There's no place like home

So I haven’t blogged recently, this is mainly due to the fact that I have worked manically for the last 3 weeks, as has Dan.  It’s been an interesting time.  We changed rotations last week which for me meant saying goodbye to my surgeons.  They have become a bit like pets to me, or perhaps children.  Over the last three months I’ve learnt what they like and don’t like, how to calm them down when they are frustrated and throwing their toys out the pram and how to calm myself down and implement  self preservation strategies which have stopped me from losing my cool with them on many an occasion.  I summed up my rotation with a card to say thank you, on the front of which was Dorothy (me), the lion, the tin man and the scarecrow all skipping along- just like our morning ward rounds.  These rounds generally involved calming down Mr E who gets very wound up about- well anything, checking all Mr A’s patients are on his very specific, and slightly odd, pain relief regime, encouraging Mr C to make decisions and (praise God for small mercies) basking in the knowledge of Mr S who is always thorough, always calm and just generally quite wonderful!   Mr S worked as a trauma surgeon in the British army and used to operate in a theatre with an unexploded bomb lodged in the ceiling; unsurprisingly those operations were swift and efficient.  What a hero (quote Dan).   As an RMO (resident medical officer) my job is to look after the patients on the ward, I oversee their care, advocate for them and am generally the person who actually knows what’s going on with their care.  Yet sometimes I reach points of frustration where I need someone else’s expertise, I can diagnoses the surgical problem but trust me you don’t want me operating on you!  Our knowledge is always being tested, our patience often stretched and our skills challenged.  

During night shifts there is one doctor in the hospital, covering A&E, the wards and being a point of reference for nurses at satellite centres as far away as three hours drive north and south of Greymouth.  On my first night one of the first patients who came in was someone with a dislocated shoulder. They were quite drunk which is these situations can be quite handy as alcohol is a good pain killer!  I diagnosed the dislocation, confirmed it with x-ray and checked the neurological and vascular supply to the arm.  I then called the orthopaedic registrar in Christchurch three hours away, who provide our orthopaedic support, to confirm the plan.  Relocate the shoulder.  Simple.  Well yes, and no.  It can be a simple procedure there are many techniques which can be used to try and pop the shoulder back in place, however if the patient isn’t relaxed or the first attempt is unsuccessful the muscles around the shoulder tighten and the procedure gets more difficult.  I put it out there to the orthopaedic Registrar “I haven’t actually relocated a shoulder before”.  In theory there should be someone on back up I can call in, but guess what, there was no one on the rota.  Meanwhile the ambulance crew bought in another patient who was drunk and had a fluctuating conscious level.  Great.   I checked the second drunk person was safe and went back to my shoulder.  I called the registrar again “there’s no one on back up, what do you want me to do”.  The shoulder needed to go in that night so I resorted to my trusted and faithful backup – Dan.  Having done A&E for six months Dan has performed relocation procedures and I quote “if you get stuck just call me”.  So I did, it was half twelve and the phone rang and rang and rang...  Up until this point I had felt quite calm but now my heart started to thud, I really was on my own.  I had a frank discussion with the patient and explained why I hadn’t relocated the shoulder, I had never done it before and I wanted to get someone to help me, this however seemed not to be possible.  My only option was to use gravity and a little manipulation to get the shoulder in, this and a lot of prayer.  There was only one technique I felt safe to use as it didn’t require harsh manipulation so no chance of damaging structures.  The patient sucked on gas and air and I lay them on their tummy, the dislocated arm flopped over the side of the couch.  I gently manipulated their arm (as per the internet diagram I had seen).... clunk.... the shoulder popped back in- praise God!  This was my first two hours of 70 that week- I will say no more on the matter.

Dan organised an end of rotation meal to which over twenty of the medical ward staff signed up to attend.  All the nurses love Dan.  I know what you are all thinking- it’s his Dashing good looks and warm smile which produces these warm fond feelings.... actually I think it is he constant singing and his hyperactivity which make him an amusing and endearing work colleague.   We turned up to the restaurant and although we didn’t fill it, we quadrupled its numbers.  It was a wonderful meal, food was eaten, wine was drunk (not by me as I drove), and there was much laughter and jokes and then........ the unexpected Sri Lankan dancing!  The consultant who came to the meal was the wonderful Dr U who is slightly mature and very well known in Greymouth.  At the end of the evening I think he had consumed a moderate amount of alcohol, enough to dis-inhibit his dancing gene, and boy did he dance!  There we were in a little restaurant with our consultant pushing back the tables and for want of a better phrase “dancing his butt off”.  I’m pleased to say we have video evidence...

