Sunday, April 29, 2007

When the Body Says No

This week a new Breast Diagnostic Assessment Unit was officially opened at the hospital where I work. It provides a facility where digital mammography, ultrasound and biopsies can be done efficiently at one site. Until now, a woman (or man) could wait three or four weeks for results of a breast biopsy, undoubtedly a very stressful delay.

While dignitaries gave speeches and staff dressed in bright pink looked on, I thought about the many people who will be referred to this unit in the months and years ahead. My family history puts me at higher risk for developing this disease, and my three daughters have a positive history on both sides of the family. I am sure that every reader of this post knows someone with cancer. As deaths from infectious diseases have decreased in the past 50 years, the proportion of deaths from cancer has risen. Many cancers can be linked to environmental and genetic risks, but what is more uncertain is the trigger that causes the abnormal cells that we all have to multiply in an uncontrolled manner.

Another group of illnesses that has increased dramatically in recent years is autoimmune disease. For some reason, the immune system attacks its own tissues, seeing them as an invader to the body. This is a large group including rheumatoid arthritis, fibromyalgia and other connective tissue diseases, type one diabetes, multiple sclerosis, ALS, and similar degenerative neurological disorders.

A few years ago I read a book written by Gabor Mate, a Canadian palliative care physician from Vancouver. When the Body Says No: The Cost of Hidden Stress explores the idea that stress and repressed emotions are triggers for the development of cancer and chronic diseases. Dr. Mate gives many case histories of people who have hidden their painful pasts, or who have lived a lifetime unable to say "NO" to the wishes and demands of others. We can push beyond our emotional limits, but at some point, the body will break down and demand that we take a break.
We all know intuitively that this is true, but it is a difficult thesis to prove scientifically. It is often easier to recognize these traits in others than in ourselves.

I met a lady who has severe autoimmune disease and a recent diagnosis of cancer. She was a highly anxious person, relying on Ativan to get her through her day. I was working with her recently and she said,

"I don't want to disappoint anyone. I have always tried to please everyone."

She was doing strengthening exercises to please her daughter, who daily chides her about not working hard enough to get better. Women are especially prone to making efforts to keep everything together, and aiming to please everyone at the same time. They also suffer from autoimmune diseases at a much higher rate than men do.

I heard Dr. Mate speak at a book reading, and was impressed with his presentation. His book is worth reading, and I have recognized the truth in what he says over and over again in my patients. I have tried to re-evaulate my priorities and responses to stress and have talked to my daughters about their own self care.

We tend to admire and commend people who are extraordinarily involved in work and volunteering, people who seldom complain or take time for themselves. These people are often unable to decline any request for help and are over-involved to their own detriment. This is not an argument for selfishness, but for a balance and honesty that will ultimately lead to healthier, happier and more productive lives.

Friday, April 27, 2007

Friday Flowers: Bloodroot

It was hard to decide which flower to feature for this week. After months of almost no outdoor blooms, I enjoyed seeing several new wildflowers and garden flowers this week. The warm weather of the past few days encouraged the plants to make up for lost time in this late coming spring, and my garden forsythia, daffodils and hyacinths are at their peak.
One of the showiest wildflowers of the early spring is the Bloodroot (Sanguinaria canadensis).

There are masses of them around the hospital and smaller patches along the river flood plain. The delicate flowers are a member of the poppy family. The flowers open before the foliage and the single, large lobed leaf is wrapped around the stem like a blanket as it emerges.

Emerging blooms wrapped in a single leaf

The blooms have eight to twelve petals and the flower is open in the sun but closes at night. The stem and root has a reddish sap which was used as a dye by Native Americans. It has also been used in herbal remedies, but the plant juices are toxic and cause death if taken internally.

I have a corner of my yard dedicated to wild flowers and ferns. I was very tempted to remove some Bloodroot from the bush and plant it in my garden. I found this information on the plant with advice in how to raise it.

No woodland garden is complete without a bloodroot colony. The early white flowers are followed by bold, green leaves, which will persist through most of the growing season. They can be transplanted at any time and will grow in most soils but are best moved when the much expanded leaf is dying down.

