Real Women Drive Stick

You Done Good - But You Had to Run Ragged

2012-01-25T06:32:00.003-05:00

We have a system in place, like most emergency departments do, to help manage the delay of discharging a patient from the ambulance into our health system. The delay is called "offload delay". There are all sorts of metrics and politics related to offload delay, and it's not pleasant to experience for anyone.

The purpose of our offload system is to get the ambulance crew back out on the road. To some extent, it's to have the patient access the emergency health system faster, but I've done the same "pre-doctor" second triage on a patient in an EMS stretcher as I do with the patients who have walked in and are waiting in the lobby.

In our hospital, if you take an ambulance to the emergency but you can walk or sit in a wheelchair, and don't have otherwise life threatening symptoms, you'll be "offloaded" into the waiting room, if there isn't an assessment space for you. For the patients who can't walk, we have four offload stretchers with a designated nurse. Once those four stretchers are filled, then the crews waiting in hallway(s) with their patients until the next available spot.

The only folks who don't experience offload delay are those who have stopped breating, are having severe respiratory distress or having an ST-elevation heart attack (STEMI). In other words, true emergencies.

Yesterday, I was the designated offload nurse. From the moment I arrived at 1130 in the morning, until 2:30 in the afternoon, I did not stop bustling from patient to patient, triaging ambulances, drawing blood, changing incontinent patients, walking people to the bathroom, assessing patients, carrying out orders, documenting, giving medications and uber-multitasking. In the first hour I offloaded 5 ambulances - two of which had ambulatory patients that I could move to another area of our department. I managed another three ambulance offloads by 6pm.

My charge nurse and manager complimented my "great work"....

And whilst I appreciate the pat on the back, I have to wonder why I nearly had to kill myself in order for the system to work so efficiently (which got me the compliment). And is working like I've literally thrown a dozen china plates in the air at the same time and have to catch all of them before they hit the ground really worth a pat on the back?

Yup. 2012 has Started.

2012-01-18T23:12:00.003-05:00

This is my motto for the year. It's a WWII poster released by the British Government which has recently found renewed fame in UK pop culture.

Needless to say, my preoocupation with life has kept me from blogging, for which I apologize to my most fervent readers.

I have holiday snaps to update and life stuff to discuss. But for tonight, I say "hi! I *am* alive..." and then head to my pillow.

G'night.

Well, Now What?

2011-12-09T12:33:00.002-05:00

It's been a little hurricane of illness in our household, between my miscarriage and D&C, my cold, T0rran's fever and cough, and then Bruce's cold.

By Wednesday it finally looked like we were heading back to healthville, as all three of us were fever free and back to our designated routine activities in some degree of better functioning.

Today, the wee man is sporting a fever and a small rash to the side of his mouth. Hand-foot-and-mouth disease? Freakish fever of unknown origin?

And with our impending trip home, it makes me kinda nervous!

It will Never Feel Right. Nor Should It.

2011-12-06T21:26:00.003-05:00

For Keegan and Neil.

Theirs is not my story to tell. Perhaps one day, I will be given permission to share the tales of these little boys, born to different families, who faced death and did not win.

In the meantime, I can convey my sorrow for their families and the people who love them.

My FB post today:

I have heard of two deaths of a child in less than 24hrs. One of someone I know, another through a friend. It is nearly incomprehensible to me that such unfairness exists in the world, when so many people either do not want or do not appreciate the children that they have (or worse!). If you are a parent, tonight, give them an extra hug and kiss and KNOW how special that life is to you and the greater world around them. May these newest angels find peace and happiness on their next journey, and their families find some measure of comfort in knowing that so many people would take away their pain and bear it for them if they could.

Not Quite a Deer in Headlights

2011-12-06T20:54:00.004-05:00

I cannot say that I have writer`s block because I do not know what to say.
Nor can I truly say that this is a block.

It is more a of a writer`s stun.

In being conscienscious about what I write, I have to engage in self-censureship.

But this takes away from my true humanity, in my humble opinion.

From thence I pontificate about what is our true humanity... the reflections we post online, or the ones which we do not share with the world for fear of retribution, judgement, employers or pity.

Ironically, the world is no better poised right now to expose the inner self for a deeper understanding of each other, whilst at the same time being made to crop, nay distort, that experience down to two sentences which won`t get you flamed or fired.

Instead, I write nothing but a cryptic hodgepodge.

Enjoy. I`m off to bury my brain in Warcraft.

Unassisted Me Now Requires Assistance

2011-12-02T20:13:00.005-05:00

My unassisted miscarriage has not progressed as I'd hoped. I haven't written over the last week, not for pregnancy related illness, but more because I got a cold the same night I found out about the miscarriage, which then translated itself into Torran's daily routine shortly thereafter. Besides still going to work (yes, I worked miscarrying caring for people with far fewer health risks than myself, including pregnancy related worries), I've not had a decent night sleep in well over a week because of Torran's nightly coughing and getting out of bed.

Bruce is now the latest proud host of the household plague.

In true soap operaesque fashion, on the eve of Bruce getting the bit hit from the cold virus, we found out that the natural miscarriage did not work. I have a huge clot in my uterus and some unknown segment of placenta which still thinks that it is trying to support a non-existant embryotic life and ramping up my pbeta-Hcg levels. When I woke this morning with that all too familiar pregnant boob pain I knew even this was the case before the ultrasound confirmed the diagnosis of "incomplete abortion".

It's a term I hate to use at work, especially for those women who did not choose to lose their pregnancy. At least miscarriage is a less brutal way to describe the same problem.

Now, I need to have a D&C, well, technically she's going to do a dilation and suction curettage. I did have the option of taking medication to induce uterine cramping to expel the so-called retained products of conception, but that isn't guarenteed. Given our upcoming court date (for our botched basement renovation, a story I have yet to share online) and Christmas plans, I can't afford to let this go on for two more weeks.

Tomorrow I go to the doctor's designated hospital, register by 8am and wait the entire day for the gynecologist to be free from delivering other women's babies AND for empty room in the OR with accompanying staff.

I'm taking the first two books of the Robin Hobb The Farseers Assassins Trilogy (my mother in law assures me that I have to complete this series before completing the third trilogy that followed the Liveship Traders, the Dragonkeeper Triology). I've already started one and I read fast. It's going to be a LONG DAY.

If I think about it too long, I get nauseated. So I won't write about it too long either. Probably, I'll be out of commission for the rest of the weekend.

A Different Kind of Petrified

2011-11-23T23:40:00.003-05:00

When I found out I was pregnant I was pleased but petrified.

Tonight I'm afraid to go to sleep. Having never gone through this kind of miscarriage (although I've had 2 others) my brain keeps instilling me with images of waking in severe cramping and haemorrhage.

Doesn't help that Bruce is on nights and my son doesn't know how to call 911.

Two Blue Lines. No Heartbeat.

2011-11-23T18:07:00.005-05:00

Two weeks ago I pee'd on a stick, twice, and was rewarded with two faint blue lines.

Joy! Pregnant!

BUT it was only the start. So much more has to go into play before I could truly relax. In fact, it was another 33weeks worth of "stuff" (although I would have been happy with a 35 week gestation).

That sense of elation was robbed from me today, after I had an ultrasound confirming that at 6 weeks, there was no heartbeat, no yolk sac and more blood than anything else. I`d started bleeding last week, but only light spotting. It was considered to be an implantation bleed, and a 5 week ultrasound was not diagnostic for viability but did demonstrate an intra-uterine pregnancy instead of ectopic. The heavier stuff started Tuesday.

I remained hopeful as I have already had a history of subchorionic bleed in the first trimester with Torran. This time, I started taking antibiotics to treat chronic endometritis (uterine lining inflammation because of infection). I also started a prescription prenatal vitamin which included 4000 micrograms of folic acid compared to the usual 40mcg because of the Factor V Leiden and MTHFR carrier risk I face. To prevent clots in the developing placenta or umbilicus, causing early miscarriage, I also started low dose aspirin.

My original bleed was no bigger than 1cm square, essentially. Tody the doctor told me that the blood has likely lifted any implanting embryo off the uterine wall, regardless of whether or not the embryo itself was growing properly. The aspirin could have contributed to the bleed, yes, but was not the cause of it.

Even though I am being told not to by my staunch supporters, I now hate myself for having taken it for the five days before the bleeding got bad. In fact, it was getting better at first - to the point of being negligible.

I am so angry at the way things have turned out. After taking a break from the assisted reproductive technologies over the summer, Bruce and I decided to wing it on our own. This decision also partly came up because we had to transfer some of our expenses over to Torran`s new nursery school and it would be a very tight budget to pay for both at the same time.

Yeah, so we did it on our own. And that is about the only positive thing I have to say right now.

I am angry and bitter.

I also do not have the brain power for platitudes...
...it will all work out
...at least you have one, some women don`t get any children
...you can still try again
...its all part of the grand design of life
...blah blah blah

I wonder how these phraseologies came into human existance. Instead, be brutally honest: life sucks sometimes. Guess I signed up for more than my share.

So, by my physician`s suggestion, I will have a natural miscarriage. In other words, do nothing and let my body expel everything, monitoring for my continued health of course.

One web site on a Google hit says natural or unassisted miscarriage is a way to experience trust in our bodies at a time when we need it most.
`
What a load of horse shit. (pardon my swearing)

It doesn`t hurt physically yet. Emotionally I am damn near a basket case. I am to expect cramping, heavy bleeding, discomfort and emotional turmoil.

Bruce is taking it in his own way. I feel sorry that I have left Torran with him for the most part of this afternoon, but I just cannot be supermom today. In fact, when I look at the wee man who is the most significant member of my family, it makes me tearful and sad. He deserves a sibling as much as any child does, pehaps moreso. I feel like a failure for not being able to provide that for him.

I know this is not the same kind of loss or hurt as the loss of a child whom you feel in the womb, give birth to and watch grow, for however long they grace your life. Having seen babies die, know the women and men who loved them, I am acutely aware of that kind of loss.

However, that doesn`t stop my overwhelming sadness, grief and bitter anger. It is not the same level as theirs, I know. But it still hurts.

It really really hurts.

Vancouver: Brief, Wet and Beautiful

2011-11-09T08:47:00.021-05:00

continuing on with our latest excursion...

We drove from Seattle to Vancouver along Chuckanut drive, a slight detour of the main highway. And yes, the name Chuckanut is exactly as it sounds. It didn't take much longer than being on the thoroughfare, principally because we didn't stop to distract ourselves with any of the sights. Torran had fallen asleep in the car and we didn't want to disturb him. However, we did stop at Fairhaven, the quaint little town just south of the Canada/US border which was supposed to be the thriving metropolis that Seattle turned into.

And, amusingly, held as many punch buggies for our beetle punchbuggy game in the town than in the entire trip between cities! (This was my second best victory day over Bruce, for those of you who know our wee obsession).

We stayed in downtown Vancouver, which is incredibly scenic despite its lack of family oriented food venues (where the *heck* can we go for breakfast other than McD's or Tim's????). However, it's a great central location for accessing the bigger attractions, as well as the Seabus ferry boat that gets you access to North and West Vancouver (so does the bus, of course but using the boat is cooler).

North Van and West Van are not suburbs of Vancouver, we learned. They are described as proudly independent and distinct by the local tour guide - which made me wonder why they keep the name Vancouver? shrug. Both are located on the north side of the Burrard inlet, north of Vancouver city.

Having arrived in the evening, we only had time to search about for a meal and found the lovely Salam Bombay Restaurant (look to the second floor) to suit our needs. Yes, having a man dressed up in costume outside to entice visitors upstairs was a bit cheesy, but the service was excellent (they *really* understood about little people at the table) and the food was yum yum yum!

Our first day started off with a bus tour of the city, originating from the Canada Place area, which is also adjacent to the tourist centre. Canada Place was built in 1986 for the World`s fair as the Canada Pavillion. The iconic design represents Canada`s maritime history and recognises BC as the gateway to the Pacific Ocean. It is now a public and private facility, cruise ship terminal, convention centre and hotel spanning over 4 blocks.

Adjacent to this building is the Vancouver Convention Centre with a living grass roof. Nearby, is the Olympi c Cauldron , where the Vancouver 2010 Olympic and Para-Olympic Flame was lit in tradition of the games, after making the longest relay route in one country in history (ours). A very impressive installation which was fenced off during the games and made people very unhappy. It would have been cool to see the fires lit up, however, now that the flame has made its way onwards for the upcoming 2012 summer olympics, we had to settle with electronic lighting.

The waterfront is a great place to watch ship and floatplane traffic along the Burrard inlet. Apparently, also the occassional roaming orca pod. The Vancouver Harbour Water Airpor t is the 8th busiest aerodrome in BC (32nd in Canada), one of the busiest water aerodromes in the world and one of the largest airfields in the world (technically). I had to use a mop to clean up after Bruce. The air traffic control tower houses two newspapers in its building and at 142m (466ft) is the tallest ATC in the world.

Using the hop-on-hop-off system of the tour bus company, we had an informative ride to gorgeous Stanley Park, a Vancouver eco tourism hot spot. The weather held out and we enjoyed a lovely stroll through the park to the Vancouver Aquarium and the famous totem poles.

Torran meets a Beluga whale

Bruce and I were very impressed with the aquarium design. Torran managed to sit still (mostly) through a teaching session about beluga whales, which are native to Canada. Now, every time he leaves a light on, I tell him that he`s infringing upon their survival. It seems to work better than nagging him about saving electricity. I still like to peek in on the animals with the beluga cam and sea otter cam from time to time (exhibits are larger than what you can see). Watch out for the crows at the outdoor exhibits, though - agressive lil fellas!

My biggest disappointment about this very short holiday was our lack of exploration about the Native peoples along the West Coast. We were only able to spend a short time at the site of the totem poles, which was once the site of a cu l tural midden from centuries of use by local natives (and is now trampled upon daily by throngs of tourists!). These huge carvings capture the imagination. I fantasized about creating one for Talfryn, my campîng group at Pennsic, then realized that I would then be the epitomy of a cultural tourist, diminishing the deeper meaning behind the symbols.

I suppose I`ll stick to my megaliths.

Using the tour bus, we ended our journey in Gastown in the northeast end of downtown.

I swear this trip was picked just to give Bruce reason to chuckle.

Vancouver was formed as groups of logging towns became bigger and merged together. Gastown was the foremost of these, founded by a man named Gassy Jack Deighton, well known at the time (mid-late 1880s) for being verbose and long winded. He opened a saloon in 1867 and coincidentally the logging town thrived until it was incorportated with adjacent Granville into the newly named city of Vancouver in 1886. Despite a fire two years later, this city centre recovered and retained much of its importance until the Great Depression of the 1930s. In the `60s the area was supposed to be bulldozed to make way for a freeway. However, concerned about its historical value and potential for revamping Gastown`s future, there was a public resistance (supported by local politicians) which eventually won out. Now its a tourist destination with places to spend money! And, probably, a highly desired place to live for downtowners as it retains the feel of cosy architecture lacking in downtown city centres (the city centre, of course, long since moved on).

Day two brought rain. Lots of rain. Not the greatest day to journey across the inlet and up the to the Capilano Suspension Bridge. However, the thrill and majesty of the bridge, the tree walk and the new cliff walk made it worth it. Not to mention the free and dry shuttle bus which also picked up at our hotel! Despite his vertigo, Bruce crossed the bridge, did 100ft high the tree walk amongst 2000 year old rainforest AND picked his way across the cliff walk (although he did avoid the jutting out parts with the glass floors). Torran was oblivious to any danger whatsoever and merrily hopped his way along every path, although he did say that the bridge was wobbly.

Just outside the Suspension Bridge is a public bus to take you further up Grouse Mountain to the so-called Peak of Vancouver (remember what I said before about the three fiercly independent cities with Vancouver in their name). But don't get stuck in the rain - there is no bus shelter!! Guess who got very very wet, despite the plastic tourist cheesey brigdge poncho?

However, the bus takes you to the gondola's doorstep. I swear that the gondola took us to the North Pole instead of the top of Grouse Mtn! The snow was heavy, wet and blanketed everything. Low lying snow clouds completely obliterated any view of the cities below. In fact, we couldn't see beyond a few hundred feet from the chalet windows. Except for the tourist shopping and snack bar at the top, it was a bit of a wasted trip for me. Bruce went outside to frolic in the snow but not for long. The wee man didn't have snow gear on, so he was verboten to play in the white stuff.

Once down the mountain, we hopped back on the bus, terminating at the ferry boat to Vancouver on the south side of the inlet. Shortly thereafter, we got the to hotel, changed into dry warm clothes and adventured for a child friendly dinner in the city. Part of that adventure took us past the Occupy Vancouver site which was getting a little lively with a rock concert in front of the tents and protesters standing in a main intersection in front of the Pacific Centre Mall (which has naught but shopping and a food court, despite its huge size - so that was a no go for dinner).

This protest piques my interest in my human watching hobby. Of the traffic blocking protesters, there were Marxist men in military garb waving a huge red flag with scythe and hammer on it, a young man cornering two pedestrians sharing with them his non-commericalist version of the movement ("We don't have to buy all the things that we see"), aboriginals calling for more native rights, grunge college students milling about and a young man dressed in a bunny costume. I wanted to take pictures of the action, but Bruce refused me, images of riots breaking out and me becoming a target running through his brain. Awww, how sweet.

We ended up at Mooses Down Under, an Australian restaurant. Bruce found it highly amusing that he had to travel all the way to Vancouver to sample Kangaroo meat (I had the Roo burger. Tastes like gamey beef). I am impressed how many retail and food establishments in the downtown decked themselves out for Hallowe'en, including Mooses. I almost felt bad that I was intentionally not decorating my house because we'd only be arriving back on the 30th. Hallowe'en is my favourite theme holiday.

Our last day in Vancouver started off with a struggle to find breakfast. Mooses Down Under is open for breakfast, but not on a Sunday, unbeknownst to us. Ironically, we ended up back at the Tim Hortons at the base of our hotel. At least they have oatmeal now, so Bruce was contented.

We spent much of the day in Granville Market on Granville Island. Where the Pike Place Market charmed us, Granville Market Wowed! us. I now want to move to Vancouver, just to live within walking distance of the market. The vibrancy of the Sunday morning energy carried into the afternoon, with throngs of people perusing the foods, munching on delicacies and watching buskers. Adjacent to the Granville Market is the Kid`s Market with toy shops, face painting, activities and a two storey climbing area. Sadly, we couldnt put Torran in the climbing zone because we would not be allowed to go in after him and I was not sure whether he would have an anxiety reaction to it, or just refuse to come out. He did get Thomas painted on his face, for which he was mostly sitting still.

