Advent Reds

I worked this weekend but there was still an hour of sunlight left when I finished today. I walked along a favourite trail where winter birds are accustomed to human handouts. It was the perfect way to rid myself of the fatigue and stress of the day.

Each Sunday of Advent, I make a simple meal and one special sweet treat. We light the Advent candles when we eat together.

Tonight I made Mexican Christmas Punch, a fruity, spiced hibiscus based drink which looks very festive. My daughter made it for me in November and it is warming and delicious on a cool night. I posted the recipe on my recipe blog.

Set the Oppressed Free

Young boy in the village of  El Ahualamo MX 

I travelled last month to Mexico to visit my family for the first time since April 2013 when my mother died. My dad has struggled with his health and it has not been easy for him to find a new normal without her around. Last year we quickly packed up Mom's clothes and personal things but during this trip we went through cupboards, shelves and drawers more thoroughly. Many of her books were full of mildew and had to be burned. I found myself drawn to old family photographs, scrapbooks and handwritten recipes in the old wooden recipe box. Most of the other things she had collected over the years were not worth bringing back to Canada. My house is full of stuff, too full in fact of items I never use. One of our daughters said, a little facetiously, that we need a good fire because she doesn't want to sort through our belongings in the future.

I did bring home these Goebel porcelain pieces entitled "Flight into Egypt". Mary and Joseph are depicted as refugees, fleeing the evil wrath of King Herod with the young child Jesus. I recently discovered Steve Bell, a Canadian singer-songwriter who has two thoughtful Advent -Christmas albums I have listened to often over the past few weeks. The song "Refugee" from the album "Keening for the Dawn" is based on a poem by Malcolm Guite.

We think of him as safe beneath the steeple,

Or cosy in a crib beside the font,

But he is with a million displaced people

On the long road of weariness and want...

Church under an ancient sycamore tree in El Ahualamo, MX

The needs of poor and displaced people in the world are so great and complex that it is hard to know how to make a difference. Jesus stated his purpose and ministry in Luke 4:18 when he quoted the words of Isaiah.

"The Spirit of the Lord is on me, because he has anointed me to proclaim good news to the poor. He has sent me to proclaim freedom for the prisoners and recovery of sight for the blind, to set the oppressed free..."

There are ways we can make a difference in our neighbourhoods, cities, country and world with our time and money. I know several people who came to Canada as refugees. I know even more who are sick, lonely and discouraged. I know of good organizations that assist people in need around the world in a respectful manner.

One thing is certain...I have no needs this season by good fortune of birth, family, citizenship and employment. With that comes responsibility to use and share wisely what I have been given.

The Young Eagle Soars

I stand at this spot where the small lazy river splits around an island below a high sand bank. The Bald Eagle nest is not easy to see without binoculars now that surrounding vegetation obscures the view but it sits atop the tallest pine tree on the embankment.

July 14, 2014 - I estimate the eaglet is about 10 or 11 weeks old on this date. After watching the nest for half an hour around 8 AM, I see no activity at all. I move to another spot on the river and find the young bird sitting on a branch far below the nest. Note the excellent camouflage!

An adult bird lands near the nest and watches but the young bird does not move. I wonder how it got down the tree and if it will be able to fly back to the nest. I know some young eagles do not survive their first flight. Three rain showers pass over on this dull day and I finally leave because of mosquitoes and lack of an umbrella.

I return in the afternoon and find the eaglet on the same branch. It is nearly impossible to see without binoculars as it blends well with the trunk of the tree. Will it get back to the nest?

July 18, 2014- Another brief visit reveals the young bird did make it back to the nest. I watch it fly back and forth to nearby branches.

An adult bird drops in but the eaglet is not interested in flying far from the nest. It is amazing to see how quickly the young bird grew to adult size.

This weekend - I arrive to see the young bird flying above the tree tops close to home. It is about 12 weeks old now.

It circles back to the nest and has a rest.

An adult bird drops off a good sized rodent and leaves as quickly as it arrived. The young bird works away at its meal.