Life is always eventful and there are many many more stories, particularly about work, that I could share.   What I will say is that doctors are human.  We live, breath, cry and make mistakes like everyone else.  Our mistakes have the potential to cost lives and that is why a safe doctor isn’t the doctor who “knows” everything, because trust me they don’t exist; a safe doctor is someone who knows what they don’t know and seeks advice from other professionals to make sure they are giving the best care.   I didn’t want to relocate that shoulder by myself and I set a limit on what I was happy to do.  If I hadn’t relocated it the patient could have had nerve damage and complications so did what I could and was lucky it worked.  So next time your GP says “I’m not sure about that, I will look it up”, don’t sit and think “what an idiot” be thankful that he is looking it up and being honest about his knowledge and expertise. 

Happy Mother’s Day

Sarah xxx

Week with the inlaws

We have just spent a week with Jeff and Sheila and it was been fabulous.  Within the first twenty four hours of chatting about their adventures it became very obvious that they definitely need to write a blog!  Perhaps one of my favourite little snippets was the story of the mobile phones.  Jeff and Sheila packed six mobile phones with them to take to Sri Lanka.  During their first night in Singapore one of the six mobile phone’s alarms went off at 2am.  Jeff managed to locate the suitcase inside which was a carrier bag, inside the carrier bag there were six phones all attached to their chargers- spaghetti junction! Jeff had to remove all the batteries to stop the alarm, after which he duck taped the batteries to the phones (duck tape is an essential when travelling).  If this wasn’t hilarious enough Jeff then explains how Sheila had also ‘planted’ her luggage bag directly in his path back to bed  nearly resulting in his demise.  Excellent! (I think we got the censored version)

We stayed around Grey for the first weekend, visiting Pancake Rocks at Punakaiki and generally drinking wine, swapping stories and enjoying each other’s company.  On Monday we set off for Nelson.  We had been telling Jeff and Sheila how wonderful Grey is and how beautiful the weather had been since we arrived in November.  As if to prove us wrong, Monday greeted us with torrential rain.  The sort of rain where the drops are so big that you are soaked in seconds and even with wipers on full speed you struggle to see. Great. Perhaps I should mention now that it was my job to book the first two nights’ accommodation at the edge of the Abel Tasman National Park.  I thought I had been really clever booking The Hairy Hobbit Eco Cottage.  A sweet little Bach high above the town with incredible views..... and an outside toilet.  As the rain pounded our car on the journey toward the Hairy Hobbit House it occurred to me that this was either going to be a great adventure, or an epic fail!

Greymouth beach

Blow holes at Pancake rocks

To my relief the rain stopped just as we reached our destination.  Dan was feeling sick (lots of windy roads and tired post nights) so I took over driving.  The Hairy Hobbit Cottage directions took us off the main road up a windy gravel track which ended with the steepest hundred meter drive I have ever seen- not for the faint hearted.  Dan drove the last bit.  

The moment of truth came as we turned into the cottage drive...   Stunning, absolutely beautiful; views for miles over the fruit fields and out to sea with a backdrop of mountains.  This was a good start which was enhanced by the discovery of a fabulous veranda with swinging chairs, a wonderful little kitchen with log burner and a bedroom with an interesting, but comfortable, sleeping arrangement.  

 

That night we played yatzee and retired to bed early.  Dan and I had to climb up a ladder in the bedroom to sleep on mattresses mounted high on a platform.  Despite there being two male Wattleys in the room no one snored and the night went without a hitch. 

The next day we caught a boat to Tonga Quary in The Abel Tasman National Park where we all walked for the first two hours and then Sheila and I left the boys to hike another four hours to their hut in the park where they would spend the night.   Meanwhile we went back to the Hairy Hobbit house where we drank tea, then wine, ate avocado and chocolate and had baths in the outside bath.  The outside bath was amazing!  This was literally a hot bath, with bubbles, under the stars looking out at the distant lights of Motueka and Nelson.  Sheila was a little unsure initially but ended up the ultimate adventurer having a ‘proper’ outside bath (I had worn a bikini).  So proud of her!

