A little of this, a little of that

Because it is currently taking Blogger more than 10 minutes for each photo I try to upload, I'm giving up after just the one tonight. I'll try in the morning...it would seem that night-time here is prime time for Bloggers to post, making the site extremely slow! If I post photos in the morning before work, it literally takes seconds for each photo to upload. Sorry 'bout that.

I am currently being driven bonkers by a car alarm outside my window that has been going off for the past half hour. I thought they stopped automatically after awhile. I can't wait for Leeanne to move out end of April (she's going home to S. Africa), so that I can take over the bedroom furthest away from the road!! My bedroom is the biggest, but personally I'd rather have a smaller room without the traffic noises.

Everyone is in a tizzy over here tonight because we may be getting up to 10cm of snow tomorrow. That's a grand total of 4 inches, at which Americans wouldn't do much more than blink an eye. However, it is more likely to be 1-2 inches of snow if it is even snow at all-- British weather forecasters being notoriously bad at forecasting, no one is apparently able to say whether it will be snow or rain. This has not stopped many of the London area schools from declaring themselves closed for tomorrow, in anticipation of "the storm." IF we do have snow, and IF it does somehow manage to accumulate to 4 inches, I may possibly be the only one at work tomorrow as public transportation will grind to a halt. Now that would be funny. I don't know, with all this supposed climate change, I'm thinking England had better learn how to deal with snow sooner rather than later.

Climate change was one of our interesting debates this weekend. I have known people who have studied this kind of thing, so I don't claim to be any kind of expert...I don't know if it's been big in the US, but a major news story this week has been the latest report that the average temperature will climb by 4 degrees centigrade by the end of the century, and they are 90% sure that this change is caused by humans. Some of you may have read State of Fear by Michael Crichton, which is the popularized version of the theories against global warming (natural cyclic trends of the earth's climate versus human-made global warming), and some of you may have seen Al Gore's An Inconvenient Truth. I have not seen it myself, but apparently some head honcho of Marks and Sparks (Marks and Spencer dept store) did see it, and allegedly freaked out about it. The next day he gathered together his M&S think tank to make changes. Whether this is true or not, Marks and Sparks is now committed to cutting their CO2 emissions, and even putting labels on their products about the amount of CO2 required to make the product and get it to their stores, to help people make environmentally conscious decisions when shopping.

An ancient ewe tree on the grounds of Buckland Hall. We couldn't decide if it was all one tree, or if two or three trees had essentially grown into each other over the years.

News

Hello hello! I am back. And what an amazing, gorgeous, refreshing weekend I had in Cymru! (Or Cambria, or Wales even-- all names for the same stunning corner of land in the UK.) We were based at Buckland Hall, in Bwlch, which pretty much turned out to be 5-star accommodation. We had twin ensuite rooms, and the entire manor to ourselves, a very attentive staff, open coffee bar, big wood fires in every room of the main part of the manor, amazing gourmet vegetarian food, 2 sessions of yoga per day, with hours of sun-drenched/misty hiking in between (yes, in Wales you can combine sunny and misty), and the gorgeous grounds of the manor itself to explore. Not to mention the wonderful people I met, and fascinating conversations we had- boy, do I have food for thought! I have loads of pictures, but it's about bedtime here, and I've spent so much time this evening organizing other things, the pics will have to wait.

Big news- Viv and I have booked our trip to......Machu Picchu!!!!! This has been Allison at my best, ridiculously indecisive to the last. Viv was no help (well, you weren't, at least not until the final moments), and each day I'd wake up and think ok, Costa Rica, we're booking that today, and I'd say something to Viv to that effect, and then be texting her the following day to say, no it's Peru. And so on and so forth. To the point where I'd finally decided upon Costa Rica today, picked a package that I loved, which has a stay at a gorgeous eco lodge as part of it since Viv keeps talking about this program she saw on eco lodges in Costa Rica, or little bungalows as she says. I'd filled out the confirmation form, entered credit card numbers and everything, when Viv called and said we should do Peru since I've had my heart set on it. Long story short (too late, I know), we have put down a deposit on Peru! And actually, what Viv said was we should do both- save the other one for the end of the year ;) Somehow I think it may be a bit longer than that until we get there, especially if we actually do intend to do Thailand and Philippines next spring. I can't believe it, I'm going to see Machu Picchu at long last! My fascination with the Incas began with a report I did in the 6th grade, but that's a story for another time.

I was also trying to coordinate a chunk of 2-3 days while I'm home to go and see my grandfather in Michigan-- it's a bit tricky, what with the wedding in Boston and the trip to Peru, and trying to work with my parents' schedules, so I don't know if it will happen yet. Unfortunately, no one was at home when I called this evening, so I haven't gotten very far at this point.

However, I am going to Dartmoor National Park with a bunch of people on another Backabush tour for the first holiday weekend in May. And I've started to look at fares for Vermont week with the fam (Heilalas and Johnsons and Burks, oh my) in July. Heard back from Virgin Airways finally, in regard to my complaint following my flight back to the UK after Christmas. They gave me 5000 miles back in my account, which I suppose is something, although I would have appreciated say 250 pounds toward a future flight a lot more. Especially knowing I will need flights to the States mid-summer and again in November for Jenn's wedding. Ah well.

I hope to post more about Wales and put up some pics tomorrow night. Namaste. :)

Some "Me" Time

I am off for my yoga and hiking weekend in the Brecon Beacons in Wales, later on this afternoon. I am very much looking forward to it, and it seems like the weather may be in a mood to cooperate. I'm packing my rain jacket just in case though, it will be Wales after all!

I was on the verge of booking the Costa Rica package for me and Viv last night, when I suddenly realized I'm thinking about Peru and Machu Picchu all the time....specifically thinking it will be "Holy Week" while we are there, and although I'm not very religious, I am very spiritual. And I guess I'm thinking the 4-day trek (camping) to Machu Picchu will be more meaningful in that sense. Hmmm.

Back online Sunday or Monday.

Mind games

A big pet peeve of mine-- people who bottle things up until it is too late to do anything to address the problem because it has gone beyond the stage of possibly being fixed before the other party had any idea there even was a problem, or until they explode inappropriately. We had a bit of a bru-ha-ha at the ole homestead this evening over our recent electricity bill. As has been all over the news lately, there has been a huge rate increase for electricity and gas here in Britain. Actually in everything it seems, because they just increased the fare for all public transportation too, as apparently they do every New Years' Day. Argh. But anyway, I recently bought a decent size electric heater at Homebase, which I then left in our lounge until I brought it into work. Our office, which is on an abandoned ward, can be very cold, and we all decided to contribute a few pounds each toward an electric heater. Now, our recent electric bill was pretty high, higher than our gas bill in fact, and someone decided the huge increase from when the bill was last paid in October until now, must have been due to the fact that I'm using electric heaters all the time. And wrote a nasty, accusatory email with offensive language, stating they were not going to pay a full third of the bill when I was the one using so much electricity. I now have an apology, after I gave an explanation of where the electric heater actually lives (as above), but I really don't like this style of communication. There was no reason for this whole thing to ever have been played out with such drama and disrespect, when it could have been dealt with diplomatically face to face. As it eventually was, once everyone was home together tonight-- But the damage had already been done from the awful email earlier in the day. Final tally: it's the electricity company to blame with large rate increase, not any individual in our house using tons and tons of electricity.

Now, this person is not British, but it did get me to reflecting over the past almost year I have lived here... I have found that the British stereotype of being very reserved and not discussing feelings and not bringing up problems until (quite often) it's too late, is still alive and doing very well in Blighty. I've run into this obstacle in several important instances, and it's like banging your head against a brick wall, "If you'd only said something to me, I had no idea!..." Very, very, very frustrating to know a situation might have been avoided or resolved, some compromise reached, if only you had known what the other person was thinking or feeling. Again, this is not to say that every British national fits this stereotype, but you do get to often wishing you were a mind reader over here. Sheesh.

