My worst flight ever!

Last Wednesday, I was scheduled to leave Galena at 4:25 pm fly on a 1900 (a small prop plane, but bigger and nicer than other super small planes) to Fairbanks. Then I was scheduled to fly a Saab 2000 (still a prop, but looks like what people think of when they think of a commercial airliner albeit a small one). The weather in Galena on Wednesday was not good and we were all holding our breath. Ravn doesn’t fly on Thanksgiving and three of my co-workers and I were booked on the last flight. High school doesn’t end until 3:55 pm and so the three of us who teach high school were expecting to need to have part of our last class covered. With the weather looking so poor I thought that I’d probably be able to teach all day, and not leave until late, if we made it out at all. Quite honestly, I was mentally preparing to not get out of Galena at all.

Boarding the plane in Galena

Lunch starts at 12:05 and my students are always the last ones to lunch because not only is my classroom one of the farther ones from the entrance into the gym the students must use for lunch, but I dismiss them late nearly every day. On Wednesday the kitchen staff had outdone themselves and created an absolutely amazing feast. On the serving line they had turkey, mash potatoes, cranberry sauce, home-made rolls, and a choice of pumpkin pie or strawberry pretzel delight ( think there must have been a vegetable on the serving line, but I don’t remember it). Then outside of the kitchen in the self-serve area there was green bean casserole, stuffing, sweet potato casserole, roasted asparagus, turkey gravy, a fresh vegie tray and the usual salad bar. While my students were working, I checked out lunch during the elementary school lunch and decided that since the students at the end of the line frequently get gipped on the self-serve items, that I would dismiss early. I dismissed my students at 12:02 and we walked to the gym together (I let them go the short way). It was too early so lunch wasn’t being served yet so we stood in line waiting (along with a few students who don’t have a class that period). The principal came in to monitor lunch and I told him that since my class was always the last ones to lunch, I had dismissed them early that day (I only have 8 students in that class and two were absent). Because the principal was there we actually started discussing physics in line until they started serving (still a bit prior to the bell ringing).

I got my food and went to the common room where several teachers and staff eat lunch. A couple friends had arrived and we were discussing the flight and if we thought we would make it out. I had taken 2-3 bites of my food when my phone rang. It was a local Ravn agent telling me that they didn’t think my flight would make it out, but they had a plane on the ground right then and could I come to the airport immediately. I told her I would have to ask my principal and she said to call back (I was trying to keep her on the line and walk to the gym to find him at the same time, but she clearly didn’t want to wait). I found him and before I could say anything he told me, “I’ve already heard. Go. Have a good Thanksgiving.” I went back and told my friends what was happening. One went to the kitchen to get paper plates for my food. Another called the airline to try and get on the flight too. She got the last seat. In total three of us rushed out the door with our uneaten lunches and drove straight to the airport. We were all glad to get the chance to go, but while we were waiting at the airport we realized that the three of us comprised the entire table cleaning staff. I guess one (or both) of the principals had to clean up (hopefully some students helped).

When I arrived at the Galena airport (really an airstrip with a log cabin for the Ravn “terminal” and a couple of other buildings for the other airline and the school) there were two planes on the ground a Cessna Caravan and a Piper Navajo. Galena usually has Beachcraft 1900 and Piper Navajo service. The Caravan was unusual. The “terminal” was quite full and after I checked in there was only about one seat left. I ate part of my lunch while talking with others. After awhile a pilot came over and read out the list of passengers who were on his flight. That group headed out and boarded the Caravan. The rest of us waited about 20 minutes before our pilot came over and said he had seven seats and seven passengers for Fairbanks. I counted at there were seven of us still waiting. He suggested using the restroom (none of the planes that fly regular service to Galena have lavatories) and when something was ready we followed him out to the plane (this is pretty standard procedure. There’s no TSA, no ID checks and names are only called when there’s more than one flight for a given destination waiting). As we were walking out to the plane one of my friends remembered a fourth friend, who teaches elementary school was also on our flight that afternoon. We don’t know if she got a phone call or not.

The pilot giving the safety briefing. 

The van and de-icing

He also did a lot of the de-icing from the ground.

Thanksgiving lunch on the plane - actually this is mostly fake. 

I ate some of it in the airport in Galena and more in the 

airport in Fairbanks and I'm afriad I have to admit

I threw some of it away.