The following day we met the boys as they walked out of the national park.  The meeting was faultless in its timing.  I was just showing Sheila where the boys would exit the park as they came striding round the corner.  Over the next day striding turned to limping as they recovered from their 32km adventure.  

We then set off towards the bed and breakfast we had booked for the next two nights.  Before we left the UK we were put in contact with Buzz and Bebe, who had been at our church but moved to Nelson two years ago to set up a bed and breakfast.  As we arrived at their house all the aches from the walking evaporated as we saw our incredible rooms, each beautifully created and dressed with wonderful clean clear colours.  The beauty inside the house was exceeded by the views from the balcony, miles of glistening sea which flowed into an estuary walled by a long spit creating an ever changing scenery as the tide moved in and out and all this framed by the Able Tasman Park with its peaks in the background. 

That evening we went for dinner in Nelson.  I ordered a gluten free pizza (I am now being very good with this diet) and Dan, Jeff and Sheila all ordered dinners which required consumer participation in the cooking.   As their dinners were brought out from the kitchen they sizzled as a hot rock, which was the plate for their meat, cooked the raw hunks of meat which sat on top.  The idea is that you cook your meat on the rock to the exact specification you require.   Dan had beef, lamb... and chicken.  Those of you who know me well can probably imagine my feelings about the raw chicken on his plate- EEEEEEEEK.  I was once nicknamed detox girl by my friend Rachel Maddock, after using half a bottle of cleaning product in one raw chicken preparation session!   Although I am improving it still produces anxiety when I see raw chicken.  My brother in law Ben was preparing a curry for the family during their summer vacation at our house and I practically followed him round the kitchen with detox making sure he didn’t contaminate anything, especially my spices!!  I nearly died when he wanted to leave the chicken on the work top marinating all day because the fridge was full.  Needless to say I made room in the fridge!  The psychiatrist in me has decided to name this condition ‘Aldous chicken fear’, as it seems I have inherited this from my mum, yet somehow it has been magnified during its inheritance to me.  Anyway, I was distracted from my Aldous chicken fear as I watched Dan trying to coordinate his food.  In front of him were three types of meat, all cooking away, a bowl of chips to the right and salad to the left not to mention a pot of béarnaise sauce.  Bringing this meal to fruition required intense concentration as Dan turned his meat, removed the chicken so as not to overcook it, sliced the lamb, passed chips across the plate and dropped salad onto the sizzling rock.  The whole meal was a great success and I consider the experience therapy for my Aldous chicken fear!

 

The following day was another day of culinary delights as we wine tasted at a local winery whilst sharing a platter of scrummy food and then went to the Boat Shed for dinner.  This was no ordinary dinner was we ordered ‘Trust the Chef’.  This means you get multiple small dishes allowing you a taste of all the wonders they are cooking.  We had eight courses and the boys managed deserts too!  I will add a list of the food we ate for those interested.   The amazing thing was that we all felt we had tasted amazing food, had a wonderful evening and none of us felt sick!

We returned from the north via Buller Gorge where Dan and I did a tandem zip line across the river and spent the weekend relaxing. 

Dan and I are now about to go back to work and Jeff and Sheila continue on their adventures with another four weeks in NZ before they fly home via America. 

Hope everyone in the UK is doing well.

Much love

Sarah x

Dan Writes...

Overall we are doing well, have settled in and starting to get to know folk. Work, as in all hospitals, can be tiring, stressful and emotionally draining but the beauty of the surrounding area lends itself to recuperation. I am also loving the summer sun, I always feeling happier when its sunny. Sarah however has managed to be jealous of the snow in the UK. Weather is amazing whatever it is...

Also, to get my own back as many of these blogs paint me in a disastrous light, I want to share a little story about my wife.

