Queensland Ambulance and Boo-Ya! Boots

The past few weeks have been a whirlwind for me, and I haven't logged it, so this is a long post. The first adventure was riding with the Queensland Ambulance Service on a Friday night. Since our territory was downtown and the Valley (think Whyte Ave in Edmonton), we saw an awful lot of intoxicated/drugged people, and lots of vomit. Only one broken ankle, also brought on by inebriation. It was a busy night, and the attendant I was with allowed me to do blood sugars, blood pressures and ECG leads.
I also allowed myself to fulfill a desire of 19 years, and bought myself knee high Doc Martens black boots. They are fantastic, and I always feel a little wicked when I wear them. They seem to have broken me in, starting with a blister that covered most of one heel. Now they are super comfy, and I love them as much as a woman can love a pair of boots (which I’ve heard is a lot)
The exam preparation was a crazy week of stuffing my head full of stuff. Lots of caffeine and chocolate went into it. And a little wailing and gnashing of teeth. The exam itself was spread over two days, and was mentally exhausting. After it ended, I gave myself the best present possible, and had an hour long massage. Heaven! Then packing up began. I am putting all my things in storage over the Christmas break, and Rob and I will find a new place to live in January.
I am now doing my elective placement in Bundaberg for 4 weeks. I start off with two weeks of Palliative Care, and the 2 weeks of Emergency. I drove the 4 hours north of Brisbane on Saturday, and took Apollyon with me, as I found a place that would let me keep her. She was distressed to be in the car at first, but then found her favorite spot was on my lap, co-piloting. So cute. My first day on the wards was definitely interesting: psychosis, uncontrolled cancer pain, dysfunctional family dynamics and Cheyne- Stokes breathing. I was paired up with a Dr. John Chapman, and we had what he would call a hectic day. We had 4 admissions from home, via the ER. They were all terminal cancer patients having breakthrough pain that was not being controlled, and 1 had difficulty breathing because the cancer in his lungs were squeezing his windpipe shut. One lady thought she was in India and that people were trying to poison her and begged us to take her to the hospital....
We are expecting a few departures this week. I have learned an awful lot about morphine and all its opioid equivalent friends. And that terminal cancer pain requires a LOT of morphine. For example, one patient is getting 300 mg of morphine per day, plus Fentanyl patches worth 450 morphine mg equivalents. The average ER visit type trauma pain would get you 2.5 mg of morphine. And unfortunately, when they land in ER, that's ALL THEY GET. Can you imagine the suffering if you were at those levels and then bumped down like that??? Unfortunately, these palliative patients are sometimes dismissed as drug seekers, or worse, subjected to rafts of tests and scans and probes to heroically find out the problem and "fix" them. The problem is they are dying, their bodies are changing in preparation, and it's just not fixable. The palliative care area has evolved to help make the last months, weeks and days as comfortable and the least distressing for the patient as possible. That does not include stuffing them full of IV fluid which ends up swelling their legs and bellies (i.e. not in their blood vessels), and subjecting them to painful and invasive tests that will not change the course of their disease or its management. So we spent a fair amount of time in ER rescuing patients from earnest doctors.
The end of the first day was good, satisfying, but I was exhausted. I went home at 7pm, put on my jammies and went to bed. The second day was also a lot of running around, but I don't feel nearly as tired. I guess it's just the transition from sitting on my butt studying all day to actively seeing patients. I am LOVING every minute of finally getting to interact with real people!!!

Car freedom

For the first time since 1998, we don't have a car payment.  As of Sept 22, the Matrix is paid for.  And for the first time ever, I had a car warranty expire on time rather than distance.  The 5yr/200,000km warranty expired at 5 years and 198,000km.  Last Saturday the Matrix did roll over to 200,000km or 0.2 gigameters on the way to visiting Mom at the bird sale in Innisfail.



The bird sale was cold this year, even colder than usual.  The sale was slow too, so Mom packed up early and spent more time visiting her friends Helen & Paul.

The big news!!!

Barb's Facebook status caused a flurry of comments, so I guess I should fill in the details.

As you may or may not know; Barb is in Australia studying medicine while I am still in Canada waiting for my working visa (GSM subclass 175).  When I applied processing time was about six months.  I had applied in July 2008 with Barb starting in Jan 2009.  We then found out it was taking a bit longer because of backlog from a rule change in 2007.  Then more months passed.  Then in May 2009, the Aus Immigration department cut back the number of people they were letting and changing the priority the were processing the visas in.  Then just last week the changed the rules again.  The estimated time of processing moved to 2012.  That's right, four years to process a visa application.

We began experimenting with a few other possibilities.  We thought of me coming to Australia and then applying in-country because processing is much faster.  But, that doesn't work because Aus uses a points system and because I am now 40 years old, I get 5 less points than when I was 35-39.  This means I no longer have enough points.  I could have gone as a spouse on Barb's student visa, but I would only be allowed to work 20 hours a week.  It's pretty hard for two people to live on one part-time salary.  We were even toyed around with Barb coming back to Canada and try again to get into a Canadian med school.