After we boarded the plane, the pilot made sure everyone was in and then climbed along the window to enter the plane at the pilot’s seat. He made sure everyone had their seatbelts on and told us about the emergency beacon and how it should go off automatically in the event in a crash, but in case it didn’t he explained where the manual switch was. He also told us where the survival gear was (right wing locker) and then there was quite a pause. We just sat there and then the pilot started talking on his radio. We began to get nervous. When you’re flying from a village out you never feel confident you’re going to make it until the plane takes off. When you fly from a hub to a village you aren’t assured the plane will land until well it lands. I’ve been on planes that circle and turn back, never a good feeling. When the left engine turned off we got really nervous until I noticed a blue van labeled “ethylene glycol.” I realized the engine was just turned off for de-icing. The van had a generator in the back and hoses running out a hole in the side. There was a cherry basket attached off of the roof and someone sprayed down the plane. The left engine turned back on and then the right engine shut off. At this point I was feeling pretty confident and sure enough after de-icing was complete, we took off.

This is the view from the Navajo, which doesn't fly very high (or fast).

The visibility was terrible, but the flight was pretty uneventful until we were about 20 minutes outside of Fairbanks. If I had flown on the faster 1900 the flight would have taken about one hour, but on the slower Navajo it takes about just under 1.5 hours. Therefore, we were about an hour into the flight when the winds picked up. The Navajo is a small plane (remember the seven seats and seven passengers- the plane was full) and we were hit with crosswinds. The crosswinds pretty much threw the plane from side to side. It was the worst I’ve been in and it was bad enough I was concerned about someone getting air sick. There are no flight attendants, lavatories or even air sick bags on the plane so if someone got sick it wouldn’t be pretty. Thankfully, no one got sick and we landed in Fairbanks three hours early.

After deplaning (you walk down the steps of the plane – the ones attached to the plane, not a stairwell that is rolled up- onto the tarmac and then into the terminal) I went to the ticket counter to see if there were any earlier flights I could get on. There was a flight that should have already departed, but had been delayed. They had seats on the flight, but since the plane was a relatively small prop plane (a Dash-8 with 37 seats, much larger than any of the flights to and from Galena) they don’t fill all the seats because of weight. They weren’t able to put me on the flight because as it was they had to take fourteen bags off the flight and send them on an Alaska Airlines flight to Anchorage. Thus, I had many hours to wait.

My flight to Anchorage was a Saab 200. This is the only plane Ravn flies that has assigned seats. It is bigger than a Dash-8, but still fairly small and a prop job. The flight attendant was really annoying. Every sentence of her safety briefing was followed by her walking down the aisle and checking things. Then when she got to the end she stopped and checked every phone to make sure it was in airplane mode (which was really stupid because we then sat on the tarmac for a long time and then had to get de-iced and so we didn’t take off for another 45 minutes or more. I, and probably everyone else, switched the airplane mode back off as soon as she was gone).

Finally, about the time we were scheduled to arrive in Anchorage, we departed. The pilot warned us that the flight in had been bumpy, especially close to Fairbanks and so they expected it to be a bit bumpy. I don’t remember very well, but I think it was a bit bumpy leaving Fairbanks, but nothing major. I’ve flown a lot and had a lot of turbulence so it wasn’t a big deal. However, about 20 minutes before we landed in Anchorage it became a major deal (FYI flight time is only an hour). The plane hit major winds as we were approaching Anchorage and for the last twenty minutes it rocked back and forth and I think up and down. It felt like we were on a ship being tossed around by wicked seas. Since it was dark out you couldn’t see the ground and it also seemed to be like we were on a rocket hurtling through space. The multiple directions of movement made the plane feel like it was moving much faster than it was. My seatmate was an older woman whom I’m pretty sure has flown a lot and across the aisle was another older woman from Galena who I know has traveled extensively. They were scared to death. At one point my seatmate looked so green, I asked her if she was going to vomit. I commented that we had no airsick bags and a man two rows up apparently heard me and held up a bag offering it to us. She thought she was going to be okay and we declined it. Both women hunkered down in their seats petrified. I spent the time craning my neck to see out the windows on the other side of the plane and ahead because these were the only windows out which you could see the lights of Anchorage. The rocking off the plane made it so discombobulating that one couldn’t tell how high we were or what sort of downward progress we were making. By looking at the lights, I was able to keep myself more centered. As we approached touchdown I was coaching my seatmate, “we’re almost down.” Then “we’re feet from touchdown.” And finally, “there it is touchdown.” The stopping was a bit rough, but we made it.

I have to admit, while my seatmate thought I wasn’t bothered at all through the landing, I not only was, but I was also contemplating a recent Ravn Air Group crash. On October 17 (the day I flew back to Galena after my ear surgery), Ravn Air crashed a Saab 200 in Unalaska. Since the crash the NTSB announced the pilot has 14000 hours in a Dash 8, but only 201 in a Saab 200. Ravn recently acquired the Saab 200s when they purchased Peninsula Airways, which flew to Unalaska. Ravn is now using those planes for many of the Anchorage-Fairbanks flights. After the announcement, I said Ravn needed to have their pilots who need experience in the Saab 200 the Anchorage-Fairbanks flights because neither of those airports are tricky landings. Now, with all that in mind I was on a Saab 200 that was rocking and shaking and none of these thoughts were helping.

