January 2012 Fourth First Week in Rankin Inlet
What an exceptional week this has been! So many people looked at me askew when I said I was coming to Rankin for January. Many knew I was crazy as I posted the December temperatures on facebook, or mentioned that the Arctic was a great place to be in January. These first few days have proven this is the place to be.
Getting here...late as usual. Vancouver to Winnipeg flight was late, for no noticeable reason. Winnipeg to Rankin was late, but we were all warned on check in that the flights might end up in Churchill or back in Winnipeg due to weather conditions in Rankin. All the flights the day before were cancelled. While we were waiting the Calm Air flight left. That seemed like a good omen. However, they then announced that our flight was going to be delayed by an hour. An hour later we were still sitting in the airport, and then they announced we were boarding. Good.
Winnipeg was cool. It was the first time they had cold temperatures and the first big snow came December 31st. Temperatures on Jan 2nd were below 0 but not by much. On the plane they were announcing the temperature in Rankin Inlet was -32. I began to feel a little antsy and wonder if I really was making the right decision!
Since arriving the temperatures have been quite normal, usually around -30 with a wind chill of -45 to -50. I thought that walking in -50 was wrong, but have found that actually it works quite well. Now, of course, I am on first call. That means I have a car. It also means not enough exercise to sleep, which is just totally annoying. Thought there might be some activities that would help, and there are, yoga in Tuesday and Thursday, Walk Tall is Tuesday and Thursday. I will be able to sleep, for sure, on Tuesday and Thursday!
Yesterday we had a really unusual day. The first time, ever, that the fire alarms went off at the Wellness Centre. I walked through and the director said, “It must be real”, so went back to the Maternity and told them it was for real. We all dressed into all our clothes and got out, as did everyone else. It was the first time I had seen the physios since arriving. It was great! Got pictures of all the staff standing outside, in their parkas, waiting for the building to be cleared. Lucikly for us, the fire hall is next door to the Wellness Centre. He walked over and checked the building and then called whoever turns off the alarms. They couldn’t do it, and had to call someone else, and eventually they did go off. The noise was phenomenal, so I just stood outside, with the smokers, who found the whole situation so stressful that they needed a smoke break!
We had a birth on Tuesday. I was the second. It was just on the edge of normal, so was interesting to watch. I have learned that as a second it is best to sit on the sidelines, until needed and then just, be a second. It means that really not doing anything until the mother is pushing. That is always interesting when things are normal, but not quite.
Right now I am sitting looking out the window at the beautiful clear sky with the sun coming up, in the middle of the horizon, not on the east, and a low line of cloud beginning to come up in the southwest. It is unbelievably bright, as there are no trees, and lots of ice. It means you can see forever and the sun seems to be brighter than anywhere else on earth.
It is truly stark and beautiful here, and I am so happy to be here in January.
Saturday, January 7, 2012
Saturday, October 8, 2011
This Week in Cambridge Bay
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I only have a week left in this village, and have been spending the day cleaning, and thinking of what to make with the food I have left over. All very exciting? Not really.
Went to the Northern store this morning and was surprised at how little what I needed cost, and also at what they had. I had tried to buy a small pack of SOS cleaning pads earlier in my stay, but there were only large packs. Today small ones were in, as well as very small packets of laundry soap. Also got red onions..still expensive though at about $6.00 a lb, alfalfa sprouts and good bread, which is $5.90 a loaf. That was all pretty amazing.
It is the end to a very challenging and fun week.
Last Sunday the ultrasound lady here was doing maternity ultrasounds for women from other villages. They were to have come here on Friday, but no planes were flying so they came on Saturday and she worked Sunday doing the ultrasounds. I was on first call, and was just taking my puppy, Kiska, out for a walk, when a call came in from her that one of the ultrasounds did not look good, and could I come in and talt to the mother. Of Course, since that is my job.
Went in, looked that the ultrasound and talked to the mother, and then tried to decide what needed to be done. Most referrals we do with Stanton Territorial hospital in Yellowknife, but for a detailed ultrasound this woman would need to go to Edmonton. Medical genetics and Maternal Fetal Medicine are also there. So women from villages here who have problem pregnancies go to Yellowknife (a two hour flight) to have their babies, or to see obstetricians. If there are any other types of problems they go to Edmonton, which is two or three flights, and four hours away. (It also has better shopping but most of the women here are pretty happy with what Wal Mart and other stores have in Yellowknife. And everyone brings back a big bow of Tim Hortons' donuts. Tim Horton's in Yellowknife is the most lucrative franchise in Canada!)