It is a full time job feeding this youngster. Bald Eagles may have two or three young and those nests must be very crowded and busy. The adult returns and perches as the young bird finishes eating.

They both sit outside the nest but in the next hour the young bird does not try another flight. It does its wing exercises several times though. It needs to work hard on strength, coordination and endurance. (That is a line I also use with my patients)

Now that the eaglet has fledged, it must learn to hunt for itself. The adults will continue to feed it for a while but it will be on its own before winter arrives.

It has been interesting and inspiring to watch this young Bald Eagle grow under the watchful care of its parents. Most birds nest secretively but there is nothing secret about this large eyrie where eagles perch confidently overlooking their territory. Many times this scripture from Isaiah came to my mind.

Isaiah 40:28-31

Do you not know? Have you not heard?

The Lord is the everlasting God, the Creator of the ends of the earth.

He will not grow tired or weary, and his understanding no one can fathom.

He gives strength to the weary and increases the power of the weak.

Even youths grow tired and weary, and young men stumble and fall;

but those who hope in the Lord will renew their strength.

They will soar on wings like eagles; they will run and not grow weary,

they will walk and not be faint.

Enjoying Small Things

This is one of the places I sit along the river to watch the Bald Eagle nest. Yesterday I waited for most of the morning through a couple of rain showers and then in humid sunshine.

There are many birds along this bend in the river including nesting Bank Swallows, Belted Kingfishers, Baltimore Orioles, Rose-breasted Grosbeaks, Northern Flickers, Common Yellowthroats to name a few. Sitting still is never boring.

I saw only one Yellow Swallowtail butterfly but there were many Skippers and Cabbage Whites on the wildflowers. A small worm photo bombed the picture of a Skipper on a wild daisy.

The decline in native butterflies is significant. I haven't seen a single Monarch Butterfly this year.

These small creatures often give a picture of the health and balance of the ecosystem.

A pair of Belted Kingfishers entertained me with their warrior rattles and enthusiastic fishing techniques.

I have watched these young Mallard Ducks since they were small and sheltered by their mother. Today they swam boldly upstream with no adults in sight.

This river is ideal for canoeing and kayaking as it loops lazily around the countryside. These ladies were headed for a community about 15 minutes away by car, but the water route will take a couple of hours. We chatted as they passed downstream at a slow speed.

I was pleased to see a shy female Rose-breasted Grosbeak on a willow branch near my sitting spot. Her mate sang a loud, bubbly song from a leaf-shrouded tree top as she quietly looked for food.

I am never disappointed with the beauty and diversity of life around me.

Eagle Watching

CLICK ON PHOTOS TO ENLARGE

I spent the past month birding in the same location along a small river where a single eaglet is growing in leaps and bounds. We first visited the nest on April 26 and the female was still incubating the egg(s). Two weeks later an eaglet was barely visible over the edge of the nest. On May 31, the eaglet was able to sit up on its own and was exercising its wings. It had few feathers and a lot of fluff and both parents were vigilant, never leaving the youngster alone.

Things were about the same one week later. Only one parent was seen but it stayed at the nest for long periods of time.

Two weeks later I saw the eaglet alone for at least thirty minutes. It sat in the nest and rested out of sight at intervals. One parent brought some food and stayed at the nest for over an hour. Once again, I did not see the adult eagles together at the nest.

I visited the nest today in the rain and stayed a couple of hours until the skies cleared. The eaglet is about eight weeks old now and has its flight feathers. It exercised frequently and was able to lift its wings and get to a branch outside the nest. It is almost adult size but is not able to fly. The young bird sat out for a few minutes at a time and then returned to the nest for a rest. An adult dropped a rodent off once in two hours and stayed only for a minute or two before leaving.

The adults were absent from the nest but were vigilant from a distance. They soared above the nest as if demonstrating how to fly. I think the young bird will catch on soon. 

Composite photograph

Career Stories: Centenarians

Doll on display at the Dickinson House in Manotick, Ontario

Over the years I have the honour of meeting a few centenarians who aged with grace and dignity. Most of the patients I work with are aging badly with any number of chronic and degenerative diseases. We all want to know the secret to growing old well, maintaining our independence, health and quality of life in later years. 