A lovely stroll along the waterfront brings you to the H.R. MacMillan Space Centre in Vanier Park (also home to the Maritime Museum and the Vancouver Museum, neither of which we were able to visit this trip). Vanier park itself is lovely, with bike and foot trails, public art (yarn bombing!) and lots of room to enjoy the surrounding mountain scenery. The Space Centre was small, in my humble opinion, and I wish I could have enjoyed it more. However, the wee man and I did touch a moon rock! Bruce enjoyed crashing the space shuttle several times on a simulator. Torran found much entertainment in pressing buttons and wiggling joysticks without much purpose, much like any 3 year old boy I suppose. We watched a somewhat lame planetarium movie presentation on Galileo and the origin of the telescope. It is meant for a general audience, and likely not one trying to keep a busy 3 year old boy still and quiet. Not enough stars in the showing to keep him interested.

Vancouver is definately on our Do It Again list, particularly when Torran gets older and is able to better enjoy what the city has to offer (read: we are better able to entertain him with stuff we also like to do). Of course, the rest of B.C. remains for us to discover as well!

photos!

Seattle aka Coffeetown

2011-11-05T19:38:00.014-05:00

...or more specifically Starbuckstown. Of course, a local may say that lessens the cultural importance of the city, and now, I'd have to agree with them.

When Bruce and I had to choose where to go on our Aeroplan miles vacation in October, we were a wee bit limited in choices. Partly to do with the season (no hurricanes please), partly because of a certain man's dislike of warm beach holidays, and that we only had a week and a tight budget. When looking at Vancouver, Aeorplan would not let us fly there round trip on their reward miles.

Spend lots of money with us but the rewards have ...Restrictions - sound familiar?

I suggested that we take a look at going to Seattle, driving up the coast into Vancouver and then flying home. Wham, bam! We had a holiday booked.

I'm very glad that we went to this city of which I sadly admit I knew little beyond Sleepless in Seattle, Fraiser and Starbucks. I did touch upon each of these on our trip: we took a duck tour (thanks Cpt. David Buoy) that went past the floating house from the movie (which is listed for $2.5 million dollars, but the listing does not include the number of tour boats and looky-loos that will be on your waterfront doorstep), went up the Space Needle which is a city landmark and part of the tv show's logo and you can't go past a corner without seeing the green and white lady of the coffee shop (and yes, we did stop in there once or twice).

Essentially, we only spent a day in Seattle, but it was enough to whet our appetite for a return visit, particularly when Torran is older and can better appreciate the EMP Museum at the foot of the Space Needle in the so-called Seattle Centre (which is NOT the centre of town). No, medical readers, this isn't an emergency medical physician museum, it's the Experience Music Project and Science Fiction Museum and Hall of Fame. The EMP was founded by Paul Allen of Microsoft and futher expanded to include the "music" of science fiction - although this, too, has been expanded to include Sci-Fi and related genre exhibitions. It also has the Seattle Monorail running "through" a portion of it, a leftover attraction from the 1962 World's Fair (also the first US full scale commercial monorail). Yep, Jes, it's older than Disney's. How convienient for us that the only two stops it has are in front of our hotel and at the Seattle Centre! (Bruce's idea)

The EMP building is meant to look like a smashed guitar from a bird's eye view, given that the music it caters to is pop and grunge culture (there's entire sections dedicated to Jimi Hendrix and Nirvana). I didn't think that Torran would have a particularly good time there (any place that is generally restrictive for the wandering wee warrior has limited enjoyment capabilities). So I wasn't really keen on going into it despite its funky exterior. But two things drew me into going into the site: Cpt. Buoy saying they have hands on instruments of all kinds that you can play (a bit of a stretch: it was keys, drums, guitar and vocals) and the newly created AVATAR exhibit.

I admit to being "rah rah" patriotic when I have cool things to throw my Canadian weight behind, like the Olympic and Para-Olympic althetes and Glittertown related folks. In this case, James Cameron, creator and director of AVATAR. Now, I'm not going to be a hippocrite, I still stand that the storyline of AVATAR was, honestly, over-done and predictable, but Cameron alluded to the same in interviews. However, the technology he helped pioneer to make the film is pretty awesome to a layperson like myself. And, if I continue to be honest, I found myself sitting tensely in the final battle scenes, cheering for the good guy (even if I knew he was going to win).

One of the neat-o highlights of this Seattle trip for me, therefore, was the chance to use a version of Cameron's technology on myself and "become" the AVATAR. The exhibit has a mock motion capture simulator allowing you to translate yourself into a character from the movie. Mind you, you don't get to wear all the same cool gear the actors wore. However, you do get the chance to email yourself the clip. Mine didn't make it to my inbox, sadly (boo hoo!!) but I've watched other people on you tube and wonder if I really would have wanted to publish it. The experience was far more ... entertaining, perhaps, than the final cut! Although there was one guy who boogeyed his AVATAR and it was hilarious to watch! (If you do scroll through any of the videos, the directions people are given are on the floor beneathe them i.e. walk this way, wave on this side, so that's why their heads are often down and arms are out).

Torran enjoyed generally messing around and touching ...everything. He didn't get the joke behind sign on the Battlestar Gallactica exhibit: Don't Frakkin Touch the Artifacts! We skipped out on the "be a rock band" exhibit because he was likely going to have an anxiety attack around being in the sound studio with lights etc. And we didn't do the Horror Film exhibit as much as we really would have wanted to because we didn't want to potentially traumatize his young mind - particularly because his language and conversational skills would neither allow him to explain any anxiety or problems he may have had as a result nor would we be able to explain fully how the images were only pretend for those people who enjoy scaring themselves, like his crazy parents. Although I have to admit, having him stand beside a full sized statue of some horror creature or Alien model with an absolutely gorgeous grin on his face would have been priceless!

Seattle had such a warm and friendly feel to it. There's public artwork visible just about everywhere, including a the striking 2002 installation Glass Blades at the EMP by local artist John Fleming. Cpt. Buoy said that if public funds are used to build a building %1 of the cost has to go towards public art. Everywhere was decked out for Hallowe'en, people were quite nice and it all seemed very accessible. The Occupy Seattle movement was small compared to others I've seen, their messages equally unique. We didn't get to "do" all the tourist highlights (Bruce is glad we missed the Gum Wall, and for hygiene reasons with Torran's touchy touchy hands, I am too), but we did make it down to the Pike Place Market and watched the fish tossing guys (Pike Place Fish) being filmed by The Travel Channel (I think...).

From the Market, we ambled towards the waterfront and the Seattle Aquarium. It was a wee bit disappointing. However, they had the coolest jellyfish tank I've ever seen. We also watched the sea otters being fed close up (my anti-zoo self cringing at their small enclosure for meal time - four concrete walls, water, a stone shelf and three windows for gawkers like me). I think Torran got a kick out of the otters laying on their back to eat, but he bored quickly. We had to make every bite seem like a fascinating and one of a kind experience!

For dinner, we stopped in steps away at The Crab Pot at Pier 57, Miner's Landing. Finally, Bruce, a restaurant that we've seen on TV (Man vs Food) that was OPEN. (You have to understand, Bruce watches sports, movies and food on tv. Not much else. So when we've gone to featured restaurants locally or abroad only to find them closed, we've been sad. So sad). When we were in Boston at Dick's Last Resort, a sarcasm themed restaurant that tickled both our senses of humour, we thought we'd hit the height of Americanism in food finery. The Crab Pot is an equal top tie! The food is brought in a heaping pile to your table - literally! They put a huge paper on the table, equip you with your crab bashing wooden mallet and platter, then dump the pot of steamed crab right on the table.

RIGHT ON THE TABLE. Did I mention that it's right there, on the table?!

Ok, yes, kinda eww weird. And yes, it confused Torran (with whom we still fight with EVERY meal to use his utensils) immensely. However, as they say in Rome... ah what the hell? Everyone else it doing it! Torran was thrilled that I was banging on the table in regular intervals. He wanted in on the action, and did get some for a while, but I was afraid that Mr. Grubbyhands would let the mallet slip and it would do a swan dive into someone's drink at a neighbouring table. Oh, and don't worry, the mess was easy to clean up - drop the shells in the bucket on the floor that comes free of charge! What a hoot!

(Have I mentioned that I was brought up well heeled and can sit in a formal dining room and eat properly when it is required of me?)

More photos are to be had on my picasa album - enjoy!! (more may appear on the post over the weekend)

So chicka, Whereyabeen?

2011-11-01T17:00:00.007-05:00

October has been a very busy month for me, including two trips out of the city, Torran's first field trip, The Linden Fund gala fundraiser, and Hallowe'en... not to mention Torran starting his speech therapy earlier in the month.

So, there will be a few catch up posts.

Firstly, thank you for your generous support of The Linden Fund during the fall gala event A Night to Dream. Bruce and I spent the evening in the company of wonderful family and friends, hospital NICU staff and preemie supporters celebrating the miraculous wee warriors that are our premature children. We wish we could have had all of our friends and preemie parents out with us - now that *would* be a huge party!

The Linden Fund Board of Directors and staff celebrate the evening's success

Preemie mother Jack Hourigan speaks of how she coped in the NICU by focusing on the details around her daughter Tess' hospitalization.

Much to my surprise, I was awarded The Linden Fund's Evan Award for outstanding volunteerism. In this photo, I make mention of Torran's premature birth and share the award with Bruce for his support of what I do.

First Field Trip: Chudleigh's Apple Farm

2011-10-16T15:24:00.005-05:00

but boy oh boy did we get rained out! Torran had his fill of apple, though! (and in the middle picture, he doesn't have hay poking his bum - that's Torran saying Cheese for the camera!)

Boston: The UK Invasion

2011-10-10T08:07:00.007-05:00

Bruce doesn't have much in the way of travel perks with his job - at least not here in Canada. It's a shame when you consider that without ATC, planes wouldn't go anywhere, disgruntled airline staff and security or not.

However, he is allowed, once every three years, to request a company paid visit to certain ATC centres to monitor their operations. "Fam visits" (familiarization) as they are called enhance the understanding of process mapping from start to finish of a flight passenger.

Thus, last week we spent three days in Boston. Certainly, not enough time to fully investigate the city and surrounding area (especially not with a pre-schooler in tow). It did give us a flavour for the city though. The city centre is very easy to navigate, especially via transit ($2 per adult fare). There are water taxis crossing the harbour as well, but the price is $10 per adult per direction... talk about overinflation of prices!

Founded by British Puritan colonists in 1630, Boston is one of the larger and older cities along the New England Coast. Of course, the area was already inhabited by Native Americans for thousands of years. Although the roots of the city lie with the UK, today the city very proudly touts itself as the heart of the American revolution in the late 1170s. Apparently 60% of Boston is landfill in a previously existing inlet.

I found it ironically amusing that the Old State House, which was then the seat of British Government, which had its symbols of British monarchy (the Lion and Unicorn rampant) torn down by prostesters 200 years ago, is now a renovated and preserved building on the "Freedom Trail", a "must do" part of Boston tourism. On the Trail its listed instead as the site of the Boston Massacre, where British soldiers fired upon violent angry protesters, killing 5 of them and sensationalized by Paul Revere's engraving of the event (as sited by other souces). Sure, the main level is now an entrance for the underground T train, but it the renovated heraldic symbols probaby look more spiffy than they did in their day! Another interesting point is the level of the road alongside the building, as indicated by the bottom row of windows. The ground level has been raised over the centuries and almost covers the windows completely.

The history of the city is colourfully ripe with propaganda, very much reminding me of modern Americanism. Happenings like The Boston Tea Party are hotly debated. We were told by a historian in Williamsburg Virgina that this event wasn't colonists protesting taxation, but was the organised action of American smugglers (smuggling Dutch tea) whose own tea was being priced out of the market because the price of tea was actually very low, even with the taxes (and kick backs) being applied to the tea of the East India Trading Company. These same smugglers were well known and politically active wealthy merchants. Maybe they are the ones who went in disguise and threw away their shoes so that they couldn't be linked to the property terrorism?

But the teachings of the schools and tour guides, and as adopted for political propaganda, remains that the so-called Boston Tea Party resulted from a spontaneous mob of unhappy colonists going about the Dartmouth and dumping the tea in protest of taxation (without representation finishes the motto... of which some people blantantly ignore the corrollary: "we would pay tax if our governmental representative voted in favour of it"... and then, like Canadians, loudly complain about the taxes imposed by their elected officials?). Renowned and respected Benjamin Franklin, favoured paying the British Government back for the lost taxes. Inevitably, the mob action lead to a cycle of knee-jerk reactions which culminated in the American revoluationary war (which had been brewing for years).

This is why I'd like a time machine and a video camera! To clarify the interpretation of history unequivocally!

As a side note, another skewed version of history is the Ride of Paul Revere, credited with the protection of America by a British invasion in April 1775. He was a silversmith merchant who notified the Colonialists whether the attacking troops were coming by land or by sea (the Charles river). His name is flaunted as the sole protector of Boston in this attack. But without an iphone, how is that possible in the 177os, really. Just a little bit of online digging brought up the name Robert Newman, to whom there is pittance paid. He lit the lamps indicating whether the stationed Redcoats would arrive to capture the armaments in the city by land or sea (being the Charles River). Newman faced armed troops at the door of Old North Church who had seen the brief signal and were investigating its meaning. Insodoing, he simultaneously informed Revere and the city of Charleston of the Redcoat plan. And no one knows for sure who sold out General Gage, who planned the invasion, in the first place!

Likewise, riders Sybil Ludington, a 16 year old girl, and Israel Bissel, a postie (a post rider is the more specific term) participated in notifying Colonists of British attacks in the 1770s. Ludington rode harder and faster than Revere would have had to ride. Bissel rode his first horse to death. But they are not given the same credit and hero worship.

Modern Boston is a hodge podge of architecture. The Big Dig created improved roadways and more land fill. Previously disused wharfs are now expensive condo property. Amdist it all are the vestiges of the 18th Century and the neo development in-between, making for a city of complimentary contrast (at least to my untrained eye). Generally speaking, the locals were quite friendly, with their unmistakeable New England accents.

Torran loved the Children's Museum - so much so that he refused to leave for lunch! We spent most of the morning there whilst Bruce was doing his work related day out. Admission was reasonable. I almost considered spending the entire afternoon there as well, but we met up with Bruce at the sadly lacklustre Boston aquarium instead. Torran was far less impressed with their penguins then he was with the building blocks at the museum.

We managed to tie in a short visit with Bruce's friends from university and their son. It was amusing to watch the two boys interact... and then my pessimist brain started to knock on her cell door. I think I'm going to have to observe Torran at nursery school to see how he is with other kids. Watching him, I could tell he really wasn't sure what to do with young Alexander, or how to dialouge his wants to him - even when they both tripped over each other's feet and fell to down. At least they were both giggling!

Quite a Different Boy Today

2011-09-28T10:21:00.002-05:00

Although he's not 100% yet, Torran has recovered about 75% of his energy; the last 25% being that which he uses to get into mischief! He has recovered some of his appetite and thirst. Only one cough/throw up this morning so far. And he's been able to play with his Thomas trains and walk around on his own steam - quite different from yesterday!

Still home from school today so we can monitor his progress and keep him from spitting up on the school toys. tomorrow should be much better.

Germ Cesspool 1; Torran 0

2011-09-27T11:47:00.007-05:00

Torran is a sick little boy.

This illness started with his first introduction day to the new nursery school the thursday before Labour day weekend. Three hours of exposure to little people and two days later he's getting sniffles. No big deal, there was no fever and the cough was only a problem at night, as coughs can be. For two weeks he'd intermittently cough a couple of times at night, waking himself and us up. A drink of water and he'd go back to sleep.

A week ago Saturday the fever and real cough came. Again, it wasn't a huge problem, but he was coughing frequently enough and had ongoing fever that we kept him home from nursery school. His appetite was reduced, but he was still putting food in. So long as the fever was under control, he had enough energy to be a monkey.

By wednesday I was pretty fed up with not getting any sleep because of his cough, and how much coughing he had throughout the day. I broke the rules and gave him a half dose of the cough suppressant and decongestant for 6 year olds. He still didn't have a runny nose, and the gunk wasn't in his lungs. The congestion was pretty much in his head. It helped to a degree, and at least he got more sleep that night.

The fever broke initially on Thursday (although he was still coughing a lot). Friday he was allowed to go to school despite an occassional cough (still no fever). Saturday was pretty uneventful until the night time...

He woke up Saturday night crying, unable to express his needs and generally miserable. And he was febrile again. After much much coaxing, he finally conveyed that his ear hurt. It's not usual for ears to hurt because of a cold, either because of fluid build up in the ear, or because of a secondary ear infection.

Sunday morning, a little more eloquent because he wasn't fatigued by sleep, he was able to convey that both his ears hurt. Off I went to get over the counter ear drops for infection (also useful for the eyes). His fever hadn't returned during the day but I had also given him meds for pain which may have been masking it. Torran even seemed to have regained more of his appetite by the weekend as he pillaged much of the Not-So-Innocent Viking Chick's fries at dinner time (my SCA friend Lyda).

That evening, he bounded around the garden with Bruce and the NSI Viking Chick and I bounded around Azeroth (Warcraft).

Plauge hit him during the night. His fever raged, he coughed and gagged on his very thick mucous which then made him throw up his entire meal. That night, Torran woke coughing, gagging and vomiting every two hours or so. Needless to say, I didn't sleep. Bruce barely got enough to get into work.

Monday Torran had no energy at all. He sat up for 20 minutes to eat a slice of toast and spent the rest of the day laying on myself, Lyda or the couch. Lyda had changed her plans and hung out with us until Bruce came home, which was really helpful when Torran threw up all over me and both of us needed a bath (whilst the Bell technician was working in the house to install the new tv service). He was grimacing all day on and off in pain, but denied ear pain or headache. In the morning, he answered yes about his throat hurting, but that response didn't last the whole day.

Three year olds aren't the most articulate to express pain when they're sick to begin with. Add his other issues in there and basically our best bet is to go by objective evidence. At one point I was hopeful when, after bathing him for the third time for vomitting green bile all over himself, he splashed a bit in the bath, wanted to play with the toys and then had a mind to get into mischief with the towel rack. After which, he had some appetite and ate the mother measured out 10 goldfish crackers. He wanted more but I didn't want to push his tummy. This energy spurt was short lived, however.

Torran's paediatrician took us in at the end of the day (thank you!!), after an eventful barfy ride in the car to get there. I have never cursed the poor quality of the roads as much as I did with the basin jammed under Torran's chin with him straped in the car seat as his second meal of the day, the goldfish crackers, exited his mouth.

His emesis didn't concern me so much, save that I couldn't control it from happening - it was all related to gagging on large amounts of mucus (kids can't clear it as well as adults). That he'd only pee'd once from 7am until 5pm did.

