Medical Reserve Corps

Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

I have volunteered to be a member of a local medical reserve corps (Pulaski County MRC Team 1).  It is still in the forming stage as we recruit members, etc.  There are many on-line courses that can be taken to ready yourself or to take as a review every few years.  A-Train allows me (and other members of my team) to access these courses and to keep a transcript log of the courses we take (and add those not taken through this site).  It also allows our leader to suggest courses for us, to contact us for periodic meetings, etc.  Through this site, I can link to others such as the federal site "Office of the Civilian Volunteer Medical Reserve Corps". 

I am told that most MRC’s have difficulty getting physicians to sign up.  We need to train along with the EMT’s, fire departments, city planners, hospitals, etc so that when disasters (be it California’s fires or earthquakes, Arkansas’ tornados and this year floods, the Gulf’s hurricanes, school shootings, etc) happen we are ready.  We need to be ready as well as willing.  I would encourage you to volunteer.  You can specify that you are not willing (or able) to be deployed great distances or for extended periods of time.  By being educated in the lingo, organization, and vouched for (they can check your degree, etc) ahead of time it will be easier for you to be “used” when the time comes.

You can search for an MRC in your area here.

I began this course a few years ago and have been slowly learning more about disaster response (man and nature made).  Arkansas recently set up a website for registering as a volunteer, so they could “vet” us prior to being called out.

The Arkansas ESAR-VHP System is an electronic database of healthcare personnel who volunteer to provide aid in an emergency or major disaster. Our System is ultimately designed to register health volunteers, apply emergency credentialing standards to registered volunteers, and allow for the verification of the identity, credentials, and qualifications of registered volunteers in an emergency.

Registered healthcare volunteers will be contacted to determine availability when there is a need for emergency personnel. If available for deployment the volunteer will be provided with the appropriate contact and reporting information.

I would like to encourage you to volunteer or at least on a personal level learn what you need to do as an individual to keep yourself and family safe.  That will lessen the need of responders to do rescue.

IS-22 Are You Ready? An In-depth Guide to Citizen Preparedness

SurgeXperiences 210 – Call for Submissions

 Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

The next edition (210) of SurgeXperiences will be hosted by From Dupont to Abdoun (photo credit) on November 9, 2008.

This site is a product of my experiences as a Georgetown medical student (near the famous Dupont Circle) on academic sabbatical living in Amman, Jordan (near the not so famous Abdoun Circle).  I plan to return to the U.S. in 2009 to complete a residency in emergency medicine.  It is my hope to tell the stories of the many wonderful patients and diseases I have encountered, to describe health care in Jordan, and to elaborate (or maybe just ramble) on some of my thoughts about practicing medicine in a developing country.  Thanks for reading!

The deadline for submissions is midnight on Friday, November 7th.  Be sure to submit your post via this form.

SurgeXperiences is a blog carnival about surgical blogs. It is open to all (surgeon, nurse, anesthesia, patient, etc) who have a surgical blog or article to submit.

Here is the catalog of past surgXperiences editions for your reading pleasure. If you wish to host a future edition, please contact Jeffrey who runs the show here.

Turkey-Pumpkin Stew

Earlier this week I had a short conversation with Dr B, Surgery, Cooking, Art....Life. Passionately. She mentioned making pumpkin-apple soup, pumpkin gratin and (of course) roasted pumpkin seeds. I recalled having a recipe for turkey-pumpkin stew that actually uses the pumpkin shell for the serving bowl. Neither of us could find it on-line. I don’t recall where I got it. Most likely a magazine or newspaper back in the 80’s. I typed it up to share with Dr B and decided I would make it myself. Here is the recipe and some pictures.

