"Sunday, Monday Happy Days....."

Nearly at the end of my first month here. I can't believe I'm a month in already - it has flown by, but as far as money goes, the end of the month can't come quick enough. We're down to our last few cents pretty much, and I'm dreading my next credit card bill from the UK, cos we've had to rely on the credit card a lot this last week. Still 6 days to go till pay day, then hopefully we should be alright.

Certain things here are cheap (petrol, car rental, eating out) but I was surprised by the cost of other things like car insurance, phones, internet, cable TV, fresh food from supermarkets - so we seriously underestimated how much we'd need to survive the first month. The good thing is we are paid very well here (and I won't have to pay any income tax), so after pay day we should be good. For anyone who is considering a year here, there's other cost considerations that you don't necessarily think about - like I lose a years pension, and also my added years conribution contract gets cancelled and I lose it permanently. This was disappointing, but in the whole scheme of things was never going to put me off coming. I will probably have to send some money home to keep the bank balance in the black, but thankfully we have rented out our house at home so it's not as bad as it could be. I'm also hoping to save a little lump sum by the end of the year to make up for the pension.

It's always nice to hear from friends and family back at home. I think I speak to them more now than when we were at home. With e-mail, texts and Skype it's so easy to keep in touch. I haven't been home sick at all really, but there's been a few things I miss - I miss rugby (I've got 16 sports channels here, and not one shows any non-American sports), proper hills and mountains (Michigan is lovely but pretty flat).

I'm quite glad we don't have to hear about the election every 5 minutes though. In fact if I didn't check the BBC website now and again I'd have no idea there was an election going on at all. US news channels don't report much from outside the US. (The icelandic volcano did get a brief mention but only because transatlantic flights were affected). I think I check the BBC website now and again just to check that home is still there and not sunk under the sea.

Work last week was good. I had to visit Occupational Health - it was reassuringly the same painful crap experience that it normally is. I had a bonus day off - I was a Reserve one day - so I just go in in the morning to help start lists, and in case someone is sick, but after a couple of hours I could go home again.

I was anaesthetising for robotic laparoscopic surgery all week. It was a bit weird at first to see a robot operating. The surgeon sits in the corner of the room and controls it like a playstation 3 basically. It's pretty much the same as any laparoscopic (keyhole) surgery but takes three times longer. Thats my take on it anyway. It's quite impressive though that they manage to do a radical cysto-prostatectomy (removal of bladder and prostate) by keyhole surgery with about 200mls blood loss! I would argue that the 10 hour anaesthetic time may negate some of the benefits however, but who am I to suggest such a thing. Also a hysterectomy and radical prostatectomy are done in this way. From an anaesthetic point of view there's not much to do - stick a tube down the trachea, make sure you've got good iv access, watch for the usual complications of laparoscopic surgery - which I also got to see and had my first experience of handling a critical incident. (In 1 case - surgical emphysema with suspected pneumothorax which turned out not to be, in another case a ET tube herniated out half way through!) Things went very smoothly - as soon as I reported to the surgeons there was a problem I had their full cooperation, and basically we fixed the problems and they continued - no dramas.

Hopefully by my next post I'll be paid and we'll be on a spending spree! Happy Days! :-)

Till then,

Drake.