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.