Turkey-Pumpkin Stew Cooking Time: 2 hrs & 45 minutes
Serves 4-6


INGREDIENTS:
8"-10" pumpkin or squash
2 Tbsp flour
1 Tsp salt
1/8 Tsp ginger
2 lb turkey, cubed
2 Tbsp oil
1 medium onion, diced
2 Tbsp flour 2-3 thin carrots, quartered
1 cup yellow squash, thickly sliced
1/2 - 3/4 lb green beans
1 cup beef bouillon

INSTRUCTIONS:
Slice 1" off top of pumpkin for lid and reserve.
Scoop out seeds and pumpkin pieces from the sides, leaving shell about 3/4" thick; reserve pieces.
Combine flour, salt, and ginger. Toss turkey cubes to coat.
Heat oil in large skillet; brown turkey cubes.
Add reserved pumpkin pieces and remaining ingredients to skillet. Bring to boil, stirring. Simmer for 10 minutes.
Place pumpkin shell on baking pan. Turn turkey mixture into shell; cover with its own lid. 
Add 1" hot water to baking pan. Bake in 350ºF oven until turkey chunks are cooked through, about 2 hrs and 45 minutes.
Cover pumpkin with foil about midway through cooking to prevent darkening of shell.

Pumpkin with turkey/veggies in roasting pan.

Pumpkin with lid after baking.

Stew ready to eat with cheese roll.

My husband and I both like this stew, but agree that it is a little bland for our palettes.  So if you have any suggestions for added seasoning, I’d love to hear them.

Gifts from Blog Friends

My blog friend, Dr Cris, sent me some hand-knitted gifts from Australia.  It was an exchange for the quilts I made for her children (Mr J and Ms Z).  Here is a picture of the hat and scarf that I will be wearing when it gets colder.
Here is a picture of the two bookmarks that I am already using.

I realized that I had not shared this gift of knitted socks that Dr Smak sent me several months ago.  My only excuse is that it was back in the summer and too warm to wear them.  I put them away.  It is almost cold enough for me to wear them.

Progress Note on Hawaiian Lobster Quilt

I started this quilt at the suggestion of my blog friend, Dr Theresa Chan (rural doctoring).  The post on it’s origins can be read here.  As I explained there, I enlarged the lobster pattern I found here (link removed 3/2017) and then “blended” it into the “Hoya” Hawaiian appliqué block.   The Hoya block I found in a book I have called Hawaiian Quilting by Elizabeth Root.  For the border, I again used the Hoya block and added the leaves from the Anthurium block for the center area of each border.  The corners are the Angel’s Trumpet block.  All three blocks can be found in the Elizabeth Root book.

The quilt top is now basted to the batting and backing.  I used the “fusible” Warm and Natural batting.

Here is a close view of the lobster with his antennae.

The machine quilting will be both outline and echo.  Here I have taped around the center in preparation to do the first echo.

So Theresa put on your thinking cap.  When it’s finished how are we going to auction it to raise the proposed money for Zippy and children’s brain cancer research?

Marking and Markers

Updated 3/2017 -- photos (except my own) and all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

This past weekend, Kevin MD, told us about Sharpie’s actually being anti-bacterial.

Surgeons use markers to identify the right body part for procedures. Unfortunately, they care become contaminated with bacteria which can lead to surgical site infections.
Enter the Sharpie: "As it turns out, the ink used in a Sharpie pen has an alcohol base, making it an unexpected germ fighter." ….

That’s nice to know, but mostly what I got from the report was the reminder to clean the tips of the reusable markers with an alcohol based wipe between patients.  For me the marker helps me in my planning, not in my germ control.  Here is my post on marking/markers from last December.

Marking is very important in both my quilting and my surgery work. I don't mean the kind of marking that gives you "yellow snow" (nod to Frank Zappa) or the kind that leaves you a trail of crumbs to find your way home (Hansel and Gretel).

In plastic surgery, a lot of time can be spent in the preop area marking your patient. So you want a marker that won't wash off so easily that it is gone with the scrub. For breast and body "work", I use (and the nurses tell me so do most of the others) a black Sharpie.

