How To Get The Anesthesiologist To Listen To You

Here you are in a thin ugly gown, on a gurney, in Pre Op Holding. The blanket full of hot air is on you to warm you up. Your i.v. is in and the Pre-Op Nurse and O.R. Nurse have introduced themselves. You anxiously await the person you are going to meet who will take you through your surgery, your anesthesiologist.

They breeze in through the curtains with a smile. They may have a syringe or two in their pocket. You sense an urgency or rush to them, but when they smile and look you in the eye they make you feel like they have all the time in the world for you.

Your mind goes blank. You answer questions. If you are lucky, they will actually look I your mouth, listen to your lungs, and heart. Many of my colleagues do not listen, not even after intubation for bilateral breath sounds. They just look at the chest for even rise on both sides, mist in the tube, and end-tidal CO2.

Now is not the time to blather on and on about your feelings about anesthesia and surgery. You are scheduled for surgery, the entire room is set up full of instruments, and you are going to go under anesthesia. Now is the time to be present. Muster up all the courage you have, look the anesthesiologist in the eye, and let them know what is most important to you for this surgery.

"I puked like crazy the last surgery and I don't want to throw up like that again."

"I don't want to remember anything, not even the trip from here to the OR."

"that tape make my skin blister and react."

"last time it took me forever to wake up." ( but were you comfortable?)

"I am afraid of the pain" or "I party a lot" or "I think I might need more than usual"

These statements enlist an anestheiologist's help to get you through your experience. Some things may have a preference and affect the anesthesia care a lot. "I don't want to go to sleep" well in some cases you can get a regional, and let a little sedation be used instead. Usually lower body surgery, or perhaps shoulder or arm. Know that there are options.

If an anesthesiologist encourages you for regional, take it. You will feel better in the long run. Just ask for them to snow you through everything so you don't remember. That is easy to do.

Your surgeon has a preference for type of anesthesia, and also for the anesthesiologist. They won't work with certain people. Try to think of it not as two against one, but a well-oiled team working smoothly to get you your care.

If you are fat, old, or have a very small chin, your entire team, including your anesthesiologist, is working very hard to take care of you. Anesthesia for you is risky. Give your anesthesiologist the time to check you out, make a plan, and go get the special equipment before you go in the room. You are not going to die, but your anesthesiologist is going to use more of their skills to get you through. Far? You use more oxygen and have less lung volume, and possibly a difficult airway. There is so much fat inside your throat we can't always see the vocal cords when we look. In the old days we used to do an awake fiberoptic intubation, but now we use a video equipment the 'Glide Scope' to help us intubate you fast when you are asleep and not breathing. Our equipment doesn't always fit well to monitor your blood pressure. Old? Just know there is a lot of mileage on your ticker. It won't like anesthesia, and will need careful support until anesthesia is out of your system. Small chin makes it hard to get int the breathing tube, there is not enough room for the tongue to move out of the way to let us see the vocal cords when we look.

What not to say to your anesthesiologist:

"I am sensitive to medicines" Our anesthesia meds are different from all other kinds of medication. You wouldn't want to wake up in surgery would you? More is better than enough or not enough in this situation.

"I am allergic to" and hand them a huge long list. We only want to know what makes your throat swell up or gives you a rash because the next time it makes your throat swell up.

" I am Jehovah Witness and I don't take blood." depending on the bleeding risk of your surgeon and operation, don't be surprise if an anesthesiologist excuses themselves from your care. Some will let a colleague who is less upset by watching you exsanguinate and taking care of you while you are in hypovolemic shock than others.

"I need pain meds now!" I have had people call me out of surgery to give them meds. If you need them that bad, bring your pills with you and ask the nurse to call and ask for permission for you to take them. The only thing that matters to us is that you let us know what you take and when because our drugs can mix with your medication and recreational mind-altering subtances.

Overly involved family member...please...unless your loved one is demented, let them talk for themselves. It is not about you.

If you are alone, don't stress, we will be family for you. And even hold your hand as you drift off to sleep...

Namaste,

Reiki Doc

On Trust: Lessons from a Life Lived

Three Blind Mice passed today. Actually, last night. I touched her belly to see if there were babies. There were none.  She was actively dying, and did not react.

The Catholic part of me says she died because the water drop bottle gizmo did not work. I put a new one in the cage, and she seemed to take to it. The others didn't. When I put the bowl of water back in, they perked up. But, thinking she was pregnant, I got a new water bottle plus the old one, and hung them both on her cage. At the veterinarian she was drinking drinking drinking.

But the spirit part that is connected to her, is saying no. The reason she was so cute making noises was that she was wheezing in the beginning. Rats don't make noises like that, says the book I bought about rats. Along with the problem of pregnancy in store rats that are bred for reptile food, is a virus. It is uniformly fatal. Even if a rat seems okay, they will succumb of heart failure. Any sneezing or wheezing is a bad sign. Only a good rat veterinarian can treat it, and only half the time treatment works.

I put her in a box lined with tissues. I will show her to my son. What did I learn from this 'relationship'?

I can care for and truly love and animal I used to be frightened of.

I cared for her with good housing and a trip to the vet, who, unfortunately was not a rat specialist.

Her sweetness and trust is not lost on me. That is the part that stays the most. She knew me, did not suffer, and was not afraid.

I bleached the rest of the cage parts to disinfect them.

And the others? Well, her oldest roommate has ribs sticking out. I think it is sick too. And the two new ones? One almost bit the snake when I tried to feed it. They are going back to the reptile shop. Even the rat rescue won't take a mean one that bites. I did not socialize them.

Would I try a rat again? Definitely. But not now.

And for the snake? We are going back to mice for a time.

I am so glad I gave her Reiki and the transition symbol last night. And said goodbye.

Namaste,

Reiki Doc

Three Blind Mice Update

Just in case you were wondering what the Vet said, I'll tell you:

1) foot is okay

2) ears are okay (little scabs on them)

3) vote by the team in the back--'it's a girl'

4) I have no clue if she's pregnant. How long have you had her? (28 days is gestation)

5) Looks like the eye never formed. May have other congenital abnormalities

6) This rat has too much going on to be healthy--lots of little things

I brought her back. She is not really eating, and keeps drinking like crazy.

I think she's gonna die.

How do I handle death in a pet? Not well. With goldfish I flush.

