Posts Tagged ‘sunset’

Lower blood pressure with deep breathing

July 5, 2017

It’s a technique, and I don’t mean to brag

But when the smoker lights the first fag

And breathes deep and slow

Though the smoke is the foe

They’re champs at that very first drag.

Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, traveled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I went back to traveling and adventures in temporary positions. Assignments in Alaska, rural Iowa, suburban Pennsylvania and western Nebraska have followed.  I finished my most recent assignment in Clarinda on May 18.  Right now I’m in northern British Columbia, getting a first-hand look at the Canadian system. Any identifiable patient information has been included with permission.

I see a good number of people with high blood pressure, some better controlled than others. If the pressure is too high, I repeat the reading.  A second round of measurement less than 5 minutes after the first will give a falsely elevated reading.

Most of those with hypertension (a blood pressure greater than 140/90) smoke tobacco and drink more than healthy amounts of alcohol. I point out to the smokers that they have a valuable tool, that they didn’t realize they had.

I was still working for the Indian Health Service when I had a conversation with the worst nicotine addict I ever met. She had quit 4 packs per day about 10 years prior.  Half the relaxation of the cigarette, she said, is the deep breathing technique that goes to taking the first drag.  Every meditation system in the world stresses the deep breathing that all smokers have taught themselves.

Breathing can change blood pressure a lot. The FDA approved a device to teach people to slow their breathing down; the studies showed it safe and effective for blood pressure control.

So I tell the patient to pretend they’re taking the first puff of the day, to breathe slow and deep, and I breathe with them.

I repeat the blood pressure measurement after 6 deep, slow breaths, and almost always the top number drops by 30 points and the bottom by 15, good enough for most people. Whether the improvement is adequate or inadequate, I tell the patient to breathe slow and deep for 20 minutes a day, whether in one chunk or twenty.  For those current smokers, I point out that they could get half the calming effect of tobacco just by doing the breathing exercise that they already know how to do.


I had call last night. With light traffic in the ER I managed to get back to the hotel early, but I got called back at 10.

As far north as we are, I walked to the hospital with the setting sun in my eyes. Forty-five minutes later, I walked back in the twilight, thinking that I should have brought the bear spray with me.  I crossed the highway with literally not a single vehicle moving.


Sunrise comes with sunset; the day really is too short when it’s 75 minutes long

January 25, 2011

We watched the darkness go away

At the side of a lagoon or a bay.

     Forget solar power,

    It’s only up for an hour

The twilight is longer than day

Synopsis:  I’m a family practitioner from Sioux City, Iowa.  I’m taking a sabbatical to bring myself back from the brink of burnout, while my one-year non-compete clause ticks away, having adventures, working in out-of-the-way places, and visiting family and friends.  Currently I’m in Barrow, Alaska.

Barrow’s annual sixty-three days of darkness ended Sunday with sun-up a little past one in the afternoon, followed shortly by sun-down.  Another doctor, a guitarist, Bethany and I went out to watch, with a temperature of sixty-five degrees below zero.

The Arctic Circle runs slightly north of Fairbanks, dividing the land of the Midnight Sun from the rest of the world.  At the Equator, the sun shines twelve hours daily, and days last as long as nights.  As one travels north or south, day length during the summer grows, and during the winter shrinks, until at the Poles day and night each last six months.  In Barrow, halfway between the Anchorage and the North Pole, the summer sun stays up 82 days and the winter sun goes away for sixty-three days.  If light did not bend in the atmosphere, the darkness and light would be more symmetric.

Thus, the local joke about the detective questioning the suspect, starting with, “Where were you on the night of November to January?”

We dressed for the cold and set out from the hospital after lunch.   

Humans exude water, and in extremely cold weather groups of humans and their activities create what the meteorologists call “habitation haze.”  We left Barrow shrouded in fog, but three miles from home, clear of the ground cloud, we could see the tip of the disc peeking out from the horizon, and we turned east.

