Happy New Year - Before 2011

One more busy week, then I can settle into some sort of routine...

Happy New Year, wishing you all a prosperous and healthy 2011.

Great Canadian Memories of Christmas...

How I Made Santa Cry

There's a predictable trend in emergency departments. With snow comes sniffles; with cold comes cough. Every person less than four feet of height and under 10 years of age in the region of Peel came in to the emergency with fever and cough, cough and fever, fever and cough and vomiting after cough, feeling unwell with fever and cough...etc...most of which were within 48 hours or less of coming into the EMERGENCY department.

Of those kagillion kids who registered, maybe a dozen were given inhaled medications and, just maybe four were admitted for ongoing treatment on the ward. Perhaps even fewer than that.

And, it's not only kids who get fever and a cough, cough and a fever. Adults do too. Particularly if they've spend their entire lifetimes sucking cancer sticks and turning their lungs into black non-elastic sacs that don't actually exchange any air and become useless.

Such a patient was a man I had at the beginning of the weekend, admitted with "community aquired pneumonia" (meaning he got a cold at home and it got into his chest and caused low lying phlegm build up).

It will be a long time before I forget this gentleman, even though I only looked after him for four hours. It's not that his case was unique or unusual. He wasn't gravely ill. And it wasn't even that, as he said he'd heard several times in his lifetime, to the point of annoyance, he looked like Santa Claus (albeit needing a good bath and mani-pedi).

His personal history didn't reveal any close family or friends who would know about how he functioned at home and what help he needed. A prn order for valium was preciptated by a dependency on alcohol. He had been a heavy smoker and now lived with the medical demands of COPD.

Even those factors weren't really anything that made him remarkable for ready recall (and believe me, for the number of people that an emergency nurse can see on a daily basis, recall of an individual person of non-specific nature/situation is not an easy feat).

What struck me most was how this man, whose physical body mirrored the jolly Spirit of the Season, was incredibly lonely. He asked me whether or not I celebrate Christmas and I offered that it will be the first time in five years that my husband and I will be together for the day.

The man who looked like Santa cried.

Immediately, I left behind the "functional RN" role and laid my hand on his shoulder, offering him tissues. Not only did I feel bad that he reacted this way to something I'd said, but I knew in that moment he was remembering and longing for someone or something represented by a vision of a husband and wife being together on Christmas Day.

He didn't offer much about his sadness in concrete detail, but he didn't have to. I didn't press him for an explaination because that didn't matter. I had other tasks to complete for him and my four other patients, but they would have to wait. Just for a little while.

This man had a deeper need than antibiotics to clear up an infection.

When he was ready, I moved on to the rest of my "shift start" objectives for his care. In my short time remaining with him (my assignment to that area was only 4 hours long and, as usual, quite busy), I tried to protect him from making that connection to what may be for him the Loneliest Time of the Year in the best way I could.

I gave him my warmth of Spirit and care. And I asked people not to tell him he looks like Santa.

Sniffles from H-E-Double Hockey Sticks

We left for the UK on the 18th, and during the trip I could tell that Torran was going to come down with a cold. He was getting sneezy and sniffly. The next day, he was in full blown snot mode. Given that he was going on yet another plane, he coped well. his ears didn't bother him.

The poor little man was a mucous faucet for practically the entire visit. I'm sure if we'd taken him to Oslo, his nasal passages would have been frozen shut. Thankfully, our friends in Scotland all have children and the parents weren't afraid of us bringing our little germ cesspool around for a visit. He did share his cold with his mother, lovely boy, but I had it far less symptomatically.

I had hoped that it would only last one week. Of course, it didn't. The worse of it lasted throughout our trip. When we returned home he had the residual cough that shows up in the morning (mucous pools in the "wind pipes" during the night because of our shallow breathing and less movement). Occassionally he'd cough during the day too, but nothing concerning.

Yesterday, the runny nose started again. Today the wee man isn't himself. Quieter than usual this morning, coughing more, a touch less active and the big indicator, he didn't want to eat all of his lunch. After lunch, the fever started.

