Over the past year, I’ve developed a taste for whisky. For many years my thought of whisky was one of diesel fuel, however, this changed a year ago after a friend won a quality single malt in a raffle at an open evening we held at my Masonic Lodge.

A deep breathe and preparing to expel the vile liquid, I took a sip of a 5-year old Glenmorangie Nectar D’Or, and immediately felt this delicious, warm honeycomb gold fluid flowing down my throat.

Having dispelled my youthful drinking sprees many years ago, I’m not one to drink  at home or in a social environment. One glass of red wine would suit my evening.At times, even a glass of wine tends to be too much.

I finally found the perfect sundowner, which minimal quantity provided relaxation and stress relieving downtime. I have tried different versions of whiskies, from single malts to various blends and distilleries. From cheap to expensive, I’ve found my favourites and those that could pass off as Jet Fuel.

When Hillbrow Lodge hosted a Whisky tasting evening, I jumped at the opportunity to attend. An incredible evening, complete with a 3 course meal, had us pairing 3 Single Malts with various types of chocolates, under the guidance of our District’s resident whisky connoisseur, Simon Knutton.

IMG_4132 Expert knowledge and experience had our small group of Masons, wives and guests enthralled with the history of whisky, the methods of distilling and tasting Simon’s choice of “The good, the bad and ugly”

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My favourite of the three, was the Glenkinchie.  Matched perfectly with white chocolate, adding a creamy sweetness to the fresh fruity and oak palate.

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In 1837, the Glenkinchie distillery was founded in the  south of Pencaitland, drawing its waters from the Lammermuir Hills in East Lothian. Marketed as ‘The Edinburgh Malt’, the Glenkinchie distillery is just fifteen miles away from the city.

After the main course, we were treated to the Ardbeg. From where we were seated, as the glasses were filled on the presentation table, we could smell the strong aroma of fruity peat with a hint of vanilla.

IMG_4129Paired with dark Orange chocolate, my mouth was overwhelmed with sweet vanilla and lemon and lime, with a smokey caramel after-taste.

Dessert served, with the ambiance in the room bubbling with newly formed  whisky enthusiasts, the 3rd whisky was presented.

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Aberlour’s long-running A’Bunadh range, matured exclusively in Spanish Oloroso Sherry casks and bottled at cask strength.

Simon explained that Aberlour sits at the base of the rugged mountain range, Ben Rinnes. Nestled in the village of the same name, the distillery was founded by Peter Weir and James Gordon in 1826, though Peter was to pull out a year later. The village lies on the Lour Burn, which converges with the River Spey just 270 metres from the distillery. The 6th century Celtic saint St Drostan, baptised local chiefs in the distillery’s water source.

Whisky experts describe the nose as Jamaican Ginger cake, chocolate buttons, a kick of black pepper and sugary coffee.

Me?… well, It reminded me of Christmas Cake!

Now this whisky is aptly referred to “the ugly” by Simon. No, not the taste, as it had a delicious sweet palate with flavours of chocolate and rum soaked rum. Its the staggering 60% alcohol/volume content that makes this a very slow sipping sundowner.

A big thanks to our host, the Worshipful Master of Hillbrow Lodge, and the insightful talk and presentation by Simon Knutton.

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Zip-lining in the Magaliesburg

Posted: April 29, 2017 in Family

Being in the time-demanding careers we are in, with limited finances, N and I decided when we reached our 40’s, not to buy presents, but rather celebrate experiences with our family.

For my birthday this year, N got me a zip-lining voucher for 3, which we cashed in this weekend. An experience I was fortunate to have whilst working at the Sports Illustrated “Ruff Stuff” Challenge  in  Swaziland back in 2010, one which I’ve been saying for years we should do.

We arrived early at the Magaliesberg Canopy Tours, in the Ysterhout Kloof region of the Magaliesburg Mountain Range in the North West Province of South Africa.

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After the briefing and kitting  up, we drove a short distance to the cliffs to begin our adventure

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….off our brave little one went… (with the odd squeal or two to awaken the local habitat )

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….way above the trees…

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enjoying the views…

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the smile getting bigger after each slide…

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precarious cliff face photography..

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some a little faster than others…

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Ultimately, a family adventure I highly recommend for anyone!!

Within our profession (Emergency Medical Services) we have challenging and “head scratching” cases which no amount of education and experience can ever prepare you for.

I have been a degree Advanced Life Support (ALS) Paramedic for 14 out of 20 years, the first 6 years spent as a National Diploma and having recently updated my  Advanced Cardiac Life Support (ACLS) certificate thought I could deal with just about any case thrown at me, until I was faced with that very strange, head scratching situation recently.

I am attempting to explain the case taking into account medical professionals as well as trying to explain the case to the non-medical followers.