It is marketed as a permanent marker, but I still find that I have to remind the person prepping the patient to not "scrub too hard" or "that's enough". When you have marked the patient standing or bending in different ways to be sure you get the most skin removed, these positions and maneuvers can't be duplicated in the operating room. During the procedure, I use whatever marker the hospital has, usually the Accu-line products. Those are also what I use when I need a really fine line (ie eyelid) when marking.

The skin marker should be nontoxic and non-allergenic. If used during the procedure, then it must be sterilizable. The ink must have a visible color and must be non-reactant  with other chemicals used on the skin (e.g., povidone iodine). The ink must be resistant to mechanical cleaning but removable in time.  The information immediately below is from the first reference article.

The photo to the right is from the first article referenced below. Note how the ink "disappears" with the scrub. Their skin marking ink (1) and frequently used skin markers (2, methylene blue dye; 3, Securline, a surgical skin marker; 4, red permanent marker; 5, black permanent marker; and 6, Viscot, a surgical skin marker). (Center) Skin prepared with povidone iodine solution and scrubbed five times. (Below) Skin prepared with Betadine and scrubbed five times. Their marking ink --The formula consists of basic fuchsin (1.3 g of dye material), 5.6 ml of acetone (resolvent), 11 ml of alcohol (dissolvent), and 100 ml of distilled water. This formula may be diluted by adding alcohol.

In quilting, you want a marker that will stay long enough to see the pattern you are quilting. You want to be able to either "brush" it off gently later (as with chalk pencils) or to wash it out. The different colors of fabrics used can sometimes make this more challenging. For the quilt I am preparing for hand quilting, I used the blue washable marker on the "mustard" (light fabric) and a silver chalk pen on the brown (dark fabric). Here are some links to tips by experts like Ami Simms (blue washable marker), and Sharon Darling (Quilter's Choice Marking Pencil, Miracle Chalk).

REFERENCES

Skin Marking in Plastic Surgery; Plastic & Reconstructive Surgery, 115(5):1450-1451, April 15, 2005; Ayhan, Meltem M.D.; Silistreli, Ozlem M.D.; Aytug, Zeynep M.D.; Gorgu, Metin M.D.; Yakut, Macide M.D.

Quilt Tips From Quilters Around The World--Marking Tips
Appalachian Mountain Quilters Marking Techniques by Kimberly Wulfert

Soft-Tissue Injuries of the Fingertip

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

As we get closer to Halloween and in light of my post on preventing injuries when carving those pumpkins, I thought I would review injuries to the fingertip.  This post is a reworking of the post a did on fingertip injuries/amputations more than a year ago.  In this post, I’m going to stick to injuries of the fingertip.  (photo credit)

Fingertip (or pad) injuries are very common. They range from simple lacerations to partial amputations. Simple lacerations are repaired by suture or Dermabond (I have even told family members to use super glue. The bleeding must be stopped. The finger must be cleaned with soap and water. There must not be any tension pulling the edges apart. The glue is used on the surface, never within the cut.)

If Dermabond is used, it is best to avoid use of antibiotic ointments as these can “dissolve” the bond before the cut is healed sufficiently. 

The question is much more complicated when there is loss of tissue. The main treatment objectives are:

1) closure of the wound

2) maximize sensory return

3) preserve length

4) maintain joint function

5) achieve a satisfactory cosmetic appearance.

How these goals are achieved will depend on the amount of tissue lost, whether there is bone exposed, and which finger is involved.   It may also depend on the patient’s profession or hobbies (ie professional musician who may not tolerate decreased sensitivity to his long finger whereas a truck driver might not notice it). 

 

Injuries may also be classified according to where the amputation has occurred or whether the injury primarily involves the pulp (soft tissue) or nail bed.  These classification systems refer to the zone (photo credit) and the plane of injury.