Sigh. Frustrating circumstances! Is this a new problem, a residue of the old cold, or the cyclic neutropenia? In the absence of shunt bulging, headache and vomitting, I'm disregarding the shunt as the source of the fever.

Even so, I'm eternally grateful that he doesn't have the hypoplastic lungs the doctors told me to expect because of the oligohydramnios. Without fluid in my amniotic sac when I was pregnant, his lungs wouldn't get a chance to "breathe" the fluid and "practice". The tissues learn how to be elastic and stretch to full capacity for the newborn world of breathing air.

Similarly, I'm also thankful that the 8 weeks of intubation which caused lung damage during his time in the NICU have not evolved into the chronic respiratory problems that premature infants frequently face. He could, like Mikiya, have collapsed lung lobes. Or, facing a cold, end up with pneumonia frequently, like the NICU twins we know Marko and Maksim.

We have our many concerns for our little hero and his future development. His robust spirit served him well during the NICU and fate willing, for the remainder of his days!

Secrets of a Psychic Nurse

Every so often, I encouter a situation that particularly strikes me about people. Given the type of work that I do, I have a higher rate of exposure to incidents which lend themselves to retrospective reflection.

This retrospection may be intuitive, amusing, or horrifying in its perspective. It can give cause for grateful thought, disbelief or frustrated exasperation.

And sometimes, it's just plainly about the silliness of human beings.

Recently, I had a woman sit down in front of me to be triaged. Her complaint was not unusual for this time of year. A cough and fever which causes her discomfort and diffculty breathing. She called Telehealth who told her to go to an emergency department to be assessed for pneumonia (emergency nurses hold your tongue please).

I did her vitals, and they were, of course, fine. I say "of course" because when people are able to speak in full length run on sentences, they are not struggling for breath, and their numerical values will reflect that. That's the amazing thing about our bodies - they often give us away.

In asking for pertinent medical history, she denied having any. I pointed out that she is a smoker, which would make her feel more sick when she gets a cold. "Oh my goodness!" the woman exclaimed! "How did you know that I smoke?"

Seriously?

Frankly, I explained to her that the smell of cigarettes eminates off of her. Very blunt words, yes. Why should I have to be exposed to that malodorous scent with a smile on my face? Oh, and if you can't breathe when you have this cold, smoking is not going to help. Ask anyone with COPD (which a person inevitably gets over time when they smoke).

It is the first time that I have been so direct to a patient about the effect of second hand smoke. I even pointed out that it sets off my allergies. But the woman, bless her, was clueless as to (what could be called) my passive-agressive statements, as she continued to marvel that I knew she was a smoker without seeing her in the act or being told it. Her reaction was quite incredulous to the simplicity of my observation, and not the least bit upset with me.

Turns out, she has bronchitis, again not unusual, and she went home happy.

I was left with a little smirk on my face, that I amazed this woman with common knowledge... at least among non-smokers.

photos updated

Oslo
and
Scotland

with comments to follow (too tired to throw them in tonight!)

Oslo, Norway

I'm glad that when Bruce asked me if I wanted to take a few days on the continent during this trip, I made the executive decision to leave Torran with his parents and give ourselves a holiday within a holiday. Why? you may ask. Oslo was so cold that I got windburned THROUGH my jeans! I would have felt horrible if the wee man had come away with cold related injuries (we left his snow pants at home). Besides, we mostly hung out in museums and shops, not the place for the Tornado.

We flew from Aberdeen to Stavanger with Wideroe on a prop airplane, landing in a very small seaside aiport. The seas must have been churning because the air made it smell more like a fishing harbour than a place of aviation. From there we took an internal SAS flight to Oslo Gardermoen Airport. Getting to the city centre was a breeze with Flytoget train tickets (about $25Cnd, 170 NOK, each way), a travel time of about 25 minutes. We stayed at the Thon Hotel Opera. Bruce picked it because it was central, and because he gave up on trying to find cheap accomodation in the city centre.