The doc looked in his ears and suggested that the right one may have a bit of infection. He agreed that, without projectile vomiting (not preceeded by a cough), seizures, tracking/swelling of the shunt, and cognitive or irritability, the shunt isn't likely a cause of infection. Even though Torran wasn't pulling at his ears (which could be a sign of pain), the general malaise may have been.

So we started him on antibiotics last night, a steroid spray to maybe help reduce nasal congestion and Zofran to maybe help with vomiting, although it is mostly mechanical.

Today sees Torran much the same. He's gag/vomited less but still has absolutely no energy. He hasn't stood on his own power yet. It's just after 1pm and he's again sleeping for over an hour during the day - something he hasn't done for ages. Fever's still there too. And he's lost 1kg in weight since I weighted him last just over a week ago.

Without any new or worrying symptoms, I have to give the antibiotics a couple of days to work. At least he's been able to keep down the pedialyte (drink with electrolytes in it to replace what he lost through vomitting). But he hasn't eaten yet today. He had a "better" night with no vomitting but he still woke up several times.

Now it's just a game of symptom management, watch and wait... with lots of extra towels, clean linens and a basin on hand!

As The Season Closes: Update on the Medieval Physic Garden

2011-09-17T12:22:00.005-05:00

I don't think I posted in detail about my gardening project this year, mostly because I'd be outdoors doing the gardening or indoors researching the garden and its herbs rather than blogging about it. However I'll start to make ammendment to that now.

The physic garden was planned using The Medieval Flower Book by Celia Fisher as my inspirational source. I utilized flowers that were already growing in the garden, as well as a number of purchased plants. Initially, I planted them according to what would be most successful in my Ontario climate small plot with the least amount of attention by myself. In other words, mostly perennials (which grow back every year). I also needed to choose a selection of plants from which I would be able to find some medieval directions for medicinal use.

Over the winter, I'll continue my research to understand how they would have been grouped in a garden in medieval time according to the humoral theoryof disease. (An aside: I'm not going to make academic comment as to whether this originated with the ancient Greeks or the ancient Muslims - I've heard arguements for both sides). In some cases, such as the lavender and rosemary, I used modern suggestions of companion planting to increase my success without worrying about whether or not those companion planting rules were employed in Period. For the project, I chose 14th century because it was more reliably documentable for the plants being grown and their uses. And I utilized the French culture as a location for the garden because I'd be able to integrate my irises and my main persona is 12thC Norman-Scots (French influence in Scotland).... also, the English garden didn't truly exist in Period with the mobility of the Nobles between countries.

My project flower bed (and the adjacent area) already had the following medieval medicinal plants growing in it:

peonies
mint
daffodils
mini violets
forget me nots (?)
adjacent to it grew shrubs of raspberries and red currants

elsewhere on my property:
deliphinium (which got moved into the project bed in the spring and has fared much better with the improved sun exposure)
dogwood rose
orange lillies
blue irises (which didn't flower this year - I transplanted them last year from a neighbour's garden where they had more sun exposure. So I'll move them to a sunnier location and hope for the best)
field poppy
grape vines from my back neighbour's yard
strawberries from my side neighbour's yard

and the following medieval medicinal weeds grew wherever they want:
a species of belladonna (yep, that same deadly nightshade of my previous blog)
bindweed (yes, this "devil weed" was used as a poultice on wounds!)
chickweed
vetch
dandelions

I purchased and planted:
two more species of lavender
rosemary (which I'd attempted to grow in my garden before without much success)
dill
cilantro (leaf)/corriander (seed)
wild garlic (for use and pest control)
laurel bay leaf
white lillies
columbine - which sadly died within the first two weeks of planting
physalis (chinese lantern)
lupin
and for pest control I planted digitalis foxglove which was not used medicinally until after SCA period because it was known to be highly lethal (it is the source for digoxin, the anti-arrythmic heart drug). Medieval folks recognized that animals do not eat it. I planted it near the lupins to prevent our wild local bunnies from eating my lupin beans (I was told bunnies love lupins).
sage
cinquefoil
lady's mantle
dianthus (pinks)
artemsia - but turns out I planted the wrong species. I planted Silver mound artemsia instead of vulgaris (tarragon?).
margiolds (for use and pest control)

I imported yellow irises from my sister's garden, and I hope to steal some columbine from her as well.

Later, I was inspired to put other plants in the other beds around my house, and start a small herb plot, unrelated to the project.

Although it wasn't originally part of my plan, landscaping also found its way into my garden. I'll be creating raspberry trellises in the spring for the raspberries that I relocated/landscaped and the main stems that we originally planted six years ago when we moved here. I tried to create a waddle and daub fence but without the correct size and kind of wood to make it, it was pretty pathetic looking!

I still have an outstanding wish list of plants, including:

acanthus
mandrake (yes, it is a real plant, not just a JK Rowling creation)
nigella stavia
artemisa vulgaris (the proper species this time)
betony
borago officinalis (lungwort)
although I don't know if I'll actually have the space to integrate them into the project flower bed!
And there is still a lot of work left to do for the existing garden (not including the other flower beds that are finally getting formal attention from us!). Earlier in the week, I expanded the width of my project bed and squared it off a bit better than it pre-existed. Today I moved two peonies into the "new" raspberry and current corner that I created in the spring. I have a plant to remove from the bed which I believe is a hydrangea but it didn't flower so I'm not sure. Nested in right beside it are the daisies that need to be thinned out to make room for other plants. I also have to agressively cull the dill that is spawning in the flower bed. I made the mistake of allowing it to go to seed so I could learn the life span of the plant (as I've done with all the newly purchased plants). Dill flowers make A LOT of little seeds which drop on the ground and start to sprout before the end of the same season. I'll be relocating it to my small herb plot on the side of my house try and keep it under control in the project garden. However, some of those wee dill sprouts made their way into my side neighbour's garden (which they are ok with) and I'll likely end up trying to prevent their dill from going to seed and causing the same problems in my project bed next year! Finally there'll be some shuffling of plants to enhance the project's bed success and/or appearance.

Take Away Cough Syrup, But Given Them Poison?

2011-09-16T08:04:00.005-05:00

Torran has a night time post nasal drip. Maybe it's fall allergies (I have seasonal allergies myself), or maybe it's exposure to the cesspool of preschoolers who cough without covering their mouths or sneeze all over the shared toys that don't get wiped up right away.

Along with other countries, Health Canada deters the sale of cough syrup for sale for children under six. Basically, the same products are available for over the counter sale, but no information is provided on the packaging for dosing under six years old. This decision stems from an expert panel in 2008 and is meant to prevent the complications of medicine use, misuse and overdose in young children. In fact, a pharmacist will not assist you with dosing your under 6 year old child, and you'll be hard pressed to find the information directly from the manufactures, who make the suggestion "not reccommended under the age of 6".

Specific medications in the combination OTC drugs are of concern, namely the medications that stop the runny nose, or the cough. The recommended treatment of fever is still OTC Acetaminophen or Ibuprofen (in whatever brand label you wish).

But this safety change in practice is not going to stop children under 6 from getting sick, being sick, or needing treatment for being sick.... or their parents from stressing out about it.

Bruce and I have been aware of this little fact since Torran's first cold in 2008. The nasal drip he has at the moment is really only a problem at night, especially when he sleeps on his back. The fluid drips down to the back of his mouth/throat, collects and causes him to cough and gag, and us to lose sleep. When we sleep at night, our respirations become more slow and shallow and that doesn't help to clear these wee secretions from his airways either. So, like with any cough, the cough is worse in the morning. During the day, he may cough a handle of times. And he hasn't had a fever, so I don't even know if it is a true "cold".

When I got home from work yesterday, Bruce showed me a homeopathic remedy proudly labelling itself for children 0-6 years of age with cough and a cold.

Now, typically, a "modern" cough and cold OTC med would have as many as four ingredients: something for pain and fever, something to decongest, something to encourage coughing (for wet or congested coughs) and something to keep the person from getting drowsy from the decongestant and expectorant. Each of those *could* be sold individually, but then the company would lose it's marketability for having the "cure all" drug. Moreover, people would have to decide for themselves what drug they want and how much of it they need (shocking!!!).

This homepathic pediatric cough medicine has 10 active medicinal ingredients. TEN! I took a list and the bible on the side of the box and immediately questioned one drug in particular - Belladona, also known Deadly Nightshade, Devil's Berries, or Death Cherries.

Atropa belladona grows wild and is farmed, and has long been known as a pharmaceutical agent. It was used by 14th century medieval Italian women to dilate their pupils which would give the impression of heightened sexuality (the name Belladonna meaning beautiful lady), and it was well known as a paralytic agent (refs: Celia Fisher). A hundred years earlier, it was know that Belladonna was toxic, a single drop from a quill mixed in with large amounts of fat could be applied to a wound to help it heal - any more than that and the belladonna would "eat and perforate the flesh" (ref: Hildegard von Bingen, transl. Bruce Hozeski).

And this confuses me. They're not allowed to sell, and as parents we're not "allowed" to give decongestants to our children under 6 because of overdosing risk, but they can sell and we can give them a paralytic poison and there's no concern that a parent could overdose their child on this item?

The box lists the belladonna to treat "cold and fever symptoms". Belladonna is not an antipyretic, so how can it treat the fever? As for cold symptoms, the US MedlinePlus references the Natural Medicines Comprehensive Database (only partially available without a subscription) to state that there is insufficient evidence to rate the effectiveness of belladonna on whooping cough and bronchial asthma. Note, these are not common "cough and colds"... which may not require anticholinergic antispasmotic paralytic agents to treat them. What these websites do provide, is helpful information about side effects that are often missing from cursory web searching with generalized information about belladonna.

In fact, the product insert inside the box proclaims "no side effects" without any asterix on the claim... which is complete nonsense because EVERYTHING whether natural or chemically created has the potential to have a side effect to someone. You can't have billions of people living in the world and expect them to all react the same way or not have a reaction at all (not even to oxygen... talk to a respirologist about the negative effect of oxygen on someone with COPD).

The information panel on the box soundly lists Health Canada's web site at the bottom of it, but it's not in reference to this product in particular. Rather, it's Health Canada's general information about natural products (which I am finding particularly unhelpful at the moment). In fact, a cursory glance through the web site doesn't even have the product listed... and yes, it is made in Canada.

I don't have a problem with homeopathy if it is responsibly marketed and used. Once, I found pills of Willow's bark in a naturopathy store that failed to warn the buyer of it's anticoagulation effects. Aspirin comes from Willow's bark. If you already take aspirin or other anticoagulants, you're increasing the effect if you add Willow's bark "for aches". That particular bottle (at the time) also failed to warn against allergic reaction to aspirin. Most people who are allergic to aspirin know because they've taken a pill form in the past. Generally, people don't go around chewing on tree bark to find out they are allergic to it. So, see what I mean? Not really responsible.

Am I going to give this product to Torran again? Probably not. It didn't do anything to stop the trickle and cough during the night. He's used a steroid nasal spray before when he had over six weeks of trickle and cough last winter (during which he had two viral colds). We'd only use it sparingly because nasal sprays have side effects, not the least of which is rebound symptoms. I'll give it another week and see how he does. I don't think he's losing sleep over it, although it wakes me up, and he's otherwise his usual go go go self.

I may have given myself another project though, in the investigation of this permitted product. It has other stuff in it like Chamomile, which is sedative but generally harmless. But then it also has caffeine (coffea cruda) which is a bronchodilator and a stimulant. The product isn't labelled non-drowsy; it's a "night-time" formula. So why does the coffee even need to be in there?

And in case I am going to get any flame emails or comments from people who are soundly homeopathic, please let me re-iterate. I am not against the use of less chemically created medicines. "natural" truly isn't natural any more, really... Rosemary is a wonderful astringent but damned hard to get the fine bits of soil off of it... but you won't see soil in the products you purchase. That's the effect of "modern" technology. I also critise "modern" pharmaceuticals and marketing in the same way. Just not in this blog entry.

What does it mean?

2011-09-09T07:59:00.002-05:00

I'm no expert in the science of dreams. My dreams are often weird, sometimes vivid and occasionally disturbing. I`ve woken up crying; once laughing. Generally speaking, I have a fairly good recall - even to the wonderment of when something atypical happens (for me) like intense colours or smells. Sure, in the dreams I often feel like it`s real, but the surrounding colours don`t stand out.

Some say that dreams are the brain`s way of playing out the activities of the day, the worries of the future... and that`s what makes me query my dream of last night.

I was in a specialized centre for children with Autism with Torran. There were other parents and children there, waiting to be assigned to groups for therapy. After my group was created, mothers were saying things like my child doesn`t have as many words as yours does or your son actually talks to you. I was beginning to feel that he was being judged for being too high functioning, therefore inappropriate, for the group. It was a little hard to shake off when I woke up.

Earlier in the day, his new nursery school teacher had said she found him very mildly autistic that she might not have known had I not told her (of course, she`s only had him for five days). I have also had a conversation recently with the speech language pathologist for his upcoming group speech therapy, in which there will be other children with speech needs (not necessarily with Autism).

I read an article this morning about a mother who was amazed at her son`s ability to socialize in the absence of her teaching him social skills. Her son was three and inviting people to pretend salami sandwhich picnic lunches at school, offering popsicles to the neighbour and saying hi to just about everyone and enquire about their activities. I have tried to teach similar nuances to Torran, but he doesn`t get it.

Inevitably, comparisons between children are made by parents - even amongst parents with differing or special needs. Torran has advances in some things over other children, yes. But if you spend enough time with him, you`ll see where he has differences that are less than positive. Over time, if left unattended, our concern is that they won`t spontaneously improve or develop. That is when he will fall behind and become unsuccessful. Yeah, he`s only three now, but time will not stop for him to let him use that excuse forever.

Throughout his short life this little man has worked so hard to capture the best of his potential - and we have given him that opportunity to work hard. I don`t care that he is high functioning. That`s not a reason for me to sit back and let nature take her course.

So, go ahead and judge me and my son. He is as deserving of the same guidance and I`m going to make sure he gets it.

He's Joined the Rat Race

2011-09-08T09:41:00.003-05:00

There's a clever commercial about back to school time which my co-workers love ("it's the most wonderful time of the year") and we've officially begun our journey on that path.

Torran loves nursery school - and he's only there for a half a day! I don't know if it's the change in environment, the additional wee ones to hang out with or the curriculum (perhaps, even the new food!) but every time I've gone to pick him up, he says with a pout "You don't want to go" (meaning I don't want to go).

I'm very pleased that he's adapting to this new routine. Soon I'll be a bit more investigative about what exactly he does there and how they are supporting his particular needs. For now, I drop him off (without any fuss from him - not even a kiss goodbye today) and talk him into coming home after he's had lunch with the other kids.

And how exciting - a couple of extra hours in the day (when I'm not working) when the house is shhhhh quiet! Of course, given the amount of stuff on my/our plate, it still doesn't seem like enough time, but he can't do full days at the moment. We'll start taking him swimming in the afternoons again this week - maybe even enroll him in a real class with a teacher and see how that goes!

For now, it's a bit of gardening, my blog (!!!!), computer stuff, medieval projects, reading, exercise and housework (time for all of this???)... and a nice cuppa for the first fifteen minutes of shhhhhh

Who's Version of Motherhood?

2011-08-25T20:30:00.002-05:00

I saw the beginning third of the movie Motherhood starring Uma Thurman the other day. Of course, I wasn't watching at my leisure (that's time I reserve for HBO's True Blood... Torran may not pay attention to everything he hears, but his echolalia likes to find *certain* words). Honestly, it was a left-over from the fast flip that I do sometimes when I start Torran down to lunch (i.e. he's fully occupied on eating). What's the weather going to be like this afternoon, and any good kids' movies on?

Curosity kept me on it for a bit though. Indeed, how would Hollywood portray 24hrs in the life of an "urban mother" planning her daughter's 6th birthday?

Well, apparently Uma is more the uber mom than me... than I. Before lunch (I think) she already had three blog posts done, took her 3 year old son to the park, picked up a cake, brought her daughter's forgotten bag to school, went shopping for groceries, shopped for clothes with her gal pal, had to juggle her car/fight with urban parking AND a film crew on her street, contemplated the wording for her competition essay on "being a mother" and something else which I can't remember... was that before or after she flirted with the man twenty years her junior? (didn't she make that film already?)

Today I meant to do a meaningful "back from holiday" post when Bruce was home to entertain Torran in the morning... sat down, wrote one quick email reply, then it was already 9:30 and time to go out. Well, I did manage to make a cup of tea and have a shower first. Although I may not have actually spun out a blog post, I did open the window! After our brief sit down at "coffee" and my foot clinic appointment, it was back home and make lunch for the empty leg (aka Torran), during which Bruce dealt with a billing issue on our gas bill before he made his own lunch as I ate mine. Then we drove him to work (smart boy didn't cycle home in the lighting storm last night). 1:30pm arrived, and still no blog.

an aside: would have posted yesterday, but I don't use the computer when lighting abounds.

So... WHO in their right mind thought that a mother could possibly achieve, to any satisfactory level, the amount of stuff Uma did in the first part of this movie? Granted, one of those blog entries... or was it drafts of her essay?... was writing whilst her son was playing all alone in the living room with building blocks. Sure, that's credible mulit-tasking.

*Smirk* Torran doesn't give me the chance to sit at a computer and be thoughtful. He just comes up and shoves something on the keyboard and tells me what to do with it. Currently, he's fixated on an inflatable banana from Bruce's teenaged days in Australia when they had a pool in their garden. And its valve is completely ruptured so it can't be inflated any more. Torran refuses to stop playing with it or talking about it or insisting that anyone within a 5 mile radius can blow it up.

In the end, I shut the movie off before it reached mid-point. Or maybe it was mid-point. I don't know. The scenes weren't time-stamped. Besides the dull writing and less than brilliant acting (when Uma was "typing" her essay/blog, she would shake her head around and make facial expressions to match the voiced over narrative... I don't think I've EVER made faces to emphasize what my fingers are typing as I stare into this rectangular glowing block) the plausibility of her day completely lost me.

Yes, I know that generally speaking, for any movie made, you need to suspend your brain, your knowledge, and your understanding of the world as a whole to make it enjoyable. Sometimes, I just can't do it. Perhaps, if there had been mulitple explosions or sweaty well built men, I would have been able to achieve it with this film. But no, if there had been an explosion, it would have been written in as a threat against the school and she would have turned into G-girl and it would have been a totally different film (which I would have enjoyed, actually).

And there, friends, is my thoughtful "back from the holidays" blog.

10pm. So much for going to bed early.

Back from Pennsic War XL (40 in Roman Numerics)

2011-08-17T22:11:00.004-05:00

There isn't an interesting blog tonight. I sat at the computer with the full intention of at least getting some Pennsic XL photos out for those of my SCA family and friends to say "yep, that's me", and for those of my other family and friends to say "so that's what she did for two weeks, crazy girl".

