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It's nice to see some blue sky today.  It's been a tough week at work and I'm thankful I'm off today.  On Tuesday I spent three hours scrubbed in, wearing lead, assisting one of our rads to put a port in a patient's arm.  We had one port, no spares, no mistakes.  The second port that was ordered didn't show up in time.  Thanks Bard.

So of course a mistake was made but the rad I was working with fixed it.  Three hours is a long time to spend wearing a lead apron though.  It was exhausting but satisfying.

Tuesday morning before I scrubbed in for the arm port, a patient's husband ripped me a new one over the phone.  The sad part is, I didn't disagree with him.  He was right.  We had screwed up everything and nothing had gone as planned for his wife's biopsy.  His wife is on a blood thinner and we couldn't get her INR down.  It's technical I know but that part wasn't our fault.  All of the stuff we did trying to make arrangements for the biopsy were fucked up.  After hours of work, many phone calls, lots of running around from department to department for advice and supplies, we finally got the biopsy done yesterday.  I was with the lady off and on for ten hours yesterday.  A lovely lady who seems to know that she is already dying.  I was thankful we were able to get the biopsy done but to be honest, in the long run, the biopsy results aren't really going to make much of a difference.  Her cancer has already spread to her bones.  So exhausting but not really satisfying.  I did apologize to the lady for all the delays in getting her biopsy done and she accepted my apology with dignity.

Then on the way home there was a broken water main which seems to happen when it's cold and dark.  Took us forever to get home but we made it.

It's January.  Nothing good ever seems to happen in January.  It's cold and dark, although the sun has managed to drag it's ass over the horizon and is shining through the windows now.

Time to climb on my exercise bike and exorcise my demons.  I'm watching The Marvelous Mrs. Maisel and I love it.  It know it's not real but watching strong, brave young women give me strength as well.  I suppose I was stronger than I realize when I was young.  I wouldn't marry my boyfriend when I found out I was pregnant, even though everyone wanted me to.  I put myself through nursing school.  I moved to a new city after graduating, even though I was terrified.  I found love at the ripe old age of forty-nine, a love that accepts me as I am.  I am enough for the big guy and that still fills me with wonder.  

I took Lucy for a walk yesterday afternoon on the paths behind our house.  It was four but already the light was waning, painting the sky beautiful colors.

I put up my Christmas tree yesterday and wrapped some presents to put under it.  I hate putting up the tree but always enjoy it so much when it's up.  I love unwrapping all of the old ornaments and taking a wander down memory lane.  I have one ornament from Katie's first Christmas, a photo of her at six months, inside a tiny frame.  It's hard to believe she was so little.

So I'm baking cookies, sending off a few cards to people overseas and decorating the house.  It feels more like Christmas.  We went to our Christmas party on Friday night which was nice.  I had a glass of wine which is enough to enjoy but not enough to tell people how I really feel about them, although I'm pretty sure my face and body language does that for me. 

Our medical director however got pretty drunk and in a speech told us all that he's trying harder, he's kind of a dick.  He and I are a lot alike I think which is why we clash so much.  Not sure if he knows that.  

My bathroom reno is finished so I have a toilet in my bathroom again which is nice.  A little paint touch up today and it's done.  

Today I'm thankful for a peaceful home, filled with love.

We had a tough day Monday at work, short staffed, very sick patients.  We were asked to add on a central line and I said no and then the circumstances were shared with me.  A forty-nine year old man with end stage ALS who needed IV access for MAID (medical assistance in dying).  We couldn't say no, I wouldn't say no.

I don't know if I've ever cared for someone with ALS and I've certainly never met anyone at the end of their life with ALS.  It wasn't like "Tuesdays With Morrie", to be honest, it was awful.  He was surrounded by family who all obviously love him and cared for him but he was unable to move anything other than his eyes.  He couldn't even swallow his own saliva which upset me the most for some reason and needed constant suctioning.  And his eyes, to only be able to communicate with your eyes seems so isolating, so terrifying.

I sent my two young coworkers to take care of him during his line insertion.  There were two doctors in the room too and family members.  Special circumstances, in honor of his time here on earth.  I've been with patients who are preparing for MAID before and it is always an honor to help them, to make sure that everything will go well for them as they leave their loved ones.

This morning I googled his name and he died on Monday after he left us.  It was so nice to see a photo of him when he was healthy and full of life, he had such lovely eyes.

It always amazes me and saddens me to see people suffer so much before they die.  We all die and we all suffer in our own ways, both mentally and physically.  What might be suffering for one might not be suffering for another, but I'm not a fan of physical suffering.  It seems cruel and unnecessary.

I'm thankful my patient got to decide how his life ended.

This is an old photo from a few years ago, Southern Alberta, on our way to Waterton National Park.  It's beyond beautiful there.

I didn't work on Tuesday because my back was so sore on Monday, my whole body was sore on Monday actually.  So I took a muscle relaxant, slept in, puttered around the house, went for a walk with the dog and worked on my grandson's quilt.  By the end of the day my body felt much less battered.

I feel stress in my body.  First it was my stomach, then it was my muscles.  I saw the doctor on Wednesday and I asked for a bunch of xrays of my sore and aching joints.  Good news, arthritis in only one joint, my left knee, which means that my pain is soft tissue pain which I can do something about.  So I'll see a physiotherapist and try to be kinder to my poor body.  I felt like an eighty year old woman on Monday.  I'm back to a fifty-six year old woman today.  Fucking stress.