Founded in 1000AD by King Harald Hardråde, Oslo means "the pasture of the gods", from the Old Norse Aslo (the Norse god "As" and "lo" meaning field). It remained a small city, 3000 inhabitants by 1300, but it's Norsemen, better known now as Vikings, made their impression upon the world. Through the marriage of the royalty, the Danes ruled Norway beginning in 1380 for 400 years. Oslo was destroyed by fire in 1624, and then rebuilt by King Christian IV of Denmark and renamed Christiania after himself. Norway was ceded to Sweden in 1814 after the Napolenoic wars and remained under Swedish rule until 1905. Although changed to Kristiania in 1877, the original name of Oslo was returned to the city in 1925 by a Norwegian government.


During our first venture into this city, Bruce and I found ourselves in his little piece of heaven. The Swedish ICEHOTEL has created an indoor bar completely made with ice from the Torne River. It gets changed twice a year, and the room is kept at a steamy minus 5 degrees centigrade. The bar's walls, counter, seating and glasses (everything but the floor and roof) are made of ice, a preview of what once can expect at the ICEHOTEL. Indeed, that is Bruce the human snowman wearing an insulating poncho. We warmed ourselves with yummy cocktails and a warm drink (which was served in a normal cup of course!). Has it changed my mind to spend the night sleeping on a bed of ice and animal furs... um, no.

We roamed the city centre avidly, but were defeated by the cold (unseasonably cold and major wind chills) and the lack of shopping and tourism after 5pm - a result of the country's comfortable lifestyle and a northerly locale I reckon. The quality of life is high in Oslo, as are the taxes and cost of living. However, its people also seem driven to a good work and study ethic (at least the office block facing our hotel window always seemed to have people working hard).

To improve our explorations, we purchased The Oslo Pass for about $55 Cnd each (340 NOK) for two days and would highly recommend it to anyone touring Oslo. For an affordable price, it gives you access to all the public transportation, free entry to a number of museums, free city parking and discounts at various restaurants and shopping venues. Oslo city centre has a congestion entry charge for vehicles. We ate at Kaffistova two nights in a row, the first time because it has traditional country inspired Norwegian food; the second night because of the discount!


For our first full day out, I chose our The Viking Ship Museum (Wikingerschiffsmuseum) as our beginning destination, even though it's not my time period of focus in the SCA, I knew one Not So Innocent Viking Chick by Royal Decree who would disown me if I didn't go... and I'm so very glad that I did. Take bus number 30 to BygdØy (Huk) if the ferry across the bay is closed (off season).

The museum houses the world's best preserved examples of Viking boats. They were also used as ceremonial burial ships, and were unearthed on the Oseberg, Gokstad and Tune farms in eastern Norway in the late 1800s and early 1900s. As Vikings often cremated their burial ships and contents, finding such intact specimens is what makes them truly remarkable. Mummified bodies and some artifacts were found with the ships, but all metallics had been removed by graverobbers in the middle ages (there were holes found in the ships where someone forced their way inside).


Buried with the noblepersons were objects to help them in the the next life. This includes the only and best known surviving wooden Viking Age wagon in existance, beautified by the detailed carvings on just about all of its non functional surfaces. It was found on the Oseber ship (pictured above; build about 815-820 AD). The Oserberg ship is presumed to be a pleasure craft, requiring 30 men to operate her oars in calm waters. Only two rows of wooden planking would have been above the water line when fully loaded. As a funereal barge it held a prominent female figure (the museum calls her a Queen) who died in 834 AD. The metallic supports underneath the oak planked ship are engineered to both give structure to the ship and prevent further sag of the wooden slats. Ornate Viking carvings adorn both the bow and stern of the vessel.


The Gokstad ship (Gokstadskibet), in comparison, has a less shallow and more sturdily built hull (seen here on the left). It was built around 890 AD and had design features which indicate it would have been used as a sailing vessel worthy of the open seas. For example, the oar holes have wooden covers to prevent incoming water. An important chieftain was buried in the ship about 900 AD. The remains of 64 Viking round shields were found during excavation, which would have been mounted on the sides of the ship. Both ships would have used a square sail in good winds, although neither mast survived intact.


