Saturday, November 27, 2010

Support from Home for Our Wounded

A Homemade Quilt
As soon as a wounded soldier is taken off of the helicopter on arrival to the FST, he is taken to the shakeout shed.  Here, triage is done, and all clothing is cut off.  After treatment,  most are evacuated to Bagram Air Field, followed by Landstuhl, Germany, and then Walter Reed in the States.  All of his clothing and personal effects will still be in Afghanistan.

Another Gift of Love and Support
We have a terrific supply of shirts, sweatpants, socks, slippers, underwear, etc. that have been donated by patriotic citizens of the US who want to support our wounded heroes.  Right before they get on the helicopter to leave us, they are dressed comfortably.  They are given a toiletry kit made of donated items.  They will also receive a blanket or quilt, usually homemade.  Many of these quilts come with a personal letter from the maker thanking the serviceman for his service and wishing him a speedy recovery.  What a terrific way to express one's gratitude!  These quilts exude love!

Sewn on a Handmade Quilt

Letter Sent with a Quilt
The majority of the clothing and toiletry items are sent to us by the Landstuhl Hospital Care Project, a non-profit group from Virginia.  These folks are in constant contact with the hospital in Landstuhl, and the deployed medical units in Afghanistan and Iraq.  When supplies of a particular item are low, they post it on their website, and citizens may donate them, or send money for the purchase of the needed supplies.

People are always wanting to send "care packages" to me and others in my unit.  While we certainly appreciate the support, we really do not need anything that is not provided for us already.  Frankly, sometimes items that people back home have purchased for us and lovingly sent here go unused.  If you would REALLY like to help, I strongly suggest that you go to the LHCP website, at:

From the homepage, click on "how to help."  This will take you to a page that lists specific items that are urgently needed.  You can also make a monetary donation.  Believe me, you will be making a difference in the life of a wounded soldier!

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

Thursday, November 25, 2010

Thanksgiving in a Theater of War

Ready to run!
How do we celebrate Thanksgiving at a Forward Operating Base in Afghanistan?  Well, for starters, there was the Fallen Heroes 5K run at 0630!  This run was to honor the memory of soldiers from the 27th Engineer Battalion who have "paid the ultimate price" during this deployment.  As usual, the 909th showed everyone how athletic they are by blowing away the competition.   

At 1000 the strongman competition started.  This unit has some SERIOUS weight lifters, and they came away with several medals.

At lunch and dinner, the senior officers and NCOs of the 10th Mountain 4th Brigade Combat Team served a delicious dinner with all the fixin’s.  The DFAC tent was decorated well, too!  General order #1 prohibits the consumption of any alcohol in a war zone, but we were served sparkling grape soda poured from champagne bottles!

I’ve been getting emails from friends who seem to feel sorry for us at this time of year.  Don’t!  Being deployed isn’t a bad thing.  Sure, there are certain hardships, and the separation from family and friends can be a drag, but we have much to be thankful for!  When you live and work in an austere environment such as this, it makes you realize how fortunate we are to live in such a beautiful and bountiful country, the USA!  It makes you prioritize what is important in life, and not “sweat the small stuff.”  We cared for two severely injured Afghan soldiers today, who are fighting to protect a way of life that is vastly different from anything we are used to.  These men truly are risking their lives – their friends may be Taliban tomorrow.  Aren’t you glad that we don’t have to live like that in our country?

On this Thanksgiving Day, I hope that you can truly appreciate the freedoms that we have, and the bounty that we all share as US citizens.  The war on terror is here, not at home.  Let’s keep it that way!

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

Monday, November 22, 2010

The 909th Command Structure

SFC Biesiadecki, CPT Murphy, MAJ Provenzano
The Commander (OIC - Officer in Charge) of the 909th FST is MAJ Provenzano.  As a civilian, "MAJ Pro" is a nurse anesthetist.  He oversees all functions of the FST.  He is quite an athlete, as well.  His emphasis on fitness is quite contagious - this is the most athletic unit that I've ever served with.

The Detachment Sergeant (NCOIC - Non-Commissioned Officer in Charge, or First Sergeant) is SFC Biesiadecki.  SFC "Bies" works as an elevator mechanic when not in the Army.  He oversees the enlisted members of the unit.  His responsibilities include water, power, discipline, evaluations, supplies, training, movement, and anything else that the unit does!  His is a 68W and M6 which stands for Licensed Practical Nurse.

CPT Murphy is the unit's XO.  As an officer in this position, he is responsible for PAD (Patient Administration).  He tracks patient movement and assists the commander in arranging medevac flights.  He also manages the unit's equipment inventory.  In the civilian world, CPT Murphy teaches 8th grade science in a public school.

MAJ Provenzano, Commander, in the TOC
The office in which the command structure personnel work is referred to the TOC - Tactical Operations Center.  Here they are able to communicate with other medical assets in the theater of operations.

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

Thursday, November 11, 2010

The Providers

COL Giles, MAJ Ochsenknecht, CPT Khalil, LTC Koutlas, MAJ Jordan
The Army uses the term "providers" to mean any licensed independent practitioner in the Medical Department.  In an FST, this includes doctors and nurse anesthetists.  Medical units may have physicians’ assistants and/or nurse practitioners, dentists, optometrists, etc.

Usually, the providers of an FST rotate in for 90 days at a time, unless they are extended.  (Of course, the Army can do whatever it wants!)  This policy came about after the first Gulf War, after which many medical practitioners who had been activated lost their civilian practices and subsequently resigned their commissions.  Other members of the unit deploy for approximately 12 months.