It was a very mild day here today, around 60ish (15 degrees Celsius), which would have made for a nice run, but I'm very much not inclined to run in Leytonstone-- let me just diplomatically say it's not inspiring at all. So it was the treadmill at the gym again for me. However, as a birthday gift, my parents gave me a 3-month subscription to demandfitness.com, which came with a 4th month free. I signed up yesterday, and I must say I am very impressed! Over 150 classes, which include everything from yoga, pilates, fitness ball, ab workouts, cardio workouts, you name it, different levels available for each class, all available on demand via streaming video. Very cool. I'll let you know in a month or so how I'm getting on with it as a supplement to my gym membership!

Is it written in the stars?

I'm not a believer in horoscopes, though I do find them amusing from time to time. And for some reason, during my birthday month, I always feel compelled to check them out. I do tend to read both Capricorn and Aquarius, since my birthday is right on the cusp, but here are two of my favorites both from Capricorn:

On my birthday - "To a certain extent, every Capricorn begins a new cycle at the time of the new moon in your sign. It's just that because it takes place on your birthday, this marks a turning point of serious proportions. While leaving parts of the past behind may require courage, in doing so you're clearing the way for the promising developments in the future that will come your way from here onward."

And from this week- "Drink plenty of water, dear Capricorn, in order to keep your system properly hydrated. Water is the most important part of your diet, and it is likely that you are not drinking nearly enough. Being a water sign means that this element is the foundation of your being, making you extremely emotional, caring, and sensitive. Make sure to distance yourself from people who try to suck this life force from you."

This cottage caught my eye on our walk on Sunday, in particular I think because of its own cute little post box set into the stone wall (right side of the photo).

In case you can't get the perspective from the picture, this is actually a police dog training ground (the jumps and walls being much smaller than those used for horses). We passed along beside it on our walk through the hills of Guildford...

Rob and Nicole, probably both with the pub already on their minds as this was the second half of our walk!

More birthday fun

So, on Friday I had a very nice evening, catching up with an old high school friend. He'd been in London for a week on business, and was actually looking around to find a flat for himself and his wife. He'll be moving here next month for a year or so, on a contract through the American company he works for...and his wife, lucky devil, will spend the year traveling around Europe as she pleases, since she will not be working over here. We had dinner at a little tapas place near Hyde Park, and finished at a lovely wine bar in Covent Garden. It was very nice to have someone treat me to dinner and drinks, and also to hear from someone who hasn't seen me in years that I look good ;) Apparently, I'm very fashionable too! Oh, and, a girl who was a good friend and teammate in high school is moving to Spain in July, just after she and her fiance get married-- I now have her email, and as the saying goes, good things come to those who wait-- guess I'll be going to Madrid after all, sometime later this year!

Saturday I was pottering around home, doing home management tasks as we would call them at work, relaxing, and sleeping. But early Sunday morning, I was up and out of the house, and on a train for my last trip out to see Rob and Nicole in Guildford, before they move. It was a beautiful morning, a bit windy, but a bit sunny too. We went for 4 mile hike in the hills around Guildford-- there's some beautiful countryside right near their flat. They then drove me to the Half Moon Pub in Windlesham, near Bracknell, which used to be a favourite of my parents'...every time they had guests whilst they were living in England, they took them to this pub. It had changed a bit- there was an addition to the pub, in which they now have a proper restaurant, still keeping the pub bit of course. The big dog was missing, and there was no fire as it was too warm for one, but otherwise it was exactly as I remembered it. The food was just as yummy, and I had some Hogs Back T.E.A. (Traditional English Ale), which really went down a treat! I hadn't been familiar with that brewery until I went to the Reading Beer Festival last spring, but now I definitely look for it when I'm at country pubs. And thus ended my week-long birthday celebration, although technically my yoga and hiking weekend in Wales coming up on Friday is a birthday gift to myself.

Lots of stuff happening at work, but I'm still processing info from the Bobath course I was at on Thursday and Friday, and need to do some reflections for my CPD on what I learned, as well as update my CV, so I'll get into what's happening with my patients another time.

Looks like Viv and I are leaning toward Peru, final decision probably tomorrow or Wednesday. :)

One from the pros

This company, Tilllate.com, sends photographers to the big club nights, all over Europe. They were at ClubClass as MoS this past Saturday, so here's one I found on their web site of me and some of the girls.PS- I saw the big red fox again today on the pedestrian underpass of the Green Man Roundabout...I'm beginning to think he's good luck, and I get such a rush of happiness when I see him.

A brief interlude with snow

Lots of things happening around here. I woke up this morning to find an inch of snow on the ground- good packing snow too!!! It was gone by the time I left work this afternoon though :( Most of you probably know I absolutely love snow, so unfortunately this was just kind of a tease. Guess I'd better put together a ski weekend in Austria or something if I want to really see some snow this winter. It's finally starting to act like winter, what with this small bit of snow, and I actually had to wear my winter coat one day this week. I suppose it's too much to hope for a real snow storm around these parts.

I've got some more pics from my birthday weekend, although I've realized I didn't take any at the pub on Friday night. Oops. It was such a crazy day at work, with me running around like a chicken with its head cut off, I guess I was just too busy relaxing with friends and colleagues to think of my camera at the bottom of my bag.

Speaking of birthdays, my blog is officially one year old today. Who knew I'd keep this up for that long?! It certainly helped to keep me sane during my day hospital rotation. I don't blog as often now as I did whilst working there, but I still look forward to writing, and getting emails with people's responses and comments. Although, y'all do still remember you can click on the word "comment" and leave a comment right on the blog, yeah? ;)

Oh, and speaking of birthdays again, my Dad's is coming up. He and my mom were in Florida this past weekend for a surprise 60th birthday for Jenn's mom, at the Disney World resort. Yup, whilst I was partying here in London, they were partying in Orlando. Oh yeah, and Tress was partying in DC since she is still hanging around home for medical treatment of her arms (poor thing, she's bored stiff and can't wait to be cleared to go back to Africa). We get around as a family, eh? So my mom, sister, and I arranged for a luxury bass fishing trip for my Dad whilst he was down there-- I initially wanted to send him deep sea fishing, but for various reasons, we switched to bass fishing closer to Orlando. I think that's probably the first original gift I've ever thought of for my Dad. I always try to get personal when I give gifts, and I'm usually pretty successful, but I've been stumped for as far back as I can remember with my Dad. Oh, he's a Terry Pratchett fan, so I always buy the latest books, he loves puzzles, so I get interesting puzzles for him...but I was very proud of this fishing idea, and apparently he had a great time. Yay!

Tomorrow begins the second module of my Bobath course, which I am very excited about, so I'll just post a few more pics now, and then I need to read through the material we were given for tomorrow. One of my patients has been chosen to be our patient model, so I'm really looking forward to getting normal movement treatment ideas for her!

Nicole and Rob, looking like the cat who swallowed the canary for some reason. He got his passport back with fiance visa in place by post yesterday, big sigh of relief for them, the wedding can go ahead as scheduled! Keep scrolling down for more pics of just some of the people celebrating with me on Saturday night...

Sarah and Andy, whom I met through Jo

Jodie and her husband Rayman, who are Australian. You may remember hearing Jodie mentioned as my savior whilst working at the day hospital- I got to work with her on the wards in the afternoons.