Lastly, the Tune ship was build about 900 AD but it remains mostly in ruin (not reconstructed). It also contained a man of high rank, buried in a wooden chamber built on board the ship. However, the grave goods of this ship did not survive to modern day. The museum displays much of what was found on all the ships, as well as some other items from other finds. Some very fragile textiles and weaving cards have also survived for display in the small museum. Interestingly, there is a section which discusses how the remains were re-buried out of respect in the early 1900s, but they (and the fabrics wrapping them) barely survived 80 years in the new burial environment as discovered by researchers who dug up the bodies for DNA identification.

A short (and very cold) walk further along the fjord brings visitors to The Polar Ship Fram (Frammuseet), The Norwegian Maritime Museum (Norsk Sjofartsmuseum) and the Kon-Tiki museum (Kon-Tiki Museet). Alternatively, you can take bus 30B to Bygdoynes. In the opposite direction from the Viking Ship museum (which is also an earlier stop on the bus in this same vicinity), you can find The Norse Folk Museum (Norsk Folkemuseum), an outdoor museum of Norse life from medieval 1500s to modern day in rurual and urban settings. On this trip, outdoor = cold, so I chickened out on that one, as seconded by Bruce who bought himself a knitted Norse headband to keep out the chill, an item he usually only wears when he's cycling. Another building built literally constructed around a key piece of naval history, the Frammuseet houses the wooden Polar vessel Fram which boldly took stout Norwegian explorers Fridtjof Nansen, Otto Sverdrup and Roald Amundsen farther north and south than any other vessel. We then went to the adjacent Norsk Maritimt Museum and gained a new insight on the nautical history of the Norse people, its shipping and trade.


Our day of historical revelations ended with the trail at Akershus Fortress (Akershus Fesning) overlooking the sea. Here too, the weather robbed us of a complete exploration of the site (a 50 minute walking tour outdoors). The castle itself was also closed, perhaps because it's off season. The building of the medieval castle Akershus started in the late 1200s, mentioned first in 1300AD. Many of the surrounding structres survive from the 1300s, although they have been converted from their original purposes. Later additions were built, of course, to further fortify the castle and its ramparts, the last in 1the 1860s. Part of the Crown Prince's Bastion (1593-1604 construction phase) was removed to expand the Akershus National Penitentiary in 1860. The Penitentiary was in use during the World Wars, and closed in 1950.


The former Double Battery (1691-16952) is now the home of Norway's Resistance Museum , a sobering reflection upon the involvement of the people of Norway in World War II. Outside this building 42 patriots were executed for their anti-Nazi beliefs in 1945. It's a very effective museum, representing the politics and struggles during this insipidous time. Most of the displays are in the local dialect, however, there is enough English to make the venue well worth the trip. There are pieces of history here I never learned about in school, but wish I had. It reminds me how grateful I am that I was born in peaceful time in a democratic and affluent society.

The following day, we started out with a walk on the roof of the Oslo's new opera house (Operahusset). An award winning modern structure of italian marble and granite by the firm Snohetta, it appears part glacier as it rises above the water in an area that was previously harbour. The angles of this home to the National Ballet and Opera allow pedestrians to stroll to its peak with ease. Unlike North American buildings, however, there is little to mar the beauty of its design in the way of warning signs, anti-slip strips, handrails or guard rails. Just one little sign advises explorers go up "at your own risk". Floating in the water is the engimatic She Lies, by Monica Bonvicini, which you can make out to the right of the opera house. It turns on the water in response to the water and wind.