I responded to a chest pain case, and upon arrival at the scene, was greeted by fellow ALS Eutimia Garces, who had assessed the patient and requested assistance. She has been qualified over 2 years as an ALS and has experience in excess of 10 years in the industry, but had never encountered a cardiac patient this critical. Her assessment of the patient revealed some interesting information with regards to basic vitals and she had initiated treatment with intravenous cannulation (drip) and oxygen via nasal cannula in an attempt toward maintaining a SPO2 (oxygen saturation) of greater than 90% since the probe was not picking up pulsatile blood flow.

The patient’s vital signs were as follows:

  • Palpable thready carotid pulse at a heart rate of 214 (the ECG “heart” monitor confirmed this rate)
  • Electrical Cardiogram (ECG) presenting a Ventricular Tachycardia (V.Tach) – for the non-medical folk, this is an abnormal heart rhythm that can prove fatal.
  • Non-palpable blood pressure, recorded as 50 mmHg (dangerously low) systolic via a manual sphygmomanometer (blood pressure cuff).
  • Skin condition was grey, pale and clammy.
  • Patient initially was responding to verbal stimulus only, but with a small 50 ml bolus of fluid, became alert and orientated with a blood pressure of 60 mmHg (still dangerously low, but at least his brain was working)
  • The patient presented with severe chest pain throughout the initial interaction prior to sedation.

With regards to history, this proved to be even more interesting:

  • 65 year old male patient with an extensive cardiac history: 10 Acute Myocardial Infarctions (Heart attacks) and 26 minor non-debilitating strokes over the past 6 years.
  • Patient was on an extensive list of medication all specific to chronically managing aberrant heart arrhythmias.

Identifying the severity the condition, we all realised that the only effective method of treatment would be synchronised electrical cardioversion.

For my non-medical followers, allow me to briefly explain a few of the terms used:

  1. Ventricular Tachycardia 
  • A V.Tach is a type of regular and excessively fast heart rate that arises from improper electrical activity in the muscle and electrical pathways of the ventricles of the heart. With a normal heart rate ranging between 60 and 100 beats per minute, I’m sure you can imagine how hectic and dangerous a pulse rate of 214 would be. The ECG for the patient can be seen below

2.  Synchronised Electrical Cardioversion

A synchronised (perfectly timed) electrical shock is delivered through the chest wall to the heart via pads that are applied to the skin of the chest. The goal of the procedure is to disrupt the abnormal electrical activity in the heart and “reset” the heart to allow the natural pacemaker of the heart to restore a normal rhythm. The interruption of the abnormal beat allows the heart’s electrical system to restore a normal heartbeat.

Shocking someone who is conscious is an extremely painful experience and can be mentally traumatic for the patient, which means that some form of sedation is both compassionate and beneficial to the patient.  The dilemma Eutemia was facing, was that the patient clearly needed sedation before the procedure,  but the extremely low blood pressure excluded the use of the only two medications that ALS Paramedics carry for this purpose namely Midazolam (Dormicum) for sedation and Morphine for sedative analgesic effects. Fortunately, as ECP’s we carry a wider range of medications capable of have similar benefits without as significant side effects.

My wife, Nicole de Montille (who was with me at the time is also an ECP and an ACLS Instructor) and I debated the merits of Ketamine or Etomidate (Hypnomidate) to use for the sedation of the patient. These two medications are known in the anaesthetic and emergency environment for their anaesthetic and analgesic benefits.

Being concerned about the cardiac effects Ketamine may produce, it was decided to use half dose Etomidate, which was successful in its sedative qualities, and the patient was sedated without compromising his breathing effort.

With the patient sedated, synchronised  cardioversion was performed .  In my personal capacity I have done this many times during my career. Normally after cardioversion, I have seen a brief period of asystole (flat line) as the heart resets itself, followed by a relatively normal heart rhythm.  What occurred with this patient however left us all feeling more than a little worried and relieved in the space of approximately 15 seconds.

 

Click on image to view in full screen – ECG edited to protect case information

As you will note in the above ECG, the cardioversion successfully shocked on the R-Wave as expected;  What was not expected was that the patient went from V.Tach straight into Ventricular Fibrillation (V.Fib).   This abnormal and erratic twitching of the heart muscle can be likened to a bag of worms all wanting to move in different directions, however the problem is that this situation fails to produce a ventricle contraction which is necessary to keep the patient’s blood flow moving.

I’ve never experienced nor witnessed this happening ……….ever!! Neither Eutimia nor Nicole had ever been exposed to a patient presenting like this either.  Within a matter of seconds the monitor was set to 150J (as recommended by the manufacturer) and defibrillated (shocked the patient without synchronisation) and successfully converted the rhythm to sustainable heart rhythm with contractions and sustainable blood flow.