When I had my snake and turtle die within days after spraying for ants in medical school (and yes, like an idiot I gave the turtle ham to eat--the salt probably did it). The snake went to Valhalla on the wood in the fireplace, and I was crying. And the turtle was buried in the yard near the apartment. My tarantula died of old age,  after his last molt. I buried him. The snake appeared to me in a dream, with a mouth full of crickets like a gambler would hold a hand of cards. I had never seen him eat and was terribly worried. After the dream I had rest.

As a result, a lot of my pet-care is making sure the animals are still alive. My african fat-tailed gecko of about ten years stopped eating around the time my son was born. I felt like I had neglected him. I buried  him too.

This whole Three-Blind-Mice thing came with my uneasiness about death required in snake-keeping. Although I have made great strides in acceptance of 'the snake needs to eat' and how to appreciate the circle of Life, for this one I spent the night with in my call room, it was tough.

I have a soft spot for misfits of all types. Why? On an unconscious level, I think that the stronger spirits selected to come here in altered form. For example, Nick Vujicic, from www.lifewithoutlimits.org.

No arms, no legs, he wanted to die until he found God. Really Found GOD. It will make you cry, watching him. A true inspiration.

I don't know what I will find downstairs in the rat cage. But I asked the Vet directly, 'Is she suffering?' and he said, 'No'.

My sister had to cancel our plans yesterday due to her son throwing up on Friday night. She asked us to 'send Reiki'.* My son is Reiki Two, and we practiced the distance symbol and sent it. Balancing chakras was fascinating. Many were out of balance. But then I taught him Reiki Three. With a child, it's quick. Here are the symbols, that's it. I had once attuned him to Reiki Three in his sleep. I felt guided. Now I attuned him for real. He wants to go Reiki Master, and then Karuna. Here are the levels and what they mean:

Reiki 1: can turn the Reiki power switch on and off. Hands on or hands in aura Reiki only. Can do Self-Reiki, a very powerful tool especially in Chronic Illnesses.

Reiki 2: learn three more symbols, and the distance symbol. Can send Reiki across distance and time.

Reiki 3: Four more symbols, including the Transition Symbol, that helps ease the passage of death. And Chakra Balancing and Toning.

Reiki Master: you can now teach classes and attune others.

Karuna Reiki 1: You learn four basic symbols and are attuned to a compassionate, stronger form of Reiki.

Karuna Reiki 2: Four more symbols.

Karuna Reiki Master: You can teach and attune others to Karuna.

Please note that once Hawayo Takata's classes stopped,  traditional hands-on Reiki in the Usui system, with a long training period and very high expense, stopped in the states. There are weekend Reiki classes from all different lines of tradition. You should give yourself at least two to three months between levels to get used to the energy and to practice what you have learned every day. There are no certificates that are accredited. Reiki is all over the map.

Karuna Reiki, (TM) however, is trademarked by William Rand. He is the head of the world Reiki association. Everything Karuna is taught exactly to his specifications. Mr. Rand developed Karuna Reiki.

Wish me luck with Three Blind Mice. There will either be one dead rodent or like, twenty new ones in that cage.

Namaste,

Reiki Doc

* I started out the day with a stomach ache. It went away when I did self-Reiki. I asked my son to give Reiki, too. Instead of throwing up, I was able to get out of bed and start my day. (I wonder if the alpha particles from the solar flare are affecting the inner lining of the gut. Radiation does that.)

Taking Care of The Sick: A Story of Three Blind Mice

This is Three Blind Mice. I bought her to feed the snake. At the time, I didn't know if it was a she or a he.

I socialized her. I spared her. Because of her one eye. I have written about her, I know. But she is sick.

I bought for her a hamster ball. Last time I put her in it, her foot got caught. I loosed it, but now it is infected. Bumblefoot, or pododermatitis. She needs a vet right away.

Her stomach is gargantuan. That's why I think she is pregnant, and therefore, a she. Most rats are mixed together in shipping and at the pet store where they are raised to feed reptiles. That's where she is from. I got to know her, and I couldn't feed her to Cecil the ball python. I bought another.

A coworker at the O.R. is an animal lover. Her daughter's boyfriend is a rat rescue person. She said Three Blind Mice would be lonely, as rats are social. So I bought two week's worth of food for the snake, and let them room in with Three Blind Mice. She didn't know the difference, that they were coming and going.

What I didn't know is Rat 101: they are often pregnant AT THE PET STORE. Pet stores sex them wrong. Your She may be a He after all. And they often are infected with a lung disease that is contageous only to rats, but will lead to heart failure and death.

Rats can get pregnant immediately after giving birth. But rat dads are helpful, supposedly. The trick with rats is to get them fixed. But I didn't know. So there are twelve to twenty babies coming in a rat just on the verge of sepsis.

Do I Reiki?

No. I do more. I take them to the vet. Even if it is expensive. Even if the treatment might not work. 

And I separate the mom away from the others. To a maternity cage.

This did not come easy. I sat there for a moment, thinking about the worth of a four-dollar rat. One that is meant for snake food. I learned about myself, and who I am. And about compassion.  I researched bumblefoot and pregnancy in my Rat guidebook and on the internet. I am a doctor. I help those in suffering. What else is there to do?

The man with the finger partial amputation at the pet store, the reptile one, said, 'If I had known about rats I probably would have gotten into them. They are pretty neat.'

Which leads me to believe, I must double check how I think about animals in general. And about what I eat. And what kind of person I am. There is a lot to be said for the vegetarian lifestyle. And for kindness to animals in general.

Namaste,

Reiki Doc

Grace and Gratitude: What to Do When Children Get Sick

Yesterday I spent the morning in the Emergency Room at a Children's Hospital with my son. His vague abdominal pain had localized to the right lower quadrant of the abdomen. His finger pointed right to the appendix and it hurt him to walk. Many breakthroughs came up for me. Let's discuss them.

1)Going to work in anesthesia you have to show up unless you are in the hospital. I found myself thinking, I can let him sit until I am done with work and then go to the hospital as I drove to my mother's. Then something caught me: this is sick.  He is your son. So I started calling others at six a.m. to show up for work for me. As I spoke to the nurse in charge of the O.R., she said, 'You have to call the boss even though he doesn't like to be called in the morning and tell him your son needs to go to the hospital." And I did.

2)Using my familiarity with hospitals to the benefit of a family member first we stopped at home to get a stuffed animal. We got a HUGE killer whale that is as big as my son. Why? Did you know a stuffed animal can go in the hospital where parents can't? The O.R. Or in my case, the CT scanner. The ER doc knew me from our mutual place of training. We got extra good care.

