Anchorage - Day 2 (Wednesday)

I apologize for not posting this before now, but after yesterday I just passed out. Simple as that. But here's a taste of my Wednesday.

Wednesday
I arrived at the hospital here around 10 and the front desk helped me get in contact with the audiologists. After waiting for a bit I went in to talk to them for a while. There were 4 and three of them were in seeing patients but we were able to say hi. Around lunch I left to grab food and had a bit of time before I could meet back with anyone so I was given directions towards the Wildlife Preserve (about 40 minutes away) and was also told there was a bit of a Marsh along the way. I stopped at the marsh and took some pictures, unfortunately, the pull-off where there were swans was full of cars so I passed that one up. My plan is to head out to the Wildlife Preserve sometime while I'm here. I also visited a Michaels and got an amazing deal on some sketch pads (40% off) and some pencils/Contes to play with. I remembered that I really enjoyed using them with the last art teacher I had (way back in middle school). I'd never really taken up anything art related just because I'm pretty critical of my own stuff and i have this perfectionist streak that likes to come out. It upset me because I couldn't get things to look just the way I wanted but I still liked the effort. Real life got in the way and I stopped until recently. For some reason I just picked it up and I really enjoy it. So a few supplies later I'm good for a while.

I headed back to the hospital to meet with another one of the audiologists in the afternoon to talk about the New Born Hearing screening program and how to stream-line that process so I can hopefully better get the kids followed.

Then it was off to the ENT staff meeting to meet everyone and I got to listen in on some of the questions, plans, and problems of them switching over to the new EMR/EHR (electronic medical/health record) system. Since they're switching to the same system we are I'm hoping all will go well. Cross our fingers.

One of the audiologist called to make plans for dinner and while I waiting I went to REI to look around in the mean time. While I was there they called to say that it wasn't a good night tonight but we'd look into another night while I was there. So I used the time to shop for a winter coat. After a discussion with a staff member, I decided to get a longer shell that has some built in warmth and 'Monkey Fur' The affectionate name for the super fleecy material that Mountain Hard Ware uses. Between the clearance racks and regular mixes, I was able to get 2 fleece jackets, a fleece windstopper vest and a long shell/coat for the same as what I came in expecting to purchase with 1 coat. I've also determined that North Face, Mountain Hard Wear and the REI brand are some of the only ones that fit me leaving room for movement. Again, curvy girls with strong biceps definitely have trouble with outer layer shopping. I also picked up a smartwool hat with earflaps.

Here's the thing about smartwool and really, any marino wool. It's self-regulating. Meaning, it helps your body regulate temperature without just being too warm. Wearing super warm fleece or a long down coat were one of the reasons I always had trouble wearing hats and gloves in the winter (winters in upstate NY, Boston and Chicago, not the VA winters I've experienced recently). My body gets too warm wearing traditional winter clothes. So I got a balaclava and hat in smartwool and I have a bunch of socks now in marino wool. Hopefully I'll be mostly set. I've winterized my car, now it's time to winterize myself (which is practically done).

After my REI trip, I headed back to the hotel, grabbed a quesadia from the bistro and started to write this blog entry before I just simply passed out.

Thurs AM
This morning i slept in and woke up to very grey clouds and rain, so I've stayed in most of today and organized my loot for packaging to head back to Bethel. I'll need to go to the Post office either today or tomorrow so I can pkg up things to send back.


To Do:
- Post office trip
- Explore
- Dinner with Audiologists.

Anchorage - Day 1 (Tuesday, with excerpts from Monday arrival)

Monday Night:
So I arrived in Anchorage late last night and had an "Oh shit" moment on the plane... I was apparently supposed to pick up keys to my rental car at the Bethel Travel Management Center, in Bethel. Which I did not do. So I arrived in town and had no ride.

I called the hotel and got shuttle in route. ETA 10 minutes. He came, slowed, and drove off. I called the hotel, they re-dispatched him. 1 hr later I'm STILL sitting outside waiting. 3rd call to the hotel and I FINALLY got picked up, a little chillier than when I arrived.