Plant them in scattered plantings where the roots will not be disturbed, and pretty much forget them. They will continue to flower and produce seed every year, thereby increasing the size of the colony each year. The plant seems immune to insect and disease attack if well situated in the shade garden.

Bloodroot grows best in a sheltered woodland with bright sun in the early spring and shade when the leaves come out on the hardwood trees. It transplants easily, propagates readily, and if once established will make delightful patches in a few years. This plant is almost always found in colonies.

Plants SHOULD NOT be removed from natural habitats, unless the locality is in danger of destruction or has an over abundance of plants. It's better to obtain the seeds, which have a good germination rate, or to buy plants from a reputable nursery. (source)

We have had heavy rain the past two days. I stopped in the bush at noon yesterday and noticed that the Bloodroot flowers were almost finished, the petals covering the ground beneath the enlarging leaves. How fortunate I was to have seen their brief peak of spring beauty.

Post Script~I posted this and then read Jennifer's latest post in A Passion for Nature about wildflowers. Take a look!

Wednesday, April 25, 2007

I Hope

Tree in bloom along the river last evening

Mom was looking through my bookshelf while she was visiting and showed me a volume of poetry she had received from her mother on November 3, 1943. She was eleven years old and was in Toronto General Hospital for a tonsillectomy at the time. The book, Aunt Hattie's Place, was written by a Canadian poet, Edna Jacques. She wrote poems about nature, home, the World War and various people, with simple language that demonstrated her love of beauty and virtue. I particularly liked this poem.

Lungwort in bloom. I got this from Grandma's garden over 20 years ago

I Hope

I hope that I shall never get
So old, that pinks or mignonette
Will fail to stir within my veins
Some answering call- or April rains
Washing down azure skies will bring
No quickening rapture of the spring.

I hope that I shall never see
Pale blossoms bursting on a tree
With jaded eyes...or fail to catch
My breath in wonder at a hatch
Of chickens with small pointed bills
Yellow as April daffodils.

And little fir trees lifting up
Pale hands towards the sky's blue cup,
And old folks with their dim old eyes
Looking toward the sunset skies,
Giving me beauty through the years.

Becka and Dakota look over the river

Tuesday, April 24, 2007

Beaver Tales

The beaver attained official status as an emblem of Canada on March 24, 1975. This large rodent was central to the fur trade in this country and it was trapped almost to extinction in the 18th and 19th centuries requiring protection in the 1930's. Our nickel bears the image of this industrious little animal.

I am used to seeing muskrats along the river, but this past weekend we noticed a much larger mammal swimming towards us in a pond on the flood plain of the Grand River. It was the first time I had seen a beaver close up in the wild. I have seen many beaver lodges and dams in northern Ontario, but have not seen the architects and inhabitants of them.
This beaver was not concerned about our presence a few feet from the edge of the bank where (s)he climbed out of the water. After taking a few pictures, we walked towards the river and then noticed the beaver lodge. This one is smallish, rather messy and is built on the edge of the pond. Often the lodge is built right in the water. A dam had been built across a small creek adjacent to this pond.

From the size of this tree that was just taken down, it looks as if the beaver is preparing for some spring renovations.

Recently, some beavers were caught making a dam across a creek in the city, on the grounds of one of our universities. Their activity was considered dangerous to humans and the beavers were trapped and killed, angering many of our citizens. The beavers here have wisely chosen a conservation area for their home and are not likely to be evicted.

I read about these animals in Paul Rezendes's book, Tracking and the Art of Seeing. In his chapter on the beaver he writes,

"The beaver has been of great benefit to many wildlife species across North America, as well as to the environment itself. Beaver ponds are important water storage systems, slowing and trapping runoff and releasing it gradually. The silt-laden water slows down in the pond, releasing the heavier particles so the water is clearer downstream, and plant communities established in the sediment help to stabilize the flood plain..."

He also explains how the ponds create a new ecosystem and a place for water birds to feed and rest.

The beaver is no longer endangered here in Canada, but its greatest enemy remains man, who would prefer alter the environment in his own way and dispose of any challenger.

Monday, April 23, 2007

Moving On

A traveler came upon an old farmer hoeing in his field beside the road. Eager to rest his feet, the wanderer hailed the countryman, who seemed happy enough to straighten his back and talk for a moment.

