Busy December

  I can't believe we haven't updated the blog since 29 November.  Here is a bit of a run down of what happened.

  First off, Barb's parents arrived 4 December.  They were "lucky" enough to arrive on the hottest day since 2001.  It was 38 that day.  They almost died when they left the airport.  On the plus side, when it cooled down to 28 two days later they didn't think that was too bad.  We toured around Brisbane for a few days.  (See Pics)

  Next up was Barb's grad ball.  (See Pics)

  The next week we drove up to MacKay to see where we might live.  We took the slow trek north, heading through Bundaberg, Tin Can Bay, going to the reef at Lady Musgave island, heading through Rockhampton and finally arriving in MacKay four days later.  The next day Barb & I went house hunting while Rudy & Susan sat on an outdoor patio drinking coffee.  We put in two applications for rental houses, but haven't heard back yet.  We then drove back to Brisbane over two days.

  Next up was Barb's actually grad ceremony  (See Pics)

  The last few days have involved less driving.  We went Yatala for pies (meat pies) and a saw Skyfall and the drive-in.  We went to Stanthorpe for a couple days basically to eat.  Went to Queen Street mall, Carols by Candlelight at our church and saw the lights at Stafford Heights Baptist.  Christmas Eve we went to Bulcock Beach for the afternoon and in the evening Barb made a delicious turkey feast.  Christmas morning we had the required Eggs Benedict before went off to church.  In the afternoon we opened presents and nice lunch of cold cuts, prawns and salads.

  This morning we kicked the Klassen's out of the warm and sent them off to the land of snow. It will be about 50degrees colder when they arrive in Edmonton tomorrow.

  All in all it was a great visit.  I think we may be having them back as they mentioned a few times that "next time we should...".

Dr. Bradshaw!

Hello world! I have just received my OSCE results and have passed the final hurdle. I am now officially Dr. Barb!

Barb's last day of school... ever!

So last Friday was Barb's last day at the hospital as a medical student.  She has her lunch packed and ready to go.  This is the end of 25 years of school.  Her last exam is on the 24th of November and after that she is Doctor Bradshaw.  

Palliative Care, Smiling Billy and the Death Moth

I have been on placement with a Palliative Care unit for my elective rotation for the last 8 weeks.  It has been a great experience with an enthusiastic team of people.  Most people think it must be a very sad place to work. It's not. We make such a positive difference that I can't be discouraged with it. I also really like the extremely relational nature of the work that factors into the medical problem solving. It is lastly a very good way to observe the end stages of various pathologies.

I agree what Marijke Durning, RN has written about the discipline, and so I'll share it here:

Top 10 Myths of Palliative Care

1. If I accept to receive palliative care, my doctors have given up on me.

Palliative care doesn’t mean that doctors have given up on a patient. When palliative care is proposed, it means that the healthcare team has realized that the disease is not curable and that death can’t be avoided. By offering palliative care, you are being offered the chance to live out your remaining days as comfortably as they can be, under experts in end-of-life care.

2. Palliative care means no more treatment.

When a palliative care team takes over the care of a patient, treatment doesn’t stop. Treatment and therapies can continue, but they have a different goal. For example, if you have cancer, you still may be offered radiotherapy. However, the radiotherapy isn’t to cure the cancer but to help shrink the tumor that is causing pain or discomfort.

3. Palliative care is for people with cancer.

Palliative care is offered to anyone who is dying of a chronic or terminal illness. While many people who receive palliative care are dying from cancer, some have AIDS, heart disease, renal failure, multiple sclerosis, muscular dystrophy, and many other fatal illnesses.

4. Palliative care is for old people.

Many children are diagnosed with terminal illnesses. They may be born with a birth defect, such as a heart defect, or a disease that will cause them to die as a child or they may develop a terminal illness later on in their childhood. Palliative care is an important part of their medical care as they reach the end-of-life.