My assistant, being the most awesomest in the world. She was able to help me figure out what to do to get my car picked up today.


Tuesday:
I slept in a little because of a headache and called Travel management. I had to take a cab to their office and then another to the airport parking los to retrieve the car. Still with a headache.
Once i got up and moving, I picked up the car and came back to the hotel to look up addresses of some places i need to go.

Target: $600 worth of essentials (I know it sounds like a lot but I am stocking up and I would have easily spent 1.5-2.5 times that on the same stuff, plus I got . Toiletries (including travel size that don't exist in Bethel), toilet paper, Marino wool socks $10 instead of $20), totes to take everything back and forth. Like a softsoap refill for handsoap... in Bethel $13.99 and here in Anchorage... $3.99. I did splurge on a computer game from back when I was younger. I remembered playing in on a windows 95 system.


Sports Authority: I decided I like North Face. I tried on a bunch of Columbia fleeces and jackets but Columbia runs slender and a curvy girl like me needs. I was able to get a fleece that will be my lightweight fall/winter jacket.

Brown Jug: I picked up some wine and need to go to the warehouse later this week to set up my account so they can ship me booze in Bethel.

Me Time: Then on the way back to the hotel, I found a little salon and got my eyebrows waxed.


Still on the To-Do list while in town:
- Spend Wednesday with ENTs and Audiologists at the hospital here.
- REI/Patagonia for winter coat
- Costco - halloween candy, check out clothes selection for good
- post office, mail home anything over my 50lb limit X's 3 checked pieces of luggage

Anchorage

Tonight I fly to Anchorage and I'll be spending the week. I don't fly home until Sunday evening so I'll hopefully get some time to toodle around. I'll be meeting with the ENTs and Audiologists there and doing a bit of a Meet & Greet. Not sure how much time I'll be doing that vs. exploring, but I hope to get some good exploring done.

I'll be taking my camera and also getting some pics prepared from my trip to the park. The park where I played softball this year is a tundra park. it's got walkways all throughout it. I wouldn't have really explored except I stole a friend's toddler and we went playing and walking.

I've also started a dumpster project. A lot of the dumpsters in the area are painted so I've started taking pictures of them. They're all over town so I don't see them all the time, but as I see them I'll try to take pics.

Fog = ASL practice

Today's pretty foggy out. I didn't notice it on my way to work, but it's there. I think it's a little above the ground. Not enough to obscure driving but enough to make it impossible for planes to land. Because of this, most of my patients are either no-showing (DNKA, pronounced 'dink-a' - did not keep appointment) or calling to reschedule.

Since I used my downtime during this last weeks ENT clinic to do Medicaid paperwork for Hearing Aids (DME - Durable Medical Equipment pre-approvals), I'm using this time to study my ASL (American Sign Language). I think using downtime at work to learn more of a language that my Deaf patients use is an appropriate use of time.

Discounted Fares

It's begun... This morning I received an email - though admittedly, I didn't see it at first and a coworker had to tell me it came- that Alaskan Airlines has started it's discount period for purchasing tickets for the year. Basically, they time this every year in accordance with the PFD (Permanent Fund Dividend - which in 2011 is $1,174) that is given every year.

So from Today 9/20/11 until 10/17/11, Alaskan airlines is discounting their flights that are planned for anytime between now and August 2012. Tickets have to be purchased by 10/17 though.

My tickets home unfortunately aren't that much cheaper just because it's the holidays and they're capitalizing on this. Thus is life.  But if anyone truly wants to visit, please check the website under "Deals" and let me know what you're thinking. My apt is small and has a couch.

hole in my pocket

I think we're all aware that airline prices have gone up in the last few years.  And I knew that flying from here to the East coast to visit was going to be expensive.

I'm trying to plan my PTO to head home for Christmas. My boss is all but making me go home for 2 weeks. Because we get 2 holidays (Christmas and New Years) I actually get more like 2.5 weeks off with weekends.