"What sort of people live in the next town?" asked the stranger.

"What were the people like where you've come from?" replied the farmer, answering the question with another question.

"They were a bad lot. Troublemakers all, and lazy too. The most selfish people in the world, and not a one of them to be trusted. I'm happy to be leaving the scoundrels."

"Is that so?" replied the old farmer. "Well, I'm afraid that you'll find the same sort in the next town.

Disappointed, the traveler trudged on his way, and the farmer returned to his work.

Some time later another stranger, coming from the same direction, hailed the farmer, and they stopped to talk. "What sort of people live in the next town?" he asked.

"What were the people like where you've come from?" replied the farmer once again.

"They were the best people in the world. Hard working, honest, and friendly. I'm sorry to be leaving them."

"Fear not," said the farmer. "You'll find the same sort in the next town." (Source)

Our interim pastor retold this North American folk tale yesterday in his sermon. He was talking about people who are easily offended and who go on to develop a cynical, critical and unforgiving spirit. Our pastor is a very wise man and has suffered much in his life, from the death of a young son to cancer to the current suffering he is going through with his own cancer battle. We can choose how we respond to the good and the inevitable bad that will happen on our lives. Some become fearful and depressed, others critical and angry, while others remain optimistic, forgiving and loving. (see Ginger's post today!) The geriatric unit I work on admits many patients suffering from depression at the end of their lives. Some are tormented by regret, perhaps over affairs they have had, or broken family relationships due to unforgiveness. How sad to come to the end of life with unresolved conflict and pain.

I knew a man who was given six months to live after being diagnosed with pancreatic cancer. He was a hard man, critical and unloving, feared by his children and a friend of few. He tried so hard to mend relationships in his last months, asking forgiveness and trying to right a lifetime of wrongs. While I commended his efforts, they were not enough to undo the harm of his actions throughout the years, especially in his children. They will carry the scars of their harsh upbringing and perhaps pass them on for generations to come.

Not everyone gets a six month notice of death. I want to live each day without regret, with love and forgiveness and optimism, looking for the best in the people I see every day.

Sunday, April 22, 2007

Sparrows can be hard to ID

Two birds are in the above picture.
The bird in the top right corner seems to have
a central breast spot,

but that is not as obvious in the picture below.

I saw these sparrows near the river today in some brush. They were quite small and hopped about in the low branches and ground. I have pored over my bird guides and the internet and cannot find a good match. I thought I had a Song Sparrow in the previous post, but these birds were smaller and had more distinct markings.

Saturday, April 21, 2007

Earth Day Mini Bioblitz 2007

The Song Sparrow performed a special concert this morning

I did not register for the Blogger Bioblitz due to a lack of expertise and time. In the spirit of the event, I decided to spend one hour in the old landfill site recording the more obvious and slightly hidden things around me. I chose not to wade through the vernal pools or turn over logs and stones looking for insects. We have had warm weather with temperatures around 20C the last three days. Because of the very cold weather during most of April, the plants and trees are a little behind schedule.

I picked a small corner of the field that included a vernal pool, meadow, and a small deciduous bush, containing mainly oak and maple trees. Houses, malls and roads surround this entire area in the suburbs of our city. I went out from 9:15 until 10:15 in the morning with my trusty assistant, Dakota. I have spent a number of hours in the area this spring and knew where to look for a variety of birds.

I have seen where the Kildeer are nesting, but if I hadn't, it would heve been hard to find them today as they hid in the grass.
Here is the list of birds, animals and plants I identified.

Red-winged Blackbird 20+, Kildeer 2, American Robin 20+, Canada Goose 4, Starling 5, Mallard Duck 4, Common Grackle 2, Downy Woodpecker 1, Song Sparrow 2, Brown headed Cowbird 1, House Sparrow 20+, Brown Creeper 1, Eastern Phoebe 2, American Kestrel 1, Chickadee 1, Gold crowned Kinglet 2, Cedar Waxwing 4, Northern Cardinal 2, American Goldfinch 4, Dark eyed Junco 1, Red tailed hawk 1, House finch 4, Crow 2, Mourning Dove 3.

