Pictures Are In!!!

HELLO ROOM 15!!!!!!!!!

How are my faaaaaaaaavorite 3rd and 2nd graders doing? I miss you guys! And I must ask you to forgive me for taking so long to add the promised updates - specifically, my pictures! I am currently rotating through Surgery and that means I have to be at work by 6 am and usually don't finish before five or six at night. Plus, I couldn't find the wire that connects my Blackberry phone to the computer. But, I finally found it this morning (at 545am before I leave for the airport) and wanted to post the pictures before I left! I hope you enjoy them.

Quick POINTS OPPORTUNITY: 100 points to the group who can find the answer to the following Surgery question: Where is your appendix found? What do we do if your appendix gets inflamed?

I heard one of the groups found the answer to the Empire State Building question! Congratulations!

REMEMBER: You guys are awesome and I can't wait to see all the amazing things you all will accomplish! Have a GREAT day in school!

Cheers, Hovig (Mr. A)

PICTURE LEGEND:
(Click on the pictures to enlarge them)
1 and 2: My FAVORITE toy store in America - this place is HUGE guys!
3: This is the Tiffany's store that Mrs. and Ms. A have often spoke about. Guys - stay away!
4: A huge skyscraper for you guys! There are TONS of them in NYC.
5: Me in the subway with a subway map behind me.
6: NYC skyline with big skyscrapers at night from the Staten Island ferry. (50 points: What is a ferry?)
7: Famous NYC Hot Dog Vendor.
8: Me at Bryant Park on a beautiful day with a skyscraper behind me.
9: Picture of a bridge and skyline while I was on a subway on another bridge.
10: From my DC trip - the Cherry Blossom Festival. (50 points: What monument is behind me in the picture?)

UPDATE: Favorite Airline - The Answer

UPDATE: Results are in! Many of you responded with some great ideas - I have now included the answers to my Favorite Airline List with some explanations - the results may surprise you!

1. American Airlines
2. Virgin America
3. Southwest
4. Air New Zealand
5. Continental
6. Delta

Surprised? If I guess correct, you are probably most surprised about my favorite airline of all - American Airlines. I must admit, it is a love/hate relationship. I hate that management at the airline has created a hostile place for its employees and that hostility sometimes seeps its way into how they treat us, the travelers. But for almost two decades, AA has reliably brought me home, sometimes even with a smile and kind, welcoming service. None of the other airlines on the list have as many convenient flights to my home airport, and for that, I am grateful to AA for never giving up on my airport. Therefore, the top spot in this list belongs to American. HOWEVER, take note Virgin America or Southwest - you start flying to my home airport and you have a great chance of taking over the top spot.

I also want to note that American's Frequest Flyer Program, "AAdvantage", is awesome! I have found it to be the most flexible with the greatest ease of reward redemption. While in St. Maarten for two years, I flew American Airlines every time, and was able to fly free with reward points almost every time...even first class once!

Most of you guessed that Delta would be last on my list. I want to point out that they are last not because I think they are bad, but because it is right next to impossible to book a reward flight with their SkyMiles Awards program.

After posting, I realized that Air New Zealand didn't really belong on the list - not because I don't like it (I LOVED it and it EASILY could be first on the list - good job 98 on your guess), but because it only offers limited service to very limited destinations that are useful to me.

Finally, many of you put SWA pretty high on the list. It is true that I'm infatuated with the airline - I almost worked for them! But I mostly love how well they treat their employees; in terms of flying them - they offer limited service to my desired airports and quite frankly, I'm not all that excited about non-assigned seating.

Thanks to all of you who participated! I am now convinced that I have at least six faithful readers every week!


The following was the first post from last week inviting you to respond: It has been a while since I have done an interactive feature on my blog. So, in order to see if ANYBODY is actually reading my blog, we are going to do something a little fun today. One of my favorite things EVER is flying. I love airplanes, airlines, airports, airplane food, airplane smell, airport lines. I love everything flying!

Therefore, I have included pictures from some of my favorite airlines above. Hit the comments and rank the airlines in the order you think I like them, from MOST favorite on top to LEAST favorite on the bottom. Have fun and I look forward to seeing what you all think! I will post answers in a few days!

PS: To leave a comment, click on "comments" at the bottom of this post. Then, choose the option that says "Name/URL" or "Anonymous", leave your comment, then click "Publish Your Comment".

