Accidental Nursing: It could have been worse I guess.

You may have read my previous posts on "Accidental Nursing" where I have ended up using my nursing skills as a "Good Samaritan".

Here is another "Accidental Nursing" story from this past month.

I was busy working in my office and my husband slips a note under my door.



We had just lost our wonderful BC Ambulance renter to a house purchase, and now a temporary immigrant farm worker (Male, American caucasian with a Master's degree in Organic Farming in case you were jumping to conclusions) making big bucks in Canada was renting our Carriage house.

I put my work on hold and ran upstairs to check it out.

The dog greeted me at the door. "Hey there, pups!" I rub his ears.

Our renter's girlfriend swung the door wide open. "I can't believe it - I fainted!!!!"

Me: "Did you hit your head?"
GF: "No...."
Me: "OK then, where's the patient??"

She pointed to our renter, sitting with legs spread-eagled, slumped over a chair seat and the cupboards - pale as my morning latte. He's holding his thumb.

At this point I am thinking "OMG, he has sliced his finger off!!!"

The offending knife is lying on the counter with a host of veggies.

"Let me see it." I take charge. I need to - they are both near hysterical.

He takes the wad of toilet paper off to reveal this:



Well, OK. This isn't his thumb. He's a big guy.

I drew on my own thumb to illustrate - and re-enact it for my husband and this blog.

My husband went into hysterics when I retold the story. He has had 3 finger injuries, the first where he burned off all his skin with hot 500 degree wax, the second where he had a crush injury with starburst fracture of all fingers and the last where he eventually lost his fingernails.

A tiny superficial cut like our renters was small potatoes in my husband's books....and mine for that matter.

Of course I reacted in the way any nurse would do.

"Of COURSE you don't need to go to ED and get stitches," I laughed. "Steri-strips won't even hold that flap closed - it's only a tiny cut!"

But, like a good nurse, I got out my supply of steri-strips and a knuckle bandage and taped him up, giving instructions to see an MD if it looked infected down the road.

I was trusting his information that he was able to clean it well. Seeing how it was an injury with a knife and not one of his dirty farm implements, I told him he would be OK if he had had his tetanus immunization in the last 10 years.

Within 10 minutes....I was back to work....leaving the patient still slumped on the floor in his apartment, GF helicoptering around him.

Can you imagine this guy showing up at the local Emergency Department? (I'll bet you can!)

They should thank me.

Oh.

And our renter now?

When we had them over the other night for dinner (wound beautifully healed I must say!) and he offered to make a salad, I declined with sincere thanks.

I didn't want him going anywhere near a knife that was going to cut veggies I was going to eat!

PESTO RECIPE: for those allergic to nuts

When I go over to my cousin's house for their wonderful Christmas and Easter celebrations, I always admire her culinary skills.

My cousin's step son is anaphylactically allergic to nuts. Fortunately, he can have sunflower seeds, which is technically not a nut. Plus (added bonus!) sunflower seeds are much cheaper than pine nuts - by a long shot!! (the same amount of seeds would have cost at least $20!)

Here is the recipe she gave to me - since I was just handed a huge bag of organic basil leaves and and recently bought a bag of already peeled garlic cloves for $1 at the local farmers market!

PESTO

2 cups of fresh basil leaves: Packed
1/2 cup freshly grated Parmesan cheese
2/3 cup extra virgin olive oil
2/3 cup roasted unsalted sunflower seeds
2 garlic cloves (I used 4 because I have so many and I love garlic!)

Place all the ingredients in a food processor and pulse until finely chopped and well combined. Do not puree. To store pesto : place in a jar, top with a skim of olive oil, tightly seal and refrigerate for up to 2 weeks.


I put mine in small snack size zip lock baggies - approximately 3 tbsp in each and then put into a large freezer bag or container. You can also put them into ice cube trays and freeze and throw into a glass storage container for the freezer.

When you thaw to use, just add a touch more olive oil. A little pesto goes a long way. It's great added to pasta, or spread on french or Italian bread, and even instead of a tomato paste on a pizza!

It only took me a 1/2 hour (on my work break at home!) to make it!! Easy!!






I always keep shredded Parmesan handy: $6
Sunflower seeds $3
I keep the extra cloves of garlic in the freezer. $1

Free bag of fresh basil leaves!

I bought the mini food processor for only $6. Good investment!


I still have to add the parmesan....oops! forgot it!

It tastes sooooo good! Best of all, it only cost me $10 for the whole batch! If I were to have bought it......it would have definitely come to at least $40 pre-made. And I definitely wouldn't be able to feed the store-bought pesto to anyone with a nut allergy!