But first I finished clearing out emails, and FB notices, and then I wrote a weightly email about my son. It wasn't very long, but it acted like the catalystic stone wall for my less than awake brain and feebled creative juices.

To avoid being sombre, I'm going to avoid talking about it. I think it's also a result of the effect of returning to real life has been upon my mental well being. Run charging into the mosh pit of hell whilst naked. Because, in the worst of your dreams, you rarely have all your clothes on.

You Know We Have to Have One of These Videos...

2011-07-28T19:56:00.002-05:00

Single Digit's Single Digit.

2011-07-20T07:39:00.003-05:00

As part of the assessment with the paediatric neurodevelopmental clinic, Torran has had an occupational therapy assessment. He used to have daily OT for most of his first year at home. Having reached appropriate milestones and skills for his age, he was discharged.

I thought that he was doing ok.

In hindsight now, maybe we should have stayed on top of it a little better?

After a few months of waiting for an assessement (aside: yes... waiting... that thing which no one who comes to my department wants to do... and you wonder why I get cynical?) Torran's evaluation was less than stellar.

Surprisingly not so stellar.

Occupational therapy means the skills and body physics required to do the every day tasks of life and/or your job. "Job" in his case means, daily life activies, play and pre-writing skills.

He scored in the 9th percentile for both fine motor skills and hand-eye coordination.

That means, for every 100 children, 9 or fewer faired worse than him. 10 to 100 can do better than him. (versus an average which takes the scores of all the children, adds them up and divides by the number of children, which does not really represent where he is at in that group as lots of highs or lows skews the results)

So, let's add another therapy back on the docket.

Moreover, jaw drop, I didn't realize it was that bad.

He's going to go to nursery school in September (we've found a place that hopefully will meet his needs), so hopefully we'll be able to improve that percentile sooner rather than later. Of course, part of me is concerned that part of the gap comes from cogitive and/or sensor processing which will be harder to get around, if at all.

I'm trying not to feel like I've failed him, but I don't think that developmental delay news has hit me quite this way before (autism diagnosis notwithstanding). I'm actually kinda numb.

So it's do away with the big blocks, or any blocks that fit together for that matter (sorry Lego). No more time off from parent directed play. Lots of practice and coaching. And, results oriented parenting, which can be very lengthy and exauhsting.

One can only hope for the best.

Turns Out, I'm Twisted

2011-07-14T12:04:00.003-05:00

I've been coping with plantar fasciitis for about a year now. It's a problem where the fascia, or thick connective tissue, on the bottom of the foot (providing support for the foot arch and muscles), becomes damaged and/or inflamed. There`s lots of reasons for it, less supportive footwear, long days on my feet, falling arches and extra body weight I thought were most to blame for my etiology. I`ve had it before, but it went away after a few weeks of 600mg advil three times a day and the exercises that are most helpful for plantar fasciitis.

During the night, our feet point slightly, giving slack on the fascia which allows it to heal. Thus, the first step in the morning causes a characteristic great deal of pain (although it can also be after a period of rest/sitting or with hyper extension of the ankle) because during the night the fascia heals. That first step stretches the fascia at the connection point on the bottom of the heel and causes micro tears again.

The pain comes and goes without a pattern. There are times when it`s a dull ache and other times when I`m limping along.

I finally decided that it`s time to get it sorted out - another thing on my Self To Do list. Partly, because I want to have less pain when I am active or exercising.

Without a particular prompt, I signed myself up for a foot clinic, the referral for which came in the form of a business card handed to me by the propriater`s mother. One day I went to a shoe store that sells more supportive shoes asking if they had insert orthodics. Luckily for me, the therapist`s mother was waiting in line.

Yesterday I found out that my skeletal structure, at least in my hips, is twisted. You have two different feet, the therapist tells me. My right foot twists outwards and my left foot twists inwards. Apparently my calves are also shortened, causing premature lifting of my heels (the long term implications of which I don`t know). Orthodics can`t fix these problems but physio might help. The orthodics, not cheap (custom), will help support the arches of my feet, which are both falling, and the rotation of my heels.

If things don`t improve, there`s a night boot to wear or cortisone shots to take (at least those don`t cause the bruising advil does, just puts your heart at risk). I already have cysts in the bone of my right foot, so I don`t really want a bone spur as well. Of course, there`s his other suggestion: foot cast for 12-16 weeks and stay off my foot.

Oh and no more barefoot walking...sigh...and yes, ugly supportive nursing shoes....more sigh

What they Say about Him

2011-07-12T08:34:00.002-05:00

Here's an example of Torran's post clinic letters... I am actually looking forward to teacher based reviews instead of medical ones! Below are excerpts of some of the letters dictated by doctors during his 2011 assessments.

From Thromobsis Clinic:
"In brief, Torran is a 3-year-old boy with several medical complications; he was a premature born with 26 weeks of gestation. In brief, he developed intracranial hemorrahage with secondary hydrocephalus requiring ventriculoperioneal shunt insertion, bilateral hearing loss, nephrocalcinosis and cyclic neutropenia. He also has a history of atrial septal defect and during his initial medical admission he sustained an umbilical venous catheter-related left portal vein occlusive thrombus in March 2008, at Mount Sinai Hospital. However, due to his history of intracranial bleeding, he did not receive anitcoagulation. His additional medical history includes the diagnosis of mild autism, mild cerebral palsy and lower limb spasticity.

Since his last visit to our clinic, Torran has been doing relatively well. He currently wears bilateral lower limb braces and is undergoing physical therapy. In terms of his previous portal vein thromobsis, his parent deny abdominal distention or any epidsodes of vomiting with blood.

...Repeat ultrasound obtained today continues to show fairly marked atrophy of his left hepatic lobe. The right lobe of the liver appears unremarkable with a homogenized echotexture and no focal lesions. The main portal vein demonstrates hepatopetal flow with patency of the right portal vein. The left portal and left hepatic artery could not be identified..."

From the pediatric development physician:
"...Torran was very busy throughout the session. He did respond to his name when the examiner called him. He was working on a puzzle initially and then walked around the room and bumped into the sink on 2 occasions and fell over. He did go to his mother for comfort during these episodes. He also played with a car, pushing that along and making noise. He would go up to his mother at times and comment on things. He was noted to pretend to cook with a bowl and a spoon and commented 'are you cooking?' and 'Torran is cooking breakfast'. He referred to himself as 'you' at times, for example, 'you may have the spoon'. He talked quite a bit, sometimes not directed to others. Some of his language did appear somewhat scripted and learned. He was noted to lick and mouth some objects in the examination room. He did not spontaneously wave back to the examiner and needed prompting to do so by his mother. He generally made eye contact with his mother but not consistently with the examiner, however this was difficult to gauge given his strabismus."

Monkey See, Monkey Do

2011-07-11T08:38:00.002-05:00

Taking Torran and my 10 year old nephew to Cedar Point was an interesting experience. Pics are posted on my Picasa albums - click the link on the right of the screen.

Part of what made the holiday of interest was watching Torran mimic his cousin. Of course, most of the activities involved naughtiness, but what the hey, it's the cognitive processing that's important!

On our first morning, for example, my nephew decided that his spoon was too small to take all of the milk out of his cereal bowl. So he picked up the bowl and started drinking from it. Torran did the same... and still does stating "like Simon does". I don't correct the behaviour without smiling and being thankful that he's doing it (and certainly not sternly!).

It gives me encouragement for his future development, particularly when he goes to a nursery program in the fall. Well, assuming that he will be able to get into a good nursery program. I know that there is room at the specialized autism oriented school, but it only runs three days a week and is in a different city. I think Torran needs five days. He's on a wait list for another nursery that is integrated with differently abled children, and was started, in fact, for children with needs. However, they won't have room for him. I'm going to tour another facility in a couple of weeks which will have room *if* their plans for expansion follow through for September. Other programs he won't be allowed into because he's still not toilet trained (despite our efforts).

I don't like having all my eggs in one basket but right now I don't even feel like I have a basket at all!

Side note: The Easter Seals Society has an incontinence grant for persons 3-18 years of age who have incontinence issues. There are specific qualifications for the program, and there needs to be a medical diagnosis as the cause of the problem. For example, night time incontinence alone does not qualify, nor does a simple lack of exposure/toilet training. Thanks to the Etobicoke Children's Centre for bringing this news to our attention, and the Easter Seals for reviewing and accepting Torran into the program!

Teeter Totter Toddler

2011-06-23T22:17:00.003-05:00

A little up and down news after three long days of medical clinics in the last week: vision, liver and preemie clinics.

The findings?
Liver - status quo unchanged. In other words, it's good news that he doesn't *yet* have portal vein hypertension. Let's wait and see what another year brings.

Eyes - relatively unchanged... less patching of his eye now as the strabismus has started to correct and we aren't to over-correct him. But no, he doesn't need glasses even though he gets right up in all the objects he plays with, and the books he reads. "Some kids just like to hold things close" the doc tell us.

Preemie clinic - these folks like to complicate things a bit... well I'm sure they don't mean to, but that's generally the way it feels when we come out of clinic. They are very impressed with Torran, his temperment and the skills he demonstrated. However, they found "new" problems for us to incorporate into our understanding of our child.

They've newly identified that he has speech apraxia , and some visual isses (the full extent of which I didn't retain but includes lacking visual closure, not engaging all of his fields of vision, and being very close to objects). I'll be getting a full report from them once Canada Post stops their strike, with details of the full assessment. They also verified my concern that unless he is getting his long muscles stretched every day, he will end up with increased tone due to the muscle tightness (i.e. his brain not sending signals to his muscles properly which causes the CP), even though he is very active. The increased tone can be seen, for example, in the bend in his kness: he bicycle kicks when he swims and can't sit with his legs extended by himself, or flex his foot when he does sit on the floor with outstretched legs.

As for the diagnosis of Autism from Bloorview, they didn't challenge it, per se, but they think his is high functioning for a child with Autism. They agreed that he would benefit some some form of one of one speech/social therapy (although the OT was quick to point out that speech apraxia is an organic brain problem for which compensation tools or skills can be used, but cannot be cured through behavioural changes). They added that he is a very medically complicated and his summary of symptoms may not be able to defined adequately by ASD, but by ... something else? The Torran Effect? The Torran Syndrome?

So, after reviewing Torran head to toe, they ensured that he has us "on top" of all his needs (i.e. therapeutic services) and then, that's all, file closed. They aren't funded to follow him beyond three years, although they want to track children (and their researchable data) until school age, or beyond.

Celebrating Mischief

2011-06-15T06:41:00.002-05:00

Several times a day a parent finds herself/himself redirecting a toddler's activity. "How many times do I have to tell you?" is the anthem of having a child.

Spending each day yearning for normal childhood development makes Bruce and I very aware of how these frustrating toddler behaviours are a good thing - even when we've said "No, please" for the 100th time.

Yesterday is a perfect case in point.

We were touring a private school for children who have autism in our quest for a "structured nursery program". Athough I appreciate what the psychologist was suggesting about his social learning needs, I still think Torran would benefit from a more behavioural therapeutic approach. This school provides both aspects in a small kindergarden class run by teachers who are also autism therapy trained. They also have a 1:1 program places students in a small group, each with an instructor.

In the face of other "enhanced" nursery schools which either have a wait list or aren't getting back to me yet, it's an attractive sounding program. The september program is three half days a week, which still give me lots of opportunity to integrate him into programs with non-developmentally challenged children.

Anyways, back to mischief...
We were ending the tour and approaching the front door, when I noticed that Torran grabbed a binder from a side table near the door and put it on the floor. I thought he was getting into his usual "clear everything off the surface" mode, which he does sometimes for no specific purpose. Then he stepped up on the small binder and reached up for the light switch.

Amazing!! This is GREAT problem solving:
-see light switch: understand it turns the lights on and off; understand that it is in the on position and have the desire to put it in the off position (plus the fine motor skills to achieve this)
-understand the light switch is too far away to reach (I don't think he attempted to first to figure this out, either)
-scan a new environment and be able to pick out an object that provides elevation from a table of items...requires also the understanding of elevation
-figure out where to put this elevation, and put it there properly
-understand that in order to use the elevation, he has to step up and reach further
Not only did he accomplish this new skill set of problem solving FOR THE FIRST TIME, but he did it in a brand new environment that was noisy and distracting - that's generalization of skills to different environments which is another important developmental skill.

My initial thought was the instinctive "no no no" but as I approached him it rapidly dawned on me what cognitive processing he went through to be a little mischief maker. Instead of scolding him, myself, Bruce and the program director (who was giving us the tour) celebrated his achievement in this attempt to get up to no good.

6*

2011-06-15T06:40:00.000-05:00

The Hard Job

2011-06-04T20:40:00.003-05:00

A man arrived VSA to my resuscitation today. He collapsed an hour earlier, had CPR done by his family, early electrical defib by the fire department, further defib, oxygen and drugs by the paramedics, and further interventions in our department. Sadly, despite a timely chain of survival, it did not work. In someone who drops like that, with no known medical problems, we assume a major cardiac event.

When our efforts were over, I accompanied the doctor to deliver the horrible news to to his wife and children.

And as the doctor was talking, I started to get teary eyed. I had seen this family arrive, crying and clinging to each other, hopeful that everyone's efforts would save this man. The doctor could barely convery his full disclosure when the wife and older children sobbed with grief; hope had fled them. In my dealings with them afterwards, it was so difficult for me to talk to this family without my voice breaking because my heart was broken for them.

It wasn't my sorrow to own, but it became my sorrow to bear witness to. Watching their despondancy tore at me for the rest of the shift. In one hour, amidst the usual ED patient complement, this family's life was irrevokably damaged.

We don't have a program in place for family support during a resuscitation. Our after care is hit and miss depending on who the staff is, whether or not the Crisis team is available, and if spiritual care is requested whether or not they can attend.

Whilst I could not feel the satisfaction of helping this man back to life, it is rewarding to know that his family were not neglected after hearing "he didn't make it". Thankfully, our pace was slower this evening, and I had all the time I wanted to care for the grieving family.

I wasn't the only one who was affected to tears. The charge nurse cried, seeing the eldest child overcome with emotion to a near feral level. Another of my co-workers, who was present during the intial response and was assisting with the care of the smaller family member, a little boy who didn't understand what was going on and who may never remember his father, later said to me "and people wonder why we are the way we are - why we have nightmares".

Zee Garden, She Grows... well, mostly

2011-06-03T20:11:00.010-05:00

Finally some pictures!

BEFORE

here's a couple of pictures of what my garden looked like last year at this time (interestingly, I've noticed that my peonies haven't even opened yet - wonder if that's because of all the rain we've had?). Thanks to my father-in-law for the 2010 photos

from last year: notice the grass between the rose/peony and Torran

from last year: some kind of short-term flowering bush that dominated the back corner of the garden and the peonies that existed from previous owners; in-between, the unruly mass of raspberries and red currents we planted from cuttings when we moved here in 2005

early May 2011: cut out the big bush (and revealed an ugly boat, shrug, oh well) at the same time my neighbour was replacing the chain link fence - his chainsaw came in handy!

early May 2011: in the shade you can see the area that I've cut out of the grass to extend the garden bed. Still needs edging properly (hasn't been done in YEARS)
early May 2011: wide view of the garden before the flowers and herbs are planted/transplanted

DURING
early May 2011: Long view of garden bed planted with plants that previously existed in this bed, plants that existed elsewhere in my garden, and new purchased plants. In the back: the bush stump still has to come out, the raspberries and red currents are still unruly and not trellised and the edging is not done. There is also a large bush of stonecrop that got removed and split into four or five portions for the front of my house.

early May: fresh planting - what I'm calling the "east bed" - back row from L to R: 2 English lavender and 3 delphinium from other areas of the garden, and newly planted sage. Front row (all new): artemesia, cilantro, spanish lavender, rosemary and french lavender and potted bay laurel leaf.

Tulips are all pre-existing from bulbs. To date, I still haven't edged the front of the garden, but I have installed plastic edging in the back of the bed to control weed and grass growth from my neighbour's side of the fence. The big rose plant I was going to move, but I've decided to keep it - not least of which because it makes a pretty flower and it's too late in the season. The peonies are pre-existing as are forget-me-nots, small violets and a couple of unidentified flowers in the middle of the garden.

I do have pics of individual plants that I've moved or inserted, but that's not exciting to post. When they grow a little prettier I'll put up some more piccies. And I'll take some more pictures on Sunday with my debauchery of sorting out the raspberry and red currents, and moving them to where the bush stump USED to be. I'm hoping by then they'll perk up a bit (not looking so hot at the moment).

Excavated stump

Thank you to Bruce for extra brute strength and to a certain orange DIY store for the rental of a gas powered tiller to churn up this disused portion of my garden (the back part)... and giving my body aches and pains to complain about all day today. No photos of the power equipment though...pout pout.

And yes, I know that I'm not supposed to move plants with growth on them, oh, say like the berries that are showing up on the current bush, but I HAD to do something about it. It has not been tended since we planted it. Besides, if we lost the red currents, it won't be such a loss. We also have lots of raspberries still growing in our wild bushy area, I just need to trellis them (now that I know that I'm supposed to!). So at least we'll have some fruit crop this year.

So far, things are progressing fairly well. I have had one true death - the columbine did not survive. However, I'm going to go back to the nursery and get them to replace it (it's guarenteed for two years). I've also planted pysalis (Chinese lanterns) which some bugs have gotten a hold of. It was planted near dill and garlic which are supposed to be natural pesticidals... then I used a diluted soap spray which I use for aphids on roses... I don't know if that helped or not - but I think it killed the white lily, as all the pretty slightly chewed petals got brown and fell off. Of course, a week afterwards, I found a "natural" pest spray of boiled garlic water. Hrphm. Over this week I've planted magnoila as another natural pest control. I hope the physalis stays with it, because they are really pretty (and part of the project!).

I don't know whether or not the White Wolf Fian has accepted my challenge. However, if they do accept, I may be able to present the challenge at War of the Trilliums. In which case, the garden is still fair game for next spring's growth. In the meantime, my research books have arrived just in time to avoid the postal strike... so I have a lot of reading to do!

A Good Start

2011-05-30T12:39:00.002-05:00

Torran picked up the phone and brought it to me whilst I was doing the online GC census.

"Would you like to call on the phone?" (meaning "I would like to call on the phone.")

We had our usual interchange, the learning opportunity being me modelling a pretend phone (he can do "pretend" on objects, but we're working on imaginary play without objects).

He opened his hand fully and said "a bigger phone"... obviously the kid wants a blackberry.