Jo and James, who've just bought a little house in Clifton-Upon-Dunsmore (near Rugby)

Me, Karen and Jo, who was apparently giving me bday kisses ;)

Erm, I don't know...some lucky random clubber who was in the right place at the right time to get a birthday hug from me ;)

What a weekend

Well, my birthday weekend was a blast...I had half a thought to extend it and take one of my remaining annual leave days on Monday to make it a long three-day weekend, but then I remembered a home visit I had scheduled, so off I went to work yesterday. That's okay though, I'll take that day off on Friday Feb 2nd, which is the weekend of my yoga and hiking trip to the Brecon-Beacons in Wales. And then I've allocated my other three remaining annual leave days to a trip back to the States. I found an amazing fare online, so I will be going home for a couple of days, driving up to Boston for Nicole and Rob's wedding, then coming back to NJ in time to catch a flight to Peru or Costa Rica with Viv (we're deciding and booking everything this week), followed by a couple more days at home before I come back to the UK. Woohoo, let the new annual leave time begin! Five weeks of vacation a year definitely does make Allison a happy little worker bee. No word yet on my next rotation or potential move to Senior II, but you can bet I'll be posting on here when I do.

Anywho, on Saturday, we went to this amazing little restaurant/bar in Shoreditch called Cantaloupe. Limited menu,with a Spanish-North African influence, but everything was delicious! Everyone absolutely loved the meal, and it turned out to be quite the popular bar as well. Our meal ran pretty late, and the bar was just rammed by the time we left. 15 people decided to sing "Happy Birthday" at the top of their lungs (a few of those were big blokes with some sizeable lung power) and I was burning bright red by the end of the rendition, realizing quite a bit of the bar had joined in...I was bombarded with calls of "Speech, speech, speech" and then forced to deliver one standing in front of both strangers and friends. As embarrassing as that was, however, it was also a lot of fun, and I got a taste for being up higher than everyone else-- I later took advantage of the speakers at Ministry of Sound to dance on a stage, as it were. Technically not allowed, according to a sign posted on the speakers, but then nobody kicked me off either. Ministry was fun, although the "house" music tended toward techno and electronica. Around 2am, a live band went on, which I loved, but the headliner DJ who was on from 3:15 to 4:30 or so was a bit of a let-down, even for Nicole's boyfriend Dave who had been really looking forward to hearing this guy spin. But regardless, it was a great night, and I spent most of Sunday sleeping to recover, only getting up to join Nicole and Dave for a curry in the late afternoon. After which we watched Arsenal beat out Manchester United-- our house being Arsenal supporters :) I've got a few pictures below from Nicole's camera, haven't uploaded mine yet. Again, thanks to everyone for the cards, messages, flowers, and pressies!

I think that this was just after they'd finishing singing, and everyone was starting to realize most of the bar had been singing along...you can see I've already flushed red.

One of the side rooms at MoS had a cool leather bed with chain links hanging down all around it.

Looks like we're up to something, doesn't it...

Me and some of the girls...Nicole, Kate, Jodie, and Jo at the bottom (there were two Jo's there, the Jo you'll see in the next pic is a different one).

Not the greatest pic, but that's me and Jo, up on the speakers at MoS! And funnily enough, you can see one of my heels attached to the strap on Jo's bag.

"Go shorty, it's your birthday...

We're gonna party like it's your birthday. We're gonna sip on Bacardi like it's your birthday"
# # # # # # # #

"Oh, what a beautiful morning, oh what a beautiful day. I got a beautiful feelin', everything's goin' my way"
# # # # # # # #

I know, I know, it's a horrific mix of genres, but it is my birthday, and for the first time in a while, it is a beautiful day. The sun is shining, and although there are setbacks happening on the stroke unit this morning, it seems like nothing can get me down. Many thanks for the birthday messages and e-cards I have already received earlier today!!!! I woke up and stumbled downstairs as the zombie I normally am in the mornings, only to find a big sign plastered onto our hallway mirror that said "OVER THE HILL" highlighted in bright orange with a picture of an old lady knitting. I think I woke up both Nicole and Leeanne, I was laughing so hard. It is such a typically American way to take the piss, I knew immediately it was Nicole who put it there.

I have two sad stories this morning-- one of my little elderly ladies was scheduled to go home on Monday, which was already a delay from the original date of discharge this past Wednesday. She is the first person I have ever met who was "in service." She was a maid in the household of a posh Welsh family, and has loads of fascinating stories. She now can't leave on Monday, because they want to do an MRI and see if she needs surgery for a blocked carotid artery. If I were her family (and they are very unhappy about this), I would complain, because her D/C had been scheduled, she'd had a previous scan where they told her they thought everything was ok, and now at the last minute have changed their minds. And then there's another lady in her 60s, ready to go home for a visit this weekend, and then be discharged a week from Monday, but she did something very unsafe last night (poor insight and safety awareness can be such a problem with patients who've had a stroke), fell, and fractured her femur. So, no weekend visit, and she's being transferred to the orthopaedic ward.

But at the risk of sounding uncaring (which you all know I'm not), the sun is still shining, and I am not going to be brought low today. I will deal with these problems as they arise, comfort my patients, and keep my sunny mood. Happy Friday to you all, and Happy Birthday to me! Lots of love, Allison.

The Birthday Week

I was at one of my quarterly AMPs meetings this afternoon, which means I was at the Institute for Neurology in Queen's Square. This put me within short walking distance of Covent Garden. Some simple addition: It's January. I am the only person I know who has plenty of money left until next payday on the 31st. My birthday is on Friday. And the January sales are on...so yes, this equals Allison went shopping. For as much as I have boasted that I don't shop, I save my money for travel, this month, I broke that rule. Got some great stuff, and boy was it fun :)

Plans are coming together for the weekend. On Friday for the benefit of my co-workers, I decided to stay close by, and chose a pub that's a popular meeting spot for work things. I invited everyone on the stroke unit at the beginning of this week, and the OT team from the day hospital too. This morning I was in the main department for our weekly meeting with the acute stroke unit, and saw a big sign plastered on the door of the main office telling everyone to come out for my bday after work on Friday (thanks to Nicole, the little sneak who emailed someone in that office). So Friday has actually turned into quite the big event. But Saturday is the still the night we will be painting the town red. I've just now made reservations for 14 people for a restaurant/club in Shoreditch. We'll have some drinks at a bar or two in Shoreditch after dinner, during which time about 6 more people will be joining us. And finally around 11:30 or so we'll end up at Ministry of Sound, where at last count 10 more people will be arriving. I have a fabulous new birthday outfit with some new red lipstick too-- I figure this birthday calls for a little drama, don't you?!

"15 Minutes"

Last week, in one of the free London dailies, there was a picture of a guy riding on the underground, looking like a working stiff-- Ipod earbuds, bored look, wearing shirt and suit jacket with a poppy pinned to it. (As the news story later revealed the photo was taken during November, a time where many people wear the poppies because they are a symbol of Remembrance Day- equivalent to our Veteran's Day). The photo was apparently taken on the sly by a girl from Bavaria visiting London. She was too shy to approach him, but not too shy to take a picture. After returning back home, she apparently regretted being too shy, and started emailing his picture all over the place (the news story says it circulated among 1000s of Londoners), in the hopes that someone would recognize him, and help her to get in touch. I guess the email landed on someone's desk at this paper, they published her story and the photo, and within a day, he was found...Ben Moon, 27, and newly single as of 2 weeks ago. Talk about your timing! The paper is now offering to fly this tourist back to London to have a date with Ben, once the two potential lovebirds have agreed on a weekend. So for a short while here, at least until the date happens I presume, these two have landed themselves their very own 15 minutes of London fame It's a funny old world :)

And in other news, there is actually a serious campaign happening at the moment, sponsored by the Scottish National Party, to have Scotland separate itself from the United Kingdom. More at the BBC web site. So let me add, it's also a crazy old world.