We also discovered
Groundhog 1, Cottontail rabbit 1, Grey Squirrel 2, Black Squirrel 1, Field mouse 1, Garter snake 1

Dakota found the snake and I am very pleased that I did not panic and was able to take a picture of it at fairly close range. (well, with a little zoom!) It seems my snake phobia may be decreasing with my understanding of their place in this little ecosystem. If the dog had not seen the snake, I may have been startled by stepping on it as it blended in so well with the dead grasses.
There were very few flying insects. As we returned home I saw three dragonflies. This afternoon there are swarms of flying insects in our yard that were not around earlier in the day.

Green shoots were coming through dead grass and leaves and I did not try to identify them. The city had seeded the entire site with grass over 25 years ago, but native species now dominate the meadow. The bush had many Trout Lilies starting to poke above the ground and there were a couple of Trillium shoots as well. I know this area has an abundance of Trillium blooms in May.

The vernal pools are shrinking rapidly as we have not had a lot of rain or snow this month. I believe these are Spotted Salamander eggs. I noticed plenty of bubbles in the shallow water as gases escaped from the frost free ground. I don't know if this is normal in swamps, or if this is caused from methane created by the garbage below this site. I did take a movie of the bubbling and will post it if I can figure out how to do it.

While I saw nothing unusual, I was surprised at the length of the list compiled in such a short time, so early in our spring season here in South Western Ontario. I look forward to reading about the findings of more experienced naturalists as they participate in the Bioblitz.

Friday, April 20, 2007

Friday Flowers: Jenny's Orchids

These beautiful orchids were given to a patient of mine as a gift this Easter. I paid little attention to the many orchids for sale in the stores this past month as they were expensive and tattered looking. This plant was beautiful and fresh and gave Jenny such pleasure. I know very little about orchids. Julie Zickefoose has written a couple of posts about them this week and if you want to learn about more, follow this link and this link.

My real Friday Flower is Jenny. This lovely lady has been in the hospital for six months now recovering from an accident that left both her legs badly broken. She had extensive surgery and has had a variety of appliances and casts on her legs. At the end of last week she was finally given the go ahead by her surgeon to start putting weight on her legs. We helped her stand for the first time on Monday and each day small gains are being made towards learning to walk again. Jenny is used to being active and independent and is interested in flowers and gardening. I think I would be far less patient than she is, watching spring arrive and being unable to enjoy walking and working in the fresh air.

Spring is a time of rebirth and regeneration. Our bodies have a tremendous capacity for repair, especially after injuries to bones and muscles. Determination and a positive attitude can unlock a healing potential that often surprises me.

This post is a get well wish for Jenny, a wish that hastens the day when she can walk out of the hospital and returns to the life she left last fall. If anyone can do it, she can!

Thursday, April 19, 2007

Nesting Mallards?!

I saw this pair of ducks on the river today. The white duck was obviously with the female mallard. They were feeding on minnows which were present in large quantities where a creek emptied into the river. I found no matches in my bird guide or on the internet. Is this a domestic duck, or a white male mallard? Any ideas?

Wednesday, April 18, 2007

Ice Houses and Old Farms

The trail we walked this past weekend went through an old Mennonite farm that has been operational for at least six generations. The most interesting feature for me was the old ice house. I remember Grandma describing the ice box in her kitchen on the 1920's and how she would buy ice in the summer, just like we now purchase ice for our coolers. I never really gave much thought as to where the ice she was talking about came from.

This ice house was built into the bank of Critter Creek, a perennial creek fed by groundwater that runs through the property and into the Grand River. In the winter, chunks of ice would be cut from the creek and river and dragged by sled into the ice house. Layers of straw would add extra insulation and the ice could last into the late summer, or perhaps even into the next winter.

How could a person get through the summer, or any time of year without a refrigerator? I have given thought to that since I saw this ice house. There are certain members of our household who consider ice cream to be an essential daily food group. When I return from grocery shopping the fridge is crammed full of items that cannot stay in the cupboard. Many people I know have two fridges as well as additional freezers.