My dad also has some frequent flyer points accumulated he's offered to share for the cause. His tickets can get me from Seattle or Portland back to VA. I used Kayak.com to search flights from here to Seattle = $1250. Then I searched here to Portland = $1380. I swear it's the most expensive legs of travel I've ever seen.

I'm going to wait a little longer and try and book in October. I may also look into having the travel office help me since that's available. I feel it'll just be convoluted since I'm also using points on an airline they really don't use to make arrangements. Either way, cross your fingers for me.

Suction --- GROSS ALERT - feel free to skip

So I had a handful of kids today that needed their ears suctioned out due to wet, goopy, slimy, smelly drainage. Problem... I don't have have suction. So after I had to let all these kids leave... I am forced to go on a mission. After asking a few people. It's finally decided that I take the portable suction that's in my clinic (and hardly ever used) and use it. So currently, my assistant is trying to track down more tips so I can suck goobers out of all my kids ears and not have to make them come see the ENT when they come to town.

Car insurance

It's been a 2 day process due to time differences but I've changed my insurance to cover me here in Bethel.
I had to go with a national carrier so we'll see how that goes. But I'm licensed here, my car is registered here and now my insurance is finally switched.

Time and Temp

9:15 am @ 39 degrees F with a high of 57 degrees F (keep in mind the sun's only been up for an hour)
Sunrise: 8:16 am
Sunset: 9:07 pm

"I'm from the village" ...

I had a patient and their parent in here the other day and  I was talking to them about what we were going to do during the testing session. The parent looks at me and smiles, then says, "I'm from the village, you're going to have to speak slower or we won't understand you. We have a slower way of life."

I love this because 1) the parent is right, way of life up here is slower than most other places I've lived and even slower in the villages. My frenetic energy when I go on a cleaning tear (as my Work-Mom can attest to) is something that would be an absolute spectacle up here. and 2) the parent spoke up and told me what I needed to do to help them communicate with them.  - This should never be a source of embarrassment for anyone. Communication makes us human and creatures who love. It's the currency of life. Even in times of complete poverty or depression, the communicate your idea is essential to survive. And communication is a give and take. You can't just give a message, you have to receive it as well.

A little background on my voice:

•  At home-  my voice is a 'typical level and I sometimes swallow the ends of my words, and talk into cabinets/fridges/from the other room."  Essentially, I'm human. I do this even though I have people in my family with hearing loss- I make mistakes, I think we all do. That being said, I do try to raise my voice or talk over my shoulder. I also know that there's a very good chance I'll have to repeat or rephrase what I'm saying. I'm ALWAYS aware of situations that are difficult and try to make changes to how I'm talking before necessary. Communication is a 2 ways street. It's hard for me to know exactly WHAT a person does or does not hear in any given situation. At the same time, I've never met anyone who LIKES to have voices raised at them unnecessarily and everyone's ability to hear is different. So as much as I may try to speak clearly and loud enough, it's also the listeners responsibility to let me know if I can do something different to make things easier for them.  --So this parent was communicating beautifully--

• At work- my voice is slower, louder (not shouting but definitely projecting at times), and I enunciate. Essentially, I play it by ear, but I'm always trying to make adjustments in my voice to make it easier for someone to understand. I still have people tell me to speak up or get softer because I'm 'shouting' to them. -I'd rather have someone correct me than not be able to understand a darn thing I'm saying but pretend.

BTW, one of my humble opinions is that Enunciation is key to communication with anyone, especially with a hearing loss or when there are language barriers. That's exactly what was going on here. There was a language barrier. Many people who live in the villages grew up learning a Native Tongue, like Yup'ik. I had two teenagers last week who were just starting to learn English. And, yes, these are teenagers living in the US in this day and age. It's part of keeping a culture alive, it's being able to speak to your elders without complete assimilation into American teenage culture (lack of assimilation is NOT a bad thing in my mind).

Gave Blood!!!

Bethel had an annual Blood Drive today. ... YES, you heard that correctly, the ANNUAL blood drive (I live in such a small place that they only get a drive that often).

