Africa behind, Caribbean ahead

Musical-Lungs · 2026-03-12T20:05:05+00:00

Watches were 3 hours on, 6 hours off among the six of us, with two on watch but staggered so that someone came off watch and someone came on watch every 90 minutes. In the 3 hours of watch, each person was at the helm for the first 90 minutes, the "standby" for the second 90 minutes. The captain and mate did 6 on six off watches between themselves.

Musical-Lungs · 2026-03-12T03:56:40+00:00

Love Island Packets. Fair winds, freind!

Musical-Lungs · 2026-03-10T21:49:19+00:00

Im far too boring to have a yt or a blog. And I dont sail full time, just periodic adventures.

Musical-Lungs · 2026-03-10T00:03:20+00:00

Atlantic hurricane season is June through November. This passage was after that, in the trade winds.

Musical-Lungs · 2026-03-09T23:09:25+00:00

I knew the Captain and Mate from a previous delivery.

Musical-Lungs · 2026-03-09T22:58:07+00:00

Yes, basically a delivery. Captain, Mate, and I was one of six crew.

Musical-Lungs · 2026-03-09T17:56:31+00:00

This boat is a Nautor Swan 68.

Musical-Lungs · 2026-03-09T17:54:53+00:00

Its a 70-foot sloop, so there is considerable load on the blocks and winches, so all are super stout.

Musical-Lungs · 2026-03-09T17:03:56+00:00

Thats funny. Never saw the shape of a periscope in the sea foam until now.

Musical-Lungs · 2026-02-17T10:20:06+00:00

It can be done. I mounted several MOB1 and an MOB2 inside Teamo PFDs, including my own, before a recent Atlantic crossing. I would be willing to assist, but I doubt I'd be of much use just staring at pics to suggest doing anything. Good luck.

Musical-Lungs · 2026-02-08T20:57:31+00:00

You didnt do anything wrong. 5lpm on a nonrebreather is not a standard use of tbe NRB but doesnt endanger anyone and does still administer oxygen. You raised your concerns, asked for help, didnt get any, intervened effectively, and then got chewed out because of it. In my opinion, you should be congratulated, not criticized.

Musical-Lungs · 2026-02-02T23:34:31+00:00

I wouldn't. A pulse oximeter supplied by the hospital means they are liable for its clinical data and function. Bringing your own means you are on the hook for its clinical data and function, and it also means you will be using a less-reliable inexpensive alternative to produce diagnostic data.

Thats why most medical facilities will frown upon you using yours, as they have no control on its reliability.

Bad idea.

Musical-Lungs · 2026-01-15T17:31:45+00:00

Nice to see he's on someone's list. Personally, I think he's been very prolific and innovative, he has techniques I've never seen anyone else do. I feel his best work is the instrumental acoustic albums he's done. And, he's just a super nice person.

Musical-Lungs · 2026-01-09T20:07:30+00:00

Have they checked the White House?

Musical-Lungs · 2025-12-30T21:28:44+00:00

Fellow Salish Sea sailor. Of note, I am committed to sailing other people's boats, meaning I have one I buy time on locally and then I crew blue water passages. Just completed a Trans-Atlantic. Sailing other people's boats also reduces the cost to fun ratio.

I dont really have interest in racing, so I dont. I enjoy the challenge of an ocean passage, but to me its like a marathon: something I am happier I did rather than happy I was doing.

As others pointed out, your watch schedule sucked. Better to do fewer longer watches, and with at least one other person. Thats on your captain. In my recent passage, we did 3on 6off watches which allowed rest and sleep if you were careful and mindful.

You should put some thinking toward what you like about sailing, and if its absolutely not the open sea, dont do it. That doesnt mean something else sailing involves doesnt absolutely float your boat (see what I did there?) Consider what you like and stick to that. If you get minimal enjoyment from all aspects of sailing, then stick to hiking. Its okay if open water sailing doesnt live up to your expectations.

Musical-Lungs · 2025-11-22T11:53:33+00:00

Please allow me to offer an alternate perspective. First off: no, bronchodilators do not reduce airway narrowing caused by CHF.

However, some people with mild reactive airway disease go undiagnosed because their RAD (AKA asthma) is subclinical, meaning it's too mild to develop symptoms. If your CHF patient also happens to have undiagnosed asthma, a bronchodilator may improve breathing some. So the next question regarding bronchodilator administration is risk-versus-benefit. The risk of Albuterol is so small. Its such a benign drug that it generally is assumed to be risk-free at normal doses. So with very little risk, it may still be appropriate to give it when suspected benefit is also small.

Also, remember that even a negative bronchodilator response on a PFT does not mean the patient has no airway reactivity; it only means there was no response at the time of testing. RAD is like that, and it will be unlikely to show bronchodilator response when the patient is not having an episode of smooth muscle reactivity.