While they are out the Inuit women stay at Inuit boarding homes. Non Inuit women have to provide their own accomodation. Women who are government of Nunavut employees are put up in hotels. It is a very interesting system, that leads to lots of interesting differences. Women cannot take an escort (partner) with them unless they are under 17 years of age, or are having surgery. There are a few other reasons for them to take their partners, but those are the main two.
Just imagine going 4 hours away from your home, by plane, to have a baby, and doing it alone.
Cambridge Bay now has a birthing centre though, so residents of this town, who are low risk women can have their babies here. The birthing Centre is very nice, with lots of local art on the walls, and big rooms with lots of windows.
Spent time in the centre this week, trying to make the prenatal/emergency birth bag into a medevac bag. Was mostly successful. We need one more thing, in its own bag. That will probably come before I leave. We were also in the Birth Centre to have our pictures taken for the Nanatsiaq news, the Nunavut newspaper.
Monday I went to the office, and we had report, as always from 8:30-9:00. It is always useful, in this community, and often fun, as the people who work in the health centre are generally fun.
Then I started to make the referral to Maternal Fetal Medicine. In the south, usually, you fax a request with a consult letter, or often without even a consult letter. Not so here. You have to organize the appointment, the consult, the travel requesitions, the contacts where women stay. It took almost five hours to complete the process! Yes, most of the day on one thing! My learning curve went up dramatically on that day, but ended up feeling like it was an accomplishment.
Tues, Wed and Thurs afternoons we see clients. Actually here a lot of the women are high risk. Most smoke, although less than in other towns. Many are under 19, although may not be having their first babies. It makes the experience of being a midwife here very rich.
My favourite activity this week happened most days, and that was walking the puppy. It has been very wet here. Temperatures are not down to their usual -1 to -6 but have mostly been above 0. This means rain instead of snow. It also means mud. None of the roads are paved, and there is little grass except out on the tundra, and even there, we are far enough there, that there is mostly rock. Every time I take her out she needs a bath! It is a good thing she is very cute.
I had been given a crate to take her home, and thought I was all organized. This week I phoned Air Canada three times to organize her flight, with me from Edmonton to Vancouver. The first time Tuesday, I was on hold for 50 minutes and then had to hang up. The Second time, Wednesday I was on hold just over an hour, and had to hang up. Thursday was the exciting day when we had no communications, including internet, with the outside world because the satellite had turned away from Earth. Yesterday I finally got through, after only a few minutes, only to be told that the crate was too big to fit in the door of the airplane that was going from Edmonton to Vancouver.
So, last night I phoned Yellowknife and they are sending a crate, air freight, to me here. Puppy is going to be very expensive, just to get home.
The crate here will be left for another dog who needs to be rescued. There are lots, and many puppies. Actually discussed "Big Heart Rescue" with the women here who rescue a lot of dogs, as they might be able to start such a group in Yellowknife. Apparently the SPCA there can find homes for any Arctic puppies from the communities, but there is no way, yet, to send them to Yellowknife without paying. Big Heart has this part all sorted out in BC.
This week there were also two luncheons...one put on by the administration and catered and a potluck yesterday for Thanksgiving. It was fun yesterday with lots of food that even a vegetarian could eat! Monday was also fun, but not so much food for a vegetarian, or the three vegetarians here. In the three weeks so far, there have been three potlucks.
The other excitement this week was remembering that I had another season of "The Closer" here with me on dvd. Had been going to the library here which has a fair selection of dvd's, books, and Northern books, which I have been reading. Currently it is "Muskoxen of Polar Bear Pass", which is an old book, but very interesting, and yes, it is about Muskoxen. The library is a place a lot of this community really uses, especially perhaps because it is in the school.
Today there are two more things to do, unless I get called (on second call today). Go and walk Kiska and make vegetarian shepherd's pie! Have looked up the recipes on line, and now to make the mixture. Adzuki beans I brought with me, veggies bought, or were left here.
Friday will be an exciting day for Kiska, as she should be with me when we leave here, weather permitting, and arrive at her new home.
I only have a week left in this village, and have been spending the day cleaning, and thinking of what to make with the food I have left over. All very exciting? Not really.
Went to the Northern store this morning and was surprised at how little what I needed cost, and also at what they had. I had tried to buy a small pack of SOS cleaning pads earlier in my stay, but there were only large packs. Today small ones were in, as well as very small packets of laundry soap. Also got red onions..still expensive though at about $6.00 a lb, alfalfa sprouts and good bread, which is $5.90 a loaf. That was all pretty amazing.