Zone I is distal to the phalanx (bone)–There is no exposed bone and most of the nail bed is intact which will allow normal nail contours following healing. Treatment of these injuries is usually conservative, especially if the tissue loss is superficial and less than 1 cm square. The wound should then be left open to heal by secondary intention. Meticulous wound care and conservative debridement of these injuries are essential. A dressing of topical antibiotic ointments and non-adherent gauze left alone for several days will facilitate healing. Daily dressing changes can be done after the 4-5th day. As the scar contract, it will give an excellent aesthetic and functional result.

Zone II is distal to the lunula (growth matrix of the nail)–These are complicated by the bony exposure of the distal phalanx. The decision-making process begins with whether length should be preserved (necessitating coverage of the site) or whether sacrifice of length is justifiable in the given situation. The primary aim is to restore function to the individual, and many of these injuries can be converted to wounds with no bone exposed by rongeuring and then closure. If there is no possibility of direct closure, then cover can be accomplished by means of a local flap. The plane (slant of the injury) of zone II injuries helps determine what type of repair technique should be used.

Zone III is proximal to the lunula. –These involve the nail matrix and result in the entire loss of the nail bed. These injuries are most often treated by amputation (revising the end of the traumatic amputation and closing the stump). Replantations distal to the DIP are often not successful.

Methods of ClosureSplit

Thickness Skin Grafts (STSG)–are useful in Zone I injuries that are larger than 1 cm square. It’s advantage over FTSG is that it contracts as it heals and therefore keeps the resultant insensitive area as small as possible. Split-thickness skin from the hypothenar eminence or instep of the foot closely matches the native fingertip skin and is a good choice for the donor skin.

Full Thickness Skin Grafts (FTSG) can be taken from the hypothenar eminence, the lateral groin, the volar wrist crease, or the anti-cubital fossa (inner elbow crease). Some feel that this leaves a less conspicuous donor scar than the STSG.

Flaps are necessary when the loss of fingertip pulp is more than one-third the length of the phalanx. There need to be soft-tissue replacement to support the distal nail. Local flaps include:

Atosoy-Kleinert Flap (photo)
was first described in 1970. It is a triangular volar V-Y flap advancement for reconstruction of the distal pad. It help preserve length when the bone is exposed. It is not indicated in injuries where an oblique flap with more palmar skin loss than dorsal is present.


Kutler Lateral V-Y Flap (photo)
was first described in 1944. It employs two triangular flaps developed from lateral positions and reflected to cover the tip of the digit. This is most applicable to oblique palmar and traverse tip amputations. As the V-shaped skin flap is advanced, an incision line is created which resembles a “Y” when sutured.


Volar Flap Advancement (photo)
is credited to Moberg for coverage of thumb tip amputations. It may also be used for fingertip amputations where length is to be maintained. It provides a sensible covering (has feeling) by advancing volar skin on its neurovascular pedicle. Advancement is limited to 1 cm.


Cross-Finger Pedicle Flap (photo)
was first described by Gurdin and Pangman in 1950. It is useful in distal amputation of the index finger or thumb and in situations where multiple digits are injured and maintenance of length in the remaining injured tips is considered to be of critical importance. Cross finger flap uses skin and subcutaneous tissue from the dorsum of an adjacent finger to cover the fingertip injury. The defect created by “lifting” the flap is covered with a STSG. The pedicle is left attached for 12-14 days and then divided and “tailored” into place.


Thenar Pedicle Flap (photo)

was described in 1926 by Gatewood for coverage of injuries with exposed bone. It was modified by Smith and Albin in 1957 with a technique described as a thenar “H-flap”. The indications are similar to that for a cross-finger pedicle flap (preservation of length, exposed bone). The potential for joint stiffness with a permanent flexion contracture and /or unsightly scar in the donor area must be kept in mind. It is apllicable to injuries in the tips of the index and long fingers, but not the ring or small as the flexion required is not comfortable.Contraindications for use of the cross-finger or thenar flaps would be any general condition that might lead to stiffness (rheumatoid arthritis, Dupuytren’s contracture, etc). There is increased risk of joint stiffness with either flap in someone over 30 years of age.

