It's been so cold that I haven't been outside except to run back and forth between the car and buildings.  But that same cold has forced me to take different kinds of photos.  There is a pair of woodpeckers that live nearby and love the insect filled suet.  I love watching them.

The cedar waxwings were back yesterday, stripping the trees of their berries.  I went upstairs to the bedroom to get a better view of them and a couple of them decided to fly into the window, not sure why.  After two bird strikes, I shut the blind and left them to their business.  I don't want to find bodies on the ground.

In the fall the juvenile waxwings come back and strip fermented berries off the trees.  One day I had twenty-five drunk teenage birds hit the windows.  Apparently drinking and flying is as dangerous as drinking and driving for teens.  Two birds died but the rest survived.

I always feel restless this time of year.  I'm done with winter and want spring to come but that won't happen for awhile.  My grandson is due in seven weeks and I try not to stress about what kind of father my son will be.  I don't where he's living or what he's doing.  He is leaving Gracie alone which is good but I worry what will happen once the baby is born.

Miss Katie is doing well.  I took her for a doctor appointment last week and the receptionist had never seen Katie out of her wheelchair, didn't know Katie could walk, didn't know how tall Katie was.  We have a referral to a new psychiatrist who has training working with people with developmental disabilities which will be good.  And we also have a referral to a geneticist.  The last genetics appointment Katie had was twenty years ago and things have changed since then.  The human genome has been mapped and I would still like answers.  I understand that nothing can be fixed but I would still like to know what happened.

Last Sunday the big guy and I took Katie out for lunch at the mall.  We drove to see the horses on Fox Drive and then went to the mall.  Katie ran/walked for awhile, we had lunch and then Katie sat in her wheelchair with her legs crossed and proceeded to high five everyone we walked by.  I'm happy the valproic acid has helped with her anxiety and moods.  She's like her old self.  I enjoy spending time with my daughter again and I am so thankful.

It's cold and snowing here, a good day to stay inside and hibernate but I'm not going to do that.  Today I'm off to have lunch with my girlfriend whom I haven't seen in a few months.  The roads are covered in snow and it's fucking cold but that's never kept me home before.

My friend has multiple myeloma and had a stem cell transplant.  She is now on chemo until she dies.  What will happen eventually is the chemo will stop working and then the cancer will come back full force.  The doctor gave her 8-10 years which sounds like a long time until you start to think about it.  Only eight more harvest moons.  Eight more springs.  Eight more Christmases.

Anyway, she was very pissed off to find out that other cancer patients don't have to take chemo for the rest of their lives, so I told her that patients with neuroendocrine tumors have to have treatment for the rest of their lives as well.  She was somewhat mollified by that news.  I love this woman and we have known each other for close to thirty years.  We recently decided to adopt each other as sisters because our own sisters suck.

I made cinnamon scones to ward off the cold and I think tonight for supper I'll make tomato soup with a grilled chilled sandwich.  I don't cook for the big guy on Friday nights, it's free for all Friday and we both have whatever we feel like.  My meal is usually meatless, his is not.  He always says you don't get to be this big without eating meat.  I haven't bothered to counter his argument with facts such as cows, moose and bison are all much bigger than him and are all vegetarians.  I love him just as he is.

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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.