by Timothy Gieseke, MD, CMD

On the evening of October 8, the expected “El Diablo” winds arrived in Sonoma and Napa Counties with peaks winds of 80 mph.  Unfortunately, wildfires began that evening.  Late that night, the Tubbs Fire that started in the Calistoga area became a blowtorch that moved within 4 hours through a broad swath of Northern Santa Rosa, consuming a broad swath of our city.  We were shocked that it jumped a 6-lane freeway continuing a path of destruction through another 2 miles of North West Santa Rosa.  During that short time, emergency evacuations of residents at 2 of our 3 acute hospitals occurred (Sutter & Kaiser).  The rest of Santa Rosa awoke to explosions, dark smoke, and glowing surrounding skies.  Within hours, 5 of our 8 SNFs (1 CCRC) were evacuated to shelters and then on to other out-of-area facilities.  Communication by phone, cell, and internet was difficult with wide power outages and 80 cell towers down.  Battery-operated transistor radios allowed for local on-the-ground, real-time news (KSRO) about the surrounding uncontrolled wildfires.  When the internet returned, many of us used the EMS emergency text message system (Nixle), which sent out updates on impending fire threats based on zip code of end user.  (If you want Nixle updates, simply text your zipcode to 888-777; please note text messaging rates from your phone carrier apply - visit www.nixle.com for full details.)

We are so excited about our upcoming event that we are giving you a sneak peek of the first talk of the day by Rebecca Ferrini, MD, CMD entitled “Pain Management: First, Do No Harm”.  Dr. Ferrini has prepared a comprehensive handout to complement her presentation and with her permission, we are sharing it with our readers.  Some of Dr. Ferrini’s pearls of wisdom are provided below, and the complete handout is available for download.

Dr. Ferrini’s Pearls:

• You must do something, but you will likely NEVER alleviate all pain.  The best treatment: “I believe you”—compassion and empathy, be present and trying, hope/optimism and explanations –far exceeds the prescription.  Get the conversation off asking for opioids and back to treating pain.

by Tim Gieseke MD, CMD

I have been the Medical Director of a large CCRC since 1986, which was before we had cell phones.  Over the years, this technology has dramatically improved, but at this particular facility, I barely receive text messages and still can’t receive cell phone calls.  The big issue is the 1000-foot elevation Annadel State Park immediately next door, which blocks much of the signal of my carrier.  There is another carrier with a better signal, but even that signal is weak.  Some years ago, I tried a signal amplifier unit, but that proved ineffectual.

My new associate, Dr. David Greene, has the other carrier, but found it inadequate and did activate a better option.  Newer phones available over the past 3+ years have an option to make and receive calls by tying into the facility w-ifi system.  I went to my carrier and they set up this wifi option without charge.  I am pleased to report that I now call and receive calls with an excellent landline-like clarity.

by Tim Gieseke MD, CMD

For many years, the AMDA Foundation has sponsored the Futures program designed to expose geriatric fellows, residents (FP, IM), and advanced practice nurses to a career in Postacute and Long Term Care in a focused program at our annual meeting.  Next year, the 2018 AMDA meeting is in Grapevine, Texas from March 21-25.  The time is now to apply for a scholarship to this strategic meeting.  

Dr. David Greene MD, CMD and I are so supportive of this meeting that we have arranged through our main employer, sponsorship for 2 geriatric fellows from California to receive this award.  Hopefully, there will be other sponsors within California.

David and I have been attending the AMDA annual meeting for over 20 years.  It has been an extremely valuable asset to the career we are so passionate about.

Now is the time to apply for this superb career development opportunity.   For more information visit: http://paltcfoundation.org/index.php/our-work/futures/about  

Donations can be made directly through CALTCM and designated for California AMDA Futures Program Fellows, click here to donate.