Then he took the phone off the seat where I'd placed it and walked away. I watched him observe himself in the reflection of a cabinet:

"Hi Grandma. How are you? Bye."

It's the first time he's ever had a "conversation" with an imaginary person on a phone. He's previously said "How are you?" once or maybe twice. But never bye.

So if he had a pretend blackberry, would he be surfing the net?

I think I'll have to get more visual tools for him, so he can better understand the concept of a phone. He's heard voices over the phone and recognizes either them or their pattern of speech (some people have specific "greetings" with which he identifies). I don't know that he actually realizes that there is someone on the other side of the phone.

I also started working, again, with making words and reading with him. However, that didn't go so well. Rather than work with letters alone, I'll have to integrate images here too and hope that will make a difference. At some point, he'll be expected to be able to read basic words. I know he associates symbols with various places, for example, grocery shopping is "the banana store" (No Frills). Flash cards? Fuzzy animals? Photos? I'm not sure which route to take.

But I don't expect him to be writing any PhD papers yet.

May. Bee.

2011-05-29T12:36:00.004-05:00

I've given a lot of thought to language since investigating Torran's latest diagnosis. I often find myself re-phrasing something in my head before I say it aloud, or correcting Bruce on what he is saying to Torran. In either case, we're modifying what comes natural to us from our previous experiences and upbringing.

For example, Bruce will say to Torran "come through" or "go through" meaning leave this room and go into the living room. However, if he's standing in Torran's bedroom talking and, say, putting away clothes, it becomes a statement without concrete meaning to Torran.

If I say "fork, please" meaning eat your food with your fork, when he's playing with his food, my words lack the concrete direction that I want them to convery.

Some of the sentences we use now may be confusing to any toddler. However, it would be moreso to someone who does not yet grasp abstract language, moreso if he or she is a visual thinker - literally, their thoughts are like pictures.

Today I was reading Torran a book which described dogs arriving at the foot of a tree. He's heard it about a ga-gillion times and so the meaning of the story, accompanied by a picture of all the dogs at the bottom of the tree *could* be understood by a toddler who grasps some basic abstract concepts.

Torran leaned back, bent his knee and inserted his foot into the fold of the book saying "the foot of the tree".

That's definately indicative of concrete thinking. Amusing though it was.

So I spent a minute telling him that the bottom of the tree is also called the foot. The top of something may be the head, just like on his body. I don't know whether or not it will stick, but I have a sneaking suspicion that this is the kind of coaching that he's going to need more than typically developing children.

To be prepared to teach him in this way, I find myself re-thinking my own speech. Not that I don't want him to learn abstract concepts, by any means! But I think he needs to grasp the concrete first, otherwise it will be lost on him and he will fall behind socially and academically.

Sometimes it feels a little draining. I can't just say what feels natural. I feel like I'm nagging my husband to death correcting him all the time. And then there's the wee man. Just about every moment of his day is a "coaching opportunity". As parents, we always have to be "ON".

His developmental resource teacher suggested that we take direction from Torran for a while, six weeks, to see what has sunk in. I don't know if I have a type-A personality that can't just let it ride, or if it's that I'm afraid that six weeks will be precious time lost if nothing comes of it. She did make a provactive statement, though, in saying that if there is expectation to perform upon him, he may not "perform" for fear of failure. It's a valid point. Although I wonder how the pushy parents get away with it then?

So, Next Year Mebbe He Runs 1K?

2011-05-28T17:19:00.008-05:00

I can't believe how much energy this kid has. He was up at 6:15am, didn't stop moving at the park since 7:15am, walked a 1K, and no nap.

Remember, he's busy with a purpose, not hyperactive!

Thank you to EVERYONE who participated, donated, and volunteered. Our huge Punchbuggy Team raised over $3000 plus $5000 from a not so secret source. Fantastic!!

I'm glad we'll all do it again next year!

Rain, Rain, Go Away

2011-05-27T20:25:00.002-05:00

The big day is tomorrow and the weather isn't looking too cooperative. May-haps we'll get lucky and repeat the previous years' meterology miracle: as soon as the kids arrive, the weather starts to improve.

But it's better than sunshine, watching the wee ones running around with shirts that say "I'm walking for me".

Yes, the statistics are grim for cancers, heart attacks, car accidents, and a countless number of other horrible things... but first life has to have a start. Sometimes it's overcoming the hopelessness of that start that is the biggest challenge.

Tomorrow there will be children walking who were forcast to be paralysed, siblings on bikes in honour of their brother or sister who never made it home, and parents running whose worst days were standing at the side of a plastic box.

And they all do it to improve someone else's start. The donations do not benefit them as they face developmental challenges, lack of funding for therapies or bring back a beloved child who never saw the light of day.

Thank you for donating, for participating, for Making a Big Difference in Tiny Lives.

Lead a Horse to Water...

2011-05-26T21:46:00.004-05:00

I worked in our resuscitation area today. Our highest acuity patients in a ratio of two patients to one nurse - and sometimes that is too much!

Normally speaking we get more turnover of patients in this area than I did today. I only had four patients in my assignment of two beds over twelve hours. Of those four patients three had drug dependency issues.

Certainly I've had my evenings of getting intimate with alcohol in my youth, and less often as an adult... I certainly tolerate the side effects less effectively these days (or maybe I just choose not to tolerate them!)

One of these patients did not admit his addiction until much later in the day - one he's had for years and didn't share with his wife. Of the other two, family members were eagerly seeking help from the hospital. Correction, they wanted to have their family member fixed.

The problem is, a person can be given all the support and help in the world. At the end of the day, no one else puts the toxin in a person's system except his or herself. So, if you have all the "free" help that you need, and you fail to commit to self-help, then were do you draw the line?

And when does that line extend to other "repeat" causes for medical assistance, smokers with COPD, over-eating diabetics with uncontrolled blood sugars, or even chronic RSI from sporting injuries?

Then again, perhaps we shouldn't draw a line and just treat everyone for everything going, therby levelling the playing field... including the alcholic who comes in yet again with ETOH induced chest pain..

Well that was a short storm...

2011-05-25T21:09:00.002-05:00

So where was I? Yes, a post...

this morning we up staffed because we have a hard time covering sick calls and an even harder time working short. Because of that, I had the opportunity to attend by out departmental Council meeting by phone conference.

And silly me, I signed up to start a big project.

Don't I have enough to do?

However, this is what I've been like as long as I can remember. Busy busy busy, with multiple projects on the go. I wonder if I'm slightly attention deficit? I know I'm a good initiator... I can imagine I'd be great at coming up with ideas and handing them to my "go" person if I was a figurehead of any kind.

Of course, my entourage consists of...well... me, so that isn't going to happen any time soon.

What am I getting myself into?

Storm's here...

2011-05-25T20:59:00.002-05:00

no, literally, the storm is right over my house. Here's my "maybe" post for May - maybe I shouldn't be using my computer in a lighting storm.

I'll shut down for now and re-post if it passes in short order... or if I can stay up (been a long day)

But I can report: got my two of my research books in today for my garden project!

You May Not Have Autism, but You Sure Have Something

2011-05-23T16:36:00.003-05:00

In researching where to put my son for a "well structured nursery school" I did some superficial fact finding about the Montessori approach and autism. During this web surf, I came across a video about an autistic woman who does not seem to talk, but can communicate rather eloquently through her computer. It's titled "In My Language" and the woman in the self portrait is Amanda Baggs.

Amanda portrays herself as a low functioning autistic whose intelligence is trapped within her way of interacting with the world. It is aimed at being a very moving piece of film.

However, according to the testimonials re-printed by Blogger John Best's Autism Fraud, Amanda is faking it. Others, like the blog Facing Autism in New Brunswick (Harold L. Doherty) report the same (although the original web site with testimony has been taken down) and the discussion that follows that post is very interesting. The suggestion is that she likely has Factitious Disorder, the deliberate actions of a person to mimic an illness or exaggerate the symptoms of it. For what purpose, you might ask? Certainly the alleged faking Ms Baggs made it to CNN with video feature editorials.

Yes, an autistic person may be able to communicate more effectively through a keyboard than in verbal communication. This would be particularly true if the 80% of communication which is non-verbal interferes with the understanding of a conversation. So don`t take a phoney video too much to heart.

Maybe It's Just Me But...

2011-05-22T22:54:00.002-05:00

...I don't go into a store at closing time expecting service.
...if I couldn't take a dog in my car for allergies, I wouldn't choose to do it just for a short trip (which I'm not)
...if my son put something in his ear I wouldn't wait a week to get a doctor to take it out - and then leave without actually seeing the doctor
...I didn't notice a big earthquake yesterday
...I don't make a big deal out of having gastroenteritis, even if I do get dehydrated
...when I go out, I always carry my ID
...reality TV programs about rich baby mommas gives me the creeps (and makes me hyper concerned about what standards people are comparing themselves to)
...suicide reporting should more transparent, and not just the realm of movie stars, famous people and failed attemptees (perhaps we could all learn why it happens and how to prevent it)

and I'm sure I have more b*tchy things to say.. but I'm exhausted. So g'night.

Now approaching: The Most Wonderful Time of The Year

2011-05-21T18:41:00.003-05:00

It's not Christmas. And it's not September's back to school.

Round our house, the most wonderful time of the year is June. The one month of the year Bruce and I do no argue about how to manage the house temperature. In our typical warm but not yet stinkly humid month of June, we can keep the heat off, the A/C off AND sleep with the windows (comfortor being an optional thing).

Bruce is a polar bear. He DIES in heat. I, on the other hand, do not like to be cold. Ergo, during the winter he argues the temperature is set too high; in the summer I say the A/C is too low.

Sounds like a minor problem, right? Well, if you've ever had to cross swords with either of us, you know we're both pretty stubborn. Even at 5am when we've both been up getting ready for work (before Mr. T was born), we've had a fight about the house temperature.

I get some leverage now with Torran being in the house. Can't freeze our baby in his bed after all he's been through, can we. Of course, if he develops his father's internal heating system, then I'm out of luck.

Maybe our vows should have said for hotter or colder rather than richer or poorer?

And Now?

2011-05-20T22:50:00.003-05:00

Well I am a bit delayed, but here's the dealio... Torran is too high functioning to qualify for the IBI/ABA. The clinical psychologist who assessed him for the government program though he might no even qualify on a biologically handicapped basis just by reasing his chart. That was interesting to hear!

She gave us the gentle let down... he's great, you've done great, but he won't be best serviced here.

Ok. So pat our family on the back, rah rah we're great.

She pointed out that he's at the "top of his class" for autism. Yes, I hear what you're saying. But I don't compare him to the severely autistic kids your program is aimed at. I compare him to his peer group.

That's where we find problems.

I hate having to point out Torran's developmental deficits. Yes, it would be so much easier to close my eyes and pretend everything is going to sort itself out.

That's just not the way this life works. In fact, I don't think there has been ANYTHING in my life that has been as simple as that.

So I ask her, are you suggesting he's not autistic. "Well he's somewhere on the scale", she replies.

Yes...??? And???

Her recommendation: a good structured nursery program, only half day really because it's obvious we're so good with him and he has the potential to learn from a naturalized environment.

Yes...??? And???

Torran is already in a pre-school play and learn a couple of times a week. When they do circle time at the end of the two hour semi-structured program, it took him months to adjust and fit into the same expectation. Yet when they sing songs he's not as involved as the other kids are. You can see it. As they get older, will he always be one step behind or will he be left in the proverbial dust?

Bruce and I are also feeling frustrated about our interactions with Torran. Without the IBI approval, we don't get access to the Jumpstart program which gives parents some advice about dealing with their autistic child at home. Not only that, but we get discharged from TPAS (Toronto Partnership for Autism Services) altogether... even though he is still autistic.

So now it's a 180 degree spin from holding back on nursery school because of his prematurity, my dislike of the germ pool that nursery school harbours, and his physical and developmental delays to avidly searching for relatively close and autism/disability supportive nursery that doen't have a wait list lasting until he gets to college.

If I just close my eyes...

Pod Person Invasion

2011-05-19T17:47:00.002-05:00

I'm guessing that's what has happened to me. I fell asleep with a big, slimy, green pulsating pod beneath my bed. When I woke up, I was driven to be in the garden.

The last few days I've been pacing at the window, waiting for the rain to go away. Not for taking a nice walk with my son, no... although I have done that today. Not for cleaning my car and garage, though that's on the to do list. Not for kick starting my my activity level with some outdoor aerobics, despite my need for it.

I actually want to *WEED*

not smoke it... kill em. eradicate them. pull 'em out over several hours of back tiring work.

Now if Torran would stop waking up at 6am, I may have energy to do this after he's gone to bed!!

Blame it on the Rain

2011-05-17T20:05:00.002-05:00

or maybe writer's blog.
But I just don't feel like posting, although there's stuff I could write/vent about.

so meh.

Re-Inventing the Wheel, and Still Going Nowhere

2011-05-16T20:04:00.002-05:00

Every hospital re-invents its treatment area to shave minutes off of processing time. If they don't this, then they get penalized with less governmental funding. How does that make sense? When part of the reason why there's a delay at bedside is that patients out number the delivery of care staff 5 to 1... or more.

We have developed two new such processes in the emergency department. Last year was RAZ, Rapid Assessment Zone. This year it's HAIZ (not haze! I don't like the nomenclature myself), the High Acuity Intake Zone. It is supposed to take those level 2 and 3 ambulatory and non-ambulatory (but potentially admittable) patients in to be seen by a nurse faster... but they end up sitting in a curtained cubicle meant for a single stretcher just staring at each other, without even a TV to distract them. And forget about privacy. And yes, the patients still wait for the same reasons that they would have waited for before in the old system: there are not enough emergency beds because the hospitals are FULL!

Sure the statistics are going to show 5% improvement, 30% improvement etc in overall wait times. What they don't reflect is the ongoing lack of overall patient satisfaction. Delivery of care is never fast enough. Time to a doctor is never expeditious enough. Waiting is the bane of medical practice, regardless of how many minutes you sheer off of it. What people want is walk in, walk out and be fixed. And no amount of yay for us, we're working at 110% of what is humanly capable, dying by the end of a 12 hr shift and leaving HUGE holes open for practice error and deficits will change that.

Oh yeah, and by the way, the statistics of speedy processing also don't account for any ability to actually CARE for your patients.

So, given that hospitals will NEVER be as efficient as the Tim Horton's drive through, which seems to me what 90% of the ED clients want, then why are we pushing our staff beyond professional and legal capability?

Today, a woman was left in the hallway, with a curtain around her for privacy, waiting all day for a nameless patient to be discharged from elsewhere in the hospital. In order to keep up with the people coming into my HAIZ, getting their nursing assessments and lab work done, and finding a place for them to be seen by a doctor, the hall patient was essentially ignored after 8:30 until 2pm, when another member of the extended care team requested some tylenol for her. Damn! I think to myself, I meant to give that to her HOURS AGO! Sure, someone gave her breakfast and lunch, but not one of the three of us nurses in that area were able to follow through with the CARE of nursing this patient.

If you're breathing in the ER, that's 85% of your CARE accomplished. And please don't die whilst we struggle to keep up with everything else.

Once I had an ED physician tell me: (for administrators) the ER is like your a$$hole, no one cares that it's there until it is not working. Maybe, he is right.

Baron Tancred of Tanglewood

2011-05-15T18:08:00.003-05:00

Your flame burns ever brighter.

Thank you for gracing our lives with your vivacious laughter.

Hope there's enough coffee for you in heaven!

An Order for Magrathea

2011-05-14T21:33:00.004-05:00

If you could custom build a planet, what would it look like?

Peaceful, no war?
Free of abuse and torture?
Strict about lawn care?
Utopian in job equity?
Patient patients?
No illness?
Commerical free television?
Smaller and easier to travel within?

Or maybe you accept the planet you live on now, even though you'd like it to be a nicer place to live?

Heart Pain is Human Pain?

2011-05-13T21:22:00.002-05:00

Back in my ten years, I took a scociology summer course because I needed a senior social science course to graduate. And being the academic keener that I was, I figured it that taking a "easy" course would leave me more room for harder classes during the year.

Not that I enjoyed physics in my senior year...

During this sociology course, we had to define what it is that makes humans human. The teacher provided the answer of culture.

But I wondering if it's something more emotive than that.

Animals create social structure, insects create civilizations and there are numerous misunderstood ways of being in the greater animal kingdom.

And as much as I agree that animals have feelings and memories, I think only humans have heart ache.

Tancred is in the hospital right now, perhaps on his last machine driven breaths. He's a wonderful man who plays in the SCA. He's vibrant, driven, funny and much beloved. And right now, I can viscerally feel the heartache of his wife, Rosie, as she sits at his bedside willing him to get better.

Truly, is it that kind of pain that makes us human?

Niche

2011-05-11T21:16:00.000-05:00

I drove downtown to a Parent Advisory meeting tonight and found myself stopped at an intersection studying the people walking to and fro in the downtown bustle (I was stopped at a red light, not just randomly stopped in traffic... that would be bad). For no apparent reason, I found myself wondering about them as individuals. What do they do? Where are they going? What's their story?

After the meeting I turned that reflection inwards and found difficulty formulating answers about where I fit in the world.

Mother of a differently abled child? Of a disabled child? A crusader mother? Defensive mother? Effective mother?

I am a registered nurse, I have the skills of a nurse, but lately I haven't felt that je ne sais quoi which is used to define Nursing as an art and calling, rather than a technical science. Maybe it's because I'm in grindstone mode: get in, get job done, go home. A good shift is a shift that a)ends on time b)no one dies and c)no one shouts at me.

Bruce would have to speculate on my efficacy as a wife. I'm a tough cookie to get along with, yes, but so long as I give him footie, I don't think he'll complain about me... much. ha ha

Of my work at The Linden Fund, I am proud, but I always feel that it's never monumentally enough. A part of me hopes I'll always feel that way so I'll constantly drive to do more, fundraise more, participate more.

I play the game of being SCAdian but only moderately at best at the moment because of time, money and sometimes, lack of creative drive. An administrative job I used to have was recently not renewed for me, which I found very disappointing. However I'm sure I'll find somewhere else to put my recreationist efforts...maybe to make that garden more than just a moderately successful physic garden! (got more plants today and they're going in the ground tomorrow)

Family... Friend... Upstanding member of the community...Hobbist photographer on hold... I can't define myself by anyone of celebrity status, of financial renown, or academic prowess, although I know a number of people who inspire me with their remarkable stories (mostly parenting). Even my blog is a wee entity in the larger web.

Is that enough of a niche? Should I be on the list of nurses nominated for a Nightengale award? (and congratulations to Maryann Bracht and NICU nurses who were... I wish I'd seen more of my Trillium emerg system nurses on that list!) Should my niche include more play dates? husband dates? family dates? oh yeah, and look after myself dates?