The patient was transported to the nearby emergency department at a hospital with extensive cardiac facilities, where he woke up a few minutes after arrival, conversing with the staff and looking far better than before sedation and treatment.  As for his vitals, a radial pulse rate of 82 and a blood pressure of 110/70 – both definitely within normal ranges.

Whilst the case was mentally challenging and, to be honest, quite scary, it was one of the most satisfying one.  Witnessing a rapid turn around in the patient condition from life threatening to conversing and looking as if he had experienced a minor “episode” at the hospital.

Thank you Nicole and Eutemia, we made a dynamic team and saved a life that day.

As I’ve previously explained in the post for my Installation,  every year, the respective Masonic Lodges elect and invest a new Worshipful Master (WM) to preside over the Lodge. My Lodge, Orphic Lodge was the first week in February.

I was planning on writing this shortly afterwards, but life got in the way.

There are specific moments and ceremonies which are very special to a Mason. HIs initiation, being Raised to the Sublime Degree of a Master Mason, being installed as the Worshipful Master, and many more occasions during our masonic journey in self fulfilment and Craft progression.

For me, this installation was very special indeed. Not only was a friend Installed as WM, each of my candidates received their first office positions in the Lodge. This past year was an awesome year for me personally in my Masonic Journey. Four very good friends approached me and indicated their wish to join our prestigious Order.

And so, after going through to application process, interviews with them and later with their families, I had the privilege of initiating each of them. As their proposer into the Craft, it’s my responsibility to ensure their journey is successful. That they grow into better men and husbands, fathers and sons.

After the WM is installed, his duty is to invest his officers for the year.  My chest swelled with pride as I saw each of my candidates receive their first office appointments. Their faces echoing my pride, watching them standing taller as they were led by the District Assistant Grand Director of Ceremonies for the evening, to the office positions.

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…Me and my guys with their office collars on… unfortunately, two need to remain anonymous..

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….Ryan being his usual animated self….

After the Installation ceremony, Lodges treat the Grand, District Officers and visiting Brethren to a meal, drinks, and of course, a raffle for charity.

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Grant convincing the Brethren to part with their money…

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… whilst being exceptionally confused why there wasn’t alcohol in the ice bucket…

All in all, a fantastic night enjoyed by everyone, and I wait with proud anticipation to see each of my Brethren progress to their next steps on the ladder and growth in Masonry.

 

 

A letter from a Paramedic

Posted: February 19, 2017 in Uncategorized

This is not mine, and certainly cant take credit. However,  I feel the pain and emotions deep in the letter, having experienced severe PTSD, can only imagine that moment which had the author writing this…

By By Andy Casteel, Emt-p, roane county, Tn

I can’t tell you what working on an ambulance is like. It’s far away from anyone’s version of a normal life. Spending a 3rd of your life with your partner (24 hours on, 48 hours off) is like having a second family away from home. It comes with a different set of expectations and feelings, and a different kind of trust that exceeds nearly anything else. The experiences you have at work in this field can only be shared by you and your partner.

I won’t tell you what the worst thing I’ve seen is. That is one of the cruelest questions you could ask one of us, to go back and relive a horror that no human being should have to experience. The percentage of emergency personnel who develop PTSD is second only to the military, and we accumulate the problems that go along with it at a staggering rate (drug/alcohol abuse, divorce, suicide).

I can tell you that we have an odd sense of humor. Many of us in the right situation have literally sung “staying alive” by the beegees, or “another one bites the dust” by queen while performing CPR. This is not meant to be sick, it is only meant to keep us in rythym. 
I am sorry if while working on your family member, I appear to not be listening to you or addressing your concerns. Unfortunately I am often not permitted the opportunity to do that given the circumstances. Your loved one’s life/health can and must come before your questions.
The words “ambulance driver” are a source of great insult to us. If I were only a driver, I would not have gone to school, nor would I have more certifications in my back pocket than many floor nurses.
There is so much that should be said that the bounds of a given situation or pure professionalism prevent us from uttering. So I will say it here. 
To the lady who lost her husband following a long battle with cancer-
I am sorry. I wish that there was anything that I could say to ease what you’re going through. I am sorry that the situation you were in made it impossible for me to hide your husbands asystolic ekg strip from you, and for the painful questions that I had to ask. I want you to know that you were the very epitome of grace and courage while we were there, and that you have inspired me to try to be the same in my own struggles with grief.

To the family of the critical patient that we transferred to an intensive care unit at another hospital, who died on the way:
I am sorry that we couldn’t give you more time to say goodbye. We weren’t trying to be insensitive or callous when we told you that we had to go, we were only doing our best to care for him and keep him alive. 