After we landed the flight attendant announced that since she had been unable to finish service on the flight we could pick up our cookies (little kids call the Dash 8s cookie planes because before Ravn acquired the Saab 200s the Dash 8 was the only plane with a flight attendant and when they have on-board service, Ravn provides really tasty cookies) as we deplaned. Altogether what would be less than 350 miles, if I could fly directly, took me nearly 10 hours.
By the way, I flew an Alaska jet to Fairbanks today and am now waiting on my much delayed flight to Galena. You will be happy to learn that my flight to Fairbanks today was uneventful.

Yes, they do put ear tubes in adults

Three weeks ago I had no idea adults got tubes in their ears. In the last three weeks I have spent countless hours souring the Internet for information on tubes in adults. The most I have been able to find is mentions that yes, adults get tubes too; adult tubes are much less common and that adults don’t have to have general anesthesia. I have been unable to find anything that describes what to expect or follow-up care. Therefore, I have decided to share my experiences and the many things I have learned. My experiences may not be the same as yours and they may not even been typical (especially since I live in bush Alaska which means I cannot drive in or out of my community).

Last January I had pneumonia. Last May I had bronchitis together with a sinus infection and allergies. I went to the clinic in my community on Thursday and Monday I flew to Anchorage for the summer. That plane flight was one of the most painful flights of my life. In early June I flew from Anchorage to Los Angeles and six days later from Los Angeles to Sydney Australia. While I was in Australia I flew from Sydney to Cairns before flying back to Anchorage via Los Angeles (and Seattle). I’m telling you all of this because, while it hasn’t been confirmed, I believe my ear problems are probably the result of barotrauma. Barotrauma refers to injuries caused by increased air or water pressure, most commonly the result of flying or scuba diving. Basically barotrauma is the result of a vacuum being created in the middle ear which pulls the eardrum inward (Harvard Health).

Shortly after my return from Australia I was having tremendous trouble with my ears, but was avoiding seeking medical care (not the wisest choice). Then one evening I blew my nose. I felt a pop in my ears and could no longer stand up. I was standing directly in front of a bed and dropped straight onto the bed. The next morning I went to an urgent care clinic. The nurse practitioner instructed me to use a nasal rinse and prescribed a steroid. She also suggested that I see an ENT (which stands for Ears Nose and Throat, the official term for this type of doctor is an otolaryngologist). She didn’t seem to make it sound that important and so I didn’t worry about it too much. Three weeks later I went back because the pain in my ears had not gone away. One of the things she clarified was that it hadn’t ever gone away rather than come back.

On my return visit, the nurse practitioner said it was really important that I see an ENT. She also prescribed a stronger steroid (high dose prednisone) and a strong antibiotic because she figured since my ears had been bothered for this long, there must be an infection inside. Additionally, she added an additional allergy medicine to the three I was already taking.

At this point, I was concerned about my need to see an ENT because it was about time for me to return to my village. We don’t have an ENT here. Luckily, I was able to get in with an ENT the following Monday.

When I saw the ENT I was still on both the prednisone and the antibiotic. He added a second nasal spray to help dry out my sinuses and my ears. This was the first time I heard an important diagnosis, retracted ear drums. A retracted ear drum is where the ear drum gets pulled in towards the middle ear. This of course can (and frequently is) the result of the vacuum created by the barotrauma (that vacuum frequently fills with fluid.

I flew home on August 11^th and while the pain wasn’t as great as it had been when I left in Anchorage it was not good. I went through a lot of pain with it increasing over time. By the end of September I was reaching the end of my rope. I scheduled an ENT appointment, purchased plane tickets and put in a leave request. Unfortunately, before I was able to go to Anchorage I got a really bad case of strep throat. While I was in the clinic for the strep throat the medical professional I saw (I’m not using titles here because I live in a very small community. The title can give away too much information and I want to respect others privacy) looked at my ears and was pretty horrified. I asked her to describe what she saw and she said, “They’re not right. They’re not the right color and they’re retracted. It looks like they may be thickened too.” She then told me I might need tubes. “They do tubes in adults?” “Yes,” she assured me, “they most certainly due.”