Punchy with the thrill of seeing the sun for the first time, we got out of the SUV, leaving the engine running and the heater going full blast. 

I underestimated the cold.  After forty-five seconds trying to use the camera bare-handed, I realized how close to frostbite I’d gotten, and I went back into the vehicle.  After I warmed up, I buttoned my parka, put on my aviator’s mittens, and went back out.

Such cold becomes a sharp presence, and the slightest breath of wind hones its edge and it cuts like a razor.

But the angle of view, towards the south, meant that the habitation haze of Barrow interfered with the best view.  We got back into the SUV and headed north towards the point, laughing and joking and giddy with daylight.

We stopped in the parking lot where the road ends, and angled the windshield south.  Out in the bitter cold, with a full view now of the sun, we watched it climb to its zenith, not quite clearing the horizon, taking pictures, while our breath condensed into white crystals on our outer layers.

We observed the sun’s descent from inside the vehicle, the robust SUV heater struggling against the cold. 

The colder the air, the more it refracts, and the horizon appeared further away than expected; rather than dropping away in the distance, it rose.

At quarter past two in the afternoon, the day ended, and we headed back to town. 

We’d been out all day and we still got back in time for football.

Arrival back in Barrow: spilled milk in the Arctic night

January 18, 2011

Down the dark runway we rolled

Through the night, the snow, and the cold

    You know I might sigh

    Over spilled milk, but not cry.

I didn’t come here for the gold.

Synopsis:  I’m a family practitioner from Sioux City, Iowa, in a career change to avoid burnout.  While my one year  non compete clause ticks out, I’m having adventures, working in a lot of places, and visiting family and friends.  Currently I’ve returned to Barrow, Alaska, where I had my first locum tenens assignment this summer.

We left Anchorage at sunset.  We walked out onto the tarmac, entering the plane near the tail.  We peered around the end of the aircraft and saw the sun going down.  We will not be able to see the sun again for at least a week.  Gentle cold filled the clear air.

In the plane, a thick bulkhead with a locked door separated our area from the front of the plane, and Bethany and I thought that first class passengers took their privileges seriously.  As we hadn’t heard them called, and as none entered the plane at the front, we realized that the plane carried none.  Cargo occupied the fore part of the jet. 

Most of Alaska is “the bush,” meaning that goods and people come and go by water or air.  In state, Alaska Airlines allows three pieces of checked baggage at no extra cost.  In Barrow’s airport, you can see the flow of goods in the duct taped Rubbermaid bins.  Big screen flat-panel TV’s come in with every flight, though the baggage handlers in Barrow use as much force as baggage handlers everywhere.

Yet, on the plane we sat next to a young man who had driven a truck last May from Anchorage to Prudhoe Bay up the Dalton “highway”, then from Prudhoe Bay to Nuiqsit via the Ice Road.  He’d driven from there to Barrow along the shore, crossing bays on the ice.  Thus, a trickle of vehicles comes to the North Slope by road, and, at great risk, arrives in Barrow. 

The plane landed, hard, in the dark and snow, on the only pavement in Barrow; Bethany and I pulled on our heavy parkas before we deplaned.  Barrow’s airport has no jetway; we crunched across packed snow and ice to the terminal.  Between Barrow and Anchorage the cold had hardened to 15 degrees below zero, small snowflakes fell. 

The community pitches in for baggage handling at the airport.  Natives, who prefer the term Inuit to Eskimo, comprise more than half the population of Barrow.    

A container of milk ruptured in the baggage during the flight and spilled over the baggage infrastructure; I grabbed paper towels from the restroom, mopped as best I could, and tried to direct the luggage away from the drying residue.

I noted less airport chaos on my arrival this time than on my first trip; only half the plane had people. 

Outside, the full moon lit the snow-covered scene.  Despite the dangerous cold that greeted us, a few young men in their late teens wore baggy shorts and flip-flops.