Marija was a 99 year old lady who lived independently in a city apartment. She shopped, cooked, cleaned and looked after her 93 year old sister who had dementia. Marija was elegant with erect posture, a long braid around her head, and a beautiful face. She grew up in Eastern Europe and lived through harrowing times during World War 2. She worked hard when she and her husband came to Canada in the 1950s and raised her family while holding down a domestic job. 

Marija tripped over the edge of a step and broke her hip in a fall. She had surgery and returned home in a few days, quickly learning to get around with a walker. She would be in the kitchen cooking homemade soups and stews when I visited and never had a complaint about pain or misfortune. I discharged her from service after a few visits but received an invitation later in the year from her daughter to attend her 100th birthday party. She recovered well from her fracture and continued to live independently in the community.

I met another 100 year old lady who also returned home following a hip fracture. (Hip fractures were  my bread and butter when I did home visits!) Her hospital course was more complicated after surgery but she had a cat at home and that motivated her to get walking again. Clara had fallen off the toilet in the middle of the night but was wearing a Lifeline device and was able to call for help. She laughed when she described the good looking young firemen who came in and lifted her from the floor. 

On Clara’s wall was a framed certificate presented on her 50th anniversary of using insulin. It bore the name of Sir Frederick Banting, the Canadian physician, researcher and Nobel laureate who first used injected insulin to treat diabetes in humans. Clara developed insulin-dependent diabetes in the 1950’s and followed her diet and medication plan faithfully in the years before home blood sugar testing and fast-acting synthetic insulins were available. To reach 100 years of age, almost 60 years of them as a diabetic, is amazing considering the many people who manage this illness poorly and suffer debilitating complications in their middle years.

Both Marija and Clara lived routine lives, ate simple, wholesome meals, had interests outside of themselves and accepted life’s ups and downs without fear or bitterness. They obviously had inherited some good genes as well!

Recently I met a 99 year old man who had a productive life and currently resides in a minimum care facility. He gets around independently with his walker and enjoys a good conversation as well as several short naps throughout the day. He told me it didn’t matter if he celebrated his 100th birthday or died tomorrow. He had a successful career building large high rise apartments but life had gradually ground to a halt after he retired in his 80s. He had outlived his friends, wife, siblings and some of his children. He was cheerful and matter-of-fact but recognized we only live one day at a time. In the end our quality of life is of more value than the quantity of years we may accumulate. 

Ottawa Birding

We spent a few days in the Ottawa area visiting our daughter and new son-in-law. There is so much to see and do in the capital region but it is May and birding was near the top of my list. I decided to explore the area around their home rather than driving to more distant birding hotspots and was not disappointed. Spring was slow in arriving this year and as a bonus, mosquito season was also delayed. My husband was fishing in the Algonquin Park area while I was in Ottawa and he reported that it was the first spring fishing trip that was not accompanied by black flies and mosquitoes. Black flies and deer flies are pests that will keep me out of the bush no matter what bird may be around. Mosquitoes made their debut about the middle of this week but a bit of spray kept them at bay.

I decided to find the Bluebird trail and Osgood Link Pathway which are south of the Ottawa Airport. The first two bird boxes were at a busy intersection and a pair of Eastern Bluebirds and Tree Swallows were settling in as neighbours. I have seen Tree Swallows trying to evict Bluebirds from a nesting box they wanted but there was no aggression between these birds.

The female Bluebird was very busy gathering nesting materials while the male supervised and sang and flitted about.

Bluebirds are not commonly found in our home area and I may see only one pair a year. I seldom see them at this close range and was fortunate that they were not bothered by my presence.

I started walking the Osgoode trail near the 5th kilometer marker a little after 7 AM. This section of trail follows a marsh and creek and dense mixed bush making it ideal birding (and mosquito) territory. The was plenty of bird song but finding the singers was a challenge due to the fact that new leaves have grown quickly in the recent warm weather.

I found two very loud and persistent male vocalists;- the Rose-breasted Grosbeak in the canopy and the Common Yellowthroat in the bushes.

