Wednesday, May 13, 2015

Ayden turns 12!


You guys. My oldest baby is TWELVE. 


He's awesome and funny and full of wit and seriousness. He got two gerbils for his birthday and invited his whole class to the movie theatre to watch "Mrs Doubtfire." It was so much fun. Happy birthday Ayden! 

Tuesday, April 7, 2015

This One's for Us: Smarten Up Emergency Services

I've worked as a paramedic in BC for ten years. I've done rural, urban, and metro ops. I've transported patients to over 25 different hospitals in this province, if I count rapid fire on my fingers--in reality it's probably many more. Sometimes between wards, but generally through the hospital "gateway:" the Emergency Department. I haven't seen it all but I've seen enough to know we aren't getting it right, and no one is calling us out on it. 

What are we getting so wrong? Our treatment of non emergent care. Our attitudes towards the "not sick" that ask for our care. Emergency staff (paramedics, firefighters, ER nurses, doctors, and supprt staff) divide patients into two categories: sick and not sick. "Sick" patients are dying. Right then. In front of our eyes, with unstable vital signs and failing organs and copious bodily fluids and an unholy bluish white tinge to their skin. They need everyone's immediate undivided attention and action to hold back death long enough to (hopefully) fix what's wrong. 
"Not sick" patients can be SICK, vomiting on your shoes or feverish or sore. But they're not dying right there in front of you, this minute, today. So we say "not sick." 




I have no issues with these categories. They help us emergency workers focus in situations where seconds count. They help us triage multiple patients into those who can wait, and those who cannot. We have an understanding that if patients are able to SAY they cannot wait, they can. It's the quiet ones who are circling death. The bleeders, the strokes, the septic, the burns, the silent babies, the traumas.

What I have an issue with is paramedics, firefighters, nurses, and doctors who treat the not sick with impatience. For certain, we all sign up for "sick." We want to secure airways, reverse overdoses, bust clots, breathe for drowning lungs and stop hemorrhage. We live for it. The trauma bay is our favourite place on earth. The problem is, the not sick need us, too. 

Who needs us?

Those with mental illness. Depressed, suicidal, anxious, bipolar, schizophrenic, young, old, or in between. On their meds, off their meds, having a bad day or unable to access help any other way: these people need us.

The elderly. Those with increased incidence of falls. Constipated, unable to sleep, confused, weak, unable to pee, or just lonely. These people need us.

People with diverticulitis. 

Folks with UTIs.

Young men or women who can't breathe and are crawling out of their skin with anxiety.

Patients who need transferring between facilities. 

Those who are otherwise healthy with abdominal pain.

Individuals with the flu. Not just the run of the mill aches/pains/fever/malaise, but those who cannot manage at home, can't keep anything down, or are not getting better. 

Those who are dehydrated. 

Kidney stones.

Vomiting and diarrhea.

Conjunctivitis.

Bug bites, rashes, tooth infections, trench foot in the homeless, ulcers in diabetics, fungal infections and abscesses. 




This list ain't sexy. It doesn't involve the trauma bay, airway intervention, bronchodilators, or the cath lab. Here, we don't defeat death. Here, we meet people. We care. We comfort and reassure, catch folks who fall through the cracks, and prevent some from ever needing the trauma bay in the future. I'm angered by impatience towards these patients. I'm frustrated by the attitude that Emerg is just for the "sick." It's not. It's for everyone. We cannot turn people away when they ask for help and we definitely cannot continue to convey that we are too good, too hard, too busy and important for the "not sick." Can we improve their situation? Their health? Their day? Can we educate to prevent ill health or future unnecessary visits? Can we advocate? Smile? Reassure? Always. 

Always. 

Do your job. Sick or not sick, no more excuses and no more impatience. The end.

Sunday, March 22, 2015

...to live in this world

you must be able
to do three things;
to love what is mortal:
to hold it

against your bones knowing 
your own life depends on it;
and, when the time comes, to let it go,
to let it go.

-from in blackwater woods, mary oliver 

Wednesday, March 4, 2015

Amarys is Four!

Midday on Feb 28th I realized it was my annual "I went into labour x years ago today" anniversary. Often I reminisce lots and pull out photo albums and stuff. This year, though, I was at a very mentally engaging course on airway management so all I had time for was a quick note-to-self. But Amarys' birth memories are very special to me so it was nice to remember.

The following day was her day! She has been vocal about her birthday anticipation for months! She loved being celebrated and had a ton of fun. We had her friend party on Friday--princess themed, of course. There were thirteen kids here, half of them dressed as princesses. We decorated cupcakes, played ponies, had a scavenger hunt, and opened gifts.