Replantation of Severed Tip
Replanted single fingers can be stiff and impede the opposition of other fingers to the thumb and overall hand function. Replanted single-finger amputations can achieve better range of motion when the level is distal to the insertion of the flexor digitorum superficialis. Single-finger replantation can be considered when patients have injuries to other fingers of the same hand. All of these injuries require splint immobilization and rehabilitation that impedes immediate return to work. Single-finger replantation can be considered in special circumstances. The surgeon must not become absorbed in the technical challenge of the replantation and neglect the other associated injuries because poorer outcomes and greater financial cost (due to lost wages and cost of hospitalization and therapy) can result.




REFERENCES
Information & Pictures from Operative Hand Surgery, 2nd Edition, David Green MD, Churchhill Livingstone
Fingertip and Nailbed Injuries by Joseph Donnelly, MD

The V-Y Plasty Technique in Fingertip Amputations by Edward Jackson, MD--American Family Physicians

Fingertip Injuries--Eaton Hand Center
Fingertip Injuries/Amputations—AAOS
Fingertip Injuries by Glen Vaughn--eMedicine article
Assessment & Initial Management of Hand Injuries--Zoltan Hrabovszky

Cohen, B. E., and Cronin, E. D. An innervated cross-finger flap for fingertip reconstruction. Plast. Reconstr. Surg. 72: 688, 1983

Soft-Tissue Injuries of the Fingertip: Methods of Evaluation and Treatment. An Algorithmic Approach; Plast. Reconstr. Surg. 122: 105e, 2008; Lemmon, J. A.,  Janis, J. E., Rohrich, R. J.

Nail Lengthening and Fingertip Amputations;  Plast. Reconstr. Surg. 112: 1287, 2003; Adani, R., Marcoccio, I., and Tarallo, L.

Shout Outs

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

Kim, Emergiblog, is this week's host of Grand Rounds. Nice edition! You can read it here (photo credit).

Welcome to the Emergiblog Speedway, where the Grand Rounds 500 is about to get underway! No chance of a rain delay - our bloggers are ready to roll!

Thirty-nine bloggers have shown up for the event. All entries have qualified; no posts were sent back to the garage.

And ladies, don’t worry, you’re welcome on the track, I just wanted to use the classic starting phrase!

Life is so fragile.  Please, lend your support to Dr. Smak as her son’s brain cancer has returned.  You can go here or here to donate money towards pediatric brain cancer research.

JeffreyLeow, Monash Med Student, will be taking part in the adventure race, Anaconda Lorne,  in Dec 2008 after his exams. The organizers have helped set up a fund-raising website through which anyone can donate. Please consider donating through this link.   The donated money will go to the Burnet Institute.

any additional fundraising that can be achieved helps the Burnet Institute fight some of the world’s most deadly infectious diseases through medical research and public health education, both here in Australia and overseas. To find out more about the Burnet Institute and their work, click here.

Paul Auerbach, MD, Medicine for the Outdoors, has a nice post on the field management for a penetrating ("sucking") chest wound. 

The usual teaching for improvisational management of chest wounds is that all open wounds (particularly those in which air is bubbling) should be rapidly covered, to avoid “sucking” chest wounds that could allow more air to enter the pleural space and thus continue to worsen a collapsed lung. For a dressing, a Vaseline-impregnated gauze, heavy cloth, or adhesive tape can be used. The dressing should be sealed to the chest on at least three sides…….