3)Trust the skills of  care team members  Grace is the name of the nurse who put the i.v. in my son. We were there at change of shift, the time in the hospital when nothing gets done, because the old team want s to go home and the new team isn't informed about everyone there yet. She let him touch and see everything every step of the way. A good pediatric hospital with let kids check things out before they do the procedure. He felt the tourniquet, the numbing spray, the chloraprep wash and only said the needle part might hurt and gave him practice pinches just to know. Another nurse came out of nowhere and helped hold the arm. And in one try, BOOM! it went in. Grace's smile was big and her bedside skills were excellent.

4)Everyone is a healer The Echo Tech saying, 'good luck' to the boy as he dropped us off in the holding room. The nurse who held our son and promised him a trip to the treasure box for being so brave. And the transport people! You know the ones that push the gurneys from  one test to the other? They have LOTS of chances to make a positive impact on patient care! The hospital is full of places to make a difference in the health of our patients! Especially the ones who are in touch with their own Human Energetic System, or 'aura', know Reiki and connect to Source every day.

5) Sometimes is it better to be wrong than right There was no surgery. I took the day off, losing income, and racked up HUGE bills because of all the deductibles on my insurance. But the peace of mind is worth it. I was never that good at diagnosing appendicitis anyway as a surgery resident. What he needed were the tests and he got the tests. When I spoke to the boss at three, he said when his daughter was the same age she had the same thing as my son. But the surgeon knew him, and said, most would operate but for us we are going to wait one more day. And she got better. Sure my pride took a back seat, but the bigger picture is my son's health. And he got better.

Namaste,

Reiki Doc

P.S. every step of the way, I had my hand on him as a continuous source of Reiki. Being a Reiki Parent can help when your kids are sick.

On Socialization

"What kind of man would ask to see a baby, anyway?!" said the mother with the stroller to her mother (the grandmother) in the elevator at the mall. "I did this (gestures with hand like a karate chop into the distance) and gave him a dirty look."

Wow. The same lady who had opened the doors that were closing  by jumping across the elevator quickly was slamming some male admirer of her sleeping infant in a baby Bjorn on her chest. Quite the duality.

Today we are going to talk about what it takes to live in groups. "Live from your heart but don't forget to take your brain with you." Judgement. Only for survival, as an instinct.

What probably happened to the woman in both examples, is that her inuitive energy fields sensed something weird about the man that wanted to admire her baby. He could have been a pick-pocket, or a child molester, or a kidnapper. I doubt a sincere evolving being would have raised her warning signals. And for us, a mother and boy, two Reiki practitioners,  there was no visible or energetic discord to her bubble of safety.

Living in groups has a key thought that is a principle that determines how one interacts with others: the sense of reasonable ability to survive.  Carolyn Myss talks about this. "I will help someone to survive but not someone to surpass me." is very common thought. 

I was raised poor. The common thread I heard through my childhood was, 'our parents did better than their parents. We did better than our parents. We are raising you kids to be better than us financially.'  It was the hope of Mom and Dad for us to surpass them in every way. Even to be taller than Mom, who is 4' 11" and found this to be somewhat limiting in life.

They told us most American parents do not want their kids to even be as good as them.

And in raising us the way they did, they were priming us for success. I have a good education and career. My sister I wrote about lives in a well-to-do neighborhood and is involved in a big charity as a housewife. And my other sister jets around the globe with the 'in' crowd. She has partied with Britney Spears, met LMFAO, and been to the Playboy Mansion more than once. (I could not live her life, but she surpassed my 'Playboy Club member' parents in that respect.)

Where does the Reiki part come in? Already we have talked about energy fields and auras, and how they interact. We have talked about Intent, and its use in childraising. But now, I want to add the Collective Conscousness to the mix.

We are all connected. Energetically. In the highest sense, our thought patterns are 'catchy'. Ever been to a live sports game where the crowd is the extra man on the team? Ever notice how the winning side is louder and more vibrant than the losing one? And how fast it can switch with the momentum of the game?

Mob dynamics is an animalistic herding phenomenon that is present in the human species. Take a look at the sinking of the Italian Ship recently. Witnesses who survived said that 'women and children first' went out the window. People were pushing and shoving and walking on other people's faces in order to survive. The 'get free and live' mentality spread like wildfire, and all the socialization went out the window. There was an article by Mark Steyn about how the economy and the times are basically parallel to the dynamics of that crowd on the sinking ship.

I say, not so.

If there are enough Evolved Beings and Reiki Practitioners,  they can jack up the Collective Consciousness on purpose. I do it in the O.R. every day. And in the Labor and Delivery Room. Verbally, I am like, 'you can do it!' or 'yay!' to the surgeon. Energetically, I radiate Light, Peace, Calm and Harmony. It's 'catchy' and I do not enjoy surgeons/teamplayers in the O.R. being negative and hurting patient care. There are some patients who are so negative they trigger the Collective Consciousness and case outcome by themselves. That is harder to counter. But a room full of laughing spirits helps to cut that fear the most.

Fear? Or Love? That is the concept of duality. You get to choose. Follow your heart, but be sure to take your brain with you. You can control your reaction in a given situation. Reiki training and a daily meditation practice (even praying while in the car) help support this 'muscle' in Spirit in your core that can effect everyone around you, and thus, the World.

Namaste,

Reiki Doc

Leaving Las Vegas

The first time I went I was eight. I was not impressed. All children had to stand on a rug that was the size of a hallway, and not allowed into a casino. Sure there were places with video games where parents could check in their kids. But it seemed to me like they were dumping them there so they could gamble. The only money I spent, and it was lots of it, was for the poor hungry chickens that were inside the games that ddi a trick. I didn't care about the trick. I saw how alone they were, and starving when they ate! The only good thing about Las Vegas was the pineapple shakes at Mc Donald's. And the desert sky.

As I grew up I could take it or leave it. I didn't get the excitement people talked about when I won. I couldn't understand it. I grew up playing craps and blackjack as a kid. Never for money. For chips. Gambling was strange.

After my first love, my college sweetheart and I split up, I wanted nothing to do with a big church wedding again. And annulment. That was worse than the divorce. Mom loves Las Vegas, and she and dad eloped. So for round two, I did that. Anniversaries were there. But I went for the luck in love, not Lady Luck in gambling. That failed too.

My sons' daddy is an entirely different person from my exes. He loves Las Vegas! Took me there when I was starting to think I might be pregnant. Partying isn't good when you think "there is a bun in the oven". I had more fun with him than anyone else. Until at the noodle shop he had the conversation, where is this relationship going, anyways.