5. Palliative care means I’m very close to death.

When someone is transferred to the palliative care team, they may die within days or weeks, or they may live for considerably longer. Palliative care isn’t offered according to the amount of time you have left, but according to how much you need the services of a palliative care team approach.

6. In palliative care, they dope you up with narcotics or opioids until you die.

Pain is a big issue in palliative care. With some diseases, there is often a high level of pain, but in other diseases, there isn’t. If your disease does cause severe pain, you may be treated with narcotics or opioids, but only if you need it and only at the dosages you need it. The goal of palliative care isn’t to dope you up, but to make you as comfortable as possible during the end-of-life period. (Barb: This is an enduring myth, even among other health professionals. I have seen many patients who have actually had their opiods REDUCED while admitted under the Pall Care team. Morphine is not the only trick we have - there are other pain control medications and strategies used. )

7. If I get morphine, I will stop breathing.

Morphine does slow down respirations in many people. But proper doses of morphine usually doesn’t cause someone to stop breathing.

8. I can only get palliative care if I’m in the hospital.

Palliative care services are offered in many communities. Care at end-of-life can be given in a hospital, stand-alone residence, or at home, depending on the resources available.

9. My family can’t help if I’m in palliative care.

One of the benefits of palliative care is that it’s not only for the dying person. The palliative care team cares for the dying patient and his or her family and friends. The care at the end-of-life isn’t just about physical comfort, but it’s about emotional, psychological and spiritual support for everyone who loves and is part of the life of the dying patient. (Barb: We even allow pets to come and visit their owners!)

10. I will have no control if I agree to palliative care.

Palliative care is a specialty in medicine, just as is cardiology, pediatrics, and obstetrics. None of the specialties take over, they specialize in helping the patients under their care. If you are a patient in palliative care, you are consulted and are part of the team for as long as you are able to be. (Barb: once a patient is no longer cognitively able to accept or reject  treatments, the decisions usually are discussed with the patient's appointed Power of Attorney- usually a family member. Decisions are not made behind closed doors without discussion.)

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There is also a little bit of intrigue to keep the job interesting. Apparently there are rooms on the unit that are known to be "haunted".  Numerous patients with no relation to each other and separated by time have described the same visitor to specific rooms. Their stories match right down to ethnicity, type of jewellery worn, or where the visitor sits in the room.  Fortunately, none of these encounters have been scary or malevolent. Usually it appears as a visitor, stays for a while, then leaves:
One room is visited  by a bloke called  Billy.  He is an indigenous man (apparently the first occupant to die in the room). He sits in the corner chair and smiles pleasantly.
Another room is shared with a tall man who wears a bracelet and walks from one side of the room to the other. 
A third room is visited by a mother holding a baby.
As a Christian, I am not 100% sure about what I think of ghost stories.  They are actually not that uncommon in hospital settings.  There is a link to explore HERE  .
    Lastly, there seems to be a pretty moth that has taken up residence in the unit.  He seems to show up in different rooms. The nurse manager has nicknamed him the "Death Moth".  It is true he has appeared in a few rooms where that patient subsequently died. However, being a Palliative Care unit,  approximately 75% of admissions will end their life here.  So not ready to chalk that up as paranormal yet. Although there is a cat who seems to have this ability! Links about Oscar the Cat HERE and HERE. He's even had his story published in the New England Journal of Medicine: HERE.

Poutine Found

  Barb found a place in the valley that serves POUTINE.  The owner can't source cheese curds. He has actually tried. There was a Canadian Club at Bond University that convinced a dairy to make some for them. Unfortunately they decided not to do it anymore. I have to respect the guy for at least trying to do it right.  But mozzarella and gravy are very yummy on fries too.
(5 Dogs on Brunswick Pedestrian Mall)

I'm a sucker for a happy theropod

I have to admit, I bought it for the dinosaur. He just looked so darn HAPPY. Good thing it smells nice, too.

Our Nearest Neighbour has a Planet.

  A planet only 13% bigger than Earth was discovered orbiting Alpha Centauri (the closest star system). Problem is that it orbits 10x closer than Mercury and has a surface temperature of about 1200C. Not a good holiday destination.