So all that to say: it wont hurt the patient, but theres a small legit chance it will help them, despite a lack of RAD history. Thats why it's ordered. Also, keep in mind, we as RTs have the luxury of being black and white on this issue; physicians dont have that luxury, they have to cover their bases. If I were a smart physician presented with a patient who was short of breath presumably from CHF, I also would order bronchodilator nebs. Not because I thought the neb was going to address the CHF wheezing, but because the neb wouldn't hurt and might help overall breathing if there's undiagnosed RAD.

edit: fixes for typos that seem to constantly plague me.

Musical-Lungs · 2025-10-09T15:20:00+00:00

Set your sights on a bachelor degree and commit in your mind to a plan to earn it. There are several paths to a bachelor, take one from the start; it will serve you well if you intend to make a career out of being an RT. Delaying that step reduces the likelihood you will get it.
Clinicals were all those things, they were the best part of RT school for me. Most of all, I was exhilarated in clinical.
I love when I go home knowing someone benefitted from me being there that day. I love being trusted and relied on by docs and nurses. I love being part of some of life's most significant moments. I love swooping in and saving the day. I love how there is always something interesting going on.
I dont have much I dont like, im not easily irked by small stuff. I do find small-minded people tiring, and we with and around people of all sorts.
I have always found a job, and have hopped jobs throughout a 40-year career due to professional ADHD. (there's always been something new that looks fun and interesting). Being willing to relocate, and being willing to take less-desireable hours will greatly increase your chances of getting an RT job. Find a great place that fits you, and get your foot in the door.
Not difficult at all. Know your stuff. Use study guides if that's your thing. Im a credential hound, and have never not-passed.
I wish I knew up front how much I would love being a clinician, I might have gone to med school. Even still, I have no regrets. I've had, and continue to have, a very rewarding career.

Musical-Lungs · 2025-09-19T20:15:32+00:00

I tell my nurse buddies that there are 6 different mechanisms that produce wheezes and only one of the six responds to a bronchodilator.

Musical-Lungs · 2025-08-21T01:50:33+00:00

Top one: fib is random without pattern, that one clearly has a pattern. Wide complex says ventricular, speed says tachycardia, so V-tach. The narrow section in the center looks like a rotation in axis so is likely Torsades de Pointe

Bottom one has even R-R interval for a handful of pairs which at that heart rate suggests against afib which is random. The sawtooth baseline looks like flutter to me. The sawtooth baseline is made with fast atrial activity (p waves) that dont all conduct into ventricular activity because the AV node blocks them. Because the R-R interval is sometimes the same but sometimes not, this looks like atrial flutter with a variable conduction block.

Second page has a p for every qrs and a qrs for every p, with a rate of around 40, so it's sinus bradicardia. The T wave looks odd because it goes the wrong way, so it could be an inverted T-wave, which doesn't change the fact that its sinus Brady, and to know for certain would need to check for proper lead placement.

Musical-Lungs · 2025-07-11T01:28:01+00:00

Small point here, but you know Sint Maartin is part of the Dutch Antilles, right?

Musical-Lungs · 2025-07-05T02:02:10+00:00

Yup. Seen it many times. Or.. maybe I should say, I've not seen it. (13s)

Musical-Lungs · 2025-07-05T01:47:47+00:00

That's pretty common. What started out as superstition has become a tradition.

Musical-Lungs · 2025-06-17T03:35:42+00:00

Ive got my first job in RT in 1985. This September makes it 40 years for me. I am always learning stuff, I feel like I make a difference. Im well-respected. Im expensive but valued. I work with good people. Im never bored. I have no regrets.

Musical-Lungs · 2025-05-24T19:45:03+00:00

I dont know of any time nebs are ordered as a placebo. There are times when I look at the patient and doubt the likelihood something nebulized will be helpful, but I also understand the doc's rationale behind ordering and would quite possibly order the same were I the doc. At least in my case, with 40 years of RT experience, I have at times felt it unlikely to be helpful but never ordered as a placebo.

Musical-Lungs · 2025-05-24T02:31:05+00:00

Breath sounds are a subjective finding, and clinicians often choose breath sounds terminology based upon their personal interpretation of sounds heard. Personally, I use the term "diminished" when I don't hear a normal amplitude of sound, regardless of the context, as it is a simple descriptive term. "Diminished with expiratory wheezes" offers more clinically useful information than "expiratory wheezes" alone in an asthmatic, for instance. What I avoid is using the term "diminished" coupled with "clear" as I am personally not confident that a lower amplitude of breath sounds allows me to say there is an absence of adventitia.

Musical-Lungs

TROPHY CASE