Sunday was her actual birthday. We forgot the annual time-of-birth photo but we went out for sushi and had some very special princessy moments.





 
Amarys is bellybutton tall on me (fourth kid=I have no idea what her actual height is), weighs 36 pounds, and is starting to write her letters. She is particularly good at A, E, M, and O, and is working on C. The other day she was spelling 'Ocean' and learned that some letters are jerks and stick themselves in words without making any sound. She knows all her colours and is fastidious about correcting any and all errors in logic or truth. She is very inquisitive, always asking "How many more minutes until xyz?" and calculating what that means to her. She wants to know why for everything.
 
She loves princesses, outer space, The Pigeon (character on the above game and in a book series she loves), glow in the dark, pink, purple, soccer (eagerly anticipating her first soccer season, which starts at the end of March), dance, gymnastics, the ocean, her dog, riding her bike (LOVES riding her bike), long hair, ribbons, fancy clothes, coloring, moon sand, beans, textured or kinetic toys, polly pockets, La La Loopsie, TALKING, directing others, helping in the kitchen, and lego.
She dislikes having her hair brushed and being told what to do. She's sensitive to discomfort. She's very sensitive in general, although you might not know it since she's not all that sensitive to others. She's sensitive to herself. Which is just fine.
 
Heaven broke the mould when they made her, let me tell you. The world can't contain her. Nothing can hold her back. She's bright and brilliant, and we love her to pieces.
 
xoxo peanut xoxox

Saturday, February 28, 2015

Introducing Clover

My sister had a baby!!! She was born Wednesday February 25th, 7lbs 13oz. Her name is Clover Joy Rebecca King and I think she looks just like me  :)
Welcome to the world peanut!!! Love you!!!!!


Monday, February 16, 2015

Flight Reflections

I went flying again recently :)

One of the wisest paramedics I've met once told me that if I ever get to the end of my initial assessment and don't have a really good idea of what is going on medically? Transport fast. Your patient needs a doctor, not a medic. 

Recently, we had just that. I don't like to put people in boxes, but I do like to put their medical problems in them. You fit category (A), cardiac problem. Subcategory hyperhydration, congestive heart failure. Or (B) near drowning. Subcategory acute respiratory distress syndrome (ARDS). (C) blunt force trauma. Subcategory MVA with bilateral leg injuries. 

Yesterday I had (A) what the fuck. Subcategory never seen this before in my life. 

We were sent for a stroke. Flew out across the straight to a tiny village high up an isolated inlet on the mainland.





 We landed on their gravel helipad and loaded all our gear into a van (often medivacs require ground transport when we arrive. Which in villages too tiny for an ambulance often means a local driving a gator, golf cart, pickup truck, or van). 

So. We drive about ten minutes to a house with one of those neon "open" signs in a front window, about ten rusted vehicle shells in the front yard, along with a boat, clearly decommissioned fishing nets and floats, toddler ride on cars, three dogs, and a twenty by fifteen foot puddle. 

Inside is tidy. Warm. Cozy. And the sweetest person is waiting for us. Decidedly unwell, but definitely not having a stroke. 

 There are very effective life saving drugs a doctor can give stroke victims if the stroke is from a clot, and the medication is given within the first four hours of the onset of symptoms. But those drugs will kill patients who are having a bleeding stroke (burst blood vessel rather than a clot) so each patient with certain symptoms needs very rapid transport to a CT to determine the type of stroke so the drugs can be given if it is a clot. 

Our nearest CT is two plus hours by land from our hospital, plus assessment time, so sometimes we bypass our local hospital and fly directly to the nearest CT. We frequently *just* squeak in under the four hour mark because of the distances we cover. Our geographical coverage area is massive. 

Unfortunately for privacy reasons I can't share the exact nature of this person's symptoms but suffice it to say we were all stumped. Subcategory: WTF. 

It was a cool day. 


This is me and my favourite pilot, Kathryn. She lives in town and has two little girls around Amarys and Riley's ages. She rocks. She's been a pilot for 20+ years and used to be ski patrol. She's tough as nails and still breastfeeding her three year old, which obviously kicks ass. She knows helicopters and radios and geography like nobody else. Whenever I fly with her I suspect I possibly missed my calling. Because she's so damn cool. 


She's landed us in some very sketchy weather and even sketchier landing zones and I trust her implicitly with my life. She has a pink flight helmet. :)

This is Doug. He's a wealth of knowledge. If you win him over, he's a marshmallow. If you don't, he's a bully. He fits in my pocket. He loves me. 


I'm kidding about the pocket. He's over 6'5". 

And this is my town from the air. 


Flying makes me giddy. I LOVE IT!!! The only bad part is not being able to bring all my favourite people with me.