It is the end to a very challenging and fun week.
Last Sunday the ultrasound lady here was doing maternity ultrasounds for women from other villages. They were to have come here on Friday, but no planes were flying so they came on Saturday and she worked Sunday doing the ultrasounds. I was on first call, and was just taking my puppy, Kiska, out for a walk, when a call came in from her that one of the ultrasounds did not look good, and could I come in and talt to the mother. Of Course, since that is my job.
Went in, looked that the ultrasound and talked to the mother, and then tried to decide what needed to be done. Most referrals we do with Stanton Territorial hospital in Yellowknife, but for a detailed ultrasound this woman would need to go to Edmonton. Medical genetics and Maternal Fetal Medicine are also there. So women from villages here who have problem pregnancies go to Yellowknife (a two hour flight) to have their babies, or to see obstetricians. If there are any other types of problems they go to Edmonton, which is two or three flights, and four hours away. (It also has better shopping but most of the women here are pretty happy with what Wal Mart and other stores have in Yellowknife. And everyone brings back a big bow of Tim Hortons' donuts. Tim Horton's in Yellowknife is the most lucrative franchise in Canada!)
While they are out the Inuit women stay at Inuit boarding homes. Non Inuit women have to provide their own accomodation. Women who are government of Nunavut employees are put up in hotels. It is a very interesting system, that leads to lots of interesting differences. Women cannot take an escort (partner) with them unless they are under 17 years of age, or are having surgery. There are a few other reasons for them to take their partners, but those are the main two.
Just imagine going 4 hours away from your home, by plane, to have a baby, and doing it alone.
Cambridge Bay now has a birthing centre though, so residents of this town, who are low risk women can have their babies here. The birthing Centre is very nice, with lots of local art on the walls, and big rooms with lots of windows.
Spent time in the centre this week, trying to make the prenatal/emergency birth bag into a medevac bag. Was mostly successful. We need one more thing, in its own bag. That will probably come before I leave. We were also in the Birth Centre to have our pictures taken for the Nanatsiaq news, the Nunavut newspaper.
Monday I went to the office, and we had report, as always from 8:30-9:00. It is always useful, in this community, and often fun, as the people who work in the health centre are generally fun.
Then I started to make the referral to Maternal Fetal Medicine. In the south, usually, you fax a request with a consult letter, or often without even a consult letter. Not so here. You have to organize the appointment, the consult, the travel requesitions, the contacts where women stay. It took almost five hours to complete the process! Yes, most of the day on one thing! My learning curve went up dramatically on that day, but ended up feeling like it was an accomplishment.
Tues, Wed and Thurs afternoons we see clients. Actually here a lot of the women are high risk. Most smoke, although less than in other towns. Many are under 19, although may not be having their first babies. It makes the experience of being a midwife here very rich.
My favourite activity this week happened most days, and that was walking the puppy. It has been very wet here. Temperatures are not down to their usual -1 to -6 but have mostly been above 0. This means rain instead of snow. It also means mud. None of the roads are paved, and there is little grass except out on the tundra, and even there, we are far enough there, that there is mostly rock. Every time I take her out she needs a bath! It is a good thing she is very cute.
I had been given a crate to take her home, and thought I was all organized. This week I phoned Air Canada three times to organize her flight, with me from Edmonton to Vancouver. The first time Tuesday, I was on hold for 50 minutes and then had to hang up. The Second time, Wednesday I was on hold just over an hour, and had to hang up. Thursday was the exciting day when we had no communications, including internet, with the outside world because the satellite had turned away from Earth. Yesterday I finally got through, after only a few minutes, only to be told that the crate was too big to fit in the door of the airplane that was going from Edmonton to Vancouver.
So, last night I phoned Yellowknife and they are sending a crate, air freight, to me here. Puppy is going to be very expensive, just to get home.
The crate here will be left for another dog who needs to be rescued. There are lots, and many puppies. Actually discussed "Big Heart Rescue" with the women here who rescue a lot of dogs, as they might be able to start such a group in Yellowknife. Apparently the SPCA there can find homes for any Arctic puppies from the communities, but there is no way, yet, to send them to Yellowknife without paying. Big Heart has this part all sorted out in BC.
This week there were also two luncheons...one put on by the administration and catered and a potluck yesterday for Thanksgiving. It was fun yesterday with lots of food that even a vegetarian could eat! Monday was also fun, but not so much food for a vegetarian, or the three vegetarians here. In the three weeks so far, there have been three potlucks.