News from the world of CVAs

Hardly feels like 2007, eh? Not all of 2006 passed in a flash for me, in particular those bits related to my rotation at the day hospital. Unfortunately now on my stroke unit rotation, it's like my life is on fast forward. I have less than 3 months left, and I try hard not to think about the withdrawal I'll probably experience once it's done. Everyone on the team would love to have me repeat the rotation, but it's too popular of a rotation- there's no way the Head OT will let me do that. So my only hope to stay in stroke world is the acute unit, which is on the Senior II rotation. I'm still waiting on word from the Head OT as to whether she'll be allowed to hire to that rotation. If the answer is yes, I'll probably be interviewing in late February, and assuming I were to get one of the posts, I'd most likely be slotted into Orthopaedics until the Senior II rotation changes in early July. At that point, fingers crossed, I'd be assigned to the acute stroke unit. In the meantime, I'm still looking at all the job adverts I can find, as what I really want is to be on a stroke rehab unit. Since I can't continue on the unit here after March, I have to look at other hospitals, and hope they don't count my need for a work permit against me, like the Homerton did (very famous regional hospital in East London, with specialisation in assessment, diagnosis, and treatment of higher level cognitive disorders-- for example, Dysexecutive Function). I have a guy on my caseload right now as a matter of fact, who is fully functional on a physical level, but unable to cope with problems/new settings/changes/novelty because of higher level cognitive deficits caused by his stroke. He's been accepted to the Homerton, but there's a long long waiting list for a bed, and we're pulling our hair out because we're not specialised enough to provide him with the treatment he really needs whilst he's waiting for a Homerton bed. Which could still take more than 2 months. Argh.

Technical Difficulties

I apologize, although I changed my playlist at Loudfusion.com on Wednesday, they seem to be taking much longer than usual to catch up. Previously, it has taken up to 24 hours or so for the player on my blog to reflect changes I make to my playlist at the Loudfusion web site. Not sure what's happening at the moment, but if need be, I'll take the player down next week, since unfortunately, Christmas is over, until next December at least...

Tune

This is a relatively new song here in the UK by Mika, it's called "Grace Kelly" and I doubt it has hit the US yet. Catchy... and as they say here, "Tune!" (pronounced like Toooooooon) It's the only thing on my MP3 player for the moment, but I won't leave it on too long for fear of boring y'all. :)

Ramblings

I've been having trouble falling asleep the past couple of nights...I suppose it doesn't help that I got the TV series Bones and NUMB3RS on DVD for Christmas, and the episodes can be gruesome. I find that my patients run through my head a lot as I toss and turn. Funny how, even with six patients, which I consider to be a light caseload, there never seems to be enough time to do everything I want to do for my patients, to do everything they deserve. I guess part of that problem is that OTs in this country are at least half social workers as well. Today in particular I spent probably 3/4 of my day on the phone with various patient issues. During our multi-disciplinary meeting, we were interrupted 5 times, all calls for me with regard to one or another of my patients. The rehab assistant was all apologetic for taking me out of the meeting, but these weren't issues she could just take a message about.

Anywho, I've been craving a latte this week. I think I must be growing up, I had two coffees during the holiday week. An eggnog latte when I met up with Rob and Nicole at Heathrow on the 23rd, since we were all flying out the same day. And a peppermint mocha latte whilst I was home. I'm sure at least a few of you are groaning, thinking to yourself, ha! that's not coffee, the same way I get protestations when I call california or avocado rolls, sushi. But hey, for a girl who has shunned coffee all her life, this is a big thing. I'm using my hours off from the relative group I ran in the beginning of December to take off from work early on Friday, and do a bit of January sales shopping. Maybe I'll treat myself to a latte then. :)

I was also remembering my trip to Macys at 7am on Christmas Eve, whilst lying in bed last night or the night before. Nature called, so I turned to the sales lady and asked where the nearest toilet would be...she stared at me, and finally said, "Ah....you mean the bathroom?" Which made it my turn to stare at her. Finally, I burst out laughing and said," Yes, I mean the bathroom, I'm sorry I forgot I'm back in the States. That was rude, I'm very sorry." At which point she started laughing, and pointed a finger in the direction I needed to go. My mom was also in hysterics, having lived in England herself for 4 years, and made some crack along the lines of "What country do you think you're in, lady?" An observation: I think the English are rather European, which explains a lot of phrases that they use, and it's common across Europe to ask for the toilet, or perhaps WC, a bathroom being more that place where you take a bath or shower. But generally speaking, I do think I've absorbed more of the British culture, it has become more second nature, than it was when I first arrived.

I've been out tonight for a leaving do for the speech therapist on our unit. She's moving on to a research position elsewhere, and a lot of people, not just from the stroke unit, went for drinks and a meal at the local pub. I am a big fan of the pub life, as I've said before, it's an addictive piece of British culture that makes you feel cozy, intimate, generally warm and fuzzy all over. City pubs can't compare to country pubs for the most part, but pubs are homey places, and I love whiling away the time with friends, down the pub. It was also a great time to keep building the buzz for my bday plans. Paris is not happening, that's a definite, we couldn't get a big enough group together and I think you need that energy for a night where you are out partying until 9 or 10 in the morning. Also, many people are currently experiencing money problems-- you see, we get paid early in December because of Xmas-- specifically we were paid on 20 Dec. And we don't get paid again until 31 Jan. So many people have already spent most or all of that money they got in December, and cannot afford Paris this month...so we've agreed we will do the Eurostar party fare and cabaret night a different month, probably this summer actually. But Plan B ain't too shabby either-- we're going to Ministry of Sound, baby!! Huge nightclub in London, known worldwide for the famous DJs who play there, they put out compilation CDs every year, mostly house music. I knew I'd have to go at least once, and this is the perfect excuse. It's not an expensive entrance fee either, so we'll have dinner and drinks first, haven't decided where yet, and then we'll dance our hearts out from midnight to 7am. And this plan is drawing a big crowd of people to join me, both because it's reasonable on their wallets, and you mention Ministry of Sound and people are hooked. So I'll do something more low key for my actual birthday on the Friday, and ramp it up big time for a massive Saturday night out on the town!

My Horoscope

"Your values could undergo a 180-degree turnaround today, dear Capricorn. Recent developments in the world, in your community, among your circle of friends, and within yourself could cause you to realize that you and everyone around you is, like it or not, going through a transformation. This is always a little disconcerting for the traditionally oriented Sea Goat, but it's a positive development. Take things one day at a time and see where they take you. You'll like the results!"

Two peas in a pod

A Zen koan, to paraphrase:

If you want to find something, you have to stop looking.

HAPPY NEW YEAR!

And, she's back

I went to the GP yesterday. What a mess that was. They only had one doctor, or so they said-- it looked like two when I got there-- so I couldn't actually make an appt, but had to call the morning I wanted to go in, and they would give me a time. I missed a half day of work due to that little system, argh. Anyway, I didn't want to see the doctor they offered, I've had him before, but that's what they offered. So I walked in, sat down, and the first thing I said to him was, "I'm here because I've had a cold since October 22" and proceeded to describe my symptoms and what I've done for my cold. He listed to my chest, found it to be clear, and began to tell me I should keep using expectorant cough syrups to get rid of the phlegm and paracetemol for headaches. I was at a loss for words, I just stared at him...so he said, well, look, you've only had this for a couple of weeks, right? And I said, "NO, since October 22! I would never normally come in for just a cold!" His eyes widened a bit, and in a quiet voice, he said "Oh, ok then, we'll try some antibiotics." I just love doctors who don't listen to a word that comes out of your mouth. By tomorrow, I should know whether they're making a difference or not, although I think already that perhaps they are. Touch wood.

