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Wednesday, August 19, 2015

Ode To A Bermuda Rat Terrier

Oh little rat terrier dog
It's been a year,
rat terrier dear
But you've finally made my blog

You belonged in a purse
not alone in in the road
like a suicidal bermuda toad
So to you I dedicated this verse

You ran into the road
You didn't have a clue
What you were about to do
As I was scootering back to my abode

I saw you too late
You didn't see me at all,
You were just so darn small
Road kill was going to be your fate

I laid on the brake
and willed you to run,
Or else you'd be done
5 inches ahead was all it would take

The back tire started to come around
It was hit you or go down
On my last day in this town
Why wouldn't you give one short bound?

I couldn't run you over
So I crashed in the street
You dumb little rover
Why did we have to meet?

OK, so I am not a poet.  The dog made it safely across the road.  I ended up under the bike with my knee taking the bulk of the various forces involved.  Impact, friction, and the stretch of my upper body moving at one velocity while my lower leg was held stationary under a couple hundred pounds of bike.  After 5 years in Bermuda, with one foot out the door, I had my dreaded bike crash.  All for a little rat terrier.  I got to meet police, fire, and ambulance that day, and got to be a secret shopper at my old employer, Bermuda Hospitals Board.

The Bermuda Scooter
I limped around for a year waiting for it to get better.  I was between jobs, countries, and healthcare plans.  Canada's waiting list for knee surgery is longer than the US list for work VISA's I discovered (which is also ridiculously long).

The good news is that once I got healthcare in the US, the wait time was almost non-existent.  I went to the employee health nurse practitioner at work, she ordered an MRI.  Dreading surgery, I procrastinated about two weeks before calling, but when I did I had an appointment the next day.  I left the MRI clinic with a CD of the scan and a copy of the radiology report that day.  Within 2 days the health clinic called back and said I just needed to pick a surgeon and she would send the referral over.  That is new to me, in Canada and even Bermuda, the patient is referred at the referring doctor's choice.  You can make requests I guess, but it's not an open ended consumer decision like in the US.

So I spent some time doing research.  I tried the online ratings, there really isn't a lot of data that I would like to make a choice on in there.  Being new to town, I asked everyone I knew if they knew who the best surgeon is.  Almost everybody had an experience, and each one of them had been to and recommended a different surgeon.  So it's good that everyone was pleased with their care and willing to recommend their surgeon -- means everyone is pretty good, but I was honestly surprised to not get the same name twice.  In the end, I researched everything online, decided that I wanted to try to preserve as much of the meniscuses as possible and find someone who would do a repair if possible.  That decision led me to a recommendation to Dr. Powell and everybody I asked had only good things to say about him.  So I finally booked an ortho consult, which was within 2 days of my decision, and after meeting Dr. Powell I was immediately comfortable with my decision.  He was personable, easy to interact with, took ample time for questions, and I think he was amused at my unique patient history -- he later introduced me to one of his assistants with a smile as "the Bermuda Scooter patient."

Surgery was within a couple of weeks...as if that wasn't amazing enough, it could have been done the same week had I been mentally ready for it.  The only draw back to the surgery dates, was that it was going to conflict with a visit from a Bermuda Blog co-star...Shibby, now from Ireland!   Her tickets had been booked, but I couldn't delay either as new analyzers were arriving the following week at work and work was about to get even crazier...another unbelievable fact.

My diagnosis was lateral meniscus flap tear, and medial bucket handle meniscus repair, with a little fluid accumulation thrown in as a bonus.  I found a lot of pictures online, a video of meniscus repair which I probably shouldn't have watched as the snipping tool looks a little more like a rip and tear clamp than a high speed buzz saw, but I had a hard time really visualizing what was wrong inside my knee and what the fix was going to look like.  Here in the US, they send you home with photos of the whole thing when you wake up.

So if you need meniscectomy, here is what it looks like.  The first image is just a little tear...it would not warrant surgery on it's own.  The second image is the after when they snip it down.  Images 3 and 4 are not repairable, they are wear and tear from too much high impact...bodes for an achy old age.


This next one is what a flap tear looks like.  Unfortunately it could not be repaired.  Most of the meniscus gets very little blood flow.  This is such a case.  The flap tear before and after are top and bottom.


This next little gem is the bucket handle tear.  This is likely the little guy that caused the most problem.  This tends to cause locking of the knee as it can flip back and get stuck, like this.



And yet another bonus!  To the surprise of all awake in the room, they found a foreign body floating around in the knee...this is what cartilage that actually blows off your knee looks like after floating around and getting calcified for a year looks like.  Another likely reason sometimes my knee would stick, and sometimes it would not.