The other excitement this week was remembering that I had another season of "The Closer" here with me on dvd. Had been going to the library here which has a fair selection of dvd's, books, and Northern books, which I have been reading. Currently it is "Muskoxen of Polar Bear Pass", which is an old book, but very interesting, and yes, it is about Muskoxen. The library is a place a lot of this community really uses, especially perhaps because it is in the school.
Today there are two more things to do, unless I get called (on second call today). Go and walk Kiska and make vegetarian shepherd's pie! Have looked up the recipes on line, and now to make the mixture. Adzuki beans I brought with me, veggies bought, or were left here.
Friday will be an exciting day for Kiska, as she should be with me when we leave here, weather permitting, and arrive at her new home.
Saturday, September 17, 2011
Coming Back to Cambridge Bay
I was so excited to be coming back to the Arctic. Was trying to think of all the last minute things that were needed, and, of course, forgot a few, but not too much major. Most important was probably a vest, or fleece to wear at the office. Brita filter was another, but you can get almost anything here, if you want to badly enough.
Sent myself a box of food several weeks before leaving, packed a suitcase and a small cooler, and set off for the airport. My son, who drove me was a little concerned, as was I, about my ability to travel, since I had arthoscopic knee surgery six days previously.
I sailed through check in and security, carrying my pack sack and computer bag (heavy computer bag) on a set of wheels. Was met through security by a cart that took me through the airport to the Edmonton gate. It was late afternoon, and today we, another Midwife from Vancouver, and myself were headed as far as Edmonton.
Vancouver was interesting. The gate next to ours was going to Winnipeg and was supposed to depart at least thirty minutes before us. They started announcing delays awhile before they were supposed to load. Then they started announcing delays for our plane. For a long time they did not say what the delays were, but finally they were announced. Our plane was delayed because the staff had not all showed up to check up in. The Winnipeg plane was delayed because someone had been sick on it on the flight in, and they said "Believe me, you want it cleaned before you get on!) I was glad not to be going to Winnipeg!!
We landed safely in Edmonton and went to the hotel, had dinner, splitting an order of veggie fajitas and a salad, and off to bed. We had asked about getting to the airport for our eight o'clock flight and been told we only needed to be there an hour ahead.
So, up at six fifteen, after getting to bed about midnight, to catch the shuttle at six forty, and be there about seven. We basically went through security and onto the plane. A lot tighter than we had thought, but still good timing. No time for the last Starbucks though. There is not one in Yellowknife, although they do have the most lucrative Tim Hortons in the country, or in Cambridge Bay.
Flight to Yellowknife was unremarkable, except that it was full, and of course, it went mechanical. In this case that meant the front seat was loose, so mechanics had to come on board to tighten the seat, and readjust seat belts, etc. So, yes we were late, and we had only about a thirty minute lay over in Yellowknife, so were not going to make our next plane.
The flight was beautiful though, with the fields of the prairies and then the lakes and trees of the North West Territories.
On arrival there were four planes on the ground waiting for our flight. They were all Canadian North flights, and they just waited until ours came in, to take people to various communities. That is one of the great advantages of northern travel...along with the free meals.
A hot breakfast was served on the flight to Yellowknife, and again on the way from Yellowknife to Kuglugtuk, then a bread package from Kuglugtuk to Cambridge Bay.
We got in at 13:00, to our apartments to drop off the bags, and then to work. We were told we would not usually work on the first day, which is strange because I cannot remember a time not working on the first day.
We were given a very short orientation and started. Turned out the one midwife here was leaving in three days to go to Kuglugtuk, and we would be operating on our own. The next day was clinic.
We were introduced to everyone at the health centre, and had an amazing arrival and welcome. It was great to be north again and it looked like this trip would be full of adventure.
Saturday, September 3, 2011
A Day at the Office
Last Monday was anything but a typical day at the office, but that being as it was, it makes it a typical day.
I am working in Langley, BC right now, and for the next eighteen months. When there seemed to be a lack of northern contracts, I contacted two practices near Vancouver and asked them if I could work with them. Both responded yes. This one was closer to my home in Maple Ridge, and with the new Golden Ears bridge, it was only fifteen minutes from my home to the office in Walnut Grove. It seemed ideal!
For the last six months I have been part of this four midwife team.
Last week two Midwives were on vacation. Two was okay for covering the work, as we had fewer clients in August, knowing there would be vacations. Only, the second Midwife I was working with suddenly became very ill. It meant that I was alone, taking care of the women booked for four of us.