Sarah has decided recently she wants to try and have a gluten free diet. She appreciates hasn’t got coeliac disease but wonders if she like many others has an intolerance and she would feel better without it. All very well and good. Husband is sent with task of finding gluten free everything. Those of you who are gluten free know that whilst there are plenty of gluten free food types, trying to buy gluten free alternatives to things like bread, biscuits, crackers, and cereal can be quite pricey. But nevertheless this is what I have had to provide, and whenever I am cooking I have to come up with suitable gluten free options which often involved rice instead of pasta. The problem is that whilst I can provide this at home, Sarah’s own gluten free radar isn’t so defined and so at work she often eats things like pasta or (almost every day) biscuits.  Thus this expensive and time consuming trial (and I hope it’s a trial) is negated. Ah well...

 

In other news I have now been offered a job - in a busy ED in the north island - which starts in June. Sarah already has a job in the same town lined up so that has been a great blessing. Also we are expecting some visitors soon, people who usually generate a few good bloggable storylines of their own; so watch this space!

 

Dan (Pleased with myself for jumping on the blogging bandwagon)

Toilet Humour

I feel I should apologise before I've even started, as this entry closely resembles 'toilet humour'. However in the scheme of things a little toilet humour had never done anyone any harm (I'm sure someone has a story to the contrary to that statement).

The setting of this story is a normal day at work. Dan was dressed in his standard work attire; a shirt which is usually crumpled as Dan tries to get two days wear out of it (for which I am very grateful) but always forgets to hang it up after the first day, and trousers which have inevitably lost a button but haven't been fixed because as soon as he takes then off Dan forgets they need a button and doesn't remember until running out of the door the next day (at which point he hopes I can magically fix them in 10 seconds flat- I’m good, but not that good!). Also is the inevitable coffee stain somewhere on his person which represents the rushed coffee he tried to have mid morning before his bleep (sometimes known as a pager) went off.

A doctor’s bleep is a communication tool which enables nurses and other staff to always be able to contact the doctor looking after their patients. They simply dial the personalised bleep number and the extension of the phone they are calling from and in an instant the bleep lets out a startling shrill stopped only by its acknowledgment. This had led to many a coffee spillage for all doctors everywhere. We doctors dream of drowning the bleeps, especially at 3am during a night shift, yet we also feel attached to them.

This particularly day Dan went for a post lunch toilet break. For those of you faecally minded Dan did a number 3-4 Bristol Stool Chart motion (feel free to Google for more graphic description of the grading system and for those of you who don't have the Google facility this grading equates to a pretty well formed poo).

As Dan sorted himself out and pulled up his buttonless trousers and belt the bleep took a rather unfortunate fall, into the toilet bowel. Pre flush. Instant dilemma. Not only do these gadgets cost a lot, but without out them our connection to our patients is severed.  The bleep sank into...well you know what. If Dan flushed the toilet the bleep may disappear too and there was no way he could leave the cubical to get gloves- what if someone else flushed in his absence. Dan must save the bleep. So he decided in this moment to wrap toilet roll around his hand and grab the bleep. As he reached into the poo filled bowl the toilet paper unhelpfully disintegrated contributing to the mess. Bleep excised Dan washed it with soap and water. Silence. No bleeping, the screen was dead.

The rescue mission had been a success but the resuscitation attempt had failed.  Dan trudged to reception where he relayed the events.  Shocked yet amused the receptionists produced a donor bleep and an envelope for Dan to drop the old bleep into.

A few days later Dan was called to reception.  The unfortunate bleep had been officially replaced.  They proudly handed Dan the new bleep.  New and improved this model came with a chain which attached it to ones trousers.  No more swimming adventures for Dan’s bleeps.  Everyone breathed a sigh of relief- especially Dan.

We were very pleased to have a relaxing weekend after the poo incident.   We had a wonderful Saturday morning breakfast in Greymouth town followed by shoe shopping... for Dan.  I have learnt that the only way to make shopping bearable for Dan (and therefore me) is to fill him with coffee and cooked breakfast and then quickly take him shopping while his guard is down and he is still recovering from his protein overload.  On arrival to New Zealand two pairs of Dan’s shoes almost instantly disintegrated requiring replacement.  Dan HATES shoe shopping and confessed to me on this shopping trip that he has never bought new shoes.  However in Greymouth there is one shoe shop and it isn’t busy.  So Dan had the shop to himself and with some reassuring comments and about six pairs of good quality shoes to decided between we settled on two pairs, a result I was very pleased about!