Tim Sturgill MD JD, Symtym, will be the guest on the Dr Anonymous' Blog Talk Radio show this week. He describes himself this way

a board certified emergency physician, at mid–career, with interests in:

• Emergency Medicine
• Emergency Medical Services
• Health 2.0
• Health Informatics
• Health Law
• Health Technologies
• Medicine 2.0
• Web 2.0, semantic web

Late Day Addendum:

Alvaro Fernandez, The Brain Fitness Authority, hosts the first edition the first edition of MetaCarnival:  a Carnival of Carnivals.  Check it out here.

Welcome to the first edition of MetaCarnival: a Carnival of Carnivals (announced here), the new, monthly, and interdisciplinary gathering of blogs and blog carnivals.

Let's picture all participants in the shadow of an expansive sycamore tree, conducting a lively Q&A lunch discussion.

Article Review Highlights: Breast Cancer, 2008

Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

This post is a review of several articles from Medscape on the 2008 Breast Cancer Symposium.  It will just give you some of what I thought were the highlights from the articles.  I have listed the articles with links for those of you who wish to read the full articles.

From New Concepts and Therapeutic Approaches for Early-Stage Breast Cancer by Michaela Higgins MD and Antonio Wolff MD

Risk, Screening, and Prevention

• These include not only those related to BRCA1 and BRCA2 mutations, but also other genes whose roles have yet to be fully defined.
• CDH1 mutations are associated with a lifetime breast cancer risk of about 40%, as well as with diffuse gastric carcinomas, and CDH1-related carcinomas are usually of lobular histology.
• The lifetime risk of breast cancer for individuals affected with Peutz-Jeghers syndrome is 45%.
• Patients with Li-Fraumeni syndrome have a higher incidence of radiation-induced cancers, and consideration should be given to mastectomy rather than breast-conserving therapy and radiation for the treatment of early breast cancers in carriers of this mutation.
• The American Cancer Society recommends the use of annual magnetic resonance imaging (MRI) screening in addition to standard annual mammography in women with a lifetime risk greater than 20% of developing cancer or in those with a history of chest irradiation.
• Type 2 diabetes mellitus is an independent risk factor for breast cancer, and patients treated with metformin have a reduced incidence of breast and liver cancers.

Triple-Negative Breast Cancer

• There is considerable heterogeneity among triple-negative breast cancers. Indeed, these cancers can include, if rarely, disease metastatic to the breast, medullary carcinoma, pure apocrine carcinoma, and some metaplastic breast cancers as well as tumors defined by gene expression profiling as "basal-like" breast cancers.
• It is hypothesized that in the absence of the normal BRCA1 DNA-repair mechanism, BRCA-deficient cells are more likely to use the polyADP-ribose polymerase (PARP1) DNA-repair pathway.

From  Advances in the Treatment of Metastatic Breast Cancer by Andrew Seidman MD

Locoregional Therapy of the Primary Tumor in Patients With Distant Metastases

• Preclinical experimental evidence and hypotheses of self-seeding raise the notion that perhaps we should be more aggressive about the local control issue in more patients with simultaneous distant metastases.

ER, PR, and HER2 Status in the Primary Tumor and Distant Metastasis: A Moving Target?

• When patients are suspected of developing metachronous distant metastases, the dictum most oncologists are taught is "settle this issue and get some tissue." Biopsy confirmation of metastatic disease is the rule rather than the exception.
• At Memorial Sloan-Kettering Cancer Center, we have a unique set of matched breast primary tumors and brain metastases from patients who underwent medically indicated craniotomy; we have observed very high concordance in HER2, ER, and PR status between the breast primary and brain metastases (Brogi E and Seidman AD, unpublished data).

CNS Metastases in HER2-Positive Metastatic Breast Cancer: The RegistHER Study

• Brufsky and colleagues reported on a prospective, observational study of 1023 patients with newly diagnosed HER2-positive metastatic breast cancer.
• Of the 1009 patients included in the analysis, 337 (33.2%) experienced CNS metastases at a median time of 12.8 months from metastatic diagnosis.