 There may be more planets at Alpha Centauri, but the close-in one is right at the edge of how sensitive the detection system is. There is a new detector going online in 2017 that would be able to detect a Earth-sized planet orbiting at an Earth-like distance. I guess we will see then.

 Artist rendition

More info at  http://www.eso.org/public/news/eso1241/

and http://en.wikipedia.org/wiki/Alpha_Centauri_Bb 

Paediatrics in a nutshell

A friend of mine is on her paeds rotation now, and posted this photo of her experience. 
Yup. That about sums it up.

More weird things while shopping

Full time employee

  I just got news today that Australian Immigration has approved my company sponsored work visa.  That means that I'll be able to work full time at Lanier instead of just 20hrs a week.  Finally.
  This week I am in Melbourne on a training course.  We are learning about four different "document solutions".  Basically software that can keep track of your printing, copying and scanning.  To give a full description would take too many paragraphs. It has been a fairly full on course. My brain is full by the end of each day. 
Flying back to Brisbane on Friday after the course.

A few pics from Melbourne:

Further adventures in Cat Shearing

Lately the temperature is starting to hit the high 20s and low 30s oC Polly lets us know she is getting too hot by hanging out in the tile bathroom with  paws in the air, and being more miserable in general. Silly kitty, doesn't she know it's a dumb idea to hang out in a fur coat in summer? 
So I shaved her tonight. Minimal blood was shed. She hates me right now, but she'll feel better tomorrow.

There is enough hair here to make a sweater!

Apollyon thinks if she hides in the litterbox I can't see her.

On the wacky front for cat shearing- what about making sweaters or handbags out of it?  Crazy.

Happy Thanksgiving!

We had a wonderful potluck turkey dinner with 25 friends. There was even pumpkin pie! Everyone brought a part of the whole, and the result was magnificent.
We usually have an even split in numbers between Aussies and Canucks for the event, and it always thrills me to see the Australian reaction to a sweet pumpkin dish (savory is how pumpkin is done here).  A whole turkey is difficult and expensive to get here at this time of year (they come out for Christmas).  So I usually end up buying a turkey breast roast and legs/thighs separately and roast in the whole lot together. Our guest list this year exceeded the space our unit could handle, so we moved the event to the hall at our church. This was good not only from the space perspective, but it hit 30oC today, and it was nice to have an air conditioned space. We have SO much to be thankful for, this and every year. Next year in Mackay!

the immanent transport of a slow roasted turkey (18lbs), gravy and Tim Hortons coffee to enjoy.The car smelled insanely good.

Christmas before Thanksgiving

The Christmas goodies are starting to show up at the grocery store.

October 1. Let Christmas begin!

Seen today at the mall. Oh dear.

Rosie being cute

The pictures on the right are of Rosie tonight being her adorable self. She was waking up in here cat bed after a nap. Below is a pic from a few days back where she decided to curl up in the garabage bin.

The Big News!

On Tuesday, I received a phone call, offering me a JOB FOR NEXT YEAR!!!

 This takes 10 tonnes off my mind, and means that we no longer have to plan for multiple outcomes. WHEW! Thank you, Jesus!
I will be starting work at Mackay Base Hospital January 14, 2013.  My position is that of an intern. (North American med students move directly into fellowship programs, so internships don't happen there)  I will be doing 10 week rotations in medicine, surgery and emergency medicine, plus 2 electives (haven't decided yet).  There is also 5 weeks vacation rostered in!
Mackay is a city of approximately 80,000 that services a population of the wider area of 160,000.  It is 1000 km north of Brisbane, in the Tropic of Capricorn. It is also adjacent to the Great Barrier Reef and several National parks.  It's actually far enough north that we will have saltwater crocs in the river and box jellyfish in the ocean.
Unfortunately that means leaving our amazing church at Windsor Road, and Rob will again have to find a new job, and we will need to find a place that will accommodate our pets.
There are still close to 230 medical students waiting for jobs in Australia upon graduation. If you've been praying for us (and so many have- THANK YOU ALL!) please remember them. A big thank you for all the cheering and support we've received over the last 4 years!
I will happily post more when we know more!