I finished the antibiotic for the strep throat (my ears got SO much more painful when I had strep too) on Friday and saw the ENT on Monday. I had been concerned that he wouldn’t take how bothersome my ears were seriously (and considering how painful the flights to Anchorage for the appointments were I really didn’t want to have to endure that pain back to my home and of course back yet again to Anchorage). Thankfully, the ENT took me very seriously. He ordered a CT of my temporal bones. He wanted it done on Tuesday morning so that we could meet again Tuesday afternoon, but Providence Imaging couldn’t get me in until 2:40 pm on Tuesday. The doctor said he would see me at 4:30 Tuesday afternoon. The asked the imaging center to rush the results and instructed me to pick up a CD of the images myself.

I met with the ENT around 4:45 Tuesday afternoon after hearing the nurse on the phone requesting the imaging center send over the radiologist report. I can’t remember all of the numerous things we discussed that my doctor had been concerned with or that the report otherwise stated weren’t a problem. I do remember that the big one was he was concerned about the mastoid bone. Apparently, this bone has a honeycomb-like structure which could mean there was an infection within the bone. There was also no fluid in my middle ear and also no brain tumor between my ears (I hadn’t even though about that possibility – much- but it was a relief to know that wasn’t an issue). My eustachian tube didn’t show a problem, but CT scans can’t show eustachian tubes very clearly so there may still be an issue with my eustachian tube. Children have very narrow and more horizontal eustachian tubes and this is why they frequently need tubes until their eustachian tubes grow. As an adult, my eustachian tube is, of course, no longer growing.

The CT scans were both good news and bad news. They excluded a lot of potentially awful concerns, but they didn’t give an explanation to the retracted ear drums (and the accompanying pain). Thus, we were left with simply treating the symptoms. My ENT and I discussed the pros and cons. The cons are pretty small mostly just the potential that my ear drum didn’t close after the tubes came out. I asked about the length of time the tubes would be in because children’s tubes usually get pushed out by their growth. He told me that in adults the tubes are usually in for 12-24 months (children are usually 6-12 months). I asked what would happen if they came out and the pain returned because we hadn’t actually treated the cause, just the symptom. He told me that we would then put in longer tubes. The longer tubes are more likely to cause the eardrum to not close because they sit differently, but they also stay in longer. While I have the tubes in I would be allowed to swim in pools, but not in lakes, rivers or the ocean.

 I decided that tubes seemed the best option and asked if we would do one ear or two. My right ear was worse than my left and my doctor told me that if I lived anywhere on the road system he would only do the right ear and if that wasn’t sufficient to end my pain, then do the left tube. However, since I don’t live on the road system and my coming back in would be very difficult (I had to take off 3.5 days for this trip, plus the cost of the plane tickets) he might do two. However, he said he’d paint my ear drum with a local anesthetic, but I’d still be able to hear. He said that there is a scratching noise that really bothers a lot of people. I felt that it wouldn’t be an issue for me and so we decided that he would seek preauthorization from my health insurance for both ears. Then he would do the right ear first. If I found it to be “a piece of cake” we would go on and do the left ear. Seeing as the appointment didn’t start until after 4:30 in the afternoon it was too late to seek preauthorization on Tuesday and my flight home left at 6 am on Thursday. Thus, we tentatively scheduled the procedure for around 9, or 9:30 on Wednesday. The doctor had an operation in the O.R. first and I had a dentist appointment. The front office staff would call for the preauthorization first thing in the morning and then call me.

I was still at the dentist when she called, but when my appointment finished I called her back and while the doctor wasn’t back from the O.R. yet it was decided I would go ahead and come straight to the office.

While it took me only five minutes to drive from my dentist’s office to my ENT’s office he must have arrived in between because I didn’t see him arrive and I was called back just minutes after my arrival.

The nurse took me back and we went over the procedure including an interesting issue the doctor had failed to mention the day before. She was in the process of explaining that the tubes would affect how I heard tones when the doctor came in. The three of us continued to discuss the procedure until all of my questions were answered and then I signed the consent form (complete with the time – 9:48 am). The nurse told me that usually the most painful part was the anesthetic. She said there would probably be about 20 seconds of pain.

The nurse left the room and the doctor raised my chair and then reclined it nearly flat. He had me look to the left while he worked over my right shoulder. I really didn’t feel the anesthetic go on my eardrum. The doctor and I talked about random things related to what I do and the time he had spent living in China and so forth. While we were talking I could feel pressure on my ear and heard some noises. The biggest noise was apparently the tube being inserted. He had previously described it as a scratching sound, but it reminded me more of the noise of two plastic tubes when you try to slide one inside the other. I think because I didn’t hear what I considered a scratching noise I was taken by surprise when he said, “you’re a Rockstar. I’m finished.” “That’s it?” “Yes,” he replied, “that’s it.”