With few short hours of winter time daylight, we sojourned by public transit to the Holmenkollen ski jump, host of the World Ski Championships 2011. We wanted to utilize the day's short hours and clear skies to capture what our guidebook called "spectacular views" of the city. Instead, we were met with a challenge to figure out how to get there. The subway line, called the T-Bane, to the Holmen-Kollen was being improved for the event and therefore closed. Bruce the uber-navigator found us a shuttle bus from a nearby station on a different line. Once at the top, we forced our way through biting wind to find out that not only was access to the ski jump closed off, but so was the museum and Visitors Centre (which our book said was still open...we hadn't checked the internet though, yikes!). Needless to say, even Bruce was shivering on the top of the mountain. However, we managed to find a lovely restaurant furnished like a ski chalet and warmed up beside a nice big fireplace. And yes, the views were lovely, albeit not as much as they would have been from the top of the ski jump.


After being stuck in a traffic delay (a pedestrian was struck by a car, and I so wanted to jump out and help - thankfully the Police and Ambulance arrived before my fear of intervening in a foreign country lost its battle), we returned down the hill to the Oslo City Museum (Bymuseet) and the adjacent Vigeland Park (Vigelandsparken). The City Museum has a permanent exhibition of Oslo for 1000 years. It's medieval portion sadly lacks in content, however. And both Bruce and I were disappointed that the museum seemed to end suddenly, as if they ran out of space. Of note, the picture above of the Frogner Manor House (the entrance to the museum is off this courtyard) was taken at almost 2pm. The sun angle barely rose above 45 degrees during the day.


Either I was numb, or distracted, but I didn`t seem to notice the wind so much in the Vigelandsparken. This is one of Norway`s most visited attractions, featuring the life work of celebrated Norwegian sculptor Gustav Vigeland (1863-1943). When Norway gained independence from Sweden in 1905, Vigeland was then showcased as the country`s most important and productive sculptor. More than 200 sculptures adorn a 850 meter long parkade, featuring a bronze fountain representative of the cycle of life, the granite Monolith Plateau, and ending in the sundial The Wheel of Life. At the centre of the plateau rises a 17.3 metre high granite monolith of intertwined bodies - men, women, children in Viegland`s representation of `man`s longing and yearning for the spiritual and devine`. None of the statues have any clothes, though, which may challenge some people`s sense of divinity.


Contempory and contested in its design, the Oslo City hall (Oslo Rådhaus) is the city`s administrative body and council. On December 10th, it is also the venue which hosts the Nobel Peace Prize awards, held in Oslo since 1901. There ia a museum in the building as well, but we I think we missed closing time. There are a multitude of museums in Oslo, we just couldn`t get to all of them in two days!

You may not be able to tell by reading it, but this post has taken me the better part of an afternoon to write (with a break for supper and boy play). Thanks Bruce for taking care of the wee man so I could put it up, otherwise, given the month we have planned, it might not get done!

I`ll put up more pictures through Picasa in the near future (notification will come). But before I close off on my pebble of sand in the Norwegian beach, I`ll leave you with one more image, that of the modern take on a Norwegian troll (once the figurative opposite of a giant in Old Norse mythology and now, who knows)... interesting how culture develops in other countries, isn`t it

Scotland Santa Run

We haven't been able to get over to Scotland to see Bruce's family and friends for some time. Usually, we also go to England to see my family. It involves driving the length of the country, stopping in with people we know every other night or less, and heading out again. This style of travel is exhausting, moreso with child in tow.

This year we decided to be conservative. We stayed with Bruce's parents for two weeks, taking the opportunity for Bruce and I to "pop" over to the continent for a few days. It was certainly easier for Torran, and probably for the country for the lack of destruction we left in the wake of Tornado Torran. Best to only destroy one house!

Bruce gave us an early Christmas present this year, upgraded to first class (seat sales and thanks Norm and Sue!)!! The first class lounge at Terminal 1 in Toronto was not much to write home about, and since the airport was near empty so early in the morning, Torran would have fared much better on the ground floor in the common area. However, we bumped into a very nice gentleman and had a chat about odds and ends before finding our way onto the plane.