We then went for a walk in the rain around some old mining tunnels which were spectacular and very exciting to explore although I can’t shed my anxiety about tunnels.  We retreated home for an early night. 

Sunday was a glorious day and we spent the afternoon at Nelsons Creek with folk from our church.  The Creek meanders in a way which distributes the sediment making it very safe for children to swim in.  Across the water steps are calved out of the bank and you can climb up and jump off into the crystal clear water.  There is a free camp site with basic facilities and if you feel inclined you can pan for gold at a public panning area.  New Zealand is such a wonderful place to explore!

 

I hope everyone is enjoying the snow and it hasn't disrupted life too much.

 

Much love

 

S x

Post Christmas Blog

Post Christmas Blog

It’s January the 6^th and almost two weeks since my last blog.  Unsurprisingly a lot has happened since the last blog so here is a little update for you.

Dan worked Christmas day- well he was at work, dressed as a reindeer eating a lot of food with the nursing staff.  Being the social gentleman he is he had a hour and a half lunch break so that he could share Christmas dinner with both the morning and afternoon nurses as their shifts changed over (very clever).  Poor Dan did seem a little bored but better that than overwhelmed with sick patients!

I struggled through the evening of Christmas eve, feeling very tired and for the first time wanting the sun to go down so I could snuggle up and watch a Christmas movie and eat chocolate, not that I need an excuse to consume chocolate as Dan will tell you...  However Christmas morning greeted a fresh and excited Sarah.  I had pancakes and strawberries at a friend’s house before walking to the Baptist Church to partake in their Community Christmas Meal.  I arrived to a room of 130 beautifully set up place settings and the smell of Christmas dinner.  My first job was to dish out deserts.  Lay before me we were 150 bowls all with Christmas pudding already served up.  A little perplexed I asked them what they wanted me to do as the puddings were already served.  However what ensued was a mass operation filling each bowl with jelly, trifle, custard, pavlova and crumble as well as the Christmas pudding.   Being a woman of moderate appetite I was amazed at the size of these deserts and even more amazed at their consumption about an hour later!   As people arrived the social diversity made for a colourful and wonderful day.  We had travellers from the hostels, families with children (one family with 6 children!) a good proportion of our more senior friends and even a couple celebrating their 60^th wedding anniversary not to forget the cross dresser with his family who was wearing a rather delightful dress!  It was such a pleasure to serve people Christmas dinner and even the mammoth washing up which followed had a sense of community.  I wonder if such a Community Meal could work in the UK.  This was definitely not targeted at any particular group but an open invitation for companionship and fun.  In the afternoon I was invited to dinner by Leanne and Jonathan who were going to his mothers.  As I arrived I realised I actually knew all the other guests wither from the hospital or the Churches we had visited.  I had my second Christmas dinner in the sun.  It didn’t feel like Christmas but it was wonderful.

On the Saturday after Christmas we set off for Nelson.  Driving through New Zealand is a pure delight.  Every turn brings new topography, hills, mountains, streams, forests the beauty rolls on and on making the four hour journey to Nelson a pleasure.  As we approached our destination the urbanisation of a New Zealand city started to emerge.  This meant hardware stores, multiple supermarkets, garages, yet in the midst of unspoilt beaches with the Able Tasman nation park as the back drop.  I would do this kind of city life!  Our accommodation was an architectural feast.  A New B&B overlooking the beach.  It had a clear colour scheme- white.  The owner was one of the funniest characters I’ve met in a long time, she was in her 60s bleached blond hair and very friendly to the point where I almost felt like a family friend.   Her son had designed the building and we learnt that he was an eccentric chap who liked to explore the world bare foot- random but put everything into context.

After a day chilling we met up with Steve and Stephen for dinner.  Steve is a friend of ours, a wonderful Godly young man, rather like my husband.  He is small and hairy and talks non stop!  We attempted to have a meal but the food was two hours in coming to fruition.  I was so impressed that the boys didn’t get ratty due to the ‘hunger’, a true testament of their characters.  The time was filled with a variety of conversation spanning deep theology to ridiculous Dan/Steve humour. Steve, steve, steve, alan alan (Dan and Steve’s favourite you tube clip).   After dinner we went ice skating on a temporary ice rink.  Unfortunately having two doctors around gave Steve a (false) sense of security on the ice.  He sped round at Tasmanian devil speed but without the skill on the ice to control himself at those moments of lost gravitation towards the ice.   However at the end of the evening he had only wiped out twice and initial survey showed no breaks.  I wonder, is this what it is like having children....