In my history, you can see I don't like it, I avoid it, but when I must, I go. Husband and I enjoyed Lake Las Vegas once. And the Four Seasons was great for a friends' wedding.

But I have to share a secret. Because of Reiki and my spiritual work, I can't go. A friend is having a special birthday. (my family too me there for one. Saw Sigfried and Roy. I felt like my birthday was their excuse to do what they wanted, but it was expensive, so I was appreciative.)

Why am I sending a bouquet to the VIP suite instead of going?

It is uncomfortable to my vibration.

What? Does that make any sense?

Absolutely. We have our own vibration. There is a name one, a personality one, I can feel/hear. It is the one I tap into when I do mediumship. I know who is who without looking. I can feel it energetically, the signature of who they are. Just like mama whale has a squeak that is a name for its calf.

In addition, there is how vibrant we are at this signature. Do you vibrate at high frequency? Or it is low? Vegetarian, meditation, crystals, , making love, Nature, massage raise it. Guess what? Gambling,drinking, drugs, loud music, and hanging out with others with low vibration lower it. An aura, or human energetic system, is weakened and vulnerable to negative entities and dark entities (parasites, energetically) at this time. I have gold mesh protection. But even with that, I can have attachments if I invite them. I think four days of marijuana, getting drunk, sleeping on the floor, or with whoever I pick up, is going to make me uncomfortable and at risk for catching an entity I don't want.

So I am staying home. And spending one hundred thirty dollars on flowers that the VIP concierge made me feel cheap and promised to make my friend 'be blown away' at the same time.

What is this love of money? I don't get it. No pampering for me. No bling. It feels icky for me.

Namaste,

Reiki Doc

Breakfast Squares

When I was a kid, I was sick a lot. Most often it was upper respiratory things, such as strep throat and ear infections. It was always my neck and above. But the worst, and the hardest one to heal from, was my teeth.

I was 'dentally retarded'. That is, my baby teeth were slow to come out. For orthodontics, I needed to have all of them out at once. An oral surgeon put me to sleep and took out eight teeth at the same time. All that was left were the ones in front, from eye tooth to eye tooth above and below, and four molars in the back, one on each corner.

There was pain. At first I lived on yogurt. and cool liquids. My gums were too weak and I had to re-learn how to chew so that it would not hurt. This went on for some time.

Then mom brought me some of these breakfast foods that were popular back in the times. They were called Breakfast Squares. Mind you this is way before the concept of a breakfast wrap.

Breakfast Squares came in a foil packet, and were between two by two inches and three by three inches square. They came two to a packet. I thought, 'oh my gosh I'll never eat all that!'. But I was sick of yogurt and liquids. So I gnawed. I took a little bite of the corner, like the tiniest bite you can. And it was good! This is how I learned to eat again. Through the Breakfast Squares. Slowly. And about two weeks later, I had my first bite of cheeseburger. That was a momentous day! As my mouth healed, and the teeth grew in,  I ate more and more of my familiar foods.

Is there a Breakfast Square in your life?

Let me make an example: my babysitter who almost married my Uncle. They were in love, and I hoped she would one day be my aunt! It was like Heaven. Then out of the blue, she ran off and got married to some old guy with glasses whose parents were rich. She broke my Uncle's heart. But we never held anything against her. (she grew up without a father, and we figured that had something to do with her actions).

On Sunday, at my Mom's house, I showed her Facebook. We looked everybody up from the old neighborhood. Babysitter was the first to accept me as a friend. She actually came on Chat with me.

My psychic connection to her was wide open. I understood. She had pain being reconnected to the past.

She had doubts. She typed and erased and typed and erased, you can see it 'so and so is typing' and then it goes blank. I picked up that she still loved my Uncle. She turned away Love for Security, which is a different kind of love. Now she has a daughter, son, daughter-in-law and granddaughter who is as cute as a button.

Her brother died of a freak accident about five years ago. And she stopped speaking to her sister about ten years ago.

Here we were flooding her with love and gratitude for having found her, and she is holding back because 'I am grayer and fatter'. 

What is it she can't digest?

Love.

The most simple and natural of things.

I am studying 'Invisible Gifts of Power' by Caroline Myss, M.D. She says our capacity to give is connected to our security in our own survival. She goes as far as to say that a meal can hurt or help, depending on whether the giver also gives a sense of hope along with it. 

This blog is a Spiritual Gift of Intellect and Spirit. I adore sharing with you. I don't get paid. I have my day job. I am starting to meet people who don't get paid who are powerful workers of Spirit online. One that comes to mind first is Tom Campbell. He is one smart dude. He figured things out. Literally. The Big TOE is his Theory On Everything. You might want to check it out. Only gets reimbursed for expenses, travel, food, room.  There are others. Evita Ochel, who is head of Evolving Beings, makes videos for YouTube, and that is how I saw Tom. So the company I keep, metaphysically, vibrates at a very high rate. We are all phenocite crystal people.

Caroline Myss, M.D. spoke of a model, who took away hope of a new model at her first show. She went against her intuition. And Caroline gives example of people who feel the urge to help someone, but don't follow it, and feel guilty after.

If you are like this, you have no Spiritual Teeth. Something has taken them out from you. You need to grow them before you can be whole in Spirit again.

Find your Breakfast Square and gnaw on it. Don't settle for ice cream and yogurt. There is so much more in the banquet of life! To be enjoyed! And experienced. Know where you are. And that it is not a permanent condition. Love your pet. Smile at the homeless. Call your mom. Maybe spend time with her. Learn to interact again with others.

How do you start? By taking out the older and grayer self-judgements that are blocking you to love's flow. There are a hundred and ninety million ways to love, not all of them physical/sexual/romantic. Let the Universal Light Energy flow. Any time you think a grey thought, challenge it. Is this true? Is this kind? Would I tell my daughter or son this as truth? 

Once the heart center is opened, you never want to go back to the way you were in the past.

Life holds miracles.

Find them.

Starting with your heart today.

Namaste,

Reiki Doc

Reiki in a Hostile Workplace

There is chaos at my work.

People are suing people right and left. And inviting me to sue.

Everything about the drama seems as old as this equipment to me.

It still works.. But can you get it serviced? The answer is no. There are no replacement parts manufactured or service men to take care of them. The technology is beyond obsolete.

