Girona to San Feliu and back

Distance: 54 miles
Eelevation: minimal
Tmax: 75 degreees
Highlights: Today was supposed to be a 35 mile ride (roundtrip) down to the beach. We even brought our swimsuits in our camelbacks. Instead it was 54 miles with a headwind on a freeway for part and a little hilly road for the other part of the ride. I guess that's what happens when you deviate from the touring company's scheduled ride. When we got to the beach it was cold and windy - not a day for swimsuits and laying in the sand. The tailwind on the way back to Girona was the highlight.

Dinner tonight started with onion rings and beer sitting at a table next to American pro-cyclists (?Team Garmin again) at an Irish pub. During our intermission, we walked on the old wall that surrounds Girona (it's over 4 stories tall). We then moved on to traditional Spainsh Tapas - a buffet of tapas with toothpicks in each piece of food. You pay for the amount of toothpicks you have at the end of the night.

Camprodon to Girona

Distance: 60 miles
Elevation lost 2, 500 ft
T max: 72 degrees
Highlights: Today has been the best day of biking yet. Beautiful mountains and a lot of downhill (with just enough uphill pedaling to stretch the tired muscles). These hills are crawling with bikers. I'm not sure if it was a normal Sunday, or if it was because Saturday was so rainy, but we saw 79 road bikers (including Team Garmin) and 36 mountain bikers. Of the road bikers, we saw 33 of them in the first hour of our ride. This area of the Pyrenees is beautiful (probably the French side was just as beautiful, but we couldn't see it because of the rain). My words would not do the mountains justice - hopefully some of our pictures will show the beauty. (I'm not uploading the photos at an internet cafe, the connection is too slow. It is taking me awhile - and lots of Euros -just to post on the blog.)

Dinner tonight came from a recomendation of our Cicloturisme company: a little French bistro where we had a fantastic green bean and prawn salad with pesto dressing and "le pizze" with pate and goat cheese.

Figueres to Coustouges, France then into Camprodon, Spain

Distance: 70 miles
Elevation: 2 x 5,000 ft passes (yep- up, then down, and up and down again)
T max: 70 degrees F
Highlights: Today we woke up early and skipped the hotel´s breakfast to get on the road by 7am. Last night we found the best chocolate croissants in town and this morning we got coffee from the vending machine in the lobby of the hotel. We climbed out of the valley of Figueres to the Spainsh Pyrenees into France. We were sweating by about 7:15 am. For lunch, I used all the French I know to order us a quiche and a piece of pizza in a little patissiere in Sant Laurent de Cerdans. Why hot food for lunch? Well, it rained on us 4 times and hailed twice. Luckily we had two 5,000 foot passes to keep us warm as we struggled on our way up and to dry us out as we zipped down the hill. Also, I am very fortunate that Ben did not leave me by the side of the road as I cursed French roads. (You can tell which country you are in by the pitch and the smooth road - or lack there of -beneath your tires.) After about 10 hrs of biking (we were averaging about 5mph uphill) we made it to the ski town of Camprodon. As we turned onto the sidewalk of our hotel, Ben got his 4th flat tire of the trip. This flat tire was legit- a big piece of metal pierced both the outer tire and the inner tube (we now know that these things are called "la cubierta" and "la camera" in Catalan).

Dinner tonight was in the hotel resturant (we were too tired to go out): strawberry and melon gazpacho, sausage for Ben and a hamburger for me, fruit and molten chocolate cake for dessert.

Number of other riders: 33 (two big pro teams - one group of 10 cyclists and one group of 12 cyclists - and a bunch of stragglers like ourselves).

Figueres to Cerbere, France

Mileage: 49 miles
Elevation change: 1300 ft
T max: 73 degrees F
Highlights: Today we rode to France for lunch. Our ride today was Spain´s equivalent to California´s Hwy 1 through Big Sur and Monterrey. It was beautiful, hilly and cool. The cliffs of eastern Pyrenees run into the mediteranean here. We had breakfast/coffee by the water in this little town of Port Bou before crossing over to France. The border crossing was pretty unimpressive. Just us and some people from Holland on bikes- no border patrol. Ben brought his passport, but we didn´t even get it stamped. On our way back to Figueres, the skies opened up and we got drenched. Tonight we go to bed early since we have a long haul tomorrow. Nothing fancy for dinner -beer and pizza.

Number of other riders: 7 cyclists

Toroella to Figueres

Mileage: 31 miles
Elevation gain: nada
T max: 79
Highlights: Today we biked along the Gulf of Roses with beautiful blue-green waters and then across a wetlands nature preserve. Today is our last day along the coast. Tomorrow we go up into the mountains.
Number of riders: 7 cyclists and a ton of turists on cruiser bikes along the beach

Today Ben had his third flat tire. Instead of fixing it ourselves, we called the Cicloturisme lady who came out to our hotel to pick up the wheel. She took it to her local bike mechanic who"fixed it." Basically she did the same thing as we did yesterday, but at least she knows what is going on. If we have trouble tomorrow, she said she would drive to where ever we are and bring Ben a new bike. As a result of the wheel trouble, we got started 2 1/2 hrs late. We shortened our ride since I really wanted to go to the Dali museum in the afternooon. After our walk through the crazy Dali museum we took a stroll around the biggest castle I´ve ever seen. The Sant Ferran castle was built to house 12,000 people. It´s on this big hill outside of town. The perimeter is 3.1 kilometers and there were a ton of runners getting their evening run in. Ben and I were able to keep up with two old ladies who were walking with an umbrella.