I could question the possibilities all night long and still not arrive at a concrete answer.
If there is an answer to be had.

Working tonight so...

2011-05-10T13:53:00.002-05:00

It's tricky to compose a decent blog post when I have a toddler that now brings toys to me and will take my hand to show me something. This newly developed skill is wonderful! And he's translated it to some different environments and people.

I'm eager to get Torran started on his IBI program. Bruce and I have to do a few more interviews and make some decisions. We figure we'll have it sorted by the end of the month... although it never seems like there's enough time to resource them all!

our key points of interest:
not home based therapy
not full time
flexible hours
local
and we're still debating between ourselves whether to go with the 12hr minimum or 20 hour recommended (the theory being that any less than 20 hrs a week is therapeutically not helpful)

cost ranges from $37-$42/hr and other costs may apply as well, like reg fees, evaluations etc.

perhaps we need another month to decide? or is that just procrastinating?

Missed a day... sorry

2011-05-10T10:56:00.002-05:00

Somewhere there is a world where there are enough hours in the day, where everything goes according to plan, where to do lists get done and household projects actually end.

However, I was not in that place yesterday! As a result, I missed my blog entry, for which, to the greater blog reading community, I heartily apologize.

Here's the blog I was going to enter (a cut a paste from my first May blog with NaBloPoMo.. a time saver I was going to use, but it fell through anyways)

On Watching Biopics

I watched the HBO film Temple Gradin about Dr. Temple Grandin, a woman with high functioning autism who has earned her PhD in bovine behaviour. When we were in San Francisco, watching the Oscars in the same time zone, I saw Claire Danes get the award, but the namesake of the film didn't register with me.

Dr. Grandin was obviously par of the film making process, but I wonder truly how she felt about the outcome of the film. It practically ignored her early years and the efforts her mother made to help her interact with others. It would have been little like the understanding of autism therapy that we have today. Grandin's challenges were numerous, and it is quite an accomplishment for her to have surpassed the ugly way people are, to complete her doctorate and consult in the larger corporate world about bovine behaviour. However, I feel that the film, for breity of time, focused on a few idocyncrasies and successes, then musical montaged the rest of her life into a "it all ended happily ever after".

The movie ends with an introduction to Dr. Grandin's "becoming" an expert in the field of autism. That part made me cry as I thought of my son. I'd spent the entire movie, of course, comparing his traits to hers (which is kind of hard as there are only two scenes with her as a 4 year old, the rest are pre-college aged and beyond), and finding myself saying "he's not that bad". Therefore, part of my brain argues, does he really *have* autism?

But the reality is, there is a diverse range of "being" autistic, and pyschology still hasn't pin pointed it down. Asperger's, for example, once thought of as part of the Autism Spectrum Disorder, may be it's own discrete diagnosis in the future DSM V. Of all people, I know that medicine does not have all the answers.

My emotive sob came as I wondered whether or not Torran will be able to reach a similar potential? We've always said that at the very least we want him to be able to care for himself, have a job and enjoy companionship. An intimate relationship may be another thing altogether. My friends Rose and Michele who have autistic children caution me to think only one day at a time. Truth is, I can't help but want more for him than the basics, and it breaks my heart to think that his brain may stop him from achieving it.

Yo Mama

2011-05-08T19:04:00.002-05:00

For every smile of encouragement
There were tears of joy

In each pursed lip of disapproval
A hidden glimmer of hope in her eyes

The times of overwhelming love
Brokered against unforseen frustration

Kissed brows and cupped chins
Embracing hugs and waggled fingers

All of these and more a mother shares
That their child may take a turn

To my mother, thank you.
To my mothering friends, you inspire me.
To my son, I love you.

Maybe It's Not Worth Even Getting Cross

2011-05-08T17:04:00.002-05:00

After dinner tonight, my mischevious little man made a dash for the light coloured living room furniture despite being told that it was time to wash his hand and my screeching protestations from the kitchen (when I thought he was following me).

Of couse, such shenanigans demands a timeout.

When I put Torran in timeout, I often have to ask him to sit with his hands on his knees because he neither appreciates that he's in trouble, nor that he shouldn't be fooling around from a seated position on the floor.

This time was no different.

Me: "Torran, sit on your bum. Hands on your knees"

Torran: "Torran farted" (with the obligatory lean to one side).

Off to Lady Mary...

2011-05-07T07:23:00.003-05:00

It's the Lady Mary Memorial Tournament today. Mummy gets to SCA play without the very busy toddler, although I'm not staying for feast in the evening. I don't know if I'll get to do a proper post today. I'm still bagged from work last night - which is why yesterday's entry, which actually took me 20 minutes even just to start, was so short!

Time for a Vacation?

2011-05-06T22:47:00.005-05:00

Our short trip to San Franscisco in February did not provide the sense of refreshment that a little vacation usually does. It took me two months to get out of the miasma of worry and weariness that Torran's diagnosis brought. Things are getting a little stressful around here. I'm not so ...happy... with work these days.

Perhaps it's time to arrange a wee mental break?

The Greening Thumb: or How I Will Spend My Year

2011-05-05T17:14:00.006-05:00

Not all that long ago, when I joined the SCA, I was full of creative vim and vigor. I wanted to do it *all*, make it *all, and earn myself some respectable head nods doing so. As I joined, I was planning my wedding, so that took a little bit of a precedence towards accomplishing all these wonderful things. For a couple of years, the creative juices were flowing, the bits and pieces were being made and the service was reliable.

Then life got in the way. First, it started with being on bedrest. All of a sudden I had time on my hands, but was unable to sit up to make anything. Then, I was out of service with Torran's day to day operations. Although the demands on my time have changed over the last year and a half, I have yet to fully recover that drive to give life to a piece of history. When I am able to attend events with Torran, it's not often that you'll find me sitting still in a class. Whilst my desire to help bring the game to life through service has easily resurfaced, the same cannot be said of my spark for creative projects.

Instead of being told off by Bruce for being up late sewing or painting, I find myself thankful for the quiet night just to vegetate my brain.

Where did that lively spirit go? Yes, some of it may be lost in the parental fatigue of early mornings and interrupted sleeps, of special child parent care of appointments and therapy, or of the wearing fatigue of worrying stress. But if exploring the creative side of my brain gives stress relief, why haven't I been able to do it?

Until recently I've been unable to attend my Household Talfryn Tylwyth events of Stitch and Bitch, Sack and Burn, or whatever lingo we gave it. A day of making and painting silk banners, combined with wanting to sort out my new pavillion and it's floor, has at least made a start. Too bad I need either the weather or the circumstances of group painting to help it along.

Then, out of nowhere, the greening thumb came. I've never had an interest in gardening. As a youth, if I ever had to do it, it was an unwelcome chore that could not be over fast enough.

My mother-in-law led me nearly kicking and screaming last year into the garden when they came to visit. Maybe she started something? Now, not only am I determined to get all of the weeds out of the garden, and not just the green leaves that you can see, but right down to the roots and a foot beyond, but I'm also planning a medieval physic garden... for an Arts & Sciences SCA competition no less.

Seriously, who am I and what I have done with that other Lesley?

Maybe I Was a Sheltered Child?

2011-05-04T20:14:00.003-05:00

Whenever I receive and email which smacks of rumour or urban legend, I check www.snopes.com They are the best thing to being experts as I suppose you can get.

Recently, my father sent me an email which warns people of pop bottle bombs, easily made by kids. Snopes confirms it.

Not able to desimate a house, these devices can certainly cause serious chemical burns and physical trauma to persons in close proximity.

As much as I got up to some naughty behaviour, I never would have created something as dangerous as this just for kicks. is it me, or is there something different about the way young people are growing up these days that is different? I don't want to sound old and use some cliched phrase about "when I was that age", but it just feels that youth are ... different now. I don't mind the edgier, racier, mouthier and less clad-ness of youth. I'm not so sure this "bombs are fun to play with" mentality. And honestly, even spreading the warning, which includes manufacturing instructions, makes me wonder if it perpetuates the problem.

The Way Life Laughs at Me Sometimes

2011-05-03T15:47:00.003-05:00

In doing some internet reading, I came across Dr. Diana Robins' official M-CHAT website for screening autism risk in toddlers.

The Modified Checklist for Autism in Toddlers (hence, M-CHAT) is available from her website for download.

And, don't you know, the same screening form came in the mail late this afternoon for Torran's follow up clinic in June. "We will be able to refer your child for appropriate services..."

The coincidence had me laughing and crying at the same time.

Or Not.

2011-05-03T12:18:00.002-05:00

As I suspected, negative test. Despite all the "ideal" conditions, numbers and "stuff", the ability to create, implant and maintain an embryo has passed me by this month.

Bruce and I talked about whether or not to continue with futher attempts, even though, in an ideal world, we both want another child. When we first married, we agreed that three would be a nice number.

We have one wonderful, albeit complicated, little man.

Maybe it's time to leave it at that.

The mirror neuron system in autism: Broken or just slowly developing?

2011-05-03T11:48:00.000-05:00

I stumbled across an interesting article today:

The mirror neuron system in autism: Broken or just slowly developing?

Hmm must do some reading on this neuron system. Brains are highly complicated and I respect the people who understand the minutia of the inner workings of the mind!

Deciding Day

2011-05-02T22:38:00.002-05:00

Tuesday is this summer's Deciding Day, based on the result of IUI#3. I am truly in a middle of the road decision.

If I'm not pregnant, I can go ahead with events and plans for which pregnancy is not necessarily helpful.

If I am, then I will truly rejoice.

If not, we take a break and then decide, is it worth it to try again? Especially given the new potential outcome?

If yes, how long will it last this time?

So. Tuesday. Maybe baby, baby.

The Month of Potential

2011-05-01T06:37:00.002-05:00

Last November, I joined the blogger movement NaBloPoMo and dedicated myself to posting everyday. Since then, I've been a lurker on NaBloPoMo, watching the invitations to blog daily on monthly themes. Sometimes I knew I wouldn't be able to achieve the committment. At other times, I wasn't sure if I could be inventive enough and an interesting read for 30 some odd days. And then there was that grey month of March when Torran's diagnosis put me in a sadness funk.

As the weather improves, the summer peaks from around the corner, and I come to working terms with Torran's way of being in the world, I'm intrigued by the suggestion for May's theme: Maybe.

In that word of ambivalence, there lies an underlying suggestion: positivity. At least, the part of myself that dis-likes pessimism, the part that so desperately wanted the glum funk to pass but couldn't get past it, holds on to that potential of possiblility.

Can a word transform an entire lifetime?

I'll be happy that it can influence one month.

This Entry is Not about William and Kate's Royal Wedding

2011-04-28T11:07:00.003-05:00

and that's about the extend of my humour today. Either via my son or the wider world of germs that I am exposed to at work, I am sick with a fever, possibly gastro. We were out for dinner at The Old Mill last night enjoying our Christmas gift (thanks Mum and Dad!) when I had to excuse myself to throw up in the bathroom. Since I'm not bulemic, I was hopeful that this was an early sign of pregnancy... during the night, however, I came to realize it's just good ol' fashioned infection.

Given that I'm still hoping to be pregnant, I'm treating the fever. Plus I feel pretty crappy and achey so the acetaminophen will help with that. Fever (a temperature over 38.0-38.5 celcius) for some undefined length of time in early pregnancy can cause early formation neural tube defects. It's also not incredibly helpful in later trimesters.

Next week will be the test to see if IUI#3 worked or not. In the meantime, I'm keeping myself home and isolated from my boys, drinking fluids and keeping the fever at bay.

Hot Wee Man

2011-04-22T22:11:00.002-05:00

Well I got home tonight, looking forward to a reasonable sleep only to find Torran's fever which started probably on Thursday is nicely raging, even after a small hit of advil. I've further medicated him, gave him more fluids to drink, and undressed him a bit. I think he's getting a stuffy nose, so hopefully it's just a cold. There were two girls with coughs in playgroup recently (really, please, keep your sick children at home!). Bedtime won't be for another hour so I can recheck his temp. And he'll likely still wake up before 7am that rascal!

4th Annual Pedal4Preemies

2011-04-21T09:29:00.003-05:00

This year, my heroic and amazing wee man will walk 1K on his own!

Sponsor him on his first official charity walk and Make a Big Difference in Tiny Lives!

Black Eyed Peanut

2011-04-16T08:10:00.002-05:00

Torran fell down last week at playgroup... he's still sporting a healthy bruise. (photo from the day after)

It's The Little Things That Give Me Hope

2011-04-13T14:48:00.002-05:00

Last week we had a follow up meeting with the neurodevelopmental paediatrician who diagnosed Torran. She's going to "follow" him for all of his developmental needs through Bloorview, but she doesn't provide any of the interventional services directly (PT/OT, SLP, IBI/ABA etc). The appointment was for us to review the diagnosis with her, both of us together, and ask any questions without having to chase after Torran in the room. She was pleased to hear that TPAS and The Geneva Centre had followed up with her referral. However, she shared her frustration that there is no immediate action available from government paid agencies, particularly for mild to moderate Autistic children. She diagnosed him with moderate Autism. The treatment agencies will do their own assessments and apply their own level to the diagnosis. And that's her role completed for another year. It's an odd kind of relationship, really. Thankfully, she conveys her message in a very well delivered manner which conveys a sense of care about the child. So I don't mind that I won't see her again for twelve months. Now the ball is in our court. With this new diagnosis, if we want Torran to get help, we have to be the driving force behind it. And, we'll have to pay for it as well. The numbers are not concretely on our budget yet, but it could cost a pretty penny each month. And there's no promise that it will be effective. But there's hope... today, for the first time *ever* Torran got excited about seeing me. Normally speaking, he'll point out that a person has come home, but he doesn't get excited about it. He'll minic the intonation of a person who's saying "Daddy's home!" or "It's Nana" but it's never done spontaneously. I happened to come home when the boys were starting out for a walk, and as I walked down from the car to join them, Torran jumped up and down "It's Mummy! It's Mummy!" Although Bruce told him that Mummy was coming, he didn't tell him to get excited or jump or call out for me. When he let go of Torran's hand, Torran came towards me and then lost his focus as he saw the umbrella that I was carrying. But it's a start. Each morning, for as long as I can remember Torran being able to speak the words, I've repeated "Good morning" to him until he repeats it back to me. Usually after I say "Good morning, Torran" , I get greeted with him saying "The light is on", "Mummy will open the window", "Where's daddy?" or another non-sequitur. And he *never* said good morning or even "hi/hello" first. A few days ago, he came to me in the bedroom, tapped on the bed and said "Hi!" to wake me up. It was the highlight of my day.

Autism: Basis of Torran's Diagnosis (part 1?)

2011-04-04T19:41:00.008-05:00

[I pre-empt this blog with an apology that for reasons beyond my control, Blogger was unable to format my blog as I typed it, and re-typed it. So it looks like one big paragraph.] We attended an "intro" meeting at The Geneva Centre last week. The content of the meeting itself wasn't very helpful for our specific needs, but they did provide us with some resources to help us further understand Torran's diagnosis (NB they aren't the ones who diagnosed him, although they have to do their own assessment of him). We have a follow up with the diagnosing doctor on Thursday morning. So here's how Autism gets diagnosed according to the Diagnostic and Statistical Manual vol IV (the DSM). There are three categories that are assessed: social interaction, communication and behavioural activities. The person in question has to have six of 12 characteristics in the "triad of impairments", of which at least two must be in social interaction. Symptoms also have to be present before the age of three years of age. Communication Characteristics of Impairment: 1. No or minimal speech without attempts to compensate non-verbally. 2. Difficulty initiating and maintaining a conversation. 3. Immediate or delayed echolalia (repetition of speech either after what has just been said by another or up to days afterwards, repetitious speech by the person) 4. Minimal or absent make believe or symbolic play Torran has the last three of these characteristics. His make-believe play is him reproducing a "script" that he's heard either Bruce or I use when we model the play for him. He asks a question, but they are limited to "what" and "where", and he cannot maintain a line of conversation that he starts (he is a good responder, though, as he will answer when prompted) Behavioral Characteristics - Behaviours, Activies and Interests are Restricted 1. Intense pre-occupation/interest that is unusual in interest or intensity 2. Rigidity in non-functional routines and rituals 3. Repetitive motor mannerisms 4. Interest in parts of an object rather than the use of the whole as it is intended Of these, Torran has the first two very prominantly (he "spins" his hands and now has taken to rubbing his head down a wall, and he presses buttons on his toys or spins the wheels on them just to have that experience ie. he isn't "playing" a rythm on his electronic drums, just pushing buttons). He has an intense pre-occupation with fans, lights, opening and closing doors from time to time and anything that spins, including our front load washer and dryer (and his own similar toy). He's not so bad about rigidity though. He lines stuff up (routine) but doesn't freak out when we disrupt it. Social Interaction Characteristics of Impairment: 1. Difficulty with Non-Verbal Communication (eye contact, facial expression, body gestures, etc) 2. Difficulty with peer relationships 3. No or minimal shared attention 4. No or minimal ability to take on another person's point of view. In Torran's case, he definately has problems with non-verbal communication cues, and expressing or reading body language and facial expressions. He exhibits the third characteristic, in that he does not seek praise, he infrequently wants to share his toys with someone to whom he is very familiar (family), and he randomly draws our attention to environmental stimuli (like a fire engine going by) - although he is very good at labelling what he sees, he doesn't say "look Mummy a man walking". He just says it out loud to himself. I don't know how characteristics 2 and 4 are defined in a toddler, but he doesn't play "with" his peer group that's for sure. So I can definately see these characteristics also being part of his triad. Perhaps I'll have more defining information after the meeting with the neurodevelopmental paediatrician on Thursday. There's also a two to three year wait list for government paid therapy, which is not ideal by any means (so to all those people who abuse the emergency system I say to you please stop it!!!). I can pay for the teaching courses and learn the intervention myself (and Bruce too) but the other problem Torran has to overcome is the ability to generalize his learning to all environments. I won't be able to be his teacher throughout his school career. That's where therapy in a non-home setting is a good thing (a child may not be able to apply his learnings outside the home even if the person delivering the intervention isn't a parent). I feel stuck right now because I don't know what to do for him to help him.

Watching a Woman Drown

2011-04-03T17:23:00.002-05:00

This weekend, I watched a young woman drowing and she wasn't even it the water. Before too long, she would have died, her lungs filling with fluid from the inside. She gulped air to breathe, speaking only in two or three word sentences. Her underlying health problem, an auto-immune disease which can destroy organs like the kidneys (which help control blood pressure), sentences her to facing this fluid imbalance again in the future. She needed dialysis to have machines do for her what her kidneys could not do. My hospital couldn't provide that service for her, and we couldn't get her to one that could because all of their criticial beds were full. She had to be "bed-spaced" to another in-patient unit that was less than ideal for her treatment, but the only choice they had available for her. And none of it was her own fault. Later that night, my co-workers tell me that a person who took an intentional overdose of medication took our hospital's last ICU bed. This is when the inequity in the way people use/misuse the health care system that I see disturbs me the most.