I seem to be obsessed with aging and death lately.  In part, I'm sure because of where I work, but also because I am aging and I will die.  Mortality kind of shoves itself in your face after fifty.  I wonder how much longer I will live.  What that life will look like.

When my father was fifty-five he had open heart surgery.  This was in 1975 and it was a big deal.  I was thirteen at the time and my younger brother would have been eleven.  I can imagine my father must have been terrified at the thought of leaving his wife and two youngish children alone.  He survived.  At some point he must have read or heard a statistic that people only lived about ten years on average after open heart surgery.  He was obsessed with his death for the last fourteen years of his live.  I'm beginning to understand why now.

My father was a control freak and I may be as well (cough, cough).  There are so many things I want to do and I feel life slipping away, even knowing that really, I only have today.  I'm guessing that this is all part of the aging process, reconciling the knowledge that I will die, with the knowledge that I am not yet dead and want to enjoy the time between now and my death, all the time not knowing when that death will occur.

In the mean time I will walk the dog, work on the quilt and tomorrow the big guy and I will take Katie to watch a swim meet organized by the new agency that is caring for her.  I'm guessing there will be cheering and clapping which Katie loves.  She will get a chance to socialize with her peers and we will get to meet some of the best people in the world.  What better way to spend my time.

I'm off for four days which is lovely.  I slept in until eight this morning which feels weird but was lovely.  The cat came in when the big guy had his shower before he left for work and the cat is still on the bed, fast asleep.  I don't want to disturb her so I've left the bed unmade for now, cause I'm like that.  I lead a reckless life, leaving beds unmade, last night I didn't bother with the dishes.  Who am I?

I finally contacted Katie's old agency telling them what I thought about them discarding most of Katie's belongings when she moved a year and a half ago.  At that time Katie had just been in the hospital for surgery on her broken arm.  The agency said they would take care of the move and I was worn out that week so I let them.  I had no idea their idea of taking care of things was throwing stuff out.  The initial inventory when Katie first moved in with them only included six items which was a joke.  I kept receipts of everything that I had to buy to replace her "stuff" as it was called and two days ago I emailed them and told them I thought it was their responsibility to reimburse Katie for the cost of replacing everything.  I also told them I thought it was disrespectful to just discard someone's belongings.

To my surprise they agreed to reimburse Katie providing I sign an agreement to not ask them for any more money.  There was no argument but they were offended by my comment about disrespect.  Oh well.  Katie will be reimbursed for their, I don't even know what to call it.  Who throws out someone else's belongings like that?  Without contacting the guardian?

I'm not finished with them yet as I still plan on making a formal complaint with social services but I am thankful that Katie will have a little extra money in her bank account.

We took her out for a drive and lunch last weekend and she's quite relaxed.  She's also able to walk much farther because she's not kept in a wheelchair all the time.  She's been walking outside, getting exercise and fresh air.  It's not perfect, she's still acting out a little but mostly it's good.  To see her relaxed is wonderful, to see her laughing and shaking with excitement is wonderful.

The big guy and I were supposed to drive to Jasper yesterday but got stuck in snow and traffic and never made it out of town.  We decided it wasn't worth it, turned around and headed home.  Turned out to be a lovely day at home.  We have a bird feeder on the back deck and the chickadees were flitting about so much I thought why not set up the camera.

So I got to take pictures, not of the mountains but of the birds.  We also had a dark eyed junco visit the feeder and a downy woodpecker.  And no, I don't really know much about birds but google sure does and I'm always curious.

We had a code at work on Tuesday which upset me.  The patient didn't die thank goodness, turns out he was severely dehydrated from diarrhea, but the whole thing was a shit show and once again I felt unsupported as a nurse working in diagnostic imaging so I will have to bring that up with my manager.  I emailed both managers with my concerns and was told, "we're always here" which is really a nice sentiment but not very helpful when you're up to your ass in alligators.  So there's that.

A couple of weeks ago I had a youngish woman as a patient.  She is forty-two I think and was with us to have a central line inserted.  She was upset and couldn't stop crying.  Turns out her boyfriend had kicked her and her twin daughters out on the weekend and told her , "I can't wait for you to die".  There is so much pain and suffering in the world and I am always humbled by what people live through.  Turns out her boyfriend is an alcoholic and naturally he told her all of this while he was drunk.  I told her, "I'm sorry to say this, but your boyfriend is an asshole."  She was convinced that he was right and that this was all her fault.  I told her that this was on him.  Just before we started the line insertion she said, "I've never felt loved in my whole life.  All I want is to feel loved.", at which point I started crying too.  It's really want we all want, isn't it?  To feel loved.

We got the line in, the doc who normally is kind of a dick was kind to her, I hooked her up with a social worker and I hugged her.  She wondered if she should move her and her kids back to Ontario so that she would have family support.  I told her I thought that was a good idea.  She will need more help shortly and her children will need a guardian who cares about them when she dies.

And so it goes.  New patients.  Old patients.  Dying patients.  Patients on surveillance.  I carry a lot of grief around with me but I wouldn't want to change who I am.  I prefer this to not feeling.  And there is always suffering in life.  It's something we don't talk about in our society, we don't teach our children this either, in fact we try to shelter them from this knowledge but it's a disservice to them.  There will always be suffering in life.  We are human.  We can't avoid it.

There is suffering but there is love as well.  Hugs from the big guy.  A new grandbaby on the way.  Friends to talk to.  Birds to photograph.  A lovely little dog to walk with in the snow.  Good books to read.  Stories to tell.  It seems to balance out somehow.