A summary of my holiday week at home: I was on the wrong time zone all week. I woke up at 4am the first day, and got better by about a half hour each morning, so by the time I left, I was "sleeping in" until about 7am. I had my best night of sleep on January 1, which was my first night back in London...hey Midge, does that mean that GMT is actually the time zone my body wants to be in? (I remember you saying the US felt like the right time zone to you.) I did quite a bit of shopping, taking advantage of the excellent exchange rate (well, for those of us who live in the UK anyway), and my mom's generosity. On Christmas Eve, we were in Macy's by 7am, since I'd been up at 4am and was bored by the time Mom got up around 6am. I went with Tress to her hand doctor appt- we both decided the guy was an idiot, given that he didn't do any testing of strength, function, or sensation, didn't ask for a history of the problem, didn't look at her splints, and discussed one potential diagnosis with us, but wrote down something completely different as diagnosis on her prescription for therapy. Oh, and I especially loved the part where he told her to go get some blood tests done to see if it was arthritis or fibromyalgia! Thankfully, Tressa didn't really know what that was, but it scared the hell out of me the way he just tossed the term out casually, and without explaining it to her. Fibromyalgia is widespread pain affecting muscles, ligaments and tendons all over the body, is quite severe, and lasts for years. Nope, no thanks. Anywho, I had the name of another hand surgeon recommended by an OT I'd met through housemate Nicole, and we got her an appointment with that doctor for two days later. He seemed to be competent, and told her he thinks she has tennis elbow in both arms, suspects she has muscle tears at both elbows, and that the pain in her wrists and hands is referred from the elbows. No one seems to know exactly why the pain travels along her forearms as well, the radial nerve tunnel on both arms- she underwent a rather painful nerve conduction test at his office yesterday to make sure there's no nerve damage. And he told her no physio- just relax and try not to do things that aggrevate her arms (to the extent that is possible).

We spent Christmas Day with the Florys, Jenn and I continuing our tradition of cooking a gourmet feast for our families, although a toned down version since no one wants to work hard on Christmas Day. Standing rib roast, shrimp fra diavolo, twice-baked potatoes filled with cheese, shrimp, and sour cream, cauliflower au gratin, and pannetonne trifle for dessert. I've got a few pics from that day, see below.

Spent a lovely spa day with Viv and Rhonda, I had a Swedish massage, manicure and pedicure. And an absolutely delicious meal at Delta's in New Brunswick, a soul food restaurant- blackened catfish, mm-mmm.

We entertained the Heilalas at our house, played some Wizard, learned an addictive new game called Blokus, and generally had a good time.

I visited with a previous patient of mine from when I worked at Roosevelt, he has come a long way in recovering from his stroke. It was really amazing to see what he has accomplished since going home, and I enjoyed catching up with him and his wife.

Oh, yes, and Viv delivered the bad news that since she has just bought a new townhouse and does not yet have renters for the old condo (poor baby, she's just racking up the assets), she has backed out of our trip to Thailand and Philippines we've been planning for the last year. Therefore, I am thinking I will attend Nicole and Rob's wedding in Boston the last weekend in March after all, or at least I hope to, and I am trying to plan a trip to Peru (Machu Picchu at long last!) or Costa Rica from the US whilst I am there.

Oh, and it looks like I will be going to Paris for my bday after all!!!! Two takers so far, and I'm thinking more people will say yes...how can you say no to an authentic top-notch Parisian cabaret, I mean come on! You can't say no. It's going to be fabulous...

This pic was used for the 2006 Johnson Family xmas photocard. Some of you may find them in your mailbox this week...

We girls were very good this year...we rated a personal visit!

The family Flory. My Jenn is in the middle, with her fiance Chris next to her.

I've got to admit, it is a "White" Christmas here in London

Happy first day of winter everyone...and hurrah, the shortest day of the year is now behind us!

I have now checked in online for my flight tomorrow, and Virgin's web site says their services have not been disrupted by the fog. I looked out the window at one point today, and because of the density of the fog...or something...for a split second I thought it was snowing, a white-out of small flurries, falling fast and furious. Of course, almost instantaneously I realized how ridiculous that would be in London, but boy, was it still a disappointment to come screeching back to reality! (Incidentally, it was hard to take the new movie The Holiday all that seriously, with what looked like a good 3-4 inches of snow on the ground in Surrey. Ah, what I wouldn't give to live in Surrey- my parents had a good life there.) But hey, if there's a stereotype of London weather that people think of, this is it...pea soup fog. And I'm lovin' it for that reason-- especially since my flight is not grounded ;)

Planets, Planes and Potter News

I apparently missed this...one of the papers has done a review of 2006 in today's issue, and around August, Pluto was demoted. 70 years after it was discovered, Pluto has lost its planethood.

In other news, for those of you Harry Potter fans, check out her website, jkrowling.com to find out the title of the upcoming 7th and last book in the series.

As reported by MSN, "If you go to her home page, click on the eraser and you will be taken to a room — you'll see a window, a door and a mirror.

In the mirror, you'll see a hallway. Click on the farthest doorknob and look for the Christmas tree. They click on the center of the door next to the mirror and a reef appears. Then click on the top of the mirror and you'll see a garland.

Look for a cobweb next to the door. Click on it, and it will disappear. Now, look at the chimes in the window. Click on the second chime to the right, and hold it down. The chime will turn into the key, which opens the door. Click on the wrapped gift behind the door, then click on it again and figure out the title yourself by playing a game of hangman."

However, you have to do all these things in the order listed, or they don't work. Yes, I've tried it, I'm not ashamed to admit I'm a kid at heart!!

And finally, no, Heathrow is not closed, and no, I don't expect to be stranded here for Christmas. Whilst we are in the midst of a pea soup fog that apparently will not lift until Sunday, it is domestic and some European flights that are being affected. Heathrow was operating at about 60% of its normal flight volume today, according to news reports here, and I have it on good authority (the sister of a colleague for works for the airlines) that thus far, flights to the US are doing just fine. :-)

I love these--

"Look at you, you Nice-ish thing

To all appearances you’re a nice enough sort, but scratch the surface and there it is— a bit of the naughty itching to get out. (Pardon the pun, but that’s just the kind of thing you nice-ish folk are into, isn’t it?) You can be trusted in most public situations, but once behind closed doors—heaven only knows."

I'm a member of the Virgin Atlantic flying club, and built up a fair amount of miles over the years, especially during the four years my parents were living in England. I was in Oxford for one term in the winter of 2004, and after I left, I came back almost immediately to visit in May '04, using 50,000 miles to avoid having to pay for my ticket. Except they never took those miles from my account (wahey!!!!), and I am now using them for the second time to go home for the holidays, since my ticket was so last minute and I couldn't afford the fare otherwise. Anywho, Virgin sent me an email to take their Naughty or Nice quiz, and the results are as above. A fair assessment I would say ;) Here's hoping they forget to take the miles out of my account again this time...

"A beautiful sight, we're happy tonight..."

...walkin' in a winter wonderland.

Well, we pretty much had our first frost overnight/this morning. The Epping Forest area looked just gorgeous on my walk into work, with everything covered in a light dusting of white. The only way it could have been better would have been if it had snowed. And this- this is what I'm talkin' bout!! This feels much more like Xmas weather. If it's warm, it just doesn't seem like Christmas somehow. Maybe I should wear my PJs inside out tonight, like I did when I was a kid hoping for snow days from school- it makes it snow if you wear your PJs inside out, you know ;)

David Bowie, Goblin King

I was out shopping locally yesterday for a Secret Santa gift for work, and one of the places I checked out was HMV. The way we're doing our Secret Santa, we didn't pick names out of a hat, we're just bringing gifts in, and it will go by number...with the twist that some people like where the person who draws second can choose to keep their gift, or steal the gift from the person who went first, and so on. I wasn't sure what to buy, since I didn't know who I was buying for at our 5 pound limit, so I settled on a DVD of The Grinch Who Stole Christmas, Jim Carrey version. And as I walked down the aisle, I couldn't believe my eyes, I came across a DVD of the Labyrinth! Also for a fiver. Let me see if I can jog some of your memories...David Bowie? Jim Henson? No? Well, it has always been a favorite movie for me, even though I hadn't seen it in years and years, so I bought myself an early Christmas gift. And it's my little piece of happiness today :)

Party Pooper

8 Days Til Christmas! And less than a week now until I'm home for the holidays! And I think the only gift I don't have is one for my cat, Gerry. But I can just stop at Petco on Christmas Eve and take care of that I should think ;) And Jenn and I have managed to salvage our relatively new tradition by cooking our gourmet feast on Christmas Day as opposed to Christmas Eve, yay!!

