been better to have just gone.  I hush them, and we get to work, setting up a formal kit dump with everything we do need, and everything we might need if there are any untoward circumstances.

I have written about this before: my way of just opening my bag, grabbing what I need and getting on with it contrasts starkly with the HEMS way, where everything is laid out neatly and ticked off a checklist before proceeding.  Which is the right way?  Well, my way works, but only for me.  I can grab what I need, whenever I need it.  I am aware of the dangers of what I am doing, and mentally prepare myself.  The HEMS team are a team:  there will be different doctors working with each paramedic.  Nothing can be left to chance.  Everything has to be prescriptive.

Anyway, back to this patient.  He is now being given an anaesthetic, to facilitate me inserting a tube into his windpipe.  He's a grade 1 intubation, which means I can see the windpipe through the vocal cords so easily that I could, if I really wanted to, drop the tube in from 100 metres away.  But I refrain - after all, there are a lot of people watching, and I don't want to show off too much.  My one consolation is I am able to refuse the bougie, a device to make intubation easier, despite the fact that the HEMS paramedic tries to insist - after all, it is standard procedure for the HEMS team to use one for every intubation.

The tube goes in easily, and we package the patient for transfer to the Major Trauma Centre.  The HEMS doc is more than happy to travel with the patient, so I formally hand him over to her, and leave her to it.  Before getting back into my car I have a quiet word with the paramedic, suggesting that, despite the delay, the patient will definitely be better off travelling tubed rather than untubed.  He reluctantly agrees.

When I get home, my cat is sitting on the doorstep, waiting for me.  All is forgiven!

The Fallen

I am sitting quietly in a cafe with MrsRRD, enjoying a few precious moments between dropping a MicroRRD off at a friend and picking another MicroRRD up (we have three of these, along with a MiniRRD and a Princess RRD, remember), when my phone rings, asking me to attend a call.  A 50 year old man has fallen down some stairs, and is unconscious and fitting.   With only one car between us, MrsRRD is forced to endure a heartstopping journey on blues to the patient (she LOVES it really) and then she drives off, after leaving me her oyster card, so that I can get back from the Major Trauma Centre that I am sure I will be going to, based on what I have been told.  Unusually, the story is as given, and I rapidly make an assessment:

The man is lying on his back, feet on the bottom step, head in the kitchen.  There is very little room to work, and I have to squeeze past the paramedics already in attendance.  They tell me he has been very agitated since they arrived, and that the son has told them that he watched his father miss the last few steps and fall into the kitchen, off the hallway, and then proceed to fit.

I take a look at Tom, kneeling on the kitchen floor in my jump suit.  His airway is maintained, despite him being on his back, and his breathing is good.  There is no sign of blood loss, and his pulse is regular and strong.  His Glasgow Coma Score at this moment is 11 out of 15, made up of eyes 4 out of 4 (they are open spontaneously), verbal 2 out of 5 (he is moaning incoherently) and motor 5 out of 6 (he is moving purposefully, but not obeying any commands).  That's not bad for someone who has hit his head, and is on the cusp of whether I intubate and ventilate on scene or not.

The crew are very keen for me to get on and intubate their patient.  They are worried about how they are going to get Tom out of the house.  He won't lie still, and they cannot control his head movements.  If he has sustained a spinal injury he is in danger of making it a lot worse.

I begin to get the kit ready for an intubation, hoping that Tom will begin to come round a bit more.  After all, he has had a fit, and after someone has fitted they are usually a bit confused and out of it, what is known as post-ictal.  I ask Tom's son if his father has ever had a fit before.  He tells me that this is his first.

There is something about Tom's son that doesn't seem to fit (sorry about the pun).  He seems a little too calm, considering the fact that his father is lying on the floor, semiconscious.  I think how I might be reacting if it were my dad, and he is just standing there, writing down his details for the paramedics to take with to the hospital.

I wonder for a few fleeting seconds whether he had pushed his dad down the stairs (far too many crime novels to be good for me!) and then it hits me.

"Does your dad drink much?" I ask him gently.  He nods, and tells me that his dad is an alcoholic, drinking about three bottles of wine a day.  He had been trying to cut down, and hadn't drunk any alcohol for 2 days.  This all made sense.  When someone comes off alcohol too quickly, especially if they are a long-term heavy drinker like Tom, they are very prone to fit.  I can picture Tom coming down the stairs, and having a fit just as he reaches the bottom step, falling forwards, unable to stop his fall.

I am directed back to Tom, who is trying to sit up.

"Where am I?" he asks, querulously.  We explain what has happened.  He does not appear to understand, but is far more awake than he was when we first arrived.  I look to the crew for confirmation that they are happy to take him awake to the nearest hospital.  They signal that they are.  We carefully get Tom on to the ambulance trolley, and in to the back of the waiting ambulance.

I look around, remembering: I have no car.  I jump in the back of the ambulance.  "We'll be fine without you," chirps one of the crew helpfully.  I suggest that, while they might be fine, I would rather be taken to the local hospital to be picked up, rather than wait outside Tom's house.

As we speed up to the doors of the A&E, I see my car drive sedately in behind us.  MrsRRD has my coffee.  Now, that's service!

Training Update

Well!!  It's all going swimmingly!  Those of you keeping track may have noticed that I am getting into my stride now.  I am starting to run and cycle every couple of days.  I have managed to run 5.5km non-stop in 40 minutes, and I'm really proud of how I am getting on.

Or, I was until I made the mistake of looking at some of last year's finish times - just to see, you understand.  You just enter a runner number, and their time is displayed.  There are thousands of numbers to choose from, so I will start with runner 1000.  Hmmm.  10km in 44 minutes.  That doesn't sound promising.  Must be a good runner.  Try another one... Runner 179.  Erm, 10km in 37 minutes.  How about runner 2659?  Nope, 48 minutes.

I'm going to be last, behind the granny on her Zimmer frame.

Tachycardia

He lies there on the ambulance trolley, waxy skin, pale, tachycardic.  His pulse rate way above normal, a sure sign of blood loss.  I don't need his tachycardia to tell me that: the pools of blood on the floor of the ambulance is sign enough.  I sit next to the trolley, my hand pressed firmly against the pad applied to his mangled limb, but it seems to do little to stem the flow of blood.

His eyes roll up, and Para-Girl calls to him.  His eyelids flutter, and he is with us once again.  But for how much longer?  His skin is drenched in sweat, and yet his body feels alabaster-cold. We are losing him, and we know it.  I tinker with the intravenous fluid, but know that what he needs is blood.  I have already called ahead to the hospital to tell them to have some ready for when we get there, but will he last the journey?

As we come off the motorway, and slow to a crawl behind the selfish drivers, who want their lane and will not even relinquish it for us, I want to jump out of the ambulance, run up to the drivers and thrust my blood-stained hands against their windows.  But I sit there, pressing harder, while Para-Girl, almost as pale as our patient, mouths something unintelligible to me.  I know what she is saying, that we are not going to make it.

G-Man, our driver tonight, hunts down the spaces like a heat-seeking missile, and we are moving once again.  As we approach the last few minutes I grasp our patient's wrist, feeling in vain for a pulse.  He is hanging on by a thread, as we storm up the ambulance ramp, to the waiting Trauma Team, to bags of blood, and to a life snatched from the jaws of death.