Then out of the blue, my mother comes up with a plan.  She was planning to leave some of her farmland to each of her kids in her will.  She decided that the two quarter sections that I would be getting would be much more useful to me now than after she is gone.  Her plan was to sell the two quarters and give the proceeds to Barb and I.  With  money in the bank, plus me working part-time, we would be able to live TOGETHER until Barb graduates med school.

So, last Thursday she put the land up for sale.  By Sunday she had two offers, plus a third interested party.  She accepted the offer tonight with possession taking place October 16.  The offer was for the full listed amount. If nothing goes horribly wrong, this means that I will be able to fly back to Australia with Barb after her Christmas break in Canada.

HURRAY & PRAISE THE LORD!!!!  

For all of you praying for us, please continue to do so until the sale is final (and afterwards is good too) .

The “Oh, S%#t trees” are blooming!

University of Queensland is covered with Jacaranda trees, along with gums, tulip trees, sausage trees, bunya pines and more. But the Jacaranda has a special place with students. It's known as the "Oh s%#t tree", because it's blooming signifies that exams are near, and one had better be getting catching up on studying. It is actually superstition on campus that getting hit with a falling blossom is bad luck for exams!
They are apparently blooming early this year, because of early rains and warmer weather than usual. The story can be viewed at:


I think it's just for us med students, who have our two day finals on October 20 and 21. Oh, s%#t.
In other news, Brisbane got hit with a whopper of a dust storm, the worst in 70 years. It blew up from Sydney (where planes were being rerouted to Brisbane because of visibility), and covered everything in an orange haze. Brutal for anybody who has lung problems, such as asthmatics. For the whole day, I felt gritty, tasted grit and smelled grit. Inside and outside. It apparently even made international news! My flatmate Brady got some amazing pictures:

And the next day, just like that, it was gone, and we are back to regularly scheduled beautiful weather. Freaky.

Help! I’m being Aussified!!!

On the drive to school today, I said out loud, "I hope I can find a park...." And stopped myself. It came out without thinking, and it is exactly how the Aussies would say they hope they find a parking spot. So I am absorbing (or being absorbed) into the Aussie culture. Some other things I have caught myself saying or thinking:
How ya going?= How are you?
Sunnies= Sunglasses
Togs=swimsuit
Arvo= afternoon
Esky= Cooler (as in Colemans)
Brilliant!= Awesome!
Beyond the Black Stump= the Boondocks
Bogan= Trailer trash
Bottle Shop= Liquor store
Winge= whine
Macca's= McDonald's
Chippie=Carpenter
Sparkie= Electrician
Tradie=tradesperson
Postie= Mail Carrier, or the dirtbikes they ride on the sidewalks
Truckie= Truck driver
Bull bar=Moose rack
Ute= think the old "el Camino" half truck-half car. For some reason they are popular here.
Try= Goal in a game
Panel beaters= (car) body shop
Uni= University
Sister= Nurse (I still don't know what they call male nurses yet)
Feeling crook= feeling sick
bub= baby/toddler
dunny= toilet or (more usually)outhouse
Panadol=Tylenol
stuffed= broken
petrol=gas
hire=rent (unless it's a place, then it's still rent)
lollies=candy (including chocolate)
TimTams= fabulousness incarnate!!!

In other news, the cat, Apollyon, has had a growth on the inside of her cheek since June. I thought it had to do with losing her baby teeth and getting her adult teeth in. The growth persisted, however, and when I did some PubMed searching (how researchers Google), I found that most oral growths in cats are malignant. Yikes! So I took her to the vet, who after examining her thought it was very strange, and didn't look like a cancer or anything else he had ever seen. So he pumped Polly full of antibiotics and an antiinflamatory to see if it would reduce. It didn't, and so today Apollyon had mouth surgery. I just got back with her. She is doped up on morphine and feeling NO PAIN.........
My wallet, on the other hand, is in pain. $400 worth. Ooog. Expensive cats should come with a warranty...

Wow.

I just came back from a talk by Dr. Richard Deichmann, who is the chief of Medicine at Memorial Hospital, In New Orleans, Louisiana. He recounted the crisis of the Katrina Hurricane and what happened at his hospital, where 2000 people came to shelter at the 350 bed facility. After a few days the generators supplying emergency power failed, and people began dying. The dead were left in their rooms, as the basement morgue was underwater. I cannot imagine the smell, combined with the human and animal waste in a Louisiana summer. They somehow managed to evacuate the survivors to a field hospital and safety. Not only was that an amazing story, but he also detailed the aftermath- friends and colleagues committing suicide due to Post Traumatic Stress, and the emergency preparedness plans that have now been put in place.
The comment that stuck out at me the most was from his colleague: "It was both the most difficult and yet most rewarding time to be a physician. Totally unencumbered by getting paid or area of specialty, we were just HELPING people." Awesome.