Let's see, Friday night I was out with the stroke team, both current and alumni members, for a Christmas tapas meal/night out. It was an extremely entertaining night for reasons I can't share on here, but I'll be home soon enough to tell y'all about it in person. And last night was housemate Nicole's big birthday extravaganza. Something strange has been going on with me on and off this weekend, where I've been getting nauseous and light-headed, but I thought I was ready to go for the night out, since I was starving when we set out for dinner. We had a fabulous thai dinner in Soho, and from there headed over to Waxy O'Connors in Leicester Square. We'd been there about 20 minutes or so, and I suddenly felt really light-headed and slightly nauseous. I tried to tough it out for a few minutes, but finally went upstairs for some fresh air with a sympathetic bouncer watching over me (no, I wasn't feeling like that from alcohol, I'd had one glass of wine with dinner, and one sip of my rum and coke at the bar). Dave (Nicole's boyfriend) came looking for me after 10 minutes or so, to tell me they'd moved to a different part of the bar, and I decided to give it another go. Luckily, they'd found a little area where I could sit down, which was worlds better. I announced myself to be the designated Party Pooper, and bowed out of rounds, but had a great time regardless being chatted up. But eventually, the group decided they wanted to try another part of the bar, to which I said, no way, unless I can sit down-- so Nicole and another girl Jo ran off, and came back to say they'd found the Princess a stool, so we moved. And I was affectionately-sarcastically referred to as the Princess for the rest of the night. Which was rather ironic, considering the "stool" they'd found for me put me at about knee height with everyone else. There's a pic of it below, because hey, if you can't laugh at yourself...

From there,we went on to the Comedy Store at midnight. Everyone but me was battered at this point, but that didn't stop them from going through pitcher after pitcher of beer at the comedy club...including our housemate Leeanne, who heckled and shouted at and screamed with laughter at the three comedians in the first part of the show, and then abruptly decided she was bored at intermission and left. The show was really really good, and everyone had an ace night, which made my job as babysitter (by default being the only sober one) very hard. It took forever to get everyone out of the club, and to find the night bus. While we were traipsing around London I played referee to fights (verbal spats) that were only happening because people were drunk, and somewhere lost the quarter inch cap off the bottom of the left shoe of my favorite and most comfortable pair of high heels, lol. I also had to prevent Dave from trying to get off the night bus twice because he wanted to get onto the tube, being too drunk to realize the tube wasn't running. Our night bus driver by the way was tearing around London like the night bus in Harry Potter, and I was holding onto the grab bar for dear life, most of the way. But we finally caught a cab at Liverpool Street Station, after managing to convince the driver to take 6 people for an extra tenner on top of the metered fare (he was only insured to carry 5), and we walked in the door just after 4:30am. What a night!

The Princess

(on my little foot stool)

The Housemates

the girls

Dave and his brother Andy

At the end of the night, at the comedy club.

Meet the Stroke Team

We had a birthday party for the lovely girl in the middle of this picture. Because of confidentiality, I can't tell you much about her, although I will say she didn't have a stroke. But she needed an intensive inpatient rehab program, and we had a bed, so through a funny twist of circumstances, she came to us on the rehab stroke unit. You'll notice several of the girls are holding purple Quality Street candy boxes...she came with gifts for all of us on her birthday! Her family is absolutely lovely, and her dad took lots of pictures, talking about how important all these memories are for his daughter.
Ok, so this picture is here because I've gotten a lot of compliments lately from people both at work and outside of work on how I look when I leave my hair down. I almost always have it up at work in a ponytail or clip, because it just gets in the way otherwise, and I guess I've gotten so used to it, I tend to twist it up when we go out too...especially if I know we'll be dancing, and I'll be getting all sweaty. But I've got a hair appointment lined up for when I'm home, and I was planning to chop it all off, in the short style that I had for a long time. I've been afraid to go to anyone here, so it's grown long since I saw my hairdresser in NJ at the very beginning of this year. I'm not asking for a vote, since I already know I'd be going against popular opinion here, but I think I'm still leaning toward chopping it off-- it'll grow out again pretty quick anyway. Oh, and I've never put pictures up before, but you can see a little bit of my room in the background...

Straight No Chaser (name of the group) & "12 Days"

Ok, even if you are not a big fan of a cappella, you have GOT to watch this video, all the way through. Believe me, it's worth it, I PROMISE. (Oh, and click stop on my MP3 player to avoid competing audio, ugh.)



And if you liked that, check out http://www.youtube.com/watch?v=JKx_BTj_-IE

Scary stuff

There's a serious manhunt going on over here right now, for a serial killer they're calling the Suffolk Strangler. He (the papers are all calling the person a "he") has killed 5 victims in 6 weeks, which is apparently unprecedented in speed, and forensic psychologists believe he is taunting the police, dumping the bodies practically under their noses. Scotland Yard is involved, to help the Suffolk Police close the net. Eerily, the victims are all prostitutes. Jack the Ripper killed five prostitutes in East London over a period of 8-9 weeks in 1888. And as you all know, he was never caught. In Ipswich (Suffolk), just as they did back in Jack the Ripper's day, prostitutes are continuing to ply their trade in the red light district there, in spite of the danger...for whatever their personal reasons or habits to support, they say they need the money.

Gorillas

Have I ever mentioned that sometimes I get really jealous of Tressa? Well, this would be one of those moments. She went on a gorilla trip, and got to see the Sabyinyo group, which has the largest silverback gorilla in the world, at 450 pounds. Plus 3 wives, 2 blackbacks, and 2 babies. Here are a couple more of her photos...

Happy Birthday to (housemate) Nicole!

Inner Peace

"I am passing this on to you because it definitely worked for me and we could all use a little more calmness in our lives. By following this simple advice I heard on the Dr. Phil show, I have finally found inner peace.

Dr. Phil proclaimed, "The way to achieve inner peace is to finish all the things you've started and never finished."

So, I looked around my house to see all the things I started and hadn't finished, and before leaving the house this morning, I finished off a bottle of Merlot, a bottle of White Zinfandel, a bottle of Bailey's Irish Cream, a bottle of Kahlua, a package of Oreos, the remainder of my old Prozac prescription, the rest of the cheesecake, some Doritos and a box of chocolates.

You have no idea how freaking good I feel. Please pass this on to those you feel might be in need of inner peace."