Post ride drinks included beer from Belgium at a bar that boasts over 100 beers (bottled -not on tap). Dinner tonight included sardine gazpacho with pistachios and some tasty other bites - like squid stuffed with sausage. We´re not exactly sure what we ate since the menu was in catalán. Then we had figs cooked in some sweet liqour with ice cream for dessert.

Toroella to San Antoni de Calonge and Back

Mileage: 42 miles
Elevation Gain: about 2000 ft
T max: 87 degrees F
Highlights of the ride: 2000 ft of elevation gain is part of a training ride for US Postal team and Lance Armstrong. We saw 16 other bikers on our route today.

Today we had a beautiful day biking along the beach and then back through steamy hot wheat fields. Ben had his second flat tire today - we decided it was a faulty outer tire causing the inner tube to puncture. We changed it in Palamos at Biccecletta Esteve´s. Then we had lunch on the beach and walked up to an old castle tower. Today we found out that the Castell de Montigri (on the hill outside our hotel) was built in 1294 after King Jaume II, when he got all the disobedient counts in the area to follow his lead and keep this area of Spain part of Catalunya. The best thing we learned today was that when people in this area have the day off they say "Manaña tengo fiesta." Literally translated as "Tomorrow I have a party." I think I would take so much more advantage of my limited days off if I thought of each day off as a party.

Tonight we´re drinking cava - the Spanish version of champange.
On the dinner menu: tomato mousse with olive oil, and bruchetta with tomato, sardines, and strawberries

Torroella de Montgri

We arrived in Barcelona yesterday. Although it was about 5am in California and we were tired from not sleeping on the plane, we ventured out onto Las Ramblas in Barcelona. There we found the statue of Cristobal Columbus and some paella in an outside cafe.


Las Ramblas:


This morning we woke up early and took the train to Girona, where we rented bikes. Then we went for a short ride in the heat of the afternoon sun out to the beach. We just tested out the bikes (tomorrow we start our riding) - they´re light and fast but Ben already got a flat tire.

The Playa (or Platja in catalaño)

Tonight we´re staying at an old mill that has been turned into a hotel. After our hot bike ride we took a dip in the pool.

Hotel Moli del Mig:

Hopefully we´ll get a good night sleep tonight so that we can enjoy our bike ride in the morning!

Avalanche Class

Ben and I took an awesome Avalanche Class through Alpine Skills International in Truckee this March. We had great weather and fun people to back country ski with.

It snowed 2 feet the weekend before we were in Tahoe:


Looking down, before we get fresh tracks:


From the bottom, looking up at our fresh tracks:


Skinning back up took about an hour:

A rare moment (on my skis and in control):


It wasn't all skiing. We learned a ton of avalanche awareness skills.
Cutting a cornice:

Digging a snow pit:

Route planning:


Hopefully we'll be able to get up to Tahoe again before the snow melts.

Special thanks to Mindy for taking so many pictures:

I've never had one of my procedures video taped, however below you can see me delivering a baby via c-section. I just wanted to give a special thanks to Carlos for filming the c-section video on the last post.

Picture of Carlos at the bird sanctuary:



Our Anesthesia team: (John, Carlos, Roberto, and Gary)


Roberto and Dr. Julio (both from Cuba) with Carlos:




Dan and Carmen (scrub nurse in the c-section video):

C-section Video in Puerto Lempira

Honduras: International Health Service

This is the Puerto Limpira Surgical Team from IHS 2009. [Front Row Jon (CRNA), Gary (CRNA), Jim (General Helper); Middle Row Dr. Brown, Joan (RN), Kyla, Dan (Paramedic), Carlos (Translator), Back Row: Ben (MS4)

The map of Honduras:
La Mosquitia (also spelled La Moskitia) is the far eastern part of the the country. We stayed in Puerto Lempira. You can only get there along the coast by boat or by plane. There were three other medical teams that were flown or shipped upriver to more remote areas. These teams sent us patients for surgical consults.




Pictures:
We didn't get out of the OR much so I have just a few pictures of the area. Here are some typical houses:


Usually the houses are up off the ground if they are by the water:


The park:


The beach:



The compound where we stayed (big dorm rooms):



The Hospital:
Below are pictures of the Puerto Lempira Hospital (Top photo from Dr. Banegas).





I didn't take many pictures of the hospital wards. There are 4 medical wards: a pediatric ward, a maternity ward, a woman's ward and a men's ward. Each ward was a bunch of beds in a big room without curtains or privacy. The hospital was pretty busy but had limited supplies (no working x-ray).

Newborn preemie twins (34 wks):



(The twins weren't our patients. I just thought it was a sweet picture.)


The hospital had 2 operating rooms:



Carlos and Dan in the OR:

Jon in the main OR:



Pre-op area:
(Notice patients sharing a bed)



Post-op area:
Notice that there are no monitors. Also, notice two of the local surgeons (in blue scrubs) resting in the beds next to the patients.


Our referral system:
Patients were sent to us from outlying villages by other IHS teams with a note in a plastic bag attached via safety pin:




OR pictures:
We did 46 cases in 8 days. Nineteen of the cases were laproscopic. I did 38 cases (of which 7 cases were with the Honduran docs).


Removing breast cancer:

Circumcision with Dr. Everett:



Dr. Wood (green scrub hat), Dr. Banegas and I doing a hysterectomy:

WARNING: DON'T LOOK AT THE PICTURES BELOW IF BLOOD UPSETS YOU

Oophorectomy:





Cystic ovary after removal:




Advanced breast cancer (removal wasn't curative, but hopefully we improved her quality of life).


The amount of tissue we removed:

The mass after removal:


Post-op:



That's just a sampling of my pictures. Thank you to Carlos for taking many of the photos while I was operating. If you want to find out more about IHS check out the website:

http://www.ihsofmn.org/