"Joker" repairing a vascular injury
LTC Koutlas, MD, has been a reservist for about 6.5 years.  His radio call sign is “Joker.”  This is his 3rd mobilization; he has previously served for two tours in Iraq.  A resident of North Carolina, he is a pediatric and adult cardiac surgeon.

"Sawbones" repairs a muscle injury with help from Nguyen
MAJ Jordan, MD, “Sawbones,” is our orthopedic surgeon.  As a former infantry officer (HOO-AHH!), he was deployed with the 1st ID in Kosovo.  He is the only active duty soldier in the unit.  Due to his expertise, he not only performs surgery, but he also sees many clinic patients who require orthopedic consults.

"Ox"giving a spinal anesthetic
MAJ Ochsenknecht, CRNA, “Ox,” has 19 years of military service under his belt.  He is a prior enlisted soldier who was a member of the signal corps.  This is his 5th mobilization, 4th time overseas, and the 3rd deployment to a combat zone.

The author, "Underdog," passing gas
COL Giles, CRNA, “Underdog,” (me), just completed his 20th year of service.  This is his 7th mobilization, 3rd overseas, and 2nd in a combat zone.  

"Rambo" in action

CPT Khalil, MD, "Rambo," is our other general surgeon.  He brings to the FST his expertise as a general surgeon, trauma specialist, and critical care provider.  He would like nothing better than to go "outside the wire" on a mission.  Fortunately for us and the wounded soldiers, providers will always be "Fobbits," a term for those who never leave the FOB. 

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

Tuesday, November 9, 2010


It has been a while since my last entry.  For various reasons, we have intermittent internet and telephone blackouts that can last for days.  That being said, here is today's entry...

SSG Neumann, SGT Ford, CPT Ysmael, and SGT Anderson
The ICU is commanded by CPT Ysmael, who works as a neonatal ICU nurse as a civilian.  The NCOIC is SSG Neumann, a pediatric RN.  SGT Anderson is a police officer when not on active duty, and SGT Ford is an LPN who works in a dialysis unit.

The ICU is a multifaceted unit.  When patients are waiting for surgery, they are moved to the ICU from ATLS for monitoring, stabilization, etc.  After surgery, the ICU functions as a recovery room.  At times, minor surgical procedures are performed in the ICU to avoid tying up an OR bed which may be needed for more seriously wounded soldiers.

The ICU team in action, with CPT Johnson modeling his new Multi-Cam Uniform!
The ICU has the capability of holding up to four ventilated patients for up to 72 hours.  Most patients stay postoperatively for less that an hour.  The staff is responsible for preparing them for MEDEVAC transport.   Temperature is a real concern – great pains are taken to assure that the patients remain warm.   Riding in a Blackhawk helicopter can make people cold in a matter of minutes.  Patients are given blankets called “Ready Heats” that become warm when exposed to air, and space blankets.  We also have handmade quilts that are donated to the FST.   I’ll blog about them at a later date.

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

Tuesday, November 2, 2010

The Operating Room

The Operating Room sits between the ATLS section and the ICU.  It is equipped and staffed for two simultaneous operations, but the second bed is reserved for absolute life and/or limb threatening emergencies.  We try not to have all of our OR assets tied up in case something more urgent arrives.

LTC James, SPC Nguyen, SSG Penn, and SPC Thomas
LTC James is the OIC of the OR section.  He has 22 years of military experience and works as an operating room nurse in civilian life.  SSG Penn is a firefighter/paramedic when not activated.  He has almost 20 years of military service, and functions as a second circulating nurse when necessary.  SPC Nguyen manages a nail salon at home, as well as being a personal trainer.  SPC  Thomas works as a personal trainer.

SPC Nguyen assists 2 surgeons (LTC Koutlas and MAJ Jordan) simultaneously
Penn, Nguyen and Thomas have all received the 68D MOS, which is "Operating Room Technician."  The Army course is 16 weeks in length, at which time they are taught sterile technique, basic surgical skills, and instrument nomenclature.  They must log many hours during actual surgical cases to graduate.  Thomas just graduated last December, and was immediately activated!  These men do a remarkable job.  Unlike their civilian counterparts, they frequently first assist while providing help to another surgeon at the same time.  It is not uncommon to have an orthopedic procedure taking place simultaneously with a general surgery operation on the same patient.  These soldiers have learned to suture, insert chest tubes, perform cricothyrotomies, and apply external fixations to broken bones.  Not many civilian OR Techs can boast about having those skills!

Dental Autoclave
Big Bertha
The OR staff is responsible for sterile supplies for the FST as well as several combat outposts.  Usually, FSTs are supplied with one dental autoclave for sterilizing instruments.  We are fortunate to have a "Big Bertha" full-sized autoclave that can handle larger instrument sets.  It is an amazing machine.  We power it with electricity, but it can also use almost any fuel, including kerosene, gasoline and JP8 jet fuel!  It is not as fast as a civilian autoclave.  It takes 15-20 minutes to "flash" an instrument, depending on the ambient outside temperature.  We also have 2 water distillers for use in the autoclaves.  The surgeons who rotate to the FST must be able to operate with a minimal instrument selection.  We have major, minor, thoracotomy, craniotomy, vascular, and ortho sets, but they are very basic.  Separate instruments are "peel packed" to supplement the sets.

Not all casualties need to go to the operating room.  Sometimes, minor wounds are cared for in ATLS or the ICU.  The OR is reserved for serious injuries that cannot wait for the flight to a combat support hospital.  We basically stop bleeding, apply external fixation to broken bones, shunt vascular disruptions, and stabilize the patient for transport to a level 3 facility.

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.