Were going to call this day "sore arms" Today started at 500 am with the 15 minute mandatory getting ready time and be at the base at 545. The first 1 and 30 minutes centered on a new part of the pre-deployment phase that every soldier has to go through. It wasn't here 2 years ago when I deployed from the same spot. An unfortunate part of this war in which has been so prevalent but probably misdiagnosed is what's called Traumatic Brain Injury or commonly known as in the TBI. It is what happens to people after they obviously have trauma that causes a concussion. It can be simple and most people are familiar with it with football. Well football doesn't cause TBI but if you have enough severe concussions it can lead to significant problems. The civilian most common cause is motor vehicle accidents. Its symptoms when mild can be loss of focus, headaches, fatigue and at the other end of the spectrum lead to severe mood changes and mental retardation. Well there obviously has been a ton of blast injuries in Iraq especially over the last 8 years. The problem is that the obvious trauma to the soldier that is visible is fractures and abdominal and chest trauma. The unknown is the TBI. You could have 5 guys in a vehicle and 2 are obviously injured and the other 2 walk away. Well those 2 that walk away most likely had a level of concussion. So the test I took today was to measure your brain. You take the test before you go and when you come back. If you had an concussion serious enough it is suppose to direct treatment and possibly determine the level of disability. The funny part about it is that I took it at 545 in the AM. That is 445 Nebraska time. BOOOO. Well much to the astonishment of many I PASSED. It is series of computer based exam of reaction time and memory. Luckily I was born with a decent amount of those attributes. Anyway it isn't a pass/fail test. The key today was to get a baseline on how your brain functions. I just think its funny that they make you take that so early in the am. Lets discuss the early am surgery in my profession. In residency it was a common entity. It was par for the course to be doing a trauma case when we were on call in Richmond, Virginia. Thats where I trained for 5 years. Beautiful place. Weird in the fact that the Confederate white house was literally on the grounds of the hospital. Anyway. I really could feel very well with operating up until 4 am. From 4 to 6 am I felt like things went downhill. I know what your thinking. I hope I never get hurt at that time. Well I hope not either b/c most people at that time of night are usually not doing the right thing. Most likely I'm going to make you wait until the sun comes up unless it is limb threatening injury. I think that is just being honest. If i sleep for awhile before that 4 to 6 time period i am fine but as we did in residency it wasn't like that. That part of training though makes you mentally tough. Nothing scares you or bothers you when your done with that. So the middle of Nebraska doesn't phase me but as I get farther away from residency I am getting a little soft. I like it to not to be b/n 2 to 6 am when I'm operating. Call it a quirk but I think its rational. Now please refer to picture #1. 
This was the rest of my morning. Going through making sure your physical is done. Optometry is cleared - Need 2 pair of glasses. Don't tell them you have one b/c they may have to make them and that could delay you a week. The Dentist part is done. Did that thanks to Dr. Daly. I now officially have no more cavities b/c every tooth in my mouth has been filled. I thinks its genetic not hygiene. Like flossing, it is so overrated. Get a hearing test b/c haven't had one in 2 years. Sitting in a small booth clicking a button when you hear the sound. I just keep pushing the button. That just makes the test administrator mad. She asks "are you doing that on purpose?" I swear to her that I hear every one of them despite the fact that the shed in which we are testing has a bus driving by every minute and another idling outside. They make sure you have every test done and finally IMMUNIZATION. So what your seeing is a large cooler in front of me that holds every virus known to us that we can get immunized for. It also gives the just of the morning. Sitting with other lemmings moving from station to station. A lemming is what I believe is a small bird-like creature that lives in eastern Canada that follow each other into the water when they migrate or die. I can't remember. Somebody please clarify that for me. That is where the topic of today comes from. SORE ARMS. I so wonderfully had to get an Anthrax shot (again), typhoid shot (again), and the regular flu shot. I decided to get one in one arm and two shots in the other arm. They both hurt tonight. My advice is if someone wants to give you three immunizations in one day is to do it in one arm. I feel like that dinosaur off of the movie "Meet the Robinson's" that says I have a big head and tiny arms b/c I can't lift up my arms at the shoulder. I know, I'm soft. 
The second picture above is basically the army aspect of our contingency marching from one venue to the other. Beautiful day here. Lets talk about marching. Not that great at it. Its not so much the left - right - left thing, its more the right face and about face and all the other little intricate aspects of it. I think I knew this was going to always be tough for me b/c of my experience with step aerobics when I was younger and in shape. Tomorrow is another series of stations in order to prove that I am fit to be deployed. Hopefully something funny will be happening tomorrow also. Well I think this is enough for the day. I hope all is well with my patients and friends Play Hard Play Smart Play Together You can read more about Dr. Bohlen's experiences at the Blog Homepage. Feel free to leave a comment below.
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