I will explain the cast of characters, the New Guy, the Leader, the Embezzler, the Disgruntled Guy,  and the Homosexual. Followed by the conundrum of myself, with my Reiki heart. : )

The New Guy wants a Short Drive. He had contacted the Embezzler who holds a contract with the hospital. He arrived, lo and behold, ecstatic that his Short Drive Dreams come true. But he is new, just finished in training. And is a D.O. (doctor of Osteopathic Medicine) instead of an M.D. (doctor of Allopathic Medicine, a traditional doctor).  He does not question why if everyone were happy there would be an opening in our highly-desireable place to live. I proctor him on two cases, and he is unaware that this proctoring takes half my income for the two cases, and although I pass him, I do not think highly of his skills.

The Leader 'shot himself' politically about two months ago. He and his cohort tried to rally everybody to his side. The cause? Nuke the Embezzler. Make a new life for all of us. In secret negotiations he and his cohort offered a deal to the highest paid surgeon  a thirty percent discount on anesthesia services for one year. This was an effort to take the contract away. This blew the minds of administration, who hunkered down for the old. I can not begin to state how many hours I worked overtime to cover for the Leader to attend various meetings, and how many times I had to wake up an get to a six in the morning meeting. I got sick of it.

The Embezzler wants to keep his power. He is in denial over the legality of his trespass by taking money from the workers without their consent. And he has no clue that his top commodity, our skills, can up and go at any time. The Leader has worked for fourteen months without a contract, until being dismissed two days before Christmas. The Embezzler is from an ethnic background that is notorious for raiding money. Three others like him in the local anesthesia community have been let go from their places of work due to their poor practice of fiscal trustworthiness.

The Disgruntled Guy was the first to be told 'you will be fired'. He is astute, pays attention to details, and never had any money taken. The billing company and Embezzler knew he checked. But the problem with all of us led him to action. First the meetings, ultimately screwing the Embezzler by firing HIM with one day notice. I QUIT! Leader had one day. That is all I give you! The Disgruntled Guy is doing a start-up with the Cohort at another hospital. Disgruntled has five year's cash ready for expenses. However, upon his leaving, there was a shock wave throughout the hospital and the O.R.

Disguntled spilled to New Guy all the facts. New Guy was offered a full-time position immediately after Disgruntled left. At first he thought it was because of his skills. Now he sees the Red Flags. Number one issue for New Guy is Time Off/Vacation. It is next to impossible to get, and there is always the threat that one might have to cancel vacation if there is not enough coverage at the hospital. I told him how I planned my two-week vacation in advance. I had to defend it with a little piece of paper with the date on it, since Embezzler thought Cohort deserved the time-off to study for boards. And then the Old Guy had bought tickets to France, too! And I had to reschedule my trip one week earlier. I missed the childbirth of a friend. New Guy heard all this and gave me a hug. He wants five or six weeks' vacation. I offered to be his friend, to look out for him. And maybe to end up where he finds work instead.

New Guy took one hour of my time post call. And Leader took up another on the phone. Leader is negative. He brings up Homosexual, a mutual friend and colleague, who is suing the hospital for anti-gay remarks made by someone in the hospital. It turnsd out that there are many, MANY lawsuits against the Hospital for a Hostile Workplace. I am encourage to join Leader in a Hybrid lawsuit. Four or five others have. Leader threatened me to 'never be able to find work in the area before, but is recommending I look into New Job. Do I have thirty-thousand dollars contingency for lawsuit? Do I want to be involved? No.

What do I see? As a Reiki Heart? Well, my heart center is activated. I feel a very strong connection to my patients and my work. Not particularly the coworkers. Just my work.

And I am struck with a sense of relief now that the Leader is gone. I don't trust Embezzler. But I also appreciate the Harmony that is present while Leader is away. I do not enjoy Fear Tactics.

So what did I do?

I talked to Mom. Spent the afternoon with her, showing her Facebook and listening to her. She gives me a story from 1973, a dream, that was very, ummmm....advanced. Remote viewing, advanced technology,  and also ascended functions. She asked me not to tell anyone what was in it, so I am vague on purpose. But Mom has it going on. She asked me to climb and take down her Nine Freedoms book, the one she bought in 1962 that predicted all the current events and ascension too. Bless her for her wisdom and sight. And for her knowing about Dancing Squirrels on YouTube, and asking to look at it, even though she is not sure what YouTube is.

I manifested an opening at a work near my home. I am going to look into it. It can't hurt. Mom says. It is connected to Leader. But if the vibrations aren't right, I plan to remain where I am  and keep looking.

In all negotiations with everyone, I will present the matter of patient care first. And ego has no place there.

Namaste,

Reiki Doc

On What is Happening Emotionally, Spiritually, and in the Physical Form

Something was quite different yesterday at work. Everyone was helpful. Nobody got upset. And people were touching me! In the hall, when they said 'hello', about five or six people reached out and touched me on the arm as they said, 'hi'.

I have been in the OR daily since 1994. Let's do the math--that makes it eighteen years. 

Yesterday was different. Very different. We had a sick patient with an exploded appendix that must have ruptured like, ten days ago. Everyone was calm AND AT THE SAME TIME helpful! There were no screw-ups or blaming. And this was with the most old-school, legacy, my-father-was-a-surgeon curmudgeon at the helm!

Something else is different.

Every time I am away from my son, I ache for him. The longer I am away, the more I miss him.

Yesterday I didn't. That little empty part of my heart was full. I was happy for him to have his activities and time with his father. I have been trying to fill that empty with everything from accepting Jesus as my Lord and Savior, to relationships, to hobbies, to pets, to my son. There is always something 'missing'. 

I am whole.

My heart swells with good vibration. There is joy and love in my heart!

And my eyes. Let me put it this way--I have astigmatism and can't see far without my glasses. Like, when I drive. I can see without them. Crystal clear. And the last time I put my glasses on, everything was blurry. Like my glasses belonged to someone else.

There is a harmony, a joy, a Light in our existence.

Something has happened. Something big. Right under our noses without our knowing it. At least it happened so to me.

This is right on schedule. I have been viewing YouTube carefully. Bangonitdave got silenced. All videos gone. Komurosan did not post all day yesterday (maybe at midnight after I slept). But Komurosan is my favorite channel for getting information from the Galactic Federation of Light. There is another source, I just added her blog to my list, who had a video showing her face. She has been anonymous like me. She said that Disclosure is 'days to weeks away' and posted five days ago.

Our brothers and sisters in the sky have always been there. Our whole lives, our whole existence. Only now we get to see. And get to know them. There are our brothers and sisters in the Inner Earth (Surprise! ) called the Agathans. They fly in crafts too. I can't wait to get to know them. All of them. Our family from beyond the stratosphere of Earth and from beyond our understanding.