The right ear had been so easy that we immediately went to do the left ear. As the doctor was starting on the left ear I asked him if he’d put anything else in my right ear besides the tube because I couldn’t hear very well (and it really felt like he’d put a cotton ball in the outer ear). He told me he hadn’t but the reduced hearing was probably for three reasons: 1) my eardrum was anesthetized, 2) I had just had a small incision cut in my eardrum (this procedure by the was is called a myringotomy and the tubes are called tympanostomy tube) and 3) my eardrum had been retracted for so long it would take time for my brain to readjust to my eardrum being in the neutral position.

The left ear was a little more difficult. Apparently, my ear canals are significantly different shapes. This difference is not noticeable when examining the ear but is very apparent when trying to perform this surgery. As a result of the angle from which he had to work, the doctor had quite a bit of difficulty getting the tube in. The instrument hit the bone on the side of the ear several times and since this part wasn’t anesthetized it was rather painful. There was also a lot more of the pushing sound than I heard with the right ear. Nonetheless, if the right ear had been as difficult as the left, I probably would have still had him do both ears. I texted my aunt from the parking lot after I left. The time of the text was 10:09 am. Since I hadn’t been under general anesthesia I was clear to drive. I was also clear to fly at 6 am the following morning.

On Friday afternoon, I called the doctor’s office because I was experiencing decreased hearing. Most people have fluid behind their ears and so during the operation the fluid is suctioned out and they hear better. I hadn’t had any fluid and was struggling to hear my students. With my high schoolers the problem was simply with hearing them, but with the pre-K/kindergarten P.E. class I had significant trouble understanding them. I didn’t report this part to the nurse at my doctor’s office because I figured this was directly related to the pitch changes I had been told to expect. At the beginning of the year I had had a terrible time understanding them and it was like I had regressed, but my high schoolers were a different matter. I simply couldn’t hear them. One student had to repeat a statement three times before I heard it. When I asked her another question, I didn’t even bother asking her to repeat it. She was so frustrated from the first instance that I just read her lips without ever actually hearing the answer. This worried me and so I called the doctor’s office.

The nurse told me that during the myringotomy the doctor added antibiotic ear drops. She asked if I heard popping and cracking sounds. When I said I did she was certain that that was in fact the issue. She told me to give it until Monday. If I was having hearing issues the next step would be to get a hearing test, but the nearest audiologist would be in Fairbanks and it didn’t seem worth it for me have to go that far for a hearing test. She also felt it probably wasn’t necessary and I felt it was pointless because a hearing test won’t correct the problem. I did ask her if there was anything I could do to help get the fluid out of my ears. She told me I could plug my nose and blow like you do to pop your ears. She informed me that my ears wouldn’t pop, something I knew very well to be true since I had taken two flights to get back home. She also told me that the more cracking and popping sounds I heard while doing this, the better.

Shortly after my phone call I tried this. It was the weirdest feeling and sound. I could hear cracking and popping sounds, but I could also hear the air coming out my ears. It sounded a lot like the high-pitch sound you hear when a car window is just barely open and the car is moving at high speed.

On Sunday when I was at church I was struggling to hear and so I tried this ear clearing method several times. I worked, and I was able to hear a lot better. However, I found out on Monday that everyone in my row at church could hear it. I was told it sounded like my ears were blowing bubbles.

By Monday I could no longer hear any cracking and popping sounds while blowing, but could tell my hearing was still affected. I was going to call the doctor’s office during my prep which is after lunch. Unfortunately, while I was sweeping after lunch (I clean up the lunch tables and sweep in exchange for lunch and we have the best school lunches I have ever seen) when I suddenly got really dizzy. Not dizzy like the room was spinning, but like I couldn’t stand up. I leaned against my broom and heard a coworker asking if I was okay. I didn’t answer. I leaned against the bleachers and used them to sink to the ground. I don’t believe I answered my coworkers questions. One went and got the principal. I answered his questions with shrugs. I didn’t feel I could move my head. One coworker got my hoodie from my classroom. The principal walked me towards the front doors. He left me standing at a corner near the entrance to go and get his coat. I held onto the corner for dear life. Unfortunately, a bus had just arrived and students were streaming past me into the building. So much for being inconspicuous. As the principal went to get his truck to drive me to the clinic (a 3 minute walk away) the superintendent pulled up so we rode with him. At the clinic the principal walked me in and I was leaning against the wall when the first person came out. It was still lunchtime and the clinic was mostly unstaffed. By the time the doctor had arrived I was in the room, had been examined and was feeling much better. I learned in the examination that my tubes looked good and there was no sign of fluid in my ears. The doctor told me that the hearing problems should go away with time. Because my eardrum was retracted for so long it was stretched out and would have to tightened. My hearing problems were concerned while in the course of doing things part of what she said was said from behind and I was unable to make out what she said. She did tell me, “well if you’re hearing doesn’t improve at least you already know sign language.” That was a joke I wasn’t really ready for (and of course not totally a joke. She also knows sign language and when I said, “but I don’t want to have to rely on sign language, “ she replied that she didn’t want to either)