Female Rose-breasted Grosbeak

Their mates were busy with home building and worked quietly undercover in their dull plumage.

A very loud drummer accompanied the singers and it took some time to locate him. I rarely see a Pileated Woodpecker but they are more common in the Ottawa area.

My favourite bird singer is the Veery and they were present in this section of trail. Other Thrushes scurried around in the underbrush as well. My species count was 32 in about an hour and a half of early morning birding including several first of the year finds for me. There was still plenty of time to see tulips, flowering trees and The National Gallery in the city after breakfast.

Career Stories: The Positive Power of Belief

In the 1970s it was still acceptable to give placebo medication to patients without their knowledge. The physician would write an order for an inert pill for pain or other symptoms and staff would whisper to each other when the “medication” was given. Placebos are rarely ordered now and can only be given with consent by the patient which undermines the theoretical effectiveness of belief. Belief is strong medicine and there is physiological evidence that placebo treatment does work. 

Home care therapists were assigned a portable ultrasound machine for treatment of soft tissue inflammation and pain. Each treatment is about 5 minutes in duration and sometimes there is slight warmth emitted from the head of the machine. Generally there is no sensation except for pressure on skin as the therapist applies the gel and applicator in a circular fashion. I personally have never observed any value in ultrasound treatments, on myself or any patient, and it is hard to do a clinical study to prove its efficacy. 

I had a referral to give an ultrasound treatment to a lady who had received them in the past. She was sure this was the answer to her back pain and I took the portable unit into her older home. To my dismay all the electrical outlets were ungrounded and I could not plug the machine's three pronged cord anywhere in the house. I made a completely unethical decision, pretended to plug in the machine, and went on to give her a “massage” with the ultrasound head. She insisted that the treatment was wonderful and her pain was much improved. 

Another old lady had a very stiff neck with crepitus and pain with the slightest movement. I gave ultrasound treatments, massage, and mobilizations over the course of a month with absolutely no improvement. One day I returned for another visit. Her pain was completely gone and she had full range of movement. A friend had given her garlic cloves that had been soaked in cider vinegar for a month and she was eating one each day. I rejoiced with her and was very relieved to be done with that cervical spine! Was the garlic and vinegar a cure or a placebo? I suspect it was a bit of both but it was undoubtedly more effective in treating inflammation than anything the doctor or myself had offered.

A physiotherapist often spends a lot of time with a patient and we are practitioners who touch people in the course of treatment. Few doctors physically examine or touch their patients anymore relying instead on test results and prescriptions. A sympathetic, listening ear is a good way to start a patient on the road to healing. I truly believe that compassionate human touch is essential for health and is lacking in the lives of many people.

Most of what I do professionally is validated clinically but I never discount the placebo effect or minimize a positive experience that cannot be explained.

Winter Springs to Summer

The beginning of May and October are my favourite times of year, seasons of transition, colour and beauty. Spring is unpredictable and sometimes rushes by with its succession of introductions and openings. This year rain and fog shrouded several days of soft greens and quiet blooms. This week we finally squeezed in our annual spring walk through the woods while there was a severe weather watch in place and large thunder heads intermittently blocked the sun.

It was a long, hard winter and some warm, artistic soul yarn bombed some trees along the trail. They either really hated the blankets or really loved the trees.

All the spring ephemerals were blooming at the same time this year instead of spreading their charm over three or four week.

Bloodroot...

Trout Lily...

May Apples...

Marsh Marigold...

Jack in the Pulpit...

and Trilliums. We come year after year to admire the carpet of white.

Raven is now three years old and behaves well off leash with us. It was almost 30 C on this humid afternoon as she stopped to rest by this knoll covered with Trilliums. Wild Ginger is growing at the edge of the trail where she is sitting and its blooms are at the base of the stems, covered with dead leaves.

I rode through the bush again today, five days after these photos were taken. Most of the flowers are finished and the leafy canopy has closed off much of the light. Ferns are growing rapidly and in a short time mosquitoes will keep me away from these trails until there is a fall frost.

Happy Victoria Day!