This had happened to me previously, when I was a lot less experienced and we were working in a group of three. Interestingly, at that time a Midwife from Manitoba had visited me while on vacation, and said, oh well, that means you are only taking care of what, forty-five or so women. We counted them. There were about ninety clients. She was quite shocked.
In this practice there are many more. We had few deliveries for August, having booked fewer, and having some go in July, but we did have three women overdue.
I did not have a delivery on Sunday evening and was very thankful. Went to the office on Monday and immediately things started going awry.
Messages on the phone had to be answered, as usual, but this day there were more than usual.
The second client in said to our receptionist, "you must have a mouse in that cupboard because there is a lot of squeaking and scratching going on".
Receptionist was very daring. She said, "in this cupboard?" and then she opened the door, and closed it just as quickly. She said "I can see it there". She was asked how big it was, and she showed us about four to five inches in length, with her fingers.
I said "It sounds too big for a mouse, I think it might be a rat". The fear of God was now within all of us!
Then she asked me what we should do. My suggestion was to call the property manager. Man, did she do it quickly.
The next two clients were overdue, and due the next day. They were standing in the office commiserating with each other, while I was answering another page, when the "bug men" got there.
The most hilarious thing was looking at the door of the cupboard and seeing that a piece of cardboard had been taped over the door, just in case there was enough room for the "mouse" to crawl out.
While the two clients were talking, and the receptionist and I were talking the "pest control guys" looked in the cupboard. They said it was a rat, and it was in the trap and banging it from side to side trying to get out.
I quickly took the next client into the consult room. No point in having to watch what was going to happen.
However, it always happens that there are lots of people around when things are going a little off. Another client arrived, and everyone is talking and casually watching what the exterminators are doing. They took various things into the cupboard, and then casually left. They did mention that they had reset the traps, and also said that the rat had to have come in from the roof, in order to get where he was.
There was no more scratching or banging.
Within a few hours though, the question became, "who was going to check these traps?".
We have electronic charting in our office, and one of the perks of the program is a message system. The messages started flying. The property manager was contacted again. She has arranged for the traps to be checked once a month. I am waiting for the stench of a dead rodent that has been left in the heat for a month!! Realistically though, the office would know if one had been there more than a couple of days. Pregnant women notice smells.
The rest of the day flew by. Lots of interesting "low risk" women, with lots of "high risk" problems.
It was a fun day, with no births, but lots of appointments, and lots of fun, with this "rat" incident.
I am working in Langley, BC right now, and for the next eighteen months. When there seemed to be a lack of northern contracts, I contacted two practices near Vancouver and asked them if I could work with them. Both responded yes. This one was closer to my home in Maple Ridge, and with the new Golden Ears bridge, it was only fifteen minutes from my home to the office in Walnut Grove. It seemed ideal!
For the last six months I have been part of this four midwife team.
Last week two Midwives were on vacation. Two was okay for covering the work, as we had fewer clients in August, knowing there would be vacations. Only, the second Midwife I was working with suddenly became very ill. It meant that I was alone, taking care of the women booked for four of us.
This had happened to me previously, when I was a lot less experienced and we were working in a group of three. Interestingly, at that time a Midwife from Manitoba had visited me while on vacation, and said, oh well, that means you are only taking care of what, forty-five or so women. We counted them. There were about ninety clients. She was quite shocked.
In this practice there are many more. We had few deliveries for August, having booked fewer, and having some go in July, but we did have three women overdue.
I did not have a delivery on Sunday evening and was very thankful. Went to the office on Monday and immediately things started going awry.
Messages on the phone had to be answered, as usual, but this day there were more than usual.
The second client in said to our receptionist, "you must have a mouse in that cupboard because there is a lot of squeaking and scratching going on".
Receptionist was very daring. She said, "in this cupboard?" and then she opened the door, and closed it just as quickly. She said "I can see it there". She was asked how big it was, and she showed us about four to five inches in length, with her fingers.
I said "It sounds too big for a mouse, I think it might be a rat". The fear of God was now within all of us!
Then she asked me what we should do. My suggestion was to call the property manager. Man, did she do it quickly.
The next two clients were overdue, and due the next day. They were standing in the office commiserating with each other, while I was answering another page, when the "bug men" got there.
The most hilarious thing was looking at the door of the cupboard and seeing that a piece of cardboard had been taped over the door, just in case there was enough room for the "mouse" to crawl out.