Supposedly the grid that makes up everything there is has changed already. It only looks like the old one. But it is different. And a new energy source, Zero Field, is coming online next. It will have a few hiccups, but will free us from petroleum. Hooray!

Be glad for what is happening. I feel it already. It feels terrific! One by one it will happen to everyone. When it does happen to you, just rest and drink lots of water if you are sleepy or tingly. Allow your body to adapt. It comes in waves. If you read my Karuna posts, you will know what kind of interdimensional disturbances you might be experiencing, especially with three dimensional space and time. It sort of warps a little to your perception, then it settles out after a few days.

Make the jump! Hang on everybody! This is gonna be exhiliarating!

Namaste,

Reiki Doc

Bliss, Love and Harmony

Yesterday was better than most. I experienced a level of lovingkindness I had not experienced in a long time. Things are different. I think Reiki has been a huge part of it.

I was on call for OB. It had been an incredibly slow day. Then business started picking up. First a call for a blood patch, I prayed for guidance as I talked to this woman, with the not-so-great insurance that had a complication twice with her anesthetic. A high block, and then a spinal headache the following day. I was surprised at my candidness, and calm in that situation. She chose the patch, it went in.  And I was called away upstairs to the Unit to intubate a Leukemia patient.

"God Bless You!" the nurse said when I arrived at the room. "Thank you so much for coming so fast."

He was actively dying. And alert. In terrible respiratory distress. I looked at the armband and using his first name explained who I was, what I was going to do, and what to expect after. He had had the breathing tube before. Once asleep and intubated, blood pressure went down. Way down. He was on dopamine, vasopressin and norepinephrine drips already, and they were maxed out. 

"Can you put in an a-line?" they asked. Sure! Of course! I LOVE putting in a-lines. I hadn't for months. The right side, the vessel spasmed. On the left, I tried, and then like, WHOA!, the needle 'jumped' in and I got it. As I sutured it, my phone went off. Another epidural request.

After that epidural, I got some sleep. Maybe from midnight to two a.m.  At quarter to two, I got told there would be a c-section at two-thirty.  After a ten minute snooze, I got up, and packed my things. When the next anesthesiologist comes on, I don't like to have all my reiki books and household projects all over the room. I bring my own pillow and I take it back. Why did I pack at two in the morning for just one section? I get off work at seven. But I knew. Deep in my bones I knew I would not be back.

C-section, followed by epidural, followed by c-section. At six forty-five I was done. And the new guy was at the L&D front desk.

I got home. There was chaos. My mother had a temper growing up. Now she manifests disharmony when she watches my son. They love each other deeply. But I came home with food from Mc Donald's, not Taco Bell like he asked, because Taco Bell was closed.  They did not come downstairs, He had pulled the drawer out all the way on his dresser, and was freaking out because he could not find a pair of shorts without a zipper that fit. (He dislikes zippers. Sigh.). 

Patiently, although I was starving and exhausted, I put the food down and went upstairs. "I don't want any drama. Calm down. Did you know there are shorts in the dryer?" After that came the food fiasco.

The egg sausage biscuit came to us blank. I called the store and got upset in Spanish. (the total ripoff was about four bucks). I was surprised because the people in line waiting for food pickup, and the workers had been so nice.

It was mom's turn to say, 'just don't go back.' At the grocery store near her house, they ring items up multiple times and overcharge her. And at local fast food, she has to double-check.

I got my boy to school, and went to get a car wash at the dealer. They are free. Everything clicked. There was a ding on a wheel, and I was glad I had the insurance to cover wheels and tires.

I was a continuous source of Reiki while I spoke with the manager and receptionist.  

I came home and mom was still there. We talked and then I started to fall asleep while she was talking to me. Sitting right up in a chair. She covered me with a blanket, kissed me goodbye, and went home. This kindness was not typical of her, and I noticed it and enjoyed it.

When I woke up, I blogged. I cooked in the crock pot spaghetti and meatballs and sausage. I fed the snake, and prayed so hard for the rat not to suffer. One-eyed rat is happy, and the feeder roommates were okay. After I put the transition symbol in the rat, the snake squeezed. He didn't attack. The rat was just sitting on him calmly and the snake closed in on him. No biting the snake. No struggle. Unconsciousness came quick. 

At the store there was a woman with wrinkles and too much makeup on. There was a new flavored water in the juice section. My son wanted kool aid juice boxes. I asked him what the sweetener was, for I bet it had high-fructose corn syrup. He was like, "Look it has 100% vitamin C!" But that is typical packaging to promote added vitamins when the product inside is not healthy. Nobody advertises like that on healthy food. Then he looked at the water. I said no. Please consider the 100% organic juice packets (they are diluted to have less calories). And the lady stepped in and said, ''water is always better." And it came out of me, "No. Flavored water isn't. You don't know what kind of crap (chemicals) they put in there to make it taste like that. He gets a frozen bottle of water in his lunch every day (temperature is HUGE to him. It has to be ice cold for him to drink it)." And I walked away. No juice and no flavored water. I did not like her butting in.

Throughout the store she heard me telling my son no to chocolate, cookies, pizza, Starbucks fresh hot chocolate. He has a weight problem and he craves sugar. He actually snuck an expensive candy bar into his pocket to try to convince me to buy it. I was polite but firm, and said doing that is actually a form of stealing and we don't do that in a store. He got cocoa puffs (I can't get him to eat breakfast because he is not a morning person), little blueberry muffin packets 'for when you are at your dad's house and you are hungry.', one lunchable, turkey sandwich meat. But there was a peace in all our interactions that was welcome. Everything was calm and fair, except for his childlike ways to sneak which are quite natural for kids.

At home, dinner, movie, phone calls for the assignment to work and family. Everything flowed.

Because I am gone so much, and this weekend is time for his dad, our son asked to sleep with me. I said yes. As he fell asleep, he was close and I started Reiki to flow. I turned on the switch with the power symbol in my mind. And Reiki can heal even when you are unconscious/asleep.  Reiki helps so much when work is long. It helps give him the love and harmony he lacks because of my schedule at work.

People are nicer. It is no fluke. And it is going to keep getting better. Peace and harmony are coming to Earth. Everything will be working for the betterment of all upon the planet. It will not be without work, challenges and struggles. But they will be fair tests. Intuition and inner guidance are going to help all of us as we go through our day. Just like for example, the day I showed you in this post.