Bon Appetit!

Miracles rise out of little things: On Birth Defects

Defects are something one sees every once in a while in Labor and Delivery.
It's part of the territory.

Every parent wants a "perfect" baby, and there is often a sadness that is palpable in the room when one of those special little ones is born.

But what if that "imperfection" was actually a godsend??

You just have to go over to this blog and read this story that is quite incredible.

I know, I know...it's all you have been hearing in the news....

Aurora, Colorado.


But - believe me, it's worth the read.

You will never look at an "imperfection" in the same way again.

Love Letters

I can remember a boyfriend of mine that went away on vacation and was going to be gone for several weeks.....I did the same thing - writing a card or letter for every day he was gone....but it had quite the opposite effect!

What I didn't realize, he was seeing someone else - a married woman - on the sly. I can only imagine that he chucked them all in the garbage, unopened.

It was heartwarming to realize that a guy could actually do this for his wife.

What a wonderful thing - to be able to read those letters decades from now! Truly there is something so very personal and romantic about an *actual* handwritten letter, as opposed to a quickie email.

The couple is from Ontario originally, now based out of Victoria on Vancouver Island, B.C. Her husband has been deployed to the Persian Gulf for the next 8 months. See her original posting here.

I've got Nothing....

oh.

Except - it's your last chance to see the baby eagles before they fly away from their nest for good--------------------->

The Best Things about Being Blind

Almost 30 years ago, I had surgery - radial keratotomy (no, not laser! This was prior to that advance in vision care!) - for poor eyesight.

I was *almost* blind.

You know those letters on the wall that they use for checking vision? I couldn't even see the poster (or the wall, for that matter) - my vision was so poor.

I can remember at work, my glasses broke - as they would so often do because they were so heavy and thick - and I couldn't see to give out medications to my patients. I couldn't even see to drive home.

It was like a miracle when I finally had the surgery to correct my vision. I am now still almost 20/20 - even 30 years later.

So, it amazed me when I watched this video - this Blind guy who took a positive spin on his Blindness.

I don't know if I could be so positive. I at least could see a blurry blobby world - with light!

Watch this: (and feel gratitude that you can)

Happy Canada Day! National Anthem with Beer Bottles

Besides Hockey and Lacrosse, beer has to be one of this country's Icons.

I don't like beer, but I have to admit, these people are very inventive and it has to be the second best National Anthem rendition, after the Wilderness Call one.

"Obamacare" 101. A Simple Explanation

This has surfaced on the internet - on Reddit - and is a great explanation of what is going on in the USA. Please visit the link for Edits , links and other commentaries:

What exactly is Obamacare and what did it change?

"Okay, explained like you're a five year-old (well, okay, maybe a bit older), without too much oversimplification, and (hopefully) without sounding too biased:

What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.

Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.

So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

(Note: Page numbers listed in citations are the page numbers within the actual document, not the page numbers of the PDF file)

Already in effect:
•
It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices) ( Citation: An entire section of the bill, called Title VII, is devoted to this, starting on page 747 )

•
It increases the rebates on drugs people get through Medicare (so drugs cost less) ( Citation: Page 216, sec. 2501 )

•
It establishes a non-profit group, that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 665, sec. 1181 )

•
It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 499, sec. 4205 )

•
It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them. ( Citation: Page 30, sec. 1101, Page 45, sec. 2704, and Page 46, sec. 2702 )

•
It forbids insurance companies from discriminating based on a disability, or because they were the victim of domestic abuse in the past (yes, insurers really did deny coverage for that) ( Citation: Page 47, sec. 2705 )

•
It renews some old policies, and calls for the appointment of various positions.

•
It creates a new 10% tax on indoor tanning booths. ( Citation: Page 923, sec. 5000B )

•
It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. ( Citation: Page 14, sec. 2711 )

•
Kids can continue to be covered by their parents' health insurance until they're 26. ( Citation: Page 15, sec. 2714 )

•
No more "pre-existing conditions" for kids under the age of 19. ( Citation: Page 45, sec. 2704 and Page 57, sec. 1255 )

•
Insurers have less ability to change the amount customers have to pay for their plans. ( Citation: Page 47, sec. 2794 )

•
People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend. ( Citation: Page 379, sec. 3301 )

•
Insurers can't just drop customers once they get sick. ( Citation: Page 14, sec. 2712 )

•
Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific).

•
Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down. ( Citation: Page 42, sec. 2719 )

•
Anti-fraud funding is increased and new ways to stop fraud are created. ( Citation: Page 699, sec. 6402 )

•
Medicare extends to smaller hospitals. ( Citation: Starting on page 344, the entire section "Part II" seems to deal with this )

•
Medicare patients with chronic illnesses must be monitored more thoroughly.