While the two clients were talking, and the receptionist and I were talking the "pest control guys" looked in the cupboard. They said it was a rat, and it was in the trap and banging it from side to side trying to get out.
I quickly took the next client into the consult room. No point in having to watch what was going to happen.
However, it always happens that there are lots of people around when things are going a little off. Another client arrived, and everyone is talking and casually watching what the exterminators are doing. They took various things into the cupboard, and then casually left. They did mention that they had reset the traps, and also said that the rat had to have come in from the roof, in order to get where he was.
There was no more scratching or banging.
Within a few hours though, the question became, "who was going to check these traps?".
We have electronic charting in our office, and one of the perks of the program is a message system. The messages started flying. The property manager was contacted again. She has arranged for the traps to be checked once a month. I am waiting for the stench of a dead rodent that has been left in the heat for a month!! Realistically though, the office would know if one had been there more than a couple of days. Pregnant women notice smells.
The rest of the day flew by. Lots of interesting "low risk" women, with lots of "high risk" problems.
It was a fun day, with no births, but lots of appointments, and lots of fun, with this "rat" incident.
Wednesday, April 6, 2011
CBC was excellent Yesterday
Yesterday I made the long drive from Maple Ridge, over the bridge to Surrey, then over the Patella to New Westminster and finally over the Pitt River bridge back to Maple Ridge. As I was switching through radio channels, realized that CBC had a piece of circumcision on. Started listening. Now, whenever there are educational programs, that are related to work, I listen, but this was particularly poignant.
The first speaker (I heard) was discussing how the Canadian Pediatric Association was considering changing its guidelines on circ due to some new studies in Africa, which showed that circumsized men were less likely to develop AIDS. Interesting, but then he went to to discuss the cultural differences between Africa and Canada, and how this could make a huge difference.
In 1991 we travelled to Zimbabwe and Zambia. We were told horrific statistics about the population that had AIDS. The Zambian government, concerned about its workers, had tested all the miners in their diamond mines. There was a 50% positive HIV rate. They tested the physicians and discovered a 100% HIV rate. Sex there was obviously used differently than in the western world. The other very sad statistic was that half of the babies were being born HIV positive.
On the weekend I went to a party. Lots of parents, grandparents and children attended. Eventually about six of us were left. One of the enebriated men, whose wife and six week old son were there, announced that it had been a really bad day for his son recently, when he was circumsized. Now some of you will understand when I say that this was a group of childbirth educators, midwives and others; that talking about circing your son did not go over very well. This man actually said that he did it because he thought that is what everybody did. Since I know they attended childbirth classes, and know it was covered, it was a bit bleak to hear him say this. It means that the men are also not picking up the information.
The next speaker on CBC continued on with an interesting conversation about pain in neonates. He pointed out that 50 years ago we paralyzed babies to do open heart surgery because we did not think they felt pain. As researchers have done more and more experiments they have realized just how exquisite pain is for neonates. (Neonates are babies under 28 days of age.) This speaker discussed how some practitioners now freeze baby boys before they are circumsized, and how he is sure it hurts, but that he thinks it might be like other surgeries and also hurt on day one and day two, and maybe day three, but these babies are not given pain medication then. He also pointed out that other research shows that babies who have been circumsized have a much more intense reaction to immunizations and other forms of pain. The last really interesting thing he discussed is how we now know that neonates actually experience all pain much more acutely than adults or older children.
What an eye opener.
I had now arrived at my friends home, and turned off the car and listened to the last speaker before going in.
This was a woman, whom I expected to be quite fanatical, since she runs an anti circ organization in the US, and has been its head for 26 years. She did have a number of interesting things to say, some of which were quite surprising.
This organization does not think that circs should be stopped for religious reasons (Jewish and Muslim boys) but that males should be left intact until the age of majority, when they can decide if they want the procedure done or not. Interestingly she said that the Americans are going against religious freedom laws by circumsizing babies, and not letting them self determine their religion.
She did point out that non circumsized men have fewer infections and are cleaner, however she then talked about sexual dysfunction and how this occurrs much MORE frequently in non circumsized men. It makes sense. The forskin allows the glans to stay very sensitive, and react to touch. When the boy is circumsized his penis is much less sensitive. (A good example of this is rubbing the inside of your fourth finger gently, and then rubbing the outside of your pointer finger gently. You will see immediately that the fourth finger is much more sensitive, because the skin has been protected much more than the "pointer" finger.
This was all really interesting, and gave me some new views to help parents decide of circumcision or not. Mostly, I would like to go and listen to the whole programm again. It was excellent.