Hahahaha! Courtesy of Jean Aveyard (Mom #3)

nature's beauty

I saw a big beautiful red fox on my walk home from work today, in the strangest place. There's a big traffic circle (roundabout) in the middle of my walk, and they built an underpass for cyclists and pedestrians...it has various kinds of grass, brush, and small trees, and it's a very large underpass. But still, it's in the middle of this huge traffic circle. And I was walking toward the exit, I saw this rather large fox come trotting toward me under a bridge/overpass along the path, as if it didn't have a care in the world. He veered off into the bushes before he got anywhere near me, but I wasn't afraid, and he was a gorgeous creature. Just wanted to share ;)

pictures? what pictures?

for those of you asking about more pics from the thanksgiving weekend, i'll see what i can find, but i'm taking the 5th on most of them...i'm not all that photogenic, and my housemates made me promise to delete certain ones, from both our big night out on friday, and our big night in for the house party on saturday. it was a crazy, silly batch of pictures, in a nutshell, and i reserve the right to not publish! ;)

hey, time is flying: only 2 weeks from today til Christmas!!! (hope everyone's almost done with shopping!)

the christmas party

I have a couple of pictures of my co-workers from the day hospital (my original rotation, before the stroke unit), from the Christmas dinner we had on Friday night. We went to a Greek restaurant, where the food was excellent, the restaurant was jam-packed with long tables full of very drunk people from various offices, schools, and in our case, the hospital, and the entertainment was a belly dancer, a traditional Greek male dancer balancing towers of glasses on his head, and cheesy good-time music from a DJ. Christmas dinners/parties/balls are a huge deal over here, everyone has them, and everyone "lets down their hair" big time, no matter what part of the hierarchy their job title places them in. It really is a British thing...I was thinking today about how we always invited our rehab director and manager at the hospital in NJ to the happy hours and BBQs, etc that we had, but they always politely declined. And additionally, while I can happily remember some all-out holiday bashes my father's company used to sponsor back in the day when I was little, including magicians, bands, and someone dressing up as Santa, Christmas parties don't happen like that any more in the States (except for maybe the big money law firms). So this year I am happily taking advantage of the myriad Christmas do's that are such a cultural phenomenon over here...great fun!! Oh, and the pics- well, I'll post them when Blogger stops acting up and lets me.

"Oh yes we need a little Christmas, right this very minute..."

I have updated the MP3 player in my sidebar with Christmas tunes, both contemporary and classic. Hopefully there's something for everyone. Sometimes it takes a little time to change over to the new playlist, but by tomorrow you should hear them. I wanted to include "You're a Mean One, Mr. Grinch" but the site where I put my playlist for the MP3 player is refusing to accept it due to something in the file name, grrr! I'm doing my best to get into the spirit as much as possible, though unfortunately, I don't really have Christmas decorations over here (but I did buy a pointsettia to brighten up our living room), and I can't do all the baking I would be doing at home...ie sugar cookies, as is traditional! Not to worry, I'm sure my mom will have cookie dough ready for when I arrive, right Mom? ;) I will also have a marathon Christmas movie watching session, since all I've got here are The Santa Clause and The Santa Clause 2... in particular, the Muppets Christmas Carol is traditional for our family, over and over and over again, as well as Chevy Chase in Christmas Vacation. Classic!

Weather Watch

The weather has been all over the map today. This morning it poured rain, then there was a blue sky and sun. Then it hailed and poured rain, then the sun came out again. Then the winds picked up, to the point where whistles and moans could be heard on the wards and in our offices. And just now, as I've been sitting here in the office, trying to catch up on discharge report paperwork, we've had two powercuts due to the high winds. And let me tell you, it's not fun sitting on an abandoned ward, alone, in the pitch dark. Luckily, they didn't last for long. I'm here because I'm running the once monthly relatives' group this evening, after which I will brave the elements to attend a Christmas thing with Nicole at a famous bar in trendy Shoreditch. I have heard, from some of the family members who are already here, that the news stations have been reporting a tornado touched down somewhere in North London earlier today. Well, they do say the weather is very changeable in London ;)

The down side

I've been struggling today with the recent development of clinical depression in one of my patients, and the role we played in "causing" it. This lady is 85, presents with right-sided neglect, and decreased sensation on the right side, but she has full range of motion and good strength. In certain routine daily activities, the right side automatically comes into play, as it also does during therapeutic intervention that we structure to bring her awareness to that side. However, there is more on this patient's problem list. We believe there may be some visual field problems and referred her to the orthoptist- we're waiting for the appt. There are definitely some visual perceptual problems including figure ground, object constancy, and depth perception deficits. She perseverates a lot, and cannot easily divide or alternate her attention. And as if all that weren't enough, she has both expressive and receptive speech aphasias, although she gets the general idea during conversational speech, and sometimes manages to get out what she actually means to say.

Put all of this together, and we had to have a case conference last Thursday with her family to say that the prognosis is not good-- that even if she makes improvements with functional transfers and walking, she will need 24 hour supervision due to the cognitive deficits. Although she'd only been with us a little over 3 weeks at that point, we felt it only fair to give her family time to absorb this, ask any questions they might come up with, and begin to make a very difficult decision about whether they could look after her as a family, or tell us to begin the process of finding her a place in a residential or nursing home. Now, although this patient did not by any means follow along in the meeting, point by point, it was clear she understood the concept that we were discussing a "home" for her, and were saying she could not go back to her own home. She was very distressed by this, and kept repeating "But they love me, we all love each other. " (Referring to her family.)

Prior to the case conference, she was always motivated for therapy, always bright and pleasant. On the Friday following the case conference, she came with us to the gym for therapy, but was rather agitated. She then had the weekend with no therapy, and apparently, according to nursing staff, her family has been visiting a lot less frequently. So this poor lady knows we were talking about a residential/nursing home for her, probably doesn't understand why, doesn't understand why she can't go back home, has little to no control over her environment due to her long list of problems, and may very well feel like her family is pulling away/abandoning her. On Monday, she was a completely different person. We were told by the nurses she wasn't sleeping at night, she's not eating, she can't sit up straight in a chair, is tired all the time, couldn't be roused to keep her eyes open let alone get her transferred into a wheelchair to come to the gym for therapy, and kept repeating "I wanna go home, I wanna go home, they love me." Tuesday, the same, at which point I said to the nurses, the SHO, and anyone else who would listen, this lady needs help urgently, she's showing signs of clinical depression directly related to what we told her in the meeting. Today, the matron of the ward came to me for an update on all the patients, and I repeated myself again, and apparently today this lady's been delirious, so they finally paid attention to what I was saying.

Although I've been reassured that we did the right thing by including her in the case conference, it would not have been right to keep her ignorant of discharge plans because she would have to have been told eventually and would have had the same reaction then, I still feel awful. Just horrible. It's night and day, her emotional health and personality before the case conference, and now. But I guess even if we'd only told her family, so that we could continue to make progress in therapy, all that progress would have been lost when we did tell her. Well, that and we could never have predicted she'd have this reaction in the first place. You just never know with stroke patients, the brain can be such a delicate thing, and maybe the only thing she was holding onto in what is now a confusing world for her was going back home, where everything would be alright. Seems to be how a lot of our patients feel, actually, although for very few of them is it actually the case that they go home and everything is alright.

On birthday plans and cold wars

I've had a great idea for my upcoming birthday, but am rejecting it due to costs: the Eurostar offers a "party train" fare...you leave at 4:30pm and must be back on the train to return to London by 10:30am the next morning, for 38 pounds. Pretty nice! So I was laying in bed, having one of those nights where your mind won't stop so you're just tossing and turning, and suddenly I thought, hey! I know- the cabaret! A live burlesque show! in Paris! I mean, what more could you want for a birthday?! The trouble being, the cabarets seem to all be in the neighborhood of 75-90 euros. And with that, the train fare, and money for drinks, that's just too much to ask of people. :( I can't tell you how sorry I am to be dismissing that plan...

In other news, I have declared war on my cold/being sick. Today I have had pomegranate juice, multivitamin juice, a spicy curry for lunch (and some garlic in the form of garlic-stuffed olives), chicken soup for dinner (to which I added chili pepper flakes), I have drunk all kinds of hot and cold beverages, I bought echinacea and was talked into an elixir that boosts your immune system at the health food store, not to mention the traditional cold & flu meds, cough syrup, cough lozenges and vaporub. This evening, I did not do the strenuous portion of my gym routine, only participating in the pilates-based class instead (which I did not enjoy, generally speaking when they're called pilates-based I don't like them) because I'd been advised that things like running on a treadmill should be avoided during a cold. I have had enough of having colds! I will get rid of this one, and there will NOT be another one lurking around the corner again!! So there. Oh, yes, and I will not be having more than one or two drinks at the various Christmas do's on Thursday and Friday this week.