New Concepts and Therapeutic Approaches for Early-Stage Breast Cancer by Michaela Higgins MD and Antonio Wolff MD; Medscape Article, Oct 15, 2008
Advances in the Treatment of Metastatic Breast Cancer by Andrew Seidman MD; Medscape Article, Oct 15, 2008

SurgeXperiences 209 is Up!

Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

Resident Anesthesiology Guy, "The Choloform RAG" (photo credit), is our host for this edition of SurgeXperiences.  He did a very nice job which you can read here.   

Thanks for the submissions. I think this will be another great edition and will be my very first, both in submitting as well as in hosting. I know that some hosts like themes or stories before they get to the submissions. I will, instead, just let the authors do the talking for this edition with some distinction between the specialties so you can go where you're most likely to read as well as peruse the minds of those around you.

The next edition (210) will be hosted by From Dupont to Abdoun on November 9, 2008.

This site is a product of my experiences as a Georgetown medical student (near the famous Dupont Circle) on academic sabbatical living in Amman, Jordan (near the not so famous Abdoun Circle).  I plan to return to the U.S. in 2009 to complete a residency in emergency medicine.  It is my hope to tell the stories of the many wonderful patients and diseases I have encountered, to describe health care in Jordan, and to elaborate (or maybe just ramble) on some of my thoughts about practicing medicine in a developing country.  Thanks for reading!

The deadline for submissions is midnight on Friday, November 7th.  Be sure to submit your post via this form.

SurgeXperiences is a blog carnival about surgical blogs. It is open to all (surgeon, nurse, anesthesia, patient, etc) who have a surgical blog or article to submit.

Here is the catalog of past surgXperiences editions for your reading pleasure. If you wish to host a future edition, please contact Jeffrey who runs the show here.

Humane Society Calendar Debute

 Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

Our local humane society (Pulaski County Humane Society) began publishing a Day Planner in 2005. It has turned into a very good fund raiser for them. This past Thursday night was the debute of the 2009 seen here. I ordered several that first year to give as Christmas presents. They were such a big hit the first year, I've had to keep doing it.  You can read my post from last year on these day planners here.

As per the Humane Society’s website:

The planner makes an excellent holiday or birthday gift and will be available at outlets soon to be listed below for ONLY $25.00! This year there are over 200 heartwarming photos of pets and their owners in a highly stylized, sturdily bound planning calendar. Help the Humane Society of Pulaski County and get yours in time for Christmas and stay up to date in 2009!
But why wait? You can place your order now to receive your books in November, using this MAIL ORDER FORM. (Depending on your browser, you may need to right-click on ORDER FORM and select 'download' or 'save'). Please print the form, complete it, and mail it to the address included in it.

This year Rusty has his picture in the day planner.

“For a New York Beauty” Quilt

Updated 3/2017 -- all links (except to my own posts) removed as many no longer active and it was easier than checking each one.

TBTAM sent me a quilt block (bear claw pattern) she found while antiquing.  I have long admired the New York Beauty quilt block.  Her small gift gave me a reason to “tackle” the block and make a small quilt using it.  I did okay, but even using paper piecing some of my points and connections aren’t as nice as I would like.  When I critique my quilts, I sometimes feel as if it’s my own form of M&M.  Despite the imperfections, here it is.

I machine pieced it using the paper piecing method.   The small quilt is 24.5 in X 24.5 in.  The suggested colors (by TBTAM) were red, yellow, blue, and black.  They are all here, though just a small amount of blue.  The quilt is both hand and machine quilted.

This detail photo actually shows the colors better.

Resources for patterns and inspiration:
Quilter’s Corner Club – free New York Beauty block patterns
Mona’s Creativity – My New York Beauty
Donna Duquette – New York Beauty Blocks
Mostly About Quilts – New York Beauty for a Minnesota Beauty
New York Beauty Meets the Orient Quilt (stunning)
New York Beauty Quilt (beautiful)
Peggy Martin Workshop – New York Beauty (several beautiful quilts)