Joanna is one of fifteen children (one is in heaven) and we were invited to her family home for New Year.   They live just over the hill from Nelson so Dan and I met Steve and Stephen in Nelson and then took Steve over the hill to Joanna’s.  Monday morning was the departure date and having not slept I consumed three strong coffees before leaving.  This had the predictable diuretic effect and an hour into the journey I had already had to have two toilet stops (which is impressive even for me).  Stephen (not to be confused with Steve) wanted to show us the resurgence, an area of natural beauty where a river springs from hillside making a clear pool of water and then we decided to visit a picturesque beach for a bit of sunning and an ice-cream.

On arrival to Joanna’s we were met by her mum and a few of her siblings and some friends.  Some of you will have heard of a psychological treatment called ‘flooding’.  This works by overwhelming the senses and hopefully overcoming the fear/ phobia.  For arachnophobia this would mean going into an enclosure full of spiders.  Looking back I think this initial experience was a bit like a ‘flooding’ for me.  Any fear of meeting new people was completely overwhelmed by the situation and the realisation that these people were warm, open, loving and accepting- fear quashed.  Soon I was singing with boys as they played guitar and helping to fold the washing (of which there was lots!).  The evening was spent having a BBQ on the beach, which was a two minute walk from their house, playing ultimate Frisbee, football (Dan was impressed with my football skills), more singing and making dampers (cooking dough on the end of a wooden pole and then filling it with syrup) .  Dan had a ride on a dirt bike which he thoroughly enjoyed and more highlights include the moon-bow which appeared as a result of amazing moonlight and rain, and beautiful glow worms.  This time the glow worms were in a beachside cave.  As you went into the cave there were pockets perhaps a meter wide where fifty plus glow worms shone their little lights all together.  They were so magical I wished I could capture the moment to share with everyone, especially Grandma- it was like our own little fairy cave, she would have loved it!

After a fantastic night we decided to head back over the hill the next day.  This enabled us to have a day walking in the Abel Tasman National Park.  We decided to sea taxi into the park and walk out.  The sea taxi was a forty minute speed boat ride.  On board was a family with three small children.  As we motored to our destination the sea was quite chopping and the boat seemed to take off and land with a thud producing that ‘stomach in mouth’ feeling.  The three year old in front of us found this hilarious and her infectious giggles were wonderful to hear.   As we arrived it started to rain but we were prepared and rain coats applied we continued on.  I had decided to walk in shorts and had a special bag which strapped round my waist, like a bum bag, but with pockets for my drink each side. I had a mini Lara Croft moment (see picture) only my guns were actually massive bottles of water (much more useful!).   We walked for four hours on coastal tracts, through forest, across the beach, past mini waterfalls and finally over the estuary back to the car.  Exhausted but satisfied we went back to the hostel for our final night in Nelson.

Lara Croft moment

On our way back home we stopped for lunch in Takaka.  We found this hippy cafe which was rather large by New Zealand standards.  We ordered our food and then took our number and found a comfy sofa.  Unfortunately our food came in staggered intervals.  Every time a waiter came out Dan would eye ball the plates and if they seemed to match our order he would start vigorously waving our number at them.  It was hilarious; it was as if he was trying to bid for his food, waving this number like he was in an auction house.  Dan and my appetites somewhat balance each other out and at this point Dan was hungry.  I have seen Dan’s hunger cause odd behaviour before but this is my favourite.  I watched the people watching this mad English man and thoroughly enjoyed a good giggle (yes out loud further perpetuation the stares).  It’s good to giggle at oneself sometimes!

We are now back at work with Dan doing long days and I’m on nights.  My first night was pretty awful but I’m afraid that’s part of the job.  I always have slight trepidation when I start a night shift but there is a part of me that loves the adventure of not knowing what will come through the door.

I hope everyone had a lovely New Year and are looking forward to 2013.

Much love

Sarah x

split apple rock