Sex

Knew that title would get ya! Haha! Read on...It was an interesting day at work today-- half the team was out on annual leave for one reason or another, so it was just myself and two physios trying to manage the whole unit caseload.

For the first time as on OT, I addressed the subject of sexuality today. We had a case conference with a patient (who is going home Dec 21) and his spouse to discuss the details of his discharge. He is 57, and I believe she's 10 years younger, and by the time we'd come to the end of our conference, I just felt like I had to bring it up. For those of you non-OTs, although we aren't really told how to do it, it is stressed as part of our OT training that since we focus on holistic treatment, we should always be aware of how important sexuality is. Even more so because no other rehab professional will address it with the patient. And when you think about it, it's true, if everyone on a rehab team ignores such a major issue as sexuality, your patient may go home with lots of questions and no answers, because it wasn't something they felt comfortable bringing up. So it's our job as OTs to break the ice, and make it ok for them to ask questions. I have not had to figure out how to do this until now, as I've dealt mainly with elderly, frail patients. But today, when everything else had been said, I told M and his wife that although I'm not an expert, I'd be happy to provide information and resources if they had questions about their intimate life with each other, considering M's post-stroke deficits...and as I said this, I could feel myself going bright red. Which they and Bettina, the physio, thought was hysterical. This couple is very down-to-earth, very straightforward, and I don't know why I flushed as I was speaking, they were the perfect people to help me start figuring out how to address the subject. But on the other hand, to illustrate my earlier point, even being such a "hip" couple, they had not brought up the subject with anyone on the team, so it really is my/our responsibility to open the lines of communication so that people know they can talk about it or ask questions if they want. I just have to figure out how to have the conversation on a clinical, professional level, so that my face doesn't keep giving away the fact that I feel like I'm pushing my boundaries!

News from Rwanda

I forgot to mention on Friday that it was World AIDS Day, you'll find a new widget on my sidebar if you're interested in making a contribution. But I thought I'd copy and paste from Tressa's latest email update, hope she doesn't mind, as it's to with HIV. Oh, and Happy December everyone! 21 days to Christmas!!

"Hello all,

Friday was World AIDS Day. I'm not sure how much coverage it gets in the US, but it tends to be a big deal in Africa since the prevalence rates are very high in many countries. It's only about 4% here in Rwanda, but big donors (various foreign governments and UN organizations) like to give a lot of money for it. Partly because it's a very popular cause right now and partly because donors still feel guilty about the genocide and are willing to show it with money. On World AIDS day, you're supposed to hold lots of public events to education people, and show support for the cause.

CRS planned a day-long event at one of the centers we support here in Kigali for street kids and kids who are already household heads (lost their parents to the genocide or AIDS or something else). There were about 250 kids, from 8-22 years old. There were several speeches and we had some games for the kids; mostly questions testing their knowledge about HIV. The winners were given backpacks with school supplies in them. They did some traditional Rwandan dancing for us and presented a skit they had created showing the dangers of unsafe sex. The dancing was pretty good. I've seen it done by several times before and it takes a lot of energy and concentration! One of the best parts however, was when it rained for 10 minutes. Everyone ran under the awning, and the DJ put on some American hip hop music to pass the time. Two of the younger boys ran out into the rain and started dancing by themselves, just because they love to dance. They were definitely a hit.

Then we ate lunch, which some of the kids themselves had prepared. At this center, they have professional training courses for the kids. They can enroll in carpentry, metalwork, cooking, or tailoring during the year. CRS helps with small income generation projects for the center itself, so it can work towards being self-sustainable. We given them cows and training on how to manage them. We used to contribute their grains and oil to feed the kids, but our donor has cut its funding. After lunch was the big football game between the kids and CRS. So we played against teenagers who probably practice every day and I was by far the youngest member of the CRS team....we lost some very large number to 1, but at least we scored! And we know now who on our staff is remotely in shape (not to mention who knows the rules); it was highly entertaining at the time and I suspect will continue to provide some laughs in the re-telling.

I hope everyone is doing well. I'll be stateside for christmas and new years, which will be nice.

Love,

tressa"

The word, on Sunday night

So, this weekend...I cancelled my plans for Friday night, came home and slept. I have yet another cold (after finally getting rid of the one that lasted more than a month, I was "healthy" for maybe 3 days before showing symptoms of this one)...I've been such the social butterfly for so long now, saying yes to everything and thus having really late Friday and Saturday nights every weekend (involving alcohol, naturally, see my previous post on how over here, social event=alcohol), I think my body just decided enough is enough. I slept for a solid two hours after work, woke up, sent my apologies to the people I was supposed to meet, had dinner, and went back to bed. However, I did join up with Nicole and Rob and a whole bunch of their friends, plus housemate Nicole and her boyfriend Dave, last night for a great meal and then drinks...it's hard to say no when you're having fun, so it ended up being a late night once again. Luckily, today being Sunday, there was plenty of time for a lie-in.

In other news, let's see...I've been a busy bee getting together Christmas gifts, both homemade and bought. It's a bit more difficult to come up with ideas for things you know people really want or will really like, when you're not around to pick up the hints they drop in daily conversation. And I've always been someone who hates to say, "Ok tell me what's on your list, give me an idea..." But I think I'm managing! However, housemate Nicole's birthday is coming up in a little over a week, and I'm a bit stumped on that one, even though I live with her. And Dave has not been of much help, grrr. Hopefully I'll think of something really soon here...I've got a bit of a grace period since we're not actually celebrating her bday until the 16th, even though it's really on the 12th.

And at work, I am still very happy, which still seems to continue to amaze my supervisor. I guess in the past, she's been used to some basic grades being really stressed out, not liking the rotation for some reason, or only really settling in and realizing that they like it when the 6 months are almost over. Apparently, she heard ahead of time how much I was looking forward to starting on the stroke unit, and she was afraid it wouldn't live up to my expectations. But I'm a little different from the other basic grades, given how much experience I already had in rehab world before moving across the pond, and I already knew I wanted to specialize in stroke, had worked with stroke patients, knew what I was getting myself into. I explained to her that, professionally, doing this kind of work is why I made the move. And I'm loving every minute of it, even the hard parts of it. Nothing like taking on a challenge, and overcoming barriers. I wrote a little bit earlier about how much I enjoyed my first Bobath module, which took place on Thanksgiving and Black Friday. I am so looking forward to the next two pieces, plus I am putting in my application for the three-week Bobath course. Apparently, even though it is supposedly offered worldwide, there are no Bobath courses presently in the States...and I am now looking into the Senior II position at Whipps, which has a rotation on the acute stroke unit, and apparently I have a very good shot at securing. There are only two basic grades with enough experience to apply, me being one of them, and there will be some vacancies shortly. Good thing too, as with my work permit situation and the current OT job shortages, I can't get a Senior II job anywhere else.

Fun Facts

from London's various free newspapers. There is a new study out claiming that women get a natural "high" from talking and shopping, because that's how our brains are structured. Some of the figures quoted:

A woman will speak 20,000 words in an average day; a man will speak 7,000.

Men think about sex every 52 seconds, whereas it crosses a woman's brain only once a day, on average.

British women will spend an average of 8+ years of their lives shopping.

And one that will amuse many of you-- "Women have an eight-lane superhighway for processing emotion, men have a small country road."

Dr. Louann Brizendine claims that women have larger cortexes in their brains than do men, and conversation stimulates a rush of a dopamine, therefore talking is a natural "high" for women. Men on the other hand, don't get a response from their pleasure centers from talking, and therefore are less social. However, their brains are set up to think about sex more regularly.

Now, I don't know about you all, but I have known some guys in my time who loved to hear themselves talk...so I'm not sure what conclusions I should be drawing here ;)

A group pic from last Friday night, as we made our Thanksgiving celebrations last all weekend...;)