To the parents of the two year old that died in the fire:
I have mixed emotions for you. I am terribly sorry for your loss. I am also terribly sorry that you left several children under the age of eight to play alone while you got high at the house next door. We found your baby curled in a ball underneath a pile of clothes, badly burned but not so bad that I couldn’t count every little finger and toe. I rage at your irresponsibility, but grieve for your loss. 

To the man whose wife I did CPR on:
I wish that things had turned out differently. You were married for 70 years to a beautiful bride that I couldn’t bring back for you. There is nothing I can say in the face of that loss, but I hope you know I tried. 

To the scared parents of the 3 year old with a fever:
I understand your fear. If I’m grumpy, it’s not directed at you. It’s because I’ve been at work 21 hours, haven’t slept and have missed 2 out of 3 meals, and right before I came to get your child I ran one of the calls above this one.

To the frequent flier:
Please take the time to educate yourself about the health problems that you have. Ultimately you are responsible for your own health, and if you don’t step up and follow your doctors recommendations, and manage your issues, they will kill you. And I will have gotten to know you to the point of having memorized your medical history, allergies, medications, name, date of birth, and half of your social security number, only to walk in and pronounce you dead.

To the grumpy ER nurse at the level 1 trauma center:
I am sorry that you are having a bad day. Please don’t take it out on me or belittle the work that I have done, in many cases in an attempt to make your job easier and faster. I only ask for 5 minutes of your time to give report and provide good continuity of care. I try my best to come in with a smile, please don’t try to eat me. Kindness costs you nothing.

To the general public:
Please, please pull to the right. If we are sitting down to eat a meal, don’t make snide remarks about how you are seeing “your taxes go to work” or how we are paid too much. There is no price tag on what we do, and 40-50% of us do it for free. And most importantly of all, don’t ask the question mentioned in the second paragraph. If you want to satisfy your morbid curiosity, come ride with us for a day, and see for yourself.

Many times we are referred to as callous, insensitive, uncaring, etc. We have developed these things as a facade. It is a coping mechanism. If we didn’t care, we would not be here. The everyday world is an ugly place, and death comes for all of us. I wish I could say it was always peaceful, but very rarely does anyone get to hear another “I love you” before someone takes their last breath. 
There have been many times when I pull up in front of my house in the morning, wishing that things had gone differently. I feel like a sponge for others grief, pain, and sorrow. You soak it up in an attempt to make it better in some small, meaningful way. After that you go home and hold those who mean something to you a little closer.
The times when things do go right are like bright, shining stars in a moonless sky. Where we stabilized that guy from the car crash who had 18 broken bones and a crushed airway. Or when we brought back a 53 day old baby’s heart beat. There’s not a price tag on that feeling either. 
I hope all of you stay safe and healthy. When you don’t, we will be there. Any time, any place, no matter what. We’ll be there.
At your service always,
A paramedic.


Number 8..Session 1

Posted: December 3, 2016 in tattoo
Tags: ,

Time for tattoo number 8. The decision for this one took a while, and I’d been throwing ideas for a while. 

The end goal? 

A dragon tattoo on my chest. 

So I searched the net for ideas, chatted to friends, even one of them drawing a few ideas for me. 


…..This stunning one drawn by a very talented  and  good friend, Natalie..  Now, I couldn’t let this go to waste.. so he’s framed. 

In the end,   Charmaine found the perfect one. The moment she sent it, I knew that belonged on my chest. And so the process began.. measuring my chest to make sure the tattoo will be the perfect size. 

I’ve have been so excited about today, I could hardly contain myself when i arrived at TattooCharm and saw my stencil, waiting for me. 


Now, I came mentally prepared, knowing that a chest tattoo will be more painful than my others.. 

 I know I’m a woes when it comes to pain (I have an extremely low pain threshold). Within 15 minutes of the needles drilling into me , the endorphins kicked in.. and man down I went. My eyes felt heavy, and dozed off and on.. 

Eventually the endorphins decided, “bugger this, we’re outa here”  and boy did they leave in a hurry. 

Probably my grimacing and scrunching face gave it away, LOL, either way, we both agreed it was time time to stop. 


I can’t wait for January to finish him up.. He’s going to look  amazing !!!


Today we attended the Great Dane Rescue fund raising picnic, where many of  the rescues and their owners came to socialise and meet each other.  Hosted by Tanja and Louisa, the Founders of Great Dane Rescue.

These two dynamic women go out and rescue Danes from abusive homes, those that have been abandoned and some who’s owners just don’t want them anymore, all at their own cost and 100% reliant on sponsors.

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….Pluto got to meet his mom, Bonny…

img_0070_fotor.. and of course, Bonny needed to meet Pluto’s new mommy…

img_0065_fotor_fotor… and Pluto’s sister Veiga…

It was a great morning, watching all the Dane’s mixing with each other. Really showing their loving nature, wanting strokes and pets from everyone they could

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