Bliss. Come and get your fair share of it. There is plenty for everyone.

Namaste,

Reiki Doc

Reiki Rumblings for The Economy

There is something deep inside of me I am trying to get out. A Truth, but not one of the mind. It is from the heart. It has to do with balances. Not of the checkbook or accounting register. But of the heart.

My heart has taken note of some things in the past month. They are starting to form a thought-picture. That is how Spirit communicates. Thought-pictures. Feeling-knowing. Just information that 'pops up' into your radar. 

I have asked for Reiki guidance so that the message I write will make the most benefit available to all.

Last night I did an epidural blood patch on a lady who had a high spinal during labor. There had been neurology consult and both a cranial and lumbar MRI. She is on the not-so-great insurance that is backed by the state. She got relief from her headache with the result of my intervention on her.

When I checked this morning, we talked, after I made sure everything was all right. She asked me "why the MRI?"

I said, "do you want to know the on the record reason or the off the record one?"

She wanted both. "The on the record reason is because of your symptoms there may have been grave neurological involvement and we had to check that none of this was happening to you. The off-the-record reason is that the neurologist did not want to come in, was probably busy with other things, and should have come in himself to look at you before having ordered this test. But the peace of mind is worth the additional expense of the copays. I know they are expensive, but it is worth it."

What she said next floored me, stammering, speechless. "I have (not-so-great insurance from the state) and I won't have any co-pays. I am not worried about the cost. I won't have to pay."

My God! Over two thousand dollars in radiology services without a penny paid to any of us. And no care over who is going to foot that two thousand dollar bill. This was her fourth child, all on the not-so-great insurance! Is there no regulation for this? For those who take advantage of the system and work it?

Why is it that I, her doctor, have to buy my own insurance policy for medical care that has such a high deductible the pharmacist can't believe it ($750 each family member), that does not cover MATERNITY, and she gets four kids for FREE? There ARE no private, non-group policies that cover MATERNITY. Anywhere without paying a small fortune. And the same is for the nurses too, who struggle to meet co-insurance monthly expenses, and deductibles.  Let us call that Problem Number One.

Problem Number One, from an energetic standpoint, is an Energy Vampire. Money is the mutual exchange of energy. Your service for mine. Your effort for mine. Even exchange. With the state to back her, there is no stopping this imbalance of time, effort, and service. Total energy suck. This is not a sustainable state.

Problem Number Two, EVERYONE IS WORKING LONG HOURS LIKE DOCTORS, even NON-DOCTORS! The head of the dealership runs his establishment lean. We were talking while I waited for my car. Total expenses are over half-million dollars a month, just to stay afloat with overhead. On Tuesdays and Thursdays, everyone works a twelve hour day. The only days off are Tuesday and Thursday. Half the crew gets one day off, the other gets the other. This is how he manages to stay in business. He does not resort to psychological scare tactics and tricks. It is a good, old-fashioned 'quality sells itself' place. 

Everyone I know is working these hours! My sister, with her internship for free in her psychology program. The swim teachers at the swim school didn't get MLK holiday off. It was a normal work day in the hospital. Companies are squeezing more and more time out of their workers. There is no leisure time! I live at my work. We are so short staffed (so everyone 'gets a big piece of the pie') that I have to work post-call. That is correct, starting another day after working a 24 hour shift with no relief. "you doctors need a union", the car guy said.

How does this look through Reiki eyes? Someone is benefitting from this. It is more than the economy. WHEN do we grow? When we look inward. When we have time to explore our individuality. When we have time to try new things, to work for our dreams. This has slowly and steadily been taking away by the advertisers and industrial complex. There are constant interruptions to our day, from the TV at the gas pump trying to get you to buy more of something at the snack shop, to blaring media on radio, the internet, and TV, to really intense working conditions. Our personal power is being taken away by survival.

It is very sad.

What can we do to change all this? Go camp out at City Hall and protest? No.

We can do five things to bring prosperity, abundance and sanity back to the Economy:

1) Connect to Nature and Connect to Source. The Universal Healing Energy of Reiki itself is the never-ending supply and abundance of time and resources. DON'T LET ANYTHING derail this process. It may come in mini-sessions a day, from a Sudoku to a stoplight. Let IT DREAM, let your soul awake. Connect. 

2) ACCEPT AND ASK for Divine Intervention. Your situation now is here and here for a reason. Ask to be shown the lesson. Think about what you would like your next situation to be, how to improve. Reflect on this. Every day. Take time to listen to the workings of your Heart.

3) Try to Keep Up with the Joneses is OUT. You are you and they are they. Do not compare. For everyone has their lessons. Keep yourself on your own Divine Work.

4) PLAY!  This is another source of Divine Light. Be happy. Laugh a little. Raise your vibration as high as you can. You will be more resilient to life's little challenges. And even the big ones. Daily self-Reiki is an excellent resource for this.

5) TAKE THE ENERGY OF MONEY AND LET IT GO. Try to look PAST it at the Energy you are exchanging itself. Try to take the Marketing thing out of the picture. Think about YOUR MONEY as YOUR ENERGY from YOUR WORK, and pass it wisely to the companies that you think BEST SERVE your Highest Ethics and Divine Calling. This is far beyond simple Quality and Service. What businesses do you want to perish from the earth? Pornography, gaming, and the way that fashion is commoditizing 'perfect image' come to mind for me. They are insanity, and should stop. Perhaps you think high calorie foods, for example, what Paula Deen promotes should be banished? Either way, find what you like BEST, support it, and know that good will follow. This goes for charity, too. Support what resonates with you. And do not be afraid to spend on it, for the Universe will provide.

At Church Summer Camp, I gave all my money to the charity collection on the last day. When it came time to ride the bus home, for a full five hours, I forgot to budget for lunch. I just sat there while the rest of the kids ate at Mc Donald's. Someone noticed. Like I had so many times before, I did not want to get attention, and said with a smile, "I am not hungry." But I was. My friends knew. And gave me money. I could pay them back whenever. I got a small cheeseburger and fries and water. It was enough. I gave to God, and God provided for me.

Remember this. It is now more than ever that this Faith is required in our work. And in our families.

Namaste,

Reiki Doc

The Guest Speaker from a School Near Where Movies are Made

They're heeeere! Just like in the movie, Poltergeist, Reiki Doc announces that Intuitive Medicine is going mainstream.

Dr. Oz has been raising the awareness of the public.