The doctor determined that the dizzy spell was the result of whatever underlying condition has caused the need for the tubes rather than the tubes themselves. She taught me that the inner ear is responsible for not only your balance (which I knew), but actually you’re entire orientation in space including which way is up. Since this incident was similar to the one in the summer where my ears popped she said that anytime your ears pop it can affect your inner ear. If it were to happen again I should just lay on the floor with my eyes closed for a few minutes (my next and last class of the day told me, “well if Ms. Cannon suddenly lays on the floor we know why.”)

I love my colleagues and students. However, when you work in a place where everyone gets concerned about you and something like this happens in such a public manner you then have a lot of people you have to reassure. I had to spend much of my afternoon reassuring people. It takes time, but it sure makes you feel loved.

I'm glad you're not dead

Last Wednesday I had two new experiences. Now I like new experiences, but I didn't like needing these new experiences.
I woke up last Wednesday at 5:33 am, 12 minutes before my alarm. I didn't notice anything unusual until I went to pull my hair in a ponytail. I realized that my arm hurt way too much to have just pulled my hair up, but I didn't think much of it and headed to the pool. After I got to the pool I changed and showered. I realized while I was showering that my right arm REALLY hurt. As I walked to the pool deck I reached across my body to start the swimming app on my phone and realized my hand and arm were swollen and purple. I stopped one of my coworkers who is also the lifeguard and we discussed potential allergy related causes, but found nothing that made sense. I swam one lap and felt the pain all the way to my arm pit. I still swam (although not nearly as far as usual), but I stopped a bit early and showered. Then with my coworker advising me to call the emergency number for the clinic I did and made an 8 am appointment.
After taking my stuff to school and speaking to my principal (my workday begins at 8 am, but classes don't start until 9 am) I went over to the clinic. While I was waiting to be seen (they usually don't start seeing patients before 9 unless its urgent), the power went off. Thankfully the clinic had an emergency generator that kicked in (the power was only off for about 15 minutes so it was back on before I left). The doctor was concerned that I had a blood clot in my arm , but we don't have the imaging equipment for her to check. Additionally, there were no seats available on the commercial flights (I live in community that has no roads connecting it to anywhere else. In the summer there's a barge bringing vehicles and supplies, but otherwise everything pretty much come via air). Luckily I have medevac insurance. For $49 a year I got a membership with a medevac company. Then, if I need to be medevaced they will accept my insurance company's payment as payment in full with my having no out-of-pocket expenses. Best $50 I ever spent.I left the clinic around 9:15 am. I had given the doctor my cell phone number and she was going to call the medevac company and then let me know when they were arriving. I went back to school, filled in a few people (I had already called my principal and so he had gotten a sub). My principal drove me home and later arranged transportation of my four-wheeler home. I packed a bag and laid down. After a while, the doctor called and told me the plane was scheduled to land at 11:07. I called the school and left word so that my principal would pick me up. He picked me up a little after 10:30 for the 10 minute drive to the airport. We parked on the side of the apron and waited for the plane to arrive. Around the time the runway lights came on (which happens when the plane is, I believe, 5 miles out), the doctor arrived and parked beside us. The plane landed and drove onto the apron. The doctor then drove out to the plane and we followed. My principal carried my backpack and the three of us met two flight nurses on the ground outside the plane.

Not the plane I flew in because I was too busy to think to take a picture, but a similar one.

 There was also more snow on the ground than this picture shows.