So that is what my meniscectomy looked like, hopefully none of you will need one soon.  All for the well being of one clueless tiny little rat terrier in Bermuda.  Thanks to all the great medical team who came to Alaska Regional to try to get me back to normal speed, and thanks to Shibby for being nurse, plus colleagues who volunteered to drive me to and from the hospital, and lend their OR skilled hubbies to my case.  I couldn't be more pleased with my experience at Alaska Regional...proud to call it my new work home!

Tuesday, August 18, 2015

Jurassic Park, Alaska

Most people who haven't been to Alaska will think it is cold, and barren.  That's what they teach in school about the tundra and permafrost at certain lattitudes.  However, most of Alaska is actually coniferous forest.  The tundra makes up some of its outskirts, but the interior is mostly forest.  The Chugach National Forest is all around my new home.  And I was surprised this year to find out just how lush and rich the vegetation here is.



These little red berries grow in abundance out here. I am not sure what they are, and if they are edible or not.  I googled them, and there are several small red berries that are edible, like the backpacker berry, and several reds that are poisonous, like the moon berry.  The nature center offers guided tours that explain the local plants...I shall have to attend one next year.


The weeds were over my head, literally.


My first trip to the nature center was in March, when little patches of snow still clung to the trail.  The jungle like transformation in just a couple of months amazed me.


This is the alleged trail through the center, the Albert Loops Trail.


The huge tall plants made me think I was in Jurassic Alaska.


There were loads of little wildflowers.  Alaska summers explode in color...made up of tiny little flowers in an expanse of the grey, blue, and green landscape.




Every once in a while someone posts that a bear ran across the trail ahead of them at the Nature Center.  Seeing the thick growth and large flattened areas by its side, I suspect a few bears have daybeds in the Nature Center.  It's a relatively safe place for them to spend the day, well, for the bears at least.



These little blue flowers were absolutely stunning both in their bold color and their delightful symmetry.  I loved this little patch of color I stumbled across.


This last plant is probably a weed, but if you look closely, each one of its seeds has the shape of a heart.  There is a lot of beauty, a lot of variation in that beauty, in a short stroll in one tiny little patch of this huge Alaska world.  I can't wait to see more of it!


Monday, August 17, 2015

The Last Limp Through the Woods

The weekend before knee surgery was gorgeous and sunny.  I decided to take one last limp through the woods because I knee the salmon were returning to the Eagle River Nature Center, and when they did, one of the main trails would close.  This usually happens each summer, around August, so I headed down to the Nature Center to try the Albert Loop Trail.  I stopped at a favorite roadside pullout on the way to get a snapshot of the river.


 Little did I know that this is also a favorite spot for bears!  I spotted a couple coming out of this spot on my next drive through!  Alaska is beautiful in the summer.  The classic photo always includes this beautiful purple flower, the fireweed.


Fireweed is a pioneer plant, it is usually the first to colonize areas burnt by fire.  But you will see it pretty well everywhere along the roadsides.  Fireweed is pretty and useful.  It can be used to make teas and honey, it is a good source of Vitamin C and A, and it was used to fight infection n native medicine by placing the stem against the wound to draw out infection.

The valley just beyond Eagle River
Once I got to the Eagle River Nature Center, I checked in to check and see if wildlife had been reported in the are.  Always a good idea, so that if a bear has been sighted frequently in an area you an choose your route based on your comfort level.  A momma grizzly and 2 cubs had been sighted the night before...at the registration building.  I wanted to try the Albert Loop trail, so asked if it was well travelled.  They said yes of course, it is their most popular trail after all.

I started down the common path which leads to the Iditarod Trail that I usually take.  I stopped at the viewing deck, which was abundantly lush compared to my last visit!


The vegetation seems to overtake some of the stream in the summer.  I always think this is the best view along the whole walk.


The Albert Loop Trail very quickly became a footpath through very thick, very tall vegetation.  I was glad I had asked if it was well travelled, because I could only see a few feet ahead and a few feet behind...any bear encouters would be an unpleasant surprise to us both.  So on I walked...and walked, and walked, not encountering a soul.  I stopped and listened carefully and heard not a sound in the woods.  I started trying to whistle, and clapping my hands every few steps, just to warn any bears in the area that I was coming through.  I figure it was a good two miles before I encountered another human, so much for the well traveled bit.  The part of the trail by the stream floods in the summer, so there was a bypass route.  I was quite happy to get on this bypass as the forest is taller here, meaning there are far less head high weeds and shrubs, so you can at least see a little ways ahead.  The path is also well defined.


After the bypass, the route runs by the river.  This was the path ahead.  Pretty quiet.


The quiet little stream.  No salmon yet.


This is still the path...it seems to be more a general suggestion to simply go forward in a general direction than a trail.


