Wednesday, January 30, 2008

Weather Permitting

It has been over 18 months since my last hospital-sponsored village visit to Pilot Station, the Yupik village on the Yukon River for which I have been the primary care provider for nearly ten years. My last trip was in June of 2006 (check the archives for posts about that trip). In the interim I have made a few short social visits on my own, which usually involved seeing a few patients just because I was there, but an official visit has long been needed. The ideal is for each village to receive a week-long visit from its designated provider two to three times per year. When we are understaffed at the hospital though, village visits are a much lower priority.

So when the January schedule came out last month, I was delighted to see that I had at last been cleared for a trip to Pilot Station, and that my PA colleague Claire, who joined me for the trip to Napaskiak, would be going with me. This is still considered a training run for her, as the Napaskiak trip was a somewhat abbreviated experience. This time she is getting the full deal. We began the preliminary preparations about two weeks ago.

Lots of information and supplies need to be gathered, ordered, and shipped prior to a well-coordinated village visit. We notified various departments of our planned trip; from the Women’s Health Program we received a list of all pregnant patients in the village, and all the women with Pap smears and/or mammograms due. From Pediatrics we received a list of all children under one year of age. From the Diabetes program we received a list of all patients with diabetes and a summary of their needs—foot exam, eye exam, hemoglobin A1c. From Health Information Services we received copies of the health summaries of all patients on chronic medications—about two reams of paper there! We sent our list of supplies to be taken with us to Materials Management and they shipped stuff out ahead of time for us. One of our goals for this trip it to get as many Pap smears done as possible.

With all this arranged, along with the personal gear which includes sleeping bags, pillow, towels and every bite of food we will eat while we are there, Claire and I were ready to leave Bethel on Sunday afternoon, and planned to return on Thursday afternoon.

However, as often happens in winter here, the law of “weather permitting” came into play. On Saturday night we got hit with a blizzard which raged for more than a day. All day Sunday and into Monday, it snowed heavily and there was just about zero visibility. By the time it stopped we had about three feet of new snow—which we definitely needed, but I wasn’t thrilled about the timing. Of course our flight was on weather hold, and we weren’t going anywhere Sunday evening.

Monday morning we showed up at the small commuter airline company and checked in all our gear. Even with some of the supplies being mailed out ahead of time, there is still a ton of stuff that we take with us. Our departure was scheduled for 11 am. The snow had stopped falling by then, but the planes were on hold because the villages were having a hard time clearing their runways. This much snow all at once is pretty unusual for us.

So we sat at the terminal in Bethel for a couple of hours, waiting and hoping, but by noon our flight was canceled. We went back to the hospital for the afternoon and found ways to help out there, though neither of us were on the schedule. We had to be back at the air charter company by 4 pm, hoping to leave on the 5:00 flight. We were, but it, too, was canceled.

Tuesday morning the sky was clear and black with bright stars, so I figured all was good and we would make it out with no more problems. By 9:30 when it was getting light, a thick heavy fog had rolled in. Claire and I went back to the airport, as fog often lifts after a few hours. We waited. And waited. And waited some more. Every hour we got an update: this may lift, planes will fly if it does, don’t go anywhere. We sat for six hours. Finally, at 4 pm, the company said no, no flights today. Try again tomorrow.

But they weren’t all that hopeful for Wednesday either, as the fog was predicted to hang around for several more days. It was beginning to look like the trip would have to be rescheduled for sometime later, probably March or April.

This morning at 7 am the sky was clear and black with many stars, and the temperature has dropped considerably, from +30F to +5F, which is a very good sign for it to remain clear. Fog is a problem when it is warmer. Dutch got a call from his foreman who is the best weather predictor we know, and he said we’ll be good to go today, it should be clear and gorgeous and cold for the next four or five days.

So finally, we’ll be off to Pilot Station in a few hours! My plan now is to stay until Saturday, to make up some of the time we lost. More posts to follow…

Photos by The Tundra PA:

1. Our snowmachines, almost buried in snow.

2. Fog-bound plane, waiting to go.

3. Waiting mom and babe at the air terminal.



Anonymous Anonymous said...

Ah, weather delay. I hope you have a wonderful village trip! I just got back into town on the AK Airlines flight this morning which almost didn't take off, due to the fog!

I was wondering - do PAs also have a call schedule or is it just the docs? I know you all do RMT for villages. Just wondering how that all works.

Wednesday, January 30, 2008 1:24:00 PM  
Blogger The Tundra PA said...

Yes, we all do radio traffic (RMT) with the village health aides. The pediatricians have a call schedule, and the two family practice physicians who do high risk obstetrics. The rest of the FPs and the PAs and NPs do not take call.

Thursday, January 31, 2008 9:06:00 AM  

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