I Want a March Break Year

2011-03-29T14:01:00.002-05:00

During March break I had a pre-teen patient upon whom I was to inflict venapuncture (draw blood). She was very good about it... even better than some adults! In trying to distract her from the procedure, we were discussing March Break. I made the suggestion that she'd probably like a March break month instead of just a week. She said she'd like to have a March Break Year. Yep, I totally want one of those.

Another (insert adjective here) Girl Gets Knocked Up

2011-03-25T12:37:00.003-05:00

According to the Globe and Mail a Barrie area teenaged gave birth in a hotel in London on a school trip and left the newborn for dead.

You can imagine how I'm seething right about now.

Who's Will?

2011-03-16T21:22:00.004-05:00

So I was told today that it's "God's will" that things have happened the way they have happened.

That does that give me an excuse to slack off, I wonder? And then the big G can sort it out if he made it happen?

How Many Nurses can you buy with a Pregnancy Test?

2011-03-15T22:47:00.003-05:00

I'm annoyed this evening over yet another woman seeking a pregnancy test in my emergency healthy system. As a taxpayer, you should be too.

So she just make you pay 320 dollars or so 0f your taxes to tell her the news

a cheapo urine test is 7 dollars from any pharmacy

the fancy ones with the prediction of due date computer are maybe 20 bucks

This happens A LOT, but we can't refuse service, even though it's a waste of system resources.

Makes me wonder, if we billed directly for this service of convience, how many nurses we could hire with the funds, assuming people actually pay their bill?

Torran's Birthday Party

2011-03-13T18:03:00.007-05:00

The day started of with a play session, with his new work bench "just like Ethan and Owen"

Later, the Tornado of Toddlers whirled through out house today and we survived! Torran nearly missed out on the beginning of his party as he decided to face plant on the coffee table and put his eye tooth into the inside of his lip. Luckily, no stitching required and the black and purple bruise on his mouth matched the green and blue marker he put all over his face during arts and crafts. Marty Cummings from http://www.critters.ca/ came to entertain the kids... and the adults too! We had a Zoo theme, including having safari hats, making animal masks, and painting rice crispies animals. Torran's favourite? The jungle cupcake cake, of course! Enjoy the pictures!

Brave souls who tried the creepier critters (there were also cuddly fluffies like a bunny and a guinea pig)

Today Torran Turns Three

2011-03-10T13:02:00.005-05:00

The "label" of Torran's incubator.

The night Torran was born. Our first family photo, with our little Hero alive, on a ventilator, very swollen and fighting for live.

I was very lucky to be allowed into the Resusication room to see him (still on my stretcher because I couldn't walk). We owe a huge debt of thanks to Heather the Nurse and Lisa the Respiratory therapist who cared for him in his first crucial hours.

Two days later, Torran had lost his excess fluid from birth and remained a near skeleton like in this plastic box for weeks.

There are many challenges ahead yet in so many areas of his life. But today, today he can hold up three fingers for his age, and that's a helluva lot more than we were told to expect!

Happy Birthday Torran. We are so proud of you. We love you more than you will ever know.

A Little Quackery

2011-03-08T21:35:00.002-05:00

San Fran: The Donaldson Invation photos updated

2011-03-08T21:27:00.001-05:00

The picasa photos have been updated (comments to follow when I`m not so tired!).
Some of these have made an appearance already; others may yet be repeated again. Depends on what my editor wants me to do. ha ha

Today's Gas Price Is...

2011-03-08T14:52:00.000-05:00

(thanks Percy for the image)

San Francisco: The Deets

2011-03-08T14:21:00.022-05:00

(thanks Karen for the slang!!)

No, we don't have any rellies in San Francisco... but I do have timeshare, and it was available at a level of points I could afford. It's too bad, however, that Virgin America is pulling its flights out of Toronto and changed our departure date. Too bad, that is, because of the area we stayed in on our first night.

The Tenderloin district of SF is not the best first impression place to lay your head. Particularly when you come out of the BART train (Bay Area Rapid Transit) to Market street station, right beside the Money Mart with all the people hanging outside waiting to beg for money. I quote Wikipedia "parts of the Tenderloin have historically resisted gentrification, maintaining a seedy character and a reputation for crime". Then again, there was a running theme for the week: San Francisco has a lot of homelessness. As one folk lore story goes, the name comes not from a slaughterhouse, but from the bribes the butchers used to give the police of tenderloin beef in order to encourage police protection in the area.

Tenderloin is part of an area locally called SoMa, being south of Market Street. Our hotel in the (commercial chain X) was satisfactory, with each room being designated and decorated according to a famous locals/state celebs. We had an old typewriter in ours for the newspaper media mogul. Wonder what the people in the Cheech and Chong room got?

Thankfully, my time share was not only in a better locale (still had homeless folks though on every block) but it was nicer and more modern in appearance. It's two buildings, The Canterbury Hotel and The Whitehall Inn put together by Best Western and then bought out by Wyndham. No parking on site, but we were on foot the entire time, so it didn't matter. Everything was easily accessible either by foot or a short transit ride.

The best transit passes we found in SF were MUNI and Cable Car combination tickets (we didn't get the CityPASS option that includes some admissions) that you could purchase for up to 7 consecutive days (not including BART train). You could go on the historically famous cable cars, the regular transit buses, the cool MUNI subway which turned into a streetcar above ground (the steps raised themselves/lowered themselves to match whether it was underground or not), and the historically maintained "elevated railway"/streetcars which still run as regular transit in SF, some as far as Italty. Generally speaking, we felt safe on the transit, although there are always violent criminals amongst us.

Of these, the Cable Cars were the coolest to ride. To be fair, given that the few lines are swamped by tourists, depend on linear technology and are prone to blockages in the road, the timeliness was not bad. In fact, it was often better than that of the streetcars. Beware of the crappy musicians and questionable performing artists who camp the waiting lines with their repeated drivelling routines and hand out begging. Given that they are $5 to ride in each direction, our transit passes more than paid for themselves in Cable car use alone!

There is something charming about riding outdoors up and down steep hills with the cable driver or Gripman (brake operator) chatting to you. Fair warning: you can`t pick your seat and if you have toddlers, hold tight whilst on the outside seat - especially if they are prone to kicking the stranger standing in front of you (outside seats allow for standing persons - makes for crappy photos if you are sitting though). And they all point out that the cable car museum is FREE to enter. Although the first time I smelled those brakes coming to a stop on a steep hill, I had to wonder if the technology circa 1880 would survive. One tour operator informed us that the cable cars were started, in part, to give the horses a break from pulling heavy wagons and carriages up the hills.

San Francisco offers tourists diverse ways of touring the city, bikes, three-wheeled go-karts, walking tours, boat trips, a duck boat tour and segway tours to name a few. We chose the Hop-on-Hop-Off City Sightseeing Bus Tour Company and had a fantastic time. The city was divided into tour routes, including a night tour and Muir Woods. The bike tours have carriers for small children, but we couldn`t trust Torran not to turn the thing upside down behind us.

Of course, it wouldn`t be a trip to San Francisco without multiple visits to Fisherman`s Wharf and Pier 39 (mostly because these are the predominant sources for seafood). These are along the same section of waterfront, an gentle stroll separating them. Of course, both areas are mobbed with tourists and the paraphenelia that accompany them (yes, an Irish shoppe is essential on a waterfront pier!). Pier 39, is also home to native sea lions who loaf about all day (catch out their webcam).

Tourists beware! Access to toilets is strictly limited, especially in the Wharf! Some restaurants do not have facilities. There are public restrooms in the shopping area called Anchorage Square in the Wharf, as long as it`s not locked off or you have the key-pin access for the door. Thankfully, there are clean and enviromentally friendly, FREE, public toliets at the Maritime Museum at the end of Jefferson Street (which is what the Embarcadero becomes as you move further into the Wharf area). They save our lives on more than one occassion! Plus, there is a museum to boot and the SF Maritime National Park associated with it. A long walk along the long pier (no jokes please) gives you a nice view of the harbour, and just about as close as you can get to the Golden Gate Bridge on foot from this area.

Our favourite restauants include (in no particular order)
Joe`s Crab Shack (thanks Mike for the recommendation),
Pier Market Seafood Restaurant and Market (where you can get walk up BBQ fish),
The Cheesecake Factory (on top of the Macy`s building in Union Square, now that was darn cool... and cold!),
Pearl`s Deluxe Burgers (best burgers we`ve ever had, except for the freshly culled Kudoo burger in South Africa on our honeymoon),
Honey Honey Cafe & Crepery (great breakfast venue a block away from the timeshare), and
Bistro Boudin in the Boudin Bakery (claiming home of the original sourdough bread bowl).

If you`re not up to a sit down meal, you can try one of the local `street meat`vendors at the dungeness crab stations in Fisherman`s Wharf. We didn`t get a chance to sample from the crab stations, but I really wanted to! Easterly, past Pier 39, along the Embarcadero, with a nice view of the SF-Oakland Bay Bridge, is the revamped Ferry Building Marketplace with organic markets inside and a famer`s market outside twice a week, in support of local farms. Bruce had the best coffee there he has ever had. Since it is also less frequented by tourists, it has a charm that is definately less tacky. Well worth a visit.

Our evenings were quiet, giving Torran a chance to keep in a schedule and recover from his day long out and about. Mid trip, Bruce got severe gastroenteritis from some unknown cause. Could have been my virus from the week before (Torran had a day of being unwell before me), bad seafood (I`d hate to suggest!!) or the bird poop he cleaned off of Torran`s jacket the previous day. At any rate his statement of I`m just going to lay down for an hour and not sleep turned into hours of sleep interrupted by sickness in the bathroom. By 11pm he basically looked like a corpse with sweat. Thankfully, I was able to ascertain that he didn`t need to be taken to hospital so long as he didn`t get any worse.

He lasted through the night without further fluid losses, and my brave hubby sucked it up the next day for an early morning trip to Alcatraz, once a famous federal prison, now part of a National park. All the tour guides jokingly point out that the although the shark-infested waters surrounding the island were supposed to prevent prisoners from attempting to escape, locals swim in the bay on a daily basis for fun.

We also found family friendly attractions in the California Academy of Sciences, home of a rare albino alligator named Claude, and the San Francisco Zoo (easy ride from the MUNI train) where I saw a bear walking on its hind legs for the first time (not a recorded video). Torran particularly liked the squawk of the Macaw but his replication of the sound is, thankfully, quiet quiet in comparison.

There were lots of other sights to see and things to do. We just plumb ran out of time. On our last night, the film Oscars were running. How freakish was it for me to watch the last hour in the same time zone that it was being broadcast! Over at 9pm and I`m not dying to go to bed! But I had to anyways, we had to be up at 4am or some such crazy time to catch our flight.

A Ponderance Whilst Playing "Doctor" (or "Nurse" for that matter)

2011-03-08T10:37:00.002-05:00

Bruce bought Torran a kids "Doctor's kit" before we left for holiday. We had it out again just now, and the thought occurred to me... he can't put the toy stethescope in his ears because of the hearing aids. That led me to wonder what people with hearing aids do if they want to pursue a carreer that involves the use of stethescopes?

And what do you know, someone thought of that... stethescopes that can connect to hearing aids (the link is up for interest, not adverstising or promotion).

The Crappy Birthday Present (aka Torran's Latest Diagnosis)

2011-03-05T09:55:00.006-05:00

After a week away in San Franciso, enjoying ourselves, but also reflecting on time to time about Torran's challenges and emerging difficulties, we had a formal testing process for the Autism Spectrum Disorder yesterday.

The neurodevelopmental doctor at Bloorview kids rehab admistered the assessment tool, the Autism Diagnostic Observation Schedule (ADOS) screens him in three spheres of skills, communication, social and behavioural. She pointed out that it is a tool, and her diagnosis is also in combination with her assessment of him, his medical history, the assessment from the resource teacher of him in playgroup (she's known him since he came home) and her professional opinion in her experience with Autistic children. She said that the skill abnormalities he demonstrated and the diagnosis were not "the be all and end all", however she is very concerned about his communication and social skills.

She found him at a moderately autistic level for these, and at a mild level for behavioural skills. In isolation (ie. one or two on their own), any of these points could be present in any child. However, given the number of them that he has, his medical history, and that there is a severely Autistic family member (first cousin, who shares a grandmother with me) she favours a diagnosis of Autism. Which of the Autism Spectrum Disorders (pervasive developmental disorders) she did not specify. She even did some of the testing that would be more appropriate for a slightly younger age group in case his language skills weren't developed enough for the test.

The ADOS was semi-structured and play based (play being the way toddlers interact). Here are some examples of the testing process... anything that I point out that he didn't do are things that 3 year olds should be able to do. The testing process took over an hour.

Torran wasn't able to pretend play (like demonstrating how to wash his face or brush his teeth) without holding a concrete object.

Torran was not able to have two characters interact with each other, either by himself or with the doctor... not even when she tried to engage him by having the firetruck (he was preferencing it) rescue one of the dolls.

He would not play ball with her when she tossed him a ball, even when she asked him to. He didn't play ball when she used a doll to ask the doll he was playing with to play ball.

He repeated a question she asked (something like "What would you like to play with?") ten times in a row. That was the longest repeat but he did it a few times.

He was using inappropriate pronouns, including for himself. He would ask a question like "Do you want some more?" whilst snacking to mean "I would like some more". Or we would just say "more" to her (when he knows the whole sentence "may I have some more please?")

She showed him a book with familiar animals and simple pictures in it and asked him what was happening (testing story telling ability which is part communication and part social) and he couldn't do it. Not only that, but he just obsessed about the lamps and lights in the story, naming only two other objects and one activity.

Although he was able to answer direct questions, it was only with pre-learned phrases (for example, he could answer that we went on a cable car in SF) but he wouldn't be able to answer a question spontaneously (like How many cable cars? although he knows the phrase and meaning of "lots and lots"). He also wasn't able to pick up on communication cues either verbal or non-verbal (she started to tell him that the has a dog and he didn't give any responses at all, where he could have talked about her dog, his lack of a dog, the toy dog or the dog in the picture). His spontaneous communication is not frequently present.

he didn't want to feed the "baby" the playdoh cake (social), although he did try to eat it himself and he did offer it once tothe resident doctor who was observing. He "drank" from the cup, but did not share.

Torran also mouthed a number of objects, something he shouldn't be doing any more.

He demonstrated there, and at home, an obsession with spinning items, lights and slamming doors, as well as tossing his head back and forth (mostly when he's tired, but almost always when laying down on his back).

of course, there were many more observations... from a good perspective, he has lots of verbal phraseology, so that may contribute to his lack of gestures, he has formed a good attachment to me (Bruce wasn't there but I'm sure that this implies him too) and he isn't resistant to physical contact (with good eye contact and affectionate), he is not a rigid as other Autistic children (if we change something he is doing) and he calms quickly.

an aside, in the resource teacher's report, she noted that Torran is a happy child, but that level of happiness does not increase or seem to change in response to positive praise, which should generate more enthusiasm in a child.

The bottom line is that, whatever someone's personal opinion of this diagnosis, Torran needs intervention to enhance the skills he has, capture emerging skills and teach him skills that he either lacks or has developed abnormally. The doctor was particularly concerned that he should have aggressive therapy to help in communication and social skills to prevent severe deficits as he grows. She certainly hopes that things will improve for him with therapy.

Of course, the other bottom line is getting him that intervention. What I do know is that as further understanding of ASD comes, more children have been diagnosed. Less funding for support is available, and it generally goes to the more severely Austistic child who needs it "more" (your own personal thoughts of that statement notwithstanding). In the end, we may be in limbo with a child who is moderately-mild autistic in a household of parents who earn a decent income (like with our SSAH, Special Services at Home, application). Private funding is available, but it is expensive. I don't know what coverage we have through Bruce's insurance (he has the family policy).

I'm not surprised that they found "something wrong" as my gut was telling me that he was not developing as well as his peer group, despite his progresses. But I'm not happy about it either. If I had posted yesterday, it would have been a blog full of swear words and anger, tears and hopelessness. I'm not much better today, but at least I can think coherently enough to blog about it.

of course, my less than optimistic future oriented mind also chimes in... so what about future children?
[insert F-word here] As if worry about Torran's health and development and the anxiety of another micro prem wasn't enough.

Little Opera for Little Babies

2011-03-02T08:24:00.001-05:00

An Operatic Fundraiser for The Linden Fun is just around the corner. Tickets are still available. Check it out!

www.musicforpreemies.ca

Where'd we go? San Francisco!

2011-02-28T21:18:00.014-05:00

After posting that I was sick (blech) it was a few days until I mostly recovered, and then we were off to San Francisco.

No, we don't have family there.

It was just a place to go that my timeshare company had availability in Bruce's year ahead planned out week off.

Anyways, off to San Francisco in the wintertime it was! It doesn't rain in California from April to October, for the most part. We arrived at the tail end of the rainy season aka winter. It was very amusing to watch daily weather "Storm Watch" reports. There was even - gasp - a dusting of snow in the Twin Peaks one morning... an event not seen since the 1970s. Yes, thank the Canadians.. but not us - it was those Montrealers we bumped into who brought it with them!

I've a lot to share about SF, but my brain is mush from a horrible night sleep last night (fearful of sleeping through the 4:30am alarm) and not getting rest on the plane because I was holding a sleeping toddler. So, I'll be putting much more information up over the next few days, but to start things off, here's a smattering of photos.

Day One: Torran discovers the joys of chasing pigeonsDay Two: Torran discovers fish in the (not so great) Aquarium of the Bay on Pier 39

Day Three: The first of our bus tours with City Sightseeing San Francisco tour bus company (awesome job guys!) takes us over the famous Golden Gate Bridge.

Sadly, Bruce spent the rest of his afternoon and night in the hotel room with gastroenteritis from some unknown source. Torran napped and then he and I took a stroll about. It was a quiet evening for me.

Day Four: A wet rainy day but Bruce sucks it up for a trip to Alcatraz prison; here, in an isolation cell.

Day Five: much better weather so a visit to the California Academy of Sciences part natural history museum, aquarium, tropical bio-dome and a planetarium, all in the lovely and spacious Golden Gate Park.

Day Six: today's of frivolity started off with a trip to the SF Zoo where the Birthday Boy enjoyed a short trip on a *cold* lion.