There's the Blood Bank of Alaska that travels to villages all over and does a drive. Good news is that they were full and not even able to take walk-ins by 3/4 through the first day. I wish they'd been able to stay open longer, there's always a need. I also wish the hospital had some sort of blood bank here but maybe someday, right?

Winterized

My car now has a tail... in the front. Mine is actually zip-tied to the front grill, but it's there.

Most people are telling me that you should go out an hour before you're ready to go and plug it in.Essentially letting your car idle while you're inside for 1 hr.

I was told by the mechanic that it was best if you plug it in at night when you get home. Then when you're ready to leave in the morning you unplug, put the key in and go- no worries about going outside ridiculously early in the cold and in your PJs to start the car. Apparently, what you end up spending in extra electric is far less that what you'd end up spending on extra fuel while idling for an extra hr a day (remember, gas is currently $6 a gallon, it only changes once or twice a year though).

The only thing left to do for the car there is get my fluids replaced. (Was going to get it all done at once, but it just didn't happen)

Water... cont.

I know I've mentioned in the past how some people have water tanks and some have city-water.

I've recently been told that some actually prefer to be on tank-water because the city-water comes out red/brown tinged due to rust in the lines... yuck.

I can see Winter...

Conclusion that there's really 2 seasons here in Bethel. Winter and Summer.

I've not yet experienced Winter (but of course I'll fill you in when I get to that point), but I can tell you that It's going to be COLD. Boots are rated to -30 at a minimum. Car's are Winterized to deal with the same. Wool is a staple up here as are: BOGS, Smartwool, Columbia, Patagonia, North Face and fur. ...

Now before anyone goes at PETA on me... Animal skins are fur are used here. There is subsistence fishing, hunting and gathering. Subsistence Living is living living off the land and what you can grow, hunt and gather yourself. Native Alaskans do quite a bit of subsistence living. They hunt moose and other game. They fish for their yearly meals and they gather berries during the summer and fall. Now everything gets frozen and saved for later. Moose can be sent out to be made into particular cuts like steak and also to have summer sausage or have the meat ground for burgers. The skin and furs of these animals are used to make clothing: coats, mittens, hats, boots. Very little, if anything, is tossed after kills.This is their livelihood and not done 'just for sport' or for fashion.

To me, the weather we've had all Summer is actually more of a Fall. It was shorts-like weather for 1 day that I can recall. The rest of the time it's been at least long sleeves or pants and sometimes both. This week for instance, some locals are wearing short sleeves and some are wearing fleece coats over many other layers.

I've yet to pull out a coat other than my raincoat (which is quite lightweight) but I have been wearing long-sleeve fleece almost everyday.  (BTW- if anyone knows a good place to get good quality fleece zip-ups for a decent price, I'd appreciate the heads up). Maybe I'll be OK this Winter after all.

Car Winterization

So it's not super cold yet, BUT, looking ahead, I just scheduled my car for it's Winterization. Appt: 9/15th.

I will get it serviced to get new lube, oil and filter then 2 heaters (Block and Oil Pan), so long as my car can handle it. Everything will be rated to kick over in -30 degrees.

Rain Water

I learned last night that rainwater here is not the acid rain nastiness that I'm used to. I don't know that i would go so far as to say it's potable since the environment is picking it up from somewhere else outside, but it is gentle enough that if you wash your hair in rainwater, your hair is nice and soft.

My assistant has a couple barrels/huge Rubbermaid containers out to catch it as back-up water for when they need more than they have trucked in.

It's nice living in a place where the rainwater won't give you an instant need for a decontamination bath.

Flu Shot

I just walked into the hall to consult on a patient and the employee health Flu Shot Cart was in my hallway. I raised my hand to signal I wanted a shot while still talking about the patient and she told me to bare shoulder and write my name and birthday. Before I was done consulting, my shot was done.
Surreal and great time-management.

Darkness invades

It's still a reasonable time at night when the sun goes down (it's setting in the 9s) but what's hard to get used to is that it's still dark when i should be waking up and twilight-ish when I drive to work.