Want fries with that?

Barb received a letter today and this was the stamp; a seagull with a french fry (or chip).  If you have every been anywhere near a fish and chips shop this makes complete sense, but it is a odd choice for a stamp.

Beach lunch

Today I am up the Sunshine Coast to do an install at 1:00. If you are stopping for lunch it might as well be somewhere with a nice view. Spring is here now, so the breeze blowing in off the ocean is quite warm. I really enjoy spring and autumn in Queensland; not too hot, not too cold.

Time Once Again for Procrastabaking!

Ah yes. it's that time again.
Time to avoid reality by doing delicious Chemistry.

I find it interesting that butter is measured by weight (g) in Australian recipes, and  by volume (cups or mL) in Canadian.  The best solution to this is a converter I found at traditionaloven.

The first recipe is one of Rob's favourites that his mom used to make for him with fresh garden rhubarb. I got a copy of the recipe, and so this is what is in the oven presently:

Rhubarb Cake:
1 1/2 cups sugar
1/2 cup melted margarine or butter
2 eggs
1 cup sour cream
1 tsp baking soda
1 tsp baking powder
1/4 tsp salt
1 tsp of cinnamon
1 tsp vanilla
2 cups flour
2 1/2 cups chopped rhubarb

combine and bake in a 9" x13" pan at 350oF (180oC) for 45 minutes



The second recipe is from from my mom, which she got off the radio when she was a young lady. It originated in WW2, when eggs, milk and butter were strictly rationed.   I've also had it at a dear friend's (Dionne M-S) wedding. She baked it due to the fact that it was vegan friendly.  It's so good that it's been the Klassen family birthday cake for years.

Crazy Chocolate Cake:
3 cups flour
8 tsp cocoa powder
2 tsp baking soda
2 cups sugar
1 tsp salt

Combine and make 3 wells in the dry mixture: one big and two little. In the big well put 10 tbsp canola oil; in the smaller put 2 tbsp vinegar and 2 tbsp vanilla

Pour 2 cups cold water over everything and beat until smooth.  Bake in 9" x 13" pan at 350oF (180oC)  for 30 minutes or toothpick comes out clean. Because that's why they make toothpicks, right?

Sort of 13

It is funny how some people try to avoid 'unlucky 13'.

Almost time for MOAR EXAMS!

Paediatrics block is drawing to a close. I can't say it's been my favourite block. But I have learned a lot.

which means yet more exams.....
Must study.......

Can I do it like this?

 

 

But, then....

My goodness! I might get Rob to lock me out. He usually will dis-enable me when I ask him....

Just a small but important P.S.:  Any pictures you see of patients or conditions on this blog are not my pictures. They are not my patients.  They are gleaned off the internet (thanks Google).  I personally believe it is a gross breech of confidentiality to post pictures of anyone you are caring for.  So wonder no more about the poor little guy with the fork in his nose.

Tea Time is Awesome Time

I've noticed some neat-O tea paraphernalia about. It makes me miss our favourite place for tea, Glenn's Tea House on the QE2 Highway between Edmonton and Calgary. They have over 200 types of tea! They also serve these awesome sugar cookies with tea in them. So good.

 It 's right on Gasoline Alley.  If you haven't tried it, you should.  And if you haven't been in a while, go for us, eh?

 Enjoy:

Robot Tea

Sea Diving tea

No matter what you do, you'll never be as relaxed as this guy.

Death Star Tea

"Tea- Rex"

I think I can endorse almost anything with space invaders.

Angel wing tea cookie cutters. Assurance you will always have TWO cookies!

Origami

super practical

Not as practical.

Tea shirts

My personal favorite.

Don't mix these up. Tobacco tea would be horrid, methinks.