One of my favourite childhood books was Anne of Green Gables by Lucy Maud Montgomery. In one part of the story, Anne was beside herself with excitement because ice cream was going to be served at the church picnic. Imagine a twelve year old who had never eaten ice cream! Through a misunderstanding, she was grounded and denied this special treat, and her disappointment was almost too much to bear. The ice cream would have been prepared in a crank with ice from the previous winter.

I don't know if the Old Order Mennonites still use ice houses, especially those who live without electricity. I imagine they would use gas refrigerators. Many of them sell baked goods, meats and cheeses at our local markets, and it is unlikely the health department would allow unrefrigerated items like these to be sold to the public. I wouldn't want to use the ice from our local streams and rivers in my food due to contamination that is present from many sources.

On another note, this farm had a very old orchard with gnarled trees that were being pruned by the farmer. The deer had eaten a lot of bark in the winter from the lowest branches that touched the ground. I was reminded that our local bee hives have been affected by the mysterious bee colony collapse that has occurred across the continent. This is a small orchard, but like the big ones, it will be dependent on bees to pollinate the blossoms in a few weeks. Laura at Natural Notes wrote a recent post about the bee problem.

Do you have ice house or ice box memories or stories? Or have you lived for extended periods of time without a refrigerator?

Monday, April 16, 2007

Muskrat Signs

The trail we walked this past weekend included several areas of natural and historical interest. The entire length of the RIM Park Trail is a paved, two lane path which made the springtime walk a lot less muddy. Hikers and cyclists are asked to stay on the trail as not to disturb the wild life living in sensitive areas near the adjacent ponds, marshes and river banks.

I admire how people like Bev, of Burning Silo are able to interpret animal signs in the wild. I have asked her questions and she recently wrote this post which describes things to look for when searching for caterpillars. The post she wrote on porcupines was just as interesting.
This week, I found a book at our local library called Tracking and the Art of Seeing by Paul Rezendes. It is full of colour pictures and the text is not too difficult for an amateur nature sleuth. I would recommend it without hesitation as he describes the signs of many familiar animals and birds in a very interesting way.

My husband has spent a lot of time outdoors over the years while pursuing his favourite hobby, fishing. He does not go on a lot of walks with me, but can surprise me with his good observation skills. He is the first to see a new bird or track, even though he just has a passing interest in anything that will not grab his fishing line.

As we walked by a pond near the large sports complex, he noticed two structures made from bulrushes and other plant material. Rezendes writes:

Muskrat construct lodges that are every bit as complex as beaver lodges. Construction can begin in August and go on until late October. The muskrat begins with a large platform made of mud piled with small aquatic plants...sticks and leaves, all mixed with more mud. When the pile is about two feet high, the muskrat excavates it from the inside, hollowing it out until a chamber large enough to house a family is formed.

He also describes a muskrat feeding station. These are built in a similar fashion but are smaller than the lodges. They provide a safe place for the muskrat to forage for food away from the lodge. Muskrat are mainly herbivores, but will eat things like clams, fish, snails and mussels. The muskrat at the top of the post was photographed by my father as it ate plants at the edge of the Grand River.

These tracks were left in the soft mud at the edge of the river. I cannot say with certainty that they are from a muskrat, but I would say it would be a good guess. I would have to ask why there are just one set of prints present.
Seeing birds and animals is pleasurable, but learning to interpret their sounds, habits and trails can be even more interesting and rewarding.

Winterwoman at A Passion for Nature has sent me a link to a photo of muskrat scat. The book I mentioned has plenty of scat photos as well.

Sunday, April 15, 2007

Red-tailed Hawk

My husband and I took advantage of a sunny Saturday morning to walk a new trail that is within the city limits. On one side of the 4 km trail is a golf course, and on the other is the Grand River.
There is a 17 acre nature preserve for nesting birds, reptiles and amphibians. This hawk followed us for at least 3o minutes. I took numerous pictures and am so confused with trying to ID him or her.

The belly really doesn't match any picture in my books and trying to sort out immatures, male, female, dark phase, light phase.....oh dear, my head is aching.

Please help me!
(I also saw an Eastern Phoebe today. Got a so-so picture, but I was pleased to see a new spring bird)

Thanks to Monarch and Larry for the ID!