Someone told me we lose 6 minutes a day of daylight. not sure how true/untrue that is but it sounds about right.

Hospitality... in review

*** Disclaimer: These are my explanations and examples. Feel free to add your own 10 cents. ***

Southern Hospitality:  Charm with a southern drawl or twang. Lots of smiles and nicknames like "Hun", "Darlin", "Sugar", etc.  Slower pace. Offered tea or lemonade when you arrive (and there is NO such thing as unsweetened tea). You can strike up a conversation in the grocery store with a stranger and be acting like best friends by the time you're done checking out and you may never see the person again. Everybody nods to strangers on the street and in some places it's a tip of the hat. Gentlemanly ways are still taught and people are always there to lend a helping hand and regularly go out of their way to do it. Can be passive aggressive if someone wants their way and feels the need, e.g. the art of telling someone to go to hell with a smile and sometimes without the receiving individual even knowing you're telling them to go to hell. 


Mid-Western Friendliness:  There's a wholesome-ness. The Girl-Next-Door and the All-American-Boy archetypes. And again, The Art of being a Gentleman is also still taught and you can still start up a conversation in the grocery store. Just generally friendly. People are not mean really.

Pacific-Northwester Laid-back(ness): Nothing seems to stress these people out. Things are no big deal, clothes are no big deal. Things are functional and not stick-up-your butt. I'm pretty sure people still wave and nod but there just isn't much if any elitism.  (I haven't lived in this area so please take my opinion with a grain of salt above and beyond the fact that it's just my opinion)

Alaskan Accommodation: I'm still learning about the extent of the accommodating nature but from what I've seen people here definitely go out of their way. If you look stranded in a boat or in a car, no one passes you by. There's an honor system with things like locking doors to homes and cars (I still haven't quite gotten the hang of this one). Part of this is out of necessity. If it's winter, you wouldn't want to be stranded and you wouldn't want it to be a friend or family member stranded if someone could easily just pull over and ask if you need something.  Almost every patient I have asks how I like it here so far and offered suggestions for housing or entertainment or even recommended scheduling trips out of town, etc. People recommend places to get certain things and aren't much for the "figure it out on your own" rule. It's refreshing after spending time in places with  very different mentalities at one point or another.

Good News!!!

Background:
I have student loans to pay back for graduate work at a private institution. This adds up to a pretty penny, and the plan prior to relocating to Bethel, AK was that I'd slowly pay off these debts for the next 17or so years. This cuts into my paychecks fairly substantially when you look at interest and principle over the repayment period. I know many of you out there understand exactly where I'm coming from.

When I looked into the job here in AK, I found out that 1) There's no state tax in AK. 2) There's a dividend paid to AK residents every year (you have to establish residency first) and 3) working int he medical field, there was the option of getting loan forgiveness or repayment for working with the native population/working in a rural area.

Enter stage left... Loan Repayment Program (LRP) through Indian Health Services (IHS). Those who work in certain medical fields are qualified for tuition repayment if you work with the Native Alaskan or Indian populations and/or rural areas.

When I looking into the LRP, it was quite clear that all Federal and State loans taken out during the education period to obtain my degree (all of grad school) would be eligible for repayment, the question was IF my private loans were qualified as well. The application and policies said "federal, state and corporate loans". Corporate loans in my understanding were loans for a business but as it turns out, they consider private loans for school to be under this category.

Current:
I received an award letter that all of my grad school loans are qualified for the LRP. This means I get to save more money, and Pay off my school debt in 5-6 years instead of 17-20 years. Also, I'll be staying a little longer in Alaska than originally planned (unless I absolutely HATE the winters, which I'm doubting).
As I put it to my parents... I'd be an idiot to turn down free money.

My insides are all gooey at the prospect of being completely debt-free by the time I leave here. And who knows, maybe I'll love it enough to stay forever. Only time will tell.

Change on the horizon

Sunrise @ 7:40 (it's still dark when i get up... but it's still light when I head to bed then gets dark as I fall asleep)

Weather... a gray/drizzly 44 degrees (I pulled out the Under Armor today with a vest)