I came to a little sign directing me back to the main trails, and popped out by the River Yurt.  I had not heard of Yurts before Alaska, but yurt is a common word here.  It means something along the lines of temporary outbuilding.  There are yurt cabins, and apparently in Homer there are yurts for every purpose, even yoga yurts.


This is one of three yurts you can rent at the Nature Center for overnight camping.


There are a few volunteers who live at the Nature Center.  This is their backyard.  Very wild and beautiful.


Just before the Albert loop joins the Iditarod Trail, there is a salmon viewing deck.  It boasts another beautiful view.  The deadwood is such a stark bleak white against the vibrant green backdrop.


Well worth the short walk for this stunning view.


A couple sits just below the footbridge musing about sweet nothings.  With the reflections and the bridge, I thought this might be Eagle River's answer to Central Park.


I got back to the main trail to the parking lot just as the skies grayed over.  I was hoping my next trek would be easier, as arthroscopy was booked for the following Thursday.






Sunday, August 16, 2015

The End of an Em-bear-assing amount of photos

You might think I would get tired of watching the bears.  But  I don't.  They are just so interesting to me.  The first couple of visits to the AWCC I was just in awe of them.  On subsequent visits I got to learn a little bit more about their histories.  And it is neat to be able to start seeing their personalities come through in the repeat visits.

Hugo is not alone in her enclosure at AWCC.  She shares it with a pair of younger, but much larger bears.  Joe Boxer and Patrone.  These are coastal brown bears, while Hugo is an inland brown bear, or Grizzly.  They have evolved differently....hard to imagine the grizzly is smaller than something, but it's smaller than the coastal brown, and those in turn are smaller than the Kodiak bear.


Joe Boxer and Patrone got their names from the corporations who sponsored their care at a charity event.  The brother and sister pair are now 11 years old.


Their story is a sad one, they were orphaned when young.  Their mom was looking for protein for her babies, and tracked and killed a moose.  That hunt took her into someone's yard, cubs in tow, and their shot her.  When the human loses a bear-human conflict, it is legendary and national news.  More commonly, quietly, legally, it is usually the other way around.  Here is the story of Joe Boxer and Patrone.

In the town of Willow, a brown bear sow killed a moose calf in a resident’s backyard. The man was afraid that the bear might try to attack his dog, so he killed the sow not knowing that she had cubs (now known as Joe Boxer and Patron). In Alaska, killing a bear in defense of life or property is legal. Once he saw the two cubs at the top of a very tall and skinny birch tree, he called the area wildlife biologist to notify him of the situation.
Daring Rescue Saves Cubs’ Lives!! The biologist, who happens to be a former gymnast, daringly climbed to the top of the skinny tree and grabbed the smaller male cub by a rear leg, holding on to the tree with the other hand. He climbed down and lowered the cub into a fish net. The second cub was more of a challenge. She was a large female cub and acted aggressively. The biologist climbed to the top of the tree, injected her with a sedative then grabbed her by the scruff. As he began to climb down, the skinny birch tree began to bend and crack. The tree bent all the way over, delivering the biologist and the cub safely to the ground!


So now they hang out at the Alaska Conservation Center.  This guy is a foodie, and he comes to the viewing deck about half an hour before feeding time every day in anticipation of his 20 pound salmon.


He sits and waits patiently on his big furry butt, feet stretched out showing his little...er big...padded bear feet.


I can't quite be sure which is Joe Boxer and which is Patrone yet.  Joe Boxer is the male and slightly larger, Patrone is the female.  Joe Boxer and Hugo don't always get on quite so well...I have seen him chasing her...but she is faster!  But at naptime, she sneaks over closer to them to sleep, so they must do ok after all.


The siblings pictured above.


What a beautiful big bear!!  This is probably Joe Boxer.


All three have the dark around the eyes, .


And here we have someone anxiously waiting for their salmon dinner.


The old adage for bears in the wild is that a fed bear is a dead bear.  Once bears learn that humans or urban areas are easy food sources, they will return, and inevitably someone will be afraid for the safety of person, child, or pet, and shoot that bear.  At the Conservation Center, it's one of the only places where you can say a fed bear is a happy bear.


Unless you are a fat little black bear, who gets fed one hour before the brown bears.  This guy reminds me of my fat cat Aiden.  He just ate...but was lurking about for brown bear feeding as well, just hoping someone throws the fish over the wrong side of the fence.


He won't get hungry in hibernation, that's for sure!


With a bit of resignation, he realizes he is not going to get fed twice, you can almost see the transition from hopeful to disappointed on his face.


Unable to watch his neighbours eat their dinner, he saunters off to a favorite hillside spot to have a nap and dream bear dreams.


Have a good nap little bear!


And that's it!  The May photos are now caught up!