Thursday, February 3, 2011
A Great Day
Today was quite amazing, and very ordinary at the same time. I realized that my time in Inukjuak is more than half over, and am quite sad about that. Last time here that was not my feeling.
This day was a day of revelations and learning.
It is Thursday. It is supposed to be education day at the Maternity. If there is a southern midwife, then she does the education. They only have one student now, and she froze during a shoulder dystocia and asked me to go over it. We did that last week, so this week was going to review that and go on to breech.
The morning started, as usual, at 9:10 with only me in the office. That means that I answer the phones and say...no she is not here...no she is not here either...they might be here at 10...can I help you. The answer is taima (probably spelt the wrong way, but pronounced more of less like that) which literally translated, means the end. It is not rude. It is how the telephone conversations usually end, sort of like good bye for us.
This only went on today until about 9:45. By that time though there was one message, and someone, other than me, had to deal with it. It is basically an Inuit woman in Quebec City, instead of Montreal, really needs a translator. Her boyfriend is also there, and they speak English and no french and had a baby born early due to infection. I think the government here (Katavik, not Quebec) is trying to get them all moved to Montreal, but not really sure cause all the subsequent conversations were in Inutittut.
At the same time the co-ordinator was making calls trying to organize the maternities and a peer review meeting this afternoon with the maternity in Puvirnituq.
I did my usual. Once there, checked my e-mails, which believe it or not, takes about 45 minutes if there are 20 e-mails. Computers here are very slow at work. They are in Nunavut too. Answered the phone while I checked them, did the dishes, and cleaned up a little.
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Then there were some prenatals to do that did not get done yesterday, when only I was in the clinic because there was a home birth the night before. So, the prenatals got done, I supervised one, and went on to my other job, which is sorting out protocols.
Have had some trouble figuring out the blood work they do here for maternity patients because some things are a little unusual. They order a group and screen on everyone in the first and third trimesters. I asked why? They said that was my favourite question. Quickly said that if they explained it to me I would understand and not have trouble doing it.
Toxoplasmosis is another interesting disease here. Many Inuit have had it already, but if they have not and they are pregnant then they are tested every two months to make sure they do not serum convert. There is also special counselling because they eat so much raw meat. I read the original research about it and it said they thought it was to do with sea mammals, although fish did not pass it on. Now the protocol says it is safe to eat sea mammals, as well as fish, but all other meat needs to be completely frozen before it is eaten raw, and that it should not be handled when women are pregnant, and are negative for toxo.
So today I tackled the protocol on lab work during pregnancy. Finished it just after lunch, and faxed it to the other maternities to discuss, and realized there was nothing in it on gestational diabetes testing. Revised it and faxed it again. So, by then the education time of the day was over, and we were well into prenatals and post partums.
I had the joy of doing a postpartum with a woman who actually had some continuity with me, and seemed happy to see me. That was very nice. It was here sixth baby, but she had given this one up for adoption. I was at the birth, and at that time she was pretty upset, although she did have two very young children at home. Today she was very happy and up. It was lovely to see.
Then did a postpartum with a baby who has a heart murmur. I was involved when this baby was 3 days old,and was sent to Puvirnituq for a telehealth and ECG. Also saw the baby two days ago when resps were too high, but only about 64 in a sleeping baby, and went down a little later. The heart murmur was amazing though.
Today the babies resps were 70 when the baby was sleeping and the baby was shipped off to PUV again, and likely will go on to Montreal this time.
In the south heart murmurs are not common. I have heard one or two minor ones only. Here they are so common that they have a protocol on how they are handled. This one was so extreme that you could hear it when listening to the right lower side of the chest doing resps. It was quite amazing.
While we were taking the baby to the medevac plane another midwife was doing a labour check, and talking to the mother about possibly having a homebirth, as there is still not much heat in the maternity. She declined but also not likely in labour, so hopefully things will have turned around that way before she does go into labour. It turns out that when they built in the sink in the major birth room, they put it over the heaters, with no way to get to them. They also have the water in the heaters going the correct way only about three quarters of the time, so there needs to be constant bleeding and fixing. And there is one guy here who does it all, for all the apartments and health centre. He is a replacement and is only here for three weeks. I think he is working about 15 hours a day. (Today he asked me if it would be okay for him to paint one of the bathroom walls in the evening this week).