Did You Hear About the Elephant and the Dog?

No, this is not the start of a joke. It is a beautiful story about an elephant and a dog that have somehow created the strongest of bonds with each other. If these beautiful creatures can accomplish harmony and peace and understanding, we, the self-proclaimed "smartest" of the species should be able to as well. One can hope!

Many thanks to my friend SA who posted this story on her blog - click here to see this and many of her other great posts!

"If you don't recognize it, the wound never heals."

Recently, President Obama had the opportunity to fulfill a campaign promise when he was visiting Turkey - to call the Armenian Genocide, committed by the Ottoman Turkish Empire, a "Genocide". That opportunity passed and, quite frankly, didn't surprise most of us too much that a President would reverse course from campaign promises on the issue.

A friend of a friend writes a blog entitled "Stop Genocide - Change.org" (you can see her blog by clicking here). She has committed her life to bringing recognition to genocides in our history and coming up with ways to ensure future ones never occur. A daunting and enormous task, to say the least!

Stories of extreme hardship are shared by every single genocide survivor, not just Armenians. They each have their own stories of hardship and survival that we, as the next generation, must honor by fighting to have these atrocities recognized and preventing their repetition. The debt is due.

And as we honor the Armenian Genocide today, let us also pray for God's people who continue to suffer persecution and war through out the world.

The link to a recent article on this issue can be found by clicking here.

The link to the blog is: http://genocide.change.org/

Guest Post - On Easter

Last week was Easter and my good friend NK and I went to the Church together. We had the opportunity to celebrate Easter at St. Vartan Cathedral in Manhattan. And by 10am there were already more people in the pews than in ALL the weeks we have been going there previously...combined! But alas, we celebrated the Divine Liturgy and felt closer to God. But, in the process, NK and I aren't exactly known for always behaving. Below are snippets from our conversations - always quiet enough not to disturb those around us, but always just slightly challenging to step over the line. NK is the one who remembers all these quotes - I forget them as I'm saying them. He actually published this post - you can check out this and other great posts of his by clicking here. Otherwise, I have copied/pasted his post below for your enjoyment. And believe me, you will enjoy them.

The title of the post was:

Christ is Risen! (or why H.A. and I can't sit next to each other at church)

1. The Universe's Most Reliable Network

(as the choir is rushing through a hymn of praise to the Holy Spirit)

NK: Oh, I forgot that the Holy Spirit isn’t as important, that’s why the choir rushes through this one

H.A.: The Holy Spirit is on a 3G network

2. Only Time Will Tell

(text message sent to H.A. during services...mind you, HA was sitting right next to NK)

Some 852 yr old bishop is doing the morning reading. We might be here until next Easter.

3. Luke 4:4

(text conversation during services)

H.A.: Where are we eating after Church?

NK: Man does not live on bread alone, but on the very word of God

H.A.: Touche

4. Taking High-Speed To A Whole New Level

(after the reciting of the Nicene Creed)

NK: You know, I would hope that the choir could NOT do our proclamation of faith at 8x speed…you know, so that maybe I could get the words out of my mouth.

HA: (pause) (pause) (pause) Finally thinks of the DVD players on PCs and the "8x" feature and has to choke down an lol-moment.

Case Files: Laparoscopic Cholecystectomy

Presenting Scenario: Patient presents with complaints of right upper quadrant pain for three days, fever, fatigue, and general malaise.
ER Physician Orders: Refer to Surgical Service.

Diagnosis: Recurrent Cholelithiasis (gallstones in gallbladder).

Surgical Procedures Ordered: Laparascopic Cholecystectomy under General Anesthesia

Laparascopic Cholecystectomy Defined: This is a minimally invasive procedure where four small incisions are made in your abdomen to insert four tubes that give us access into your abdomen for a camera and three other tools, like a cauterizer, and various "grabbing" tools. We use the cauterizer to peel away fat and the abdominal covering around your gallbladder, which is located just under your liver. Then, carefully we continue to peel away, taking care not to damage your arteries and making sure we get all the gallbladder. We then insert a special tool that opens up a small bag, place the gallbladder inside the bag, close the bag (while still inside your abdomen), then we pull the bag out of the biggest incision, where the camera is usually placed.