Now another M.D.-Intuitive is going on the lecture circuit for a Medical Association. I have one of the books on CD by this author. The title of the talk is very toned down, 'how to use your intuition more in your practice'.

How do I feel about this? Kind of relieved, really. I have been holding my breath for months, wondering who would do this work. I am the most Type B out of my whole class of medical students while in my training. And this has been stressing me: who is going to take this to the healers in organized medicine? Is it me? Do I change my life?

Not really. There is something Spirit wants me to do. I have a book of messages from my patients who have passed. They stop by on their way Home, and give me inspirational advice. It has been waiting for about six months what to do with it. Now is time to try. I am staying anonymous. I can be of more help this way.

One of the limits on myself, as far as Spirit goes, is having to stay humble. Once I lose my sense of humility, my gifts are gone. Better to be backstage than out in front for me. It feels right. I want to stay protected until the time is right to make myself known, if ever. I can't make the lecture, but I know what she is able to do, much much more than she is going to let on to the group. Won't want to frighten them.

But know, It Is Happening. Doctors are being lectured to, for Continuing Medical Education hours of credit, by a lady doc who writes books. A psychiatrist that is famous and is making the rounds. 

That is a good thing.

Your doctors working with Spirit to heal your body, mind, and soul. 

Namaste,

Reiki Doc

OMG! Obesity in Labor and Delivery

"I know", I said to the charge nurse at ten o'clock last night, as she looked at me and tried to explain what was up in Labor Room 4.

"How did you know??!!", she exclaimed.

"I looked it up on the computer system before I came upstairs. There was something in your voice that made me look." I replied. "What did you tell her?"

"That we are going to put in the epidural." she said.

I matter-of-factly said, "How can you promise that? It might not go in."

"What are you going to do?" she asked.

"I am going to stick her until it goes in or she tells me to stop trying."

The charge nurse left to see the patient, while I got my cart and bag of local anesthetic from the pyxis. she came back and said, "I told her we are going to give it the good old college try."

"Thank you."

I get in the room and there is an enormous woman, with full make-up. Why they try to make the face look so nice when the body is, well, enormous with rolls of fat, is a mystery. Fake eyelashes, everything applied like a cosmetologist, hair perfect. What I see is the red thigh-size cuff barely fitting on her arm, because the arm in obesity is shaped like a cone, and the cylinder of the blood pressure cuff poorly fits. I take a large cuff on the forearm over a thigh cuff on the arm in the O.R. any day. It reads more accurate.

As I take this in, I take the energy read of the room. It is survival. Is there dark entities in her? They are going to make it tough. Is she stable, mentally and emotionally? The critical thing is, where are the folds in her fat? Back pannuses are thinnest at the fold. She could barely spin in the bed to expose her back. She had concern because her internalized monitor 'was coming out'. The external monitors can't read fetal heart tones or uterine pressure due to the insulating nature of fat.

Open mind, open heart, and prayer to St. Michael to protect and aid me, I got ready.

Twenty cc's of saline, not ten. And the local with the 22 gauge needle, not the 25, to the hub, and no contact with bone. (I had prepped wide with the betadine and draped first).

One hundred percent of my attention was on that back, with the family member in the chair I could see out the corner of my eye. Tuohy needle, to the hub, contacting bone, the spinous process. The epidural space was going to be about three centimeters in past the hub. I took care to stay in the midline. The needle, as I pressed, swerved and popped, as if guided by unseen hand. The interspinous ligament. Almost there. I leaned with all my weight with the Tuohy needle hubbed to get the three centimeters and loss of resistance that indicates the epidural space. The husband put his head in his hands as I did this. It was gory. No blood, but a needle going more than all the way in is a trip. With firm grip, I held tension on the Tuohy, took out the stylet, and grabbed the extra long spinal needle. A pop through the dura and CSF would mean I was totally in the right spot. Sometimes extra fat people have a loss of resistance outside the ligament, and the catheter will thread. No pop. No CSF. I threaded the catheter to fifteen centimeters at the skin, a first, the deepest placement ever. And when I went to remove the Tuohy needle, with all my force, I couldn't. It was stuck.

I never had been in that predicament. I pulled, and I asked gently, "can you please bend forward?' She did. The bones loosened their grip on my needle, and it came out. Test dose felt good. And it was negative. Her blood pressure dropped and she had relief of her pain.

It is better to be lucky than good.

What I have learned through the years is not to judge.

To stay in the moment with a challenge.

And to know that in that moment, once handled, lies the opportunity to show your skill set.

In this woman, as a Reiki Master, I asked for Divine Intervention in my work. I got it.

"How did you ever get that epidural in?" Lorna, a seasoned RN, asked in amazement.

"It's easy," I answered. "I prayed."

Lorna laughed a big belly laugh at that one. She knows. Poor charge nurse needed me to hold the other leg so she could put in the foley. That was a sight I would like to forget having ever seen--it was not pretty.

I did not have time for a cho ku rei. But I did have a partnership with spirit, that worked. And I did have humbleness about being there sincerely to take away pain. I also took away my judgement of how she would have terrible insurance. I was wrong. Blue Cross PPO, one of the best.

'You take care of me, and I will take care of you." said the father-to-be, on talking about his job as a server at a swanky restaurant, and what celebrities tip better than others. For a while I had thought about my role in medicine, "I will take care of you and maybe you will pay me and maybe your insurance will and maybe they will not." But I plucked it out of my mind. It was not healthy. And look! Good insurance after all!

Do not see like everybody else sees. A challenge is a gift to let us manage it. We discover how much better we are at what we do. Others show us pieces of ourselves. Embrace differences. For what we do to them we also are doing to our own hearts. Love is the only thing that will protect us and save us from any challenge.

Choose love. Hold tight to it, no matter what the challenges. And love will find the way through the challenges that await you.

Namaste,

Reiki Doc

P.S. Labor epidurals are put in by sight and by feel. When you can see the interspaces between the spinous processes, you go there. When you can't see them, you go by feel. The times you can't feel the bony prominences with pressure, you have to guess. Sometimes you go in by bouncing off the bone. You have a mental picture in your head of the space, and recreate it by bumping into the edges around it.
The reason I have a gift for the morbidly obese moms on labor and delivery, is that I have 'the sight', intuition. I go by feel. And also by guidance. I get direction like, 'that won't work there' or a feeling of forboding at different sites. I go for the one that seems 'right'. And that is how I get it. I did a four foot nine inch four-hundred pounder that way. It is never easy. But take away what you see and feel and know, and go in blind...that's where I come ahead of the rest. : D