The medevac was early enough that there was still time to go to the co-op before it closed at 6. I had wanted to go and see if the walrus carving was still there. It Is. Tomorrow, I'm hoping that my hats for Puvirnituq and the money for them comes, and then will be heading back to pick up the walrus. Only there are two there now, the one that was there previously and another, a bit smaller, a bit smoother, but with a little less character. So, tomorrow, if we do not have a birth, or other time problem, will be the day to purchase my second carving here.
I also found out today that although I refuse to to oxytocin inductions here, which the midwives do by themselves anyway, they still want me to come back. And when I said that the woman who coordinates who comes had told me to give her months next year I was interested incoming and she would organize it, they were quite happy about that.
The other part of a good day is getting all the personal things done. The laundry is done, the dishes are done, the shopping is done, and there was cauliflower/brocoflower cheese for supper. What can be better?
So, today is the day I figured out the blood tests, was useful in the maternity, heard an interesting heart murmur, had a client happy to see me, and found out my walrus has not been sold. Generally a very successful, happy day.
Monday, January 31, 2011
January 31, 2011
Today I am SO glad to be back at my one bedroom apartment. It was SO cold at work today. Workers were wearing their parkas to work in, if they sat at all during the day. One of the docs wore his parka all day. We also have a lady in early labour, and although homebirths are the exception here, it was easy to talk to her about it, because the maternity is also cold. We had tried warming it up all day, with extra heaters and lights on. Did not work particularly well.
The mechanic who is working here right now started talking to me when he was checking the heating in the maternity. He said he wanted to ask me where I was from, that he had worked, in Victoria, with the navy for 17 years, and thought I must be from there. I asked if it was my accent, and he said yes, but also I looked like someone from Salt Spring, or Quadra Island, or Victoria. Was almost taken aback, and then thought, what the hay...that is where I am from. (Born and raised in Victoria, and other than travelling, did not leave until age 23. Attended University of Victoria, and was married there as well. It is probably the reason I now live outside Vancouver...as Island life is lovely, but getting there and back is tedious.)
Lots of interesting calls today as we were trying to sort out a lady who went into premature labour on the weekend. They took her to Puvirnituq, on her way to Montreal, but conditions were bad in Montreal, and she ended up in Quebec City. Her boyfriend, though, ended up in Montreal. The Midwives were trying to help get him to Quebec City, and answer her questions about what was going on. The hospitals in Montreal have Inutittut translators, but not so in Quebec City.
As I mentioned in my weekend blog, three men are missing from here in Inukjuak. Two went polar bear hunting last Wed and one went fishing on Friday. The fisherman was found by search and rescue, who are here looking for the polar bear hunters, yesterday. He is fine and well. Today, they found the skido of the polar bear hunters, but not in the direction they said they were going. They have not been found yet. Conditions were not good on the weekend, with the wind chill dropping to -48. Everybody is worried.
One of the interesting things here is how many people are related to one another. It is probably due to the isolation. Each town has different names of families within it. Here there are masses of Kasudluaks and Aculiaks and Weetatuluks. If you read the list of people in town there will be a hundred or more of each of these names, and then you have a few families with only four members, and they came from somewhere else. In Puvirnituq the names are totally different. This is also true in Nunavut (probably not Iqaluit), that there are different family names in each community.
It has not been snowing much recently, and everything is extremely slippy. The snow has blown off all the roads and paths. The centre of the roads is more clear than the sides because cars, trucks and atv's use the road, where the side is used by skidos and pedestrians. Since the road to my house was plowed late last week, it is now like a skating rink. Not many people used it but I slid a number of times trying to get up the "hill" this morning. It is quite flat here, so a "hill" is relative. The river has finally frozen over, and sea ice has been forming for a week now. Not sure how long, or if, it will get to its normal amount. Usually it starts to form in November, and this year it started last week.
I was also told on the weekend that polar bears are newcomers here. They only started coming to the area about two years ago. So, for sure, as the global warming trend changes, it also changes animal habitat, and this is a prime example of that.
I am now drinking tea, and feeling warmer. My water is boiling, for drinking for the next couple of days. Am waiting to see what instructions will come out for February. Every month water inspectors go to all the villages and test the water. Then the health centre posts whether it should be boiled that month or not. Right now the water is boiled for 20 minutes and then, when cool, it goes into the brita. Tastes fine, but when I was here in the summer, one of the pregnant woman was really sick, and needed iv antibiotics, due to problems with the water.
My thoughts and hopes are going this evening to the families and the polar bear hunters. I am hoping that they are found quickly. It is so hard on the families when people are missing.
Hope you all have a great evening.
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