Did You Know: Deep Venous Thrombosis

One of my favorite blogs is The Cranky Flier - a blog all about airlines, airplanes, airports, and everything flying. The latest blog post is from the author's brother, who is an Emergency Room Doctor! He writes about DVT - Deep Venous Thrombosis, a serious and very dangerous clot that can form, usually in your legs. You can check out the whole post, as well as other awesome stuff on everything air, by clicking here. Enjoy!

What is a DVT?
A DVT is a blood clot in your deep veins which can often result in calf swelling, redness, and pain on one side. You can get DVTs essentially in any of the deep veins of your body, and some can be worse than others. In fact, if you get one in your thigh veins or pelvic veins then you’re in more trouble than if it’s further away from the heart in your calf veins. Often times the DVT will not cause any symptoms whatsoever, but it’s important to catch DVTs if you can.

What should you do if you think you have a DVT or PE?

How do I prevent an in-flight DVT?

Click here to go to the blog post for the Doctor's answer!

Med Student Life

Med school is certainly one of the most demanding times in a person's life. Demanding of our time, patience, passion, intelligence, resources, money, and perhaps most important, our personal life. Indeed, personal life doesn't really exist the way it did before medical school. I am currently in my Surgery rotation, which means I report to the hospital by 6am...which, as you all know, means I better get to bed early the night before or else I will be one extremely cranky Student Doctor the next day. But I'm literally at the hospital for at least 10-12 hours a day, mostly running stuff and trying to study for my exams (speaking of which, I have an exam coming up as well, this Saturday, for Internal Medicine).

As a result, I'm not the most exciting person to hang out with these days...if you can even catch me on the phone in the first place. So when a colleague of mine sent me a link to an article entitled "How to Date a Med Student," I knew I had to share some of the advice with all of you in the hopes that you will forgive my less than stellar ability to keep in touch these days. Enjoy! (Click Here for the full article!) And many thanks to Marissa Kristal, a New York based writer who penned the article that I have included tidbits from below. I don't know her, but apparently she is dating a medical student - and let me tell you, she hits the nail in the proverbial coffin regarding the breed of people we call med students.

Note: The italicized portions below are not from the original article, but rather, are my add-ons.

1. Don't expect to see them. Ever.

2. (This is my personal favorite!) They're expected to know everything. Everything! The name of the 8 billion-lettered, German sounding cell that lives in the depths of your inner ear, the technical term for the “no one's ever heard of this disease” disease that exists only on one foot of the Southern tip of the African continent. But ask them if your knee is swollen, or what you should do to tame your mucous-filled cough, or why the heck your head feels like someone's been drilling through it for oil for two weeks straight, and they won't have a clue.

3. “My brain's filled with so much information, I can't be expected to remember THAT!" will be the standard excuse for forgetting anniversaries, birthdays, and, if you get this far, probably the birth of your first-born. (It will also be my excuse for forgetting what you told me yesterday.)

4. You'll need friends with unending patience who pretend never to get sick of listening to your endless venting and complaints. Or, you'll need to pay a therapist who will pretend never to get sick of listening to your endless venting and complaints.

Case Files: Angiogram and Angioplasty

Presenting Scenario: Patient presents complaining of weakness in both legs with decreased pulse bilaterally in the lower extremities (legs).

ER Physician Orders: Refer to Surgical Service

Surgical Procedures Ordered: Angiogram (see explanation below) with Angioplasty (see explanation below) and possible stent placement. No anesthesia will be used for the angiogram and angioplasty, however, the anesthesiologist must monitor patient's vitals.

Angiogram: Procedure of visualizing blood flow through arteries to assess level of lumen narrowing. In this case, we were visualizing the iliac arteries (near the legs/abdomen). We found some pretty extensive narrowing of the lumen of the artery that leads to the right leg. BUT, we also found that due to chronic stenosis of the artery that leads to the left leg, the patient had extensive vessel growth (anastomoses) to the left leg from the one good vessel for the right leg. Therefore, when the vessel for the right leg became stenosed, the patient experienced problems in both legs.

Angioplasty: Process of getting a small balloon to the site of stenosis in the vessel. We then inflate the balloon with some pressure and let is stay there for a minute or two. We then remove the balloon and use the fluoroscopy to visualize the site of the vessel again. The goal is that the balloon will cause the vessel to stay open. It is not uncommon, however, to have restenosis at a later date.

Results: In this case, we found that the vessel was fixed successfully following angioplasty, therefore no stent placement was necessary. Patient can be discharged within the day.