For the first time, I think, Bruce was jealous of his son as Torran was not only allowed to see the cockpit, but the captain also put him in the Pilot's seat! How amazing is that! The captain's hat had a photo of his family in it, so I guess that he understands that the only people toddlers terrorize is their parents. The biggest advantage to flying first class, for us, was the individual pod seating that could flatten to a bed. I sat at one end, blocking the exit to the aisle. Then Torran basically had a high flyer's play pen to bounce around in. He found every possible button that he could press (except the call bell thankfully) and with new toys to distract him, he was a very contented young man. Even gave us almost two hours of peace and quiet as he slept.

Of course, that wasn't during meal times, so Bruce and I had to do the usual trade off for eating. (Kendra, I'm impressed that you managed on your own!!). Oh, and apparently first class passengers are also not terrorist material because they get all sorts of sharp, dangerous implements during their meals, compared to the plastic and paper of the plebs in the back (yes, where I normally sit. No, Bruce does not get any perks for travel in Canada... you have have to be active or retired airline staff, a pilot, or, Bruce says, the airline guy who cleans out the plane, to get that perk...although, personally, I think he's just being sarcastic about the last). For the most part, Torran was stellar on all of his flights. We were so relieved!!

Our days in Scotland were spent visiting friends and family. Sadly, the only stone circle Bruce made a detour to happened to be when Torran was totally zonked out in the back seat, and it was a 20 min walk to the site. Bruce didn't want to wait alone whilst I spend an hour mucking about with my camera and brain...and Torran would have woken up, I'm sure, just to make things awkward.


Visiting people with the Toddler Tornado in tow is great, albeit awkward at times. Even if they have kids of their own and a "safe" house, someone is always chasing after a little pitter patter monster. But it's also lovely to see how people take to our kid, and how we are influenced by theirs. I wrote earlier in the month about seeing the children grow, and that's what motivated it. Here Torran hangs out with Rose, the newest member of Torran's buddies. And what would a visit to our favourize Auzzies be without the latest buzz in their household, cupcakes care of Linda. Yummy!!! Too bad I can't order them for Canada... well, yes, Andrew, I could, but they'd arrive all dried out (and he'd send them to just to proove a point).

One of the folks we went to visit, is Bruce's air traffic controller friend Nick and his family. Nick helped provide the video link earlier of Torran pushing Juliet in the stroller... he wasn't that impressed that he had to share the toy, though, and kept trying to dump her out of it. When she wanted to push him, it was all we could do to get him to sit for a couple of seconds... I think my son has to learn some socialization!


During that visit, we also got the grand tour of Fairlea Steading, Nick's personal quest for making a castle out of a barn...literally. It's a huge project that he's doing by himself, save for the electrics. That includes laying underfloor heating, framing and drywall, and flipping diggers randomly. I teased Nick that he's been so preoccupied with the Steading and his family that I'll be updating his blog before he does! We were teasing Nick that if he wants to come overseas, we'll give him a second storey to build on our house. I don't think his wife appreciated that much :) She'd move to Canada, she says, but is ready to have a her husband back.

Torran also spent time with a young lass, the daughter of more air traffic controller friends, Mike and Phillipa, who is about the same age as him, but very definately the boss. And it was interesting to see him translate what she'd say or to to him into his play. At one point she told him to "back up, back up, back up!" because that's what they say to their horses. A few days later, he's saying it to the curtains in Mum and Dad's lounge after we'd closed them for the evening.

As you saw in an earlier picture, Scotland is buried under unseasonable snow. It's not that they've never seen it before, or don't know how to handle it. It's just rather early, heavy and ongoing. Partly because of the snow, and partly because of an unforseen family death, we were unable to traverse to Glasgow to catch up with some of Bruce's friends from university. He was very bummed out about it. To cheer himself up, and avoid cabin fever, Bruce bundled up the wee man and took him sledding/playing in the snow twice a day. We'd recently returned from our FREEZING cold trip to Oslo, and I was happy to hide in the warm of the house.

I'll post about Oslo later...not only have Bruce and I woken up during the night because of jet lag, but now Torran is up too, so I'll go lend a hand. More photos will be linked up through picasa soon.

It's good to be home, but I will still miss our "other" home.