Since the problem was with my right side the nurses shook my right hand and confirmed with me and the doctor what was going on (They also asked my principal if he was going with me. I replied, "No, he's my boss." He then asked them which one was going to stay and sub for me). One of the nurses got on the plane and adjusted the stretcher. Then I climbed on. They put the stretcher in as upright of a position as it would go and strapped me in around my lab and on two spots on  my legs. All in all two pilots, two flight nurses and a plane all came out to pick up little ole me.
Taking off felt weird. I have flown a lot, but I've never faced backward nor been reclined during take-off. After we were airborne and the plane had warmed up, I took off my coat and they hooked me up to a blood pressure machine and a pulse ox. Unfortunately, my good side was against the window and so this made it a bit difficult, but we made it work. At some point something got messed up with the blood pressure cuff and it got a really low reading. As a result the next time it tightened up so much that it hurt. The results were still wonky so they switched to a cuff on my forearm.
A little less than an hour later after we landed, one of the nurses grabbed my bag and we walked into a garage with several vehicles. I climbed in the back of an ambulance with one of the nurses while the other one drove. She told me I could sit anywhere so I sat on the chair (NOT the stretcher) and she sat on the bench. After the ambulance warmed up (it is winter in Alaska after all), I took off my coat so that she could get my blood pressure. (By the way, if you didn't figure it out the ambulance ride was the second new experience).
We arrived at the emergency department of Fairbanks Memorial Hospital where they were expecting me. I walked in with both nurses and they told the staff who I was and why I was there. There was a room waiting for me. One nurse walked my backpack there while I signed paperwork authorizing the flight I had just taken (and the billing of my insurance company). They had to wait until I was hooked up and my vitals were taken before leaving.
It was determined that I don't have a blood clot and then I was discharged from the emergency room. A friend of mine picked me up and I stayed with her and her family through the weekend. I went to another doctor on Friday and have had many tests done. Everything looks good except for the pain, redness and swelling of my hand and arm (which have gone down greatly by this point).
On Sunday, I flew back to Galena (yes, I had to buy a plane ticket to get back home) and a friend of mine picked me up (along with the two totes of stuff I bought while I was in town) at the airport and drove me home. You might be interested to know that in Galena the person picking you up can wait in their car and see you get off the plane. Then you can get in the car and wait until the baggage comes out. It comes out on a cart that they push up to fence and then you pick up your belongings.
Galena is a small community and when you are medevaced word travels. On Monday, I returned to school and my students' reactions were quite interesting. All of them expressed they were glad I was back, but some of the said things like, "Oh you're back from the dead!" One student stood in my doorway (I don't have him this semester) and said, "Welcome back. I heard you almost died. I'm glad you're not dead" Seeing as I received no actual medical interventions I clearly did not almost die, but it was nice to have people express their concern (and the fact that they were glad I didn't die). However, the questions about what happened were so many (not just from students) that one student suggest I make a PowerPoint slide to show whenever someone asked me about it.

We don't cancel school, but sometimes things do go a little wonky.

My first period class should have 20 students. Today, I have three. I teach at a school that is a combination of the city school (Sidney Huntington School) and a boarding school (Galena Interior Learning Academy, or GILA). SHS is a k-12 school serving the students of Galena (a town of less than 500 people). GILA is a 9-12 boarding school for student from all over the state of Alaska. We hold classes on two campuses: the SHS campus (where the k-8 classes are also held) and the GILA campus which is a former Air Force Base. The two campuses are about 3 miles apart with SHS often being called the city school because, among other things, it is located inside the town of Galena while the Air Force Base is (sort of) outside the town (officially it's in, but it definitely feels out).
 In the evenings and on the weekends the dorm staff takes care of the GILA students, but during the school day they are in classes that are mixed together with the SHS students. This means that we can't cancel school because during the scheduled school day the dorm staff are sleeping. However, sometimes situations arise that require flexibility. For example last fall we had no water at the SHS building. The elementary classes were canceled, but the high school still had classes. All of the SHS teachers had to travel to the GILA campus and find locations to work. I and two other teachers were working in the dining hall. Obviously, it's not the best situation, but we make it work. It has happened this year, but sometimes the roads are too icy to transport the students. In these cases the teachers travel to GILA (if they can't make it the school provides transportation) and classes are held wherever we can find space like the day we were out of water.
 Most of the time, weather that would cause other places to cancel we consider normal. We don't blink at -20 and -30 degree  (Fahrenheit) temperatures. When it starts getting to -45 or so transportation is provided for teachers whose vehicles won't start. At -50 the local kids aren't required to go to school, but most do.
Today, however falls into the category of unusual. I woke up this morning to the sound of snow hitting the windows and the wind howling. I could feel the house shaking (granted our buildings shake a lot more because everything except the Air Force base, which is protected by dikes, is on stilts because of flooding). I wondered if this would affect school. It did. Shortly after arriving at school I heard the rumor that one of the buses had gotten caught in a snow drift. Meanwhile stories start coming in on cars being blown across the road. Most of the trouble was between the former air force base nd town because this is a wide open area (and also the location of the airport). The first bus that should have dropped off local kids ay 7:45 am arrived about 8:10 which was the same time the first bus of GILA kids arrived. The drivers said it wasn't safe to drive the route with kids, especially for the new bus (we have two buses one is new this year) and that driver was hanging around school. Meanwhile, we have an issue. It's not safe to run the buses, but we have kids on both sides who should be on the other (city kids who need to go to GILA, GILA kids who came over for swimming or other things and then GILA kids who need to go to SHS). It was announced that students would go to classes if they were on the correct side and that students on the wrong campus would find a teacher's room to go work in. Seeing as we have about 30 city kids and 230 boarding students, I know the other campus must be pretty crazy today. Life on this side is pretty easy. Most classes are averaging 3-4 students. One of the lunch ladies came into my first period class for lunch count. She told me, "It's pizza day and we have enough pizza for the whole high school and most of them aren't here." They make the pizza from scratch and its pretty good. I'm guessing there will be a lot of leftovers.
We're waiting to see if/when the weather improves and just playing the day by ear.