Saturday, April 14, 2007

Old Order Mennonites and Technology

I received a very interesting comment on my post An Old Order Mennonite Sunday from Erik Wesner who writes a blog called Amish America. He has a lot of interest and knowledge about Old Order Anabaptists and his blog is worth visiting. In his comment he wrote,
"...the majority of OOMs in Waterloo County use only open vehicles--
which looks to be the case in your pics,
though I don't know if that is your exact area or not.

Another one of your pics (Feb 1)shows a squarish-looking closed-top--
reminds me of the buggies around Nappanee, Indiana--
they always seemed a bit boxier than the Amish ones in the area.
I wonder if those are related to Pike Mennonites,
which is supposedly one of the most conservative groups it seems."

The pictures I posted on Sunday were all of open carriages, mainly because I found the faces of the people more interesting than the buggies they were driving. My parents took all the pictures in this post, including those that show a variety of closed buggies.

We followed this buggy through the covered bridge shown at the top of the page. It had rubber tires, which are forbidden by stricter sects of Old Order Mennonites. A couple of small children were peering out the back window if this small box styled wagon.

This lovely team of horses pulled a much larger buggy at a good pace down the highway. You can see the difference in the style of the wheels.

This very bony and mangey horse pulled a smaller buggy past a house with fieldstone walls. We saw several farmhouses built in this fashion in this area near Elmira, Ontario.

Erik also commented on the solar panels we saw on this farm house. If you look on the roof line to the right of the windmill, you can see the three panels.

And the solar panel thing surprised me as well too--
I've actually seen these in quite a few midwestern Amish communities,
some of them powering electric fences. I like this as another
example of the Amish way of making decisions on technology--I feel it's quite a sophisticated decision-making process concerning what tech they do and don't allow.

This farm had no electricity lines, but several black cars were in the driveway. The Conservative Mennonites drive black cars rather than horses. It is not unusual for one family to have members belonging to different Mennonite groups. My neighbour was raised in an Old Order home, but left to join the most progressive church. She and her husband were welcomed at family gatherings in their Old Order extended families and she always felt a close kinship with them.

I have been doing some reading this week on the Mennonites in our region. There are many different groups that have formed because of various interpretations of what constitutes a plain life. We had an Old Order lady admitted to our rehabilitation unit this week, which is quite unusual as many of them do not join our federal health care or pension plans. While her family uses a horse and buggy, she was transported by ambulance for treatment following her serious accident. On Kevin Williams' blog, The Amish Cook, (Kevin is Susan Gets Native's relative) he writes about the quandry in deciding whether cell phones are acceptable technology for the Amish community.

Technology is changing the world at a dramatic pace. It must be difficult for the Old Order people to maintain a lifestyle based on how their ancestors lived hundreds of years ago when they must interact with the outside world that is so different in customs and values.

The Kissing Bridge at West Montrose, Ontario
(between Elmira and Guelph)

Friday, April 13, 2007

Friday Flowers: Potted annuals

A young Dakota on our back deck

A couple of weeks ago, we had a few warm, sunny days and I hauled my flower pots out of the garage and put them on the back deck. Our home is built on sandy soil, which allows for excellent drainage, but it is not the best soil for flower gardens. We tend to have hot, humid summers, often with little rain, and our municipality has strict watering restrictions for lawns and gardens. I have planted low maintenance and native perennial plants in the flower beds such as echinacea, sedum, lavender, bee balm, evening primrose, hostas, trilliums, ferns and lilies to name a few. I have a variety of blooms throughout the season and do not plant any annuals except in my flower pots.

I like to have plenty of colour on the deck and plant geraniums, hybiscus, miniature roses, wave petunias, as well as various herbs. To start the season, I often plant ice pansies as they tolerate frost and snow and thrive in cooler temperatures.

I am anticipating the spring weather that must be just around the corner. With the slow start to the season, I thought this prayer would be most appropriate for gardeners everywhere.