Day Seven: today was the last day and we started it off with a trip to Boudin Bakery in Fisherman's Wharf for coffee and muffins - sour dough bread is their speciality and we'd had lots of it but it's just not to our tastes at 10am on a Sunday. They make sour dough loaves in the shapes of alligators, crabs, turtles, fish and teddy bears too! That morning we took the Ride the Ducks Tour, which Cpt. Duck Rogers was graciously kind enough to let post-Bday Bruce drive once we were in the water.

Details of this little sojourn to follow!

urgh

2011-02-16T21:00:00.001-05:00

sick
blech

So That's What I've Been Doing Wrong...

2011-02-10T12:53:00.003-05:00

http://news.yahoo.com/s/ap/20110209/ap_on_re_us/us_infant_found_arena

So this American woman allegedly unknowingly gives birth in a toilet, but can't remember it and didn't know she was pregnant. And apparently, the baby was found with its head propped up on the toilet seat. Given that babies are meant to be born head first, who turned it into this position?

Maybe the reason I'm not getting pregnant is because I'm not this ... stupid.

The Way He Moves

2011-02-07T15:16:00.003-05:00

A year ago, Torran started walking with his AFO (ankle-foot orthoses - his are the hinged kind as seen in Fig 2 in the link) braces. At that time during the assessment, he was attributed with falling arches, stiff and narrow ranges in his knees and ankles, external right leg rotation and hyperextension of his knees. On a good note, he was confident and had a wide stride length. The latter, however, combined with his less than patient activity level and the tendency of his knees to give out partially, contributed to an unsteady gait.

After our time on the waiting list, he's had 12 weeks of physiotherapy for his gross motor movement in his lower legs and torso stability. It has helped, but he's still not as stable or physically competent as his peer group (simple example: he can't jump more than twice in a row before losing his balance, other tots can jump up and down repeatedly... he also can't do stairs on his own safely, or walk in a straight line). We have a "time off" period (which just means that they can rotate through another child for 12 weeks) and we start again in May, as indicated after another re-assesment.

He still has fallen arches for which I'm now doing a different foot stretch, turning his foot inwards and upwards. It's not comfy for him. We're also doing sensory stimulation exercises for the soles of his feet, and I want to start some massage for the tight muscles.

Interestingly, one of the physios who has seen Torran has pointed out that whilst he doesn't seem to be tip-toe walking, which is a bad thing for development, he is not fully planting his heel on the ground, unless he's standing. It's hard to notice on a fuzzy carpeted surface (like our basement floor), but it's just perceptible on a flat one. Instead of a normal heel-strike walk, then, the middle part of his foot is striking the floor first because his bones are actually changing their rotation. It's nearly impossible to replicate for an adult with a properly functioning foot. In the long run, it can be a problem for his posture and balance.

The AFOs come to behind his knees to push them forward into a proper resting position. Otherwise, his centre of gravity is pitched forwards. This adds to his lack of balance when he's rushing around everywhere. However, he's also getting a little knock-kneed. So we're cutting the AFOs down to SMOs (Supramalleolar orthoses, figure 9 in the link) just to see how he tolerates it but we have to watch out for the knock-knee because the SMOs do not correct for that.

As a point of interest, the physiotherapist who is involved with the monitoring of the AFO/SMOs said that some of her teenaged clients chose AFOs for colder months and SMOs for cooler months so they can reasonably wear clothes that are both seasonally functional and more like their peers.

And just to add one more complication to the mixture, his calves are underdeveloped because the ankle cannot have a full range of motion in the AFO. The calf muscles are developed with use by the foot moving up and down, hinged at the ankle. Less movement, less muscle. To my mind, this is easier to sort out, though, with exercises for the calves and time out of the braces. I mean, if the skinny boys in the gym can hulk out with calf raises and stepper machines, why not mine?

The Epitomy of Our Country's Health Financial Problems

2011-02-03T17:41:00.003-05:00

Patient arrives to desk and sits down as she is greeted by the nurse.
Triage Nurse: "May I have your health card please?"

Patient digs through her purse [card not being ready in hand]: "Well I don't have an OHIP card because I'm from Quebec but I live here now. It's expired anyways, so I guess it's ok if I give it to you."

Triage Nurse: "I'll let the Registration Clerk sort out those details with you. How may we help you today?"

Patient: "Well I've had a cold and now I'm having an asthma attack and I can't breathe."

Triage Nurse: "Have you been taking your puffers?"

Patient: "Well, my ventolin [the rescue inhaler no patient with asthma should be without, of which several puffs are used to treat an asthma attack] ran out and I don't have a doctor here yet. I took my (puffer name) twice a day [that's the way it is prescribed]. So I don't feel any better."

Triage is completed, the patient în no distress whatsoever, receives her CTAS score, and she sits down at registration.

Registration Clerk: "Because your card is expired, you have to pay for today's treatment in the emergency department."

Patient: "Well I only have American money."

Clerk: "That's okay. It's going to be about 3 and change."

Patient: "Sure."

After registration is complete, the patient then goes through the financial process of paying for the registration.

Clerk: "So it will be $320.00 for your visit today?"

Patient: "$320.00?! Oh my God! Why so much?" [this goes up to about $350 on weekends]

Clerk: "Well you are in the Emergency Department for treatment."

The patient refuses to pay, declines treatment and leaves for a walk in clinic.... at a cost of about $60.

So, if this person had a valid OHIP card, your tax dollar would have been billed $320 for her less than serious asthma attack which would have been avoided if she`d seen her family doctor or gone to a walk in clinic and kept her ventolin prescription up to date.

Oops, I Forgot to Mention

2011-01-27T23:11:00.002-05:00

Torran has been in a 12 week physiotherapy program for his cerebral palsy. Now, we know he's not hugely CP compared to some kids, like the triplets who share the room with us and can't walk or crawl when then should be able to. However, we're entitled to some guidance and exercises to make him safer with his mobility. The leg braces give him alignment. Then he has to be shown how to walk, run, and step again.

This past monday was week 11 or 12. Torran rode the tricycle down the hallway for the first time all by himself. He wasn't steering, mind you, and his feet were strapped down to the pedals. But the important thing is that his brain was co-ordinating the right and left hand sides of his brain to get him to locomote. It's not quite the same as walking because that's just swinging your legs. It's not as complicated a brain signal as holding paper in one hand and cutting it with scissors in the other (two distinctly different actions).

But yay little man, you did it!

Next week we have his review and then they'll decide what to do with him now. We feel guilty getting help for him compared to the many children we see at the rehab hospital. At the same time, he isn't quite as good on his feet or as safe as his peer group. (We went to visit twin boys yesterday who are a month younger than Torran but weren't premature... when they jump, they keep going up and down up and down up and down until they get tired of it. Torran can't jump twice in a row without falling over)

And we get up at 6am to beat the rush hour traffic and traverse to the east end of the city each week to make these appointments.

So we're challenged now... push for more or have a break with monthly consultations and a bigger push at home... problem is, we can't replicate all of the exercises for lack of equipment (like the treadmill that he walks on, holding onto a cross-bar whilst looking in a mirror, for ten minutes). or will they discharge him completely because unlike some of the other kids at the rehab, he's motoring?

So, What Does One Wear to a Turkey Basting Anyways?

2011-01-26T17:38:00.007-05:00

After a year of trying to conceive both naturally and with medicated and timed cycles, with one miscarriage during that time, Bruce and I have just stepped into the first level of "artificial insemination".

Basically, they take his goods, jazz up the motility in a sperm wash, (for him it was 60% to 99%) and use a long thin catheter (the "turkey baster"), to put it in the uterus and bypass the mechanics of the vagina and cervix at the appropriate time as monitored by ultrasound. This cycle I didn't use any ovary stimulating drugs because my doctor didn't want to change two treatment modalities at a time (I wanted to change the drug and do an IUI - intrauterine insemination).

It was totally unromantic. And only has a 15-20% chance of success, even with all the ducks lined up in a row.

And in our case, ironic. When we first faced this option before I became pregnant with Torran, I was very upset that Bruce did not want to be present for the process because it was too clinical. The irony - I had to go and be basted on my own anyways as Torran had a physiotherapy appointment one day, and playgroup the next, which required Bruce to be with him. (an aside: the current trend towards IUI is do only do one. There is less convincing evidence that two days of IUI in a row brings more sucess. We had to do two days in a row because of my timing of ovulatin and the hcg shot.)

Unromantic, flying solo and clinically dry.

And after the five minute process is over, do you say "was it good for you?"

Dear A-Holes

2011-01-19T14:01:00.004-05:00

I tend not to write about all the stuff that happens at work, more specifically my opinion on all the crap that happens at work, because I am uber conscious of the Big Brother effect of being a Professional. And yes, I did mean to capitalize P for professional.

Nurses don't just go to school and get trained in order to treat and torment the public with their diverse range of caring and complacent attitudes, well honed and horrible skills. We are a body of people who shelled out tens of thousands of dollars to earn our place as a Profession. As big P professionals, among other criteria, we must have a body of knowledge that perpetuates itself to the betterment of our clients and our industry. We engage in self-regulatory practices, ongoing education, and adhere to a strict code of ethics. If we don't we can have our Registration (akin to a Licence) revoked or suspended.

(although, if you linked through to that wikipedia article about the criteria of a Profession, I have to say that Nursing is very sorely lacking in the criteria of "High Status and Rewards")

So even though I'm not at work when I'm typing away on my blog, my personal thoughts have to be well phrased and at times guarded, because I may be called in front of a disciplinary panel for being to ... human.

Now, don't get me wrong, I'd never share confidential details about a patient online - heck I don't even give out information on the telephone if I don't know to whom I am speaking.

But sometimes I just have to vent, especially after some of the folks I had to care fore this week. And my poor husband can't always be the brunt of it.

So, if you find yourself wondering next time why your wait time in the emergency department or urgent care is in excess of several hours, and you're getting pissed off about it, consider the throngs of people around you, and that
a) several of them don't need to be in Emergency or Urgent Care, and yet, here you all are, presenting your needs to the same small group of people (ie. more patients then staff to do the work. You do the math)
b) several of them are there because of something they have done to themselves, knowing it was harmful (including silly things like shovelling snow with a history of heart attack and bypass/stents inserted)
c) many haven't bothered to go to their family doctor, or a walk in clinic for their minor illnesses (which, incidentally is far cheaper for your tax dollar... $350 vs $75 or so)
d) many have had this minor illness for several weeks and have just decided to deal with it today (oh...so you say your family doctor isn't available at your convience today? Big shock. But that's not really an emergency)
e) some of the folks holding up the beds inside the department don't want to go home because they don't want to look after themselves, therefore, you have to wait for them to be admitted, get a bed in the hospital and eat up all your tax dollars (refusing to pay for respite care does not, IMHO, count as a medical necessity for hospitalization)
f) some have been to see several doctors this week but came in because they don't believe that medications require time to take effect in the body, or haven't started medication because they want a second opinion, or didn't bother to the script filled so they feel worse
g) several, dare I say most, don't care about anyone else's issue but their own, even if it means that they waste your tax dollar and your time, whether or not your health care concern is truly greater than theirs

And whilst I'm venting, try to appreciate that the staff are people too - we have feelings and don't generally respond well to being yelled at, we have immune systems that can get your cold just as easily as you got it from some else (so put a freakin mask on!), and we have families who we have to look after once we're done looking after yours. Triage nurses *are* capable of "eyeballing" you and determining whether or not you are about to expire without even touching you (if you can yell at Triage, especially whilst standing, you're pretty much in a good place). You may not believe it, but hospitals are constantly trying to shave off minutes in Olympic training fashion to make your length of stay faster, all without increasing the staffing ratios of the people who are working their assess off to investigate and treat your health concerns (higher ratios could mean faster service, but it would cost more money).

And, generally speaking, people don't die from a cut finger - even two. So please, go take a number, continue to apply pressure and elevate your f*ing dressing and have a seat in the waiting room for triage.

New Year, New Concerns

2011-01-17T21:16:00.004-05:00

It's been a couple of weeks since I last wrote. The first week of January found me in the last planning stages of my first (autocrated) SCA event. It was a 12th Night celebration and the day turned out very well. Update and pictures to follow.

The second week was recovering from the first, catching up on work, and contemplating our new adventure in Torran's journey.

In December we met with a neurodevelopmental physician as part of Torran's ongoing follow up with Bloorview Kids Rehab. His first appointment was in 2009 before he started walking. This clinic was not part of our normal NICU follow ups through Sick Kids.

We requested the referral at some point in 2008, perhaps early 2009, as a result of concerns regarding his development. At that time, most of them were about his motor developments. The neurodevelopmental clinic does a complete assessment, not just physical, and they intended to follow up on Torran after about a year.

That time has arrived, and perhaps at just the right moment.

Torran is in what I call a grey area with his development. We recognize that he has cerebral palsy, albeit mild. He can walk and talk, but not like children of his peer group, whether they are premature or not. Granted, there aren't too many kids that we know from the NICU who have been through the same extent as Torran and are his same age. However, as early as last summer I started to get some warning signs that things may be awry.

For example, my friend's son is a month younger than Torran. When the two boys were side by side playing in the summer, the other boy had much more developed communication and interactive skills. Torran, on the other hand, could recite all the numbers, colours and shapes that we'd programmed into him (quite a few, at that). My friend, also a nurse, said she thought the kids were smart each in their own way. I bought it at the time.

Now, I'm not so sure.

Torran still doesn't seem to engage the way other 2.5-3 year olds do. When we visit friends with kids of the same age group, I tend to leave with a heavier heart and brewing concern.

When he hears a sound, he announces that he hears it, but doesn't call either my attention or Bruce's attention to it. He will bring a book to me, naming me to read it, but he won't leave a room saying "let's go" or "come with me". So he displays a partial engagement in his activities, although he likes playing with his parents.

He can talk, boy can he talk. But much of his speech is parroting what we say immediately after we say it, saying the same thing over and over again or repeating memorized stories or songs. It's called echolalia. Yup, it turns out even the cute behaviour of reciting his stories as we go shopping (or at 5am!) may be atypical development. Echolalia is normal for children as they are growing up, but it peaks at 30 months and is supposed to decline after that.

Torran is currently 31 months old corrected... so you see the grey-ness? When we ask Torran what he would like to have for lunch, generally he just parrots the question back to us. In the last few months we've been working on him answering yes or no to questions. He's starting to get the hang of it, but even that simple function isn't always reliable.

Echolalia isn't our only concern. Unbeknownst to us, that he neither nods or shakes his head or use gestures when he talks may indicate another atypical developmental pattern. He can point to indicate to things, but he doesn't always do it. He never leaves a room looking for someone to join him. He still only does parallel play with other kids (or happily by himself). Whilst he has some imaginary play (any long slim object is a phone), that play does not extend to figures or animals. He doesn't have any play talk or interaction between the toys. He makes eye contact with people mostly appropriately, but he won't follow conversation between two people. He'll play catch with one person, but not turn taking with more. He will ask questions, but today he didn't ask the therapist "what is next" between exercises when I prompted him (to get him to learn how to be an initiator). Much of his speech seems like phrases that we've programmed into him, without him creating spontaneous dialogue on his own. The list of seemingly minor things goes on.

Of these, I surprised myself as I verbalized my concern that he seems to be a really happy child, which I never mentioned to Bruce. He doesn't have toddler tantrums such as they are supposed to be. It's called the "terrible twos" for a reason - children are starting to feel a wider range of emotion, but lack the words to describe how they feel. If Torran gets upset about something it's very brief and he is easily re-directed. He may keep coming back to the behaviour that he's been asked not to do (like banging the window), but that initial toddler outburst when we pull him away or take away a toy is very brief. He's seldom scared and has very little stranger fear. Sure, having an easy going toddler may be great for a mother... but having a young man who doesn't recognize danger or fear situations appropriately may wind him up with a beer bottle in the face... or if he laughs when he's getting into trouble at school may grant him extra detention.

As an aside,the same day as Torran's assessement (part two was in Jan), I confessed to Karen that this was a concern and she knew *exactly* what I meant, and ironically had wondered it herself about Hunter on the same day. She had one woman tell her off for being concerned in such a manner because she should be grateful that her son was so easy to handle.

It could be that he is a little slower to grow into normal behaviour, given his history, that he's a boy (yep, people have excused it away through his gender), it's the way we have done things a little bit differently in raising him (like speaking behind him so he wouldn't see gestures and repeating ourselves a lot), or that it is just his personal calendar in his own happy personality.

Or he could have a developmental problem, the extent of which will truly be uknown until he reaches school age when he should be able to reason, understand abstract concepts and needs to have appropriate social skills. Sure, he can count to a million and name a million colours, but what will he be able to do with memorized information?

As a result, in the spring, the neurodevelopmental clinic will begin formal testing on him in three key areas to determine whether or not he has a behavioural or communicative issue. Right now, that falls under the Autism Spectrum Disorder.

Although I can't say as I'm surprised it's come up, I also must admit that I'm not incredibly happy about it. doesn't he have enough problems to worry about? One of my best friends has autism in her children, one more than the others, and her opinion, Torran has little to worry about (in comparison). My uncle's son is very autistic from an unknown cause. It isn't known to be a genetically transmitted disorder, but then again, not everything is known about ASD. So I worry. Of course.

The doctor agrees that there are some areas for concern. She doesn't want to rush a diagnosis, but thinks his case merits further investigation. If he doesn't meet all the criteria for ASD, then we continue to monitor his progress and intervene however we can.

This is the best way to stress out a future oriented person. I want to know what the problem is, and I want to know now so that I can work towards whatever solution or improvement I can.

In the meantime, I'm speaking to Torran (and soon it will be Bruce as well) like I'm a children's tv character with over exaggerated gestures and nodding of the head to the extent that I'm getting a neck strain. We're making changes in how we direct Torran's attention to our modeled behaviour. I'll be re-visiting his play structure with the resource teacher who has been working with him since a baby.

And I'll just have to steel myself against what I see in the advancements of my friends' children. I never want to take away from Torran the advances that he has made, and the milestones he has accomplished. Each time I see children with more disabling limitations that Torran I remind myself to be eternally grateful that he came home alive, healthy and with so many successes.

Some People Really Know How to Ring it In

2011-01-02T12:12:00.002-05:00

Looks like I have a party animal in the making! Must watch out for this one.

(This is how we found him an hour after we put him down to bed with the door closed)

Happy New Year! - After

2011-01-01T00:00:00.001-05:00

funny...feels a lot like last year so far

Happy New Year - Before 2011

2010-12-31T23:52:00.001-05:00

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...

2010-12-22T18:37:00.000-05:00

How I Made Santa Cry

2010-12-19T21:17:00.003-05:00

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

2010-12-13T13:12:00.002-05:00

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

2010-12-11T13:59:00.002-05:00

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

2010-12-06T22:40:00.001-05:00

Oslo
and
Scotland

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

Oslo, Norway

2010-12-01T12:08:00.034-05:00

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