Life at 50 below

First, let me start that saying, yes the temperature can get to -50 degrees Fahrenheit (-45.6 C). The coldest temperature I have ever personally experienced was -65 (or so because most thermometers stop working at these temperatures).
I didn't realize how shocking this was to people until I talked to my mother today. Matter of fact, I didn't realize our temperature was quite so low. My parents were apparently out shopping today and my dad kept showing people how cold it was in Galena on his weather app. Seeing as how my parents live in North Carolina this sparked a lot of interest even from people who just overheard what he was saying. My mom texted me in the middle of class saying, "-51 brrrrrrrrr." Last time I had looked it was only -47.
At these temperatures there are a number of challenges. First, the boiling point of propane is -43.6 F (-42C). This means that at these temperatures propane is no longer a gas, but rather a liquid. Matter of fact propane pretty much stops flowing at -40 (by the way -40 F = -40C). Many of the stoves here in Galena are propane (including our school ovens) so you have to have a back-up plan. For example, school lunch was baked in the former home ec classroom ovens (we don't have home ec classes, but call the room the community kitchen and use it for a variety of purposes) which are electric.
Another issue at these temperatures is many vehicles won't start. We have engine block heaters, battery heaters, and oil pan heaters (one time in the summer I heard a couple of tourists say, "wow, so many of the cars in Alaska are electric" while pointing at the car I was traveling in. I replied, "that's not an electric car." "Why does it have a plug then?" I explained that the plug was for the engine clock heater. Here in Galena, because it gets so cold the school has plugs so that people can plug in while they're at work so that their cars will start after work. Nonetheless, at 50 below or so some cars simply won't start. Yesterday, I got a text from one of my bosses which read, "-47 but we will run a van for teacher pickup for those who need it. Otherwise school as usual. Please text if you need a ride." I didn't go to work yesterday because I was sick, but I rode the school bus to school today.
Besides propane being a liquid and vehicles not starting we have a few other interesting challenges at these temperatures. As a fly-in only community we are reliant on planes for everything. Of course these planes are affected by the usual weather conditions like visibility and winds, but they are affected by the cold. We have three types of planes that fly into Galena: Navajos, Caravans and 1900s. All three are prop planes, but they have different temperature tolerances. Navajos can only fly to -40, while Caravans and 1900s can only go to -50 (Navajos and Caravans are a lot "leakier" than 1900s so you definitely want your cold weather gear on those flights).
In Galena we also have a lot of houses (including one I'm moving into soon) that are not on piped water and sewer. The water is delivered and the sewer is a holding tank that the city will pump out. The city (we're classified as a first-class-city although with a population under 500 we think of ourselves as a village) this week posted reminders that the don't deliver water or do sewer pick-ups at temperatures lower than -40. It's supposed to be warmer tomorrow (-30 or so) and they've announced that if it in fact is warmer they will run tomorrow (Saturday) which is not a usual day for delivery without a $100 weekend surcharge.
Finally, its also too cold for garbage pickup. Here in Galena we have dumpsters around town and everyone puts their garbage in these. The city empties the dumpsters and takes the refuse to the dump, but alas it is also too cold for this equipment. Therefore, they have sent a message asking people to please hold onto their refuse until it warms up and they can empty the dumpsters. Right now the birds and animals are picking open the garbage and making a big mess of it (the dumpsters close, but as they get too full people usually stack the garbage next to the dumpsters).

So, as you can see life at -50 has some unusual challenges. There are also some interesting observations. At about -30 you can feel your nose hairs sticking together, but at -50 the air just burns. At these temperatures plastic cables and other things that are usually soft can snap and fabric becomes stiff and crinkly. While most of you are probably thinking "ugh, why do you live in a place like this?" Despite the challenges I really like it here in Galena and I invite anyone to come and visit (although I won't be offended if you chose to come at a warmer time). It's supposed to really warm up on Sunday and into the early part of next week. Sunday has a forecast high of 0F, Monday 6F and Tuesday 9F. I don't trust forecasts more than a day out (and I'm not even sure I trust them that far out here because the temperatures and the forecast simply don't appear to align), but if we really do get to +9F it will feel truly warm.