Gardener's Prayer
O Lord, grant that in some way
it may rain every day,
Say from about midnight until three o'clock
in the morning,
But, You see, it must be gentle and warm
so that it can soak in;
Grant that at the same time it would not rain on
campion, alyssum, helianthus, lavendar, and others which
You in Your infinite wisdom know
are drought-loving plants-
I will write their names on a bit of paper
if you like-
And grant that the sun may shine
the whole day long,
But not everywhere (not, for instance, on the
gentian, plantain lily, and rhododendron)
and not too much;
That there may be plenty of dew and little wind,
enough worms, no lice and snails, or mildew,
and that once a week thin liquid manure and guano
may fall from heaven.

Karel Capel

What are your favourite flowering plants for pots and planters?

Thursday, April 12, 2007

Vernal pool discoveries

My daughter and I took the dog to the old dump site the other evening to explore the vernal pools and fields. We have had very little sun this month, and even though it was cold, the bright evening sky was a welcome respite from grey clouds. I have so little knowledge when it comes to naming flora and fauna, and thought some pictures would be helpful when looking through various guides. Dakota has become an asset, as he discovers new items of interest before I do and he has learned to leave the birds and rabbits alone. This is his idea of doggy paradise.

I took pictures of various mosses and emerging plants and identified salamander eggs and frog eggs in the vernal pools. A number of birds are nesting in the area.

A pair of Mallards eyed us silently and cautiously from the tall grass. The female was very well camouflaged. This goose, acting distressed, but not at all aggressive, paced around the nesting area.

There are many Red Winged Blackbirds here who continue to sing and pose for me in a most gregarious manner. I have seen no new birds in a week and am sure the cold, strong north winds have kept birds from continuing their migration across the Great Lakes.
We turned over many rocks and stones, but found no insects. It has been exceptionally cold this month and last night we had another winter storm with snow and freezing rain. Hopefully this is Old Man Winter's last gasp. The inhabitants of this field and the inhabitiants in this house hope that someone pushes the PLAY button and stops the PAUSE on spring.

My first cousin once removed, 10 year old Samuel, has started his own nature and bird blog. I love the way he writes, at times very adult like, but the child view shines through!

Wednesday, April 11, 2007

Balancing Act

I returned to work yesterday after having more than a week off and kept busy updating myself on the new admissions and changes in my regular caseload. I have said before that I really enjoy my job and that has not changed. Long walks and nature observation are stress relieving pastimes, but working with people is most rewarding for me.

I walked in a room to introduce myself to a new patient and recognized her right away from her admission a couple of years ago. She had a past history of a stroke that had left her weak on one side. When I last saw her, she was using a wheeled walker or cane to walk and used a wheelchair for distances. She had gone on a bus tour, and when the group stopped for lunch, she fell while walking into the restaurant and broke her hip. She required surgery and will be in hospital for an extended period of time.

This is a very nice lady, without cognitive impairment. I asked her if she had been using her cane or walker when she fell. Well, the answer was a sheepish, "No". I stopped myself from lecturing because it was obvious she knew she had taken a costly risk.

A big part of my job is fall prevention education. We do a number of tests to determine the risk of falling and the need for an adaptive aid. Many things can impair balance, including strokes, degenerative neurological diseases and peripheral neuropathies, most often caused by diabetes.
But many people develop weakness and balance problems because of inactivity and disuse. When is the last time you saw an adult playing hopscotch, or walking in tandem steps on a curb stone? Children often perform high balance activities as part of play.

One of the tests we do has 14 components to score a person's fall risk. We ask the patient to stand on one foot for 5 seconds, repeating with each leg. People who cannot do this tend to shuffle or walk quickly and need to use a gait aid. It should be easy to maintain a one legged stance for 20 to 30 seconds and this can improve with practice.

Another position we ask a person to take is a tandem stance, one foot in front of the other. Most of my patients are unable to do these two activities.

Our universal government health plan covers 75% to 100% of the cost of a new rollator walker and I do many prescriptions for people who need one. The problem is that people will not always use them. Pride and independence seem to be present in two year olds and eighty year olds. I feel I have done my best work when I prevent someone from having a bad fall rather than getting them back on their feet after a broken hip. Doing simple balance exercises, engaging in regular activity, and using suitable adaptive aids can help maintain independence for many years.

My new patient will always need a walker, if she is able to walk independently again. If she could only go back in time to that bus and disembark with her cane!