•
Reduces the costs for some companies that handle benefits for the elderly. ( Citation: Page 492, sec. 4202 )

•
A new website is made to give people insurance and health information. (I think this is it: http://www.healthcare.gov/ ). ( Citation: Page 36, sec. 1103 )

•
A credit program is made that will make it easier for business to invest in new ways to treat illness by paying half the cost of the investment. (Note - this program was temporary. It already ended) ( Citation: Page 830, sec. 9023 )

•
A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers. ( Citation: Page 22, sec. 1101 )

•
A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover. ( Citation: Page 800, sec. 9003 )

•
Employers need to list the benefits they provided to employees on their tax forms. ( Citation: Page 800, sec. 9002 )

•
Any new health plans must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge. ( Citation: Page 14, sec. 2713 )


1/1/2013
•If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners. ( Citation: Page 818, sec. 9015 )

1/1/2014

This is when a lot of the really big changes happen.
•
No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history. ( Citation: Page 45, sec. 2704, Page 46, sec. 2701, and Page 57, sec. 1255 )

•
If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it. (Note: On 6/28/12, the Supreme Court ruled that this is Constitutional, as long as it's considered a tax on the uninsured and not a penalty for not buying insurance... nitpicking about wording, mostly, but the long and short of it is, it looks like this is accepted by the courts) ( Citation: Page 145, sec. 5000A, and here is the actual court ruling for those who wish to read it. )


Question: What determines whether or not I can afford the mandate? Will I be forced to pay for insurance I can't afford?

Answer: There are all kinds of checks in place to keep you from getting screwed. Kaiser actually has a webpage with a pretty good rundown on it, if you're worried about it. You can see it here.

Okay, have we got that settled? Okay, moving on...
•
Small businesses get some tax credits for two years. (It looks like this is specifically for businesses with 25 or fewer employees) ( Citation: Page 138, sec. 1421 )

•
Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.

•
Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 14, sec. 2711 )

•
Limits how high of an annual deductible insurers can charge customers. ( Citation: Page 62, sec. 1302 )

•
Cut some Medicare spending

•
Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them. ( Citation: Page 801, sec. 9005 )

•
Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.

•
Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen. ( Citation: Page 81, sec. 1312 )

•
A new tax on pharmaceutical companies.

•
A new tax on the purchase of medical devices.

•
A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.

•
The amount you can deduct from your taxes for medical expenses increases.


1/1/2015
•Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.

1/1/2017
•If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers). ( Citation: Page 98, sec. 1332 )

2018
•
All health care plans must now cover preventative care (not just the new ones).

•
A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).


2020
•The elimination of the "Medicare gap"

.

Aaaaand that's it right there.

The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it's not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.

Plus, as previously mentioned, it's necessary if you're doing away with "pre-existing conditions" because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.

Whew! Hope that answers the question!"

I just had to: What to do when your kids are just starting school

OH MY. Here is the text that goes with it. You will cry:

"I graduated High School this week. When my Dad said he had a present for me I thought I was getting some cheesy graduation card. But what I received was something truly priceless. Following the ceremony he handed me a bag with a copy of "Oh the Places You'll Go," by Doctor Seuss inside. At first I just smiled and said that it meant a lot and that I loved that book.

But then he told me "No, open it up." ...On the first page I see a short paragraph written by none other than my kindergarten teacher. I start tearing up but I'm still confused. He tells me "Every year, for the past 13 years, since the day you started kindergarten I've gotten every teacher, coach, and principal to write a little something about you inside this book."

He managed to keep this book a secret for 13 years, and apparently everyone else in my life knew about it! Yes the intended effect occured... I burst out in tears. Sitting there reading through this book there are encouraging and sweet words from every teacher I love and remember through my years in this small town. My early teachers mention my "Pigtails and giggles," while my high school teachers mention my "Wit and sharp thinking.." But they all mention my humor and love for life. It is astounding to receive something this moving, touching, nostalgic, and thoughtful.

I can't express how much I love my Dad for this labor of love."

It's been a Vernus Horribilis

Sorry - I have been missing in action for a while.

I have been in the middle of a very wet Spring....no summer in sight and I am in need of a little Sunshine.

I have a few things I want to write about - in particular - a continuation of my Grandmother (the RN) and the family's life circa 1940 or so in Vancouver.....

Stay tuned.

It might take me a little bit to get going again.

Thank you for your patience.

Meanwhile, all the rain has allowed beautiful flowers to grow in our garden: