Frustrations

Recently, I spent a long time with a client (greater than 24 hours) attempting an induction to get a baby out prior to term and that ended in a cesarean delivery. I feel frustrated about this, because we were forcing her body to do something it was not yet ready to do and I disagree with this on principle. I also realize that there are medical indicators for early inductions which need to be addressed as well. Immediately after that I spent a long day, 10 hours, with a woman who was pregnant, but didn't really want another child at this point in her life and she refused to let the labor happen. When we forced the issue and made labor happen, she refused to push the baby out. She had a really difficult time and I was super frustrated with her and for her. Fortunately, the baby did well during the delivery and all is good. I did tell the multitude of friends and family that I believed that she is a huge risk for post partum depression and that she is not to be left alone for the first 2 weeks and then we will see how she is doing. I am hoping that the rest of the holiday season goes well, because I'm on call until New Years when I'm running away for a few days of R & R.

Family, Fun, Feasting = Thanksgiving

I love Thanksgiving. We had a wonderful holiday. We were invited to our daughter's home for Thanksgiving and we took the 3 hour drive up to their home after I got off work on Wednesday. We took them out for dinner that night. On Thursday, we got up and got to it! We had much work to do and we all pitched in and created a wonderful feast! We enjoyed working together to create our feast and then enjoyed eating our feast. It was marvelous to be together and have a great time creating a feast. We did everything from scratch and it makes me so proud that I am able to pass that knowledge on to my children and that they were receptive to learning about the art of cooking and creating. We stuffed ourselves and then we went for a walk to settle our dinners. Upon our return home we had pie and conversation. Then it was off to bed as Friday was a high stress day! We shopped for wedding dress fabric and were successful with that. I'm so pleased with what she chose. She will be a beautiful bride. Friday evening we had left overs and then pie, port, and chocolate. Fat and Happy pretty much describes all of us. Saturday the party started to dissolve and people returned to their own homes. All in all it was a wonderful holiday and as usual there is much for me to be thankful for and I am reminded how very blessed I am with my family, my health, and my life.

On Call

I am on call this weekend and as usual behind in my paper charting. One of the items that never gets talked about in school the the overwhelming amount of charting that goes on for every patient. We document phone calls, we document in person visits, we document and document and document. It really gets old, because it takes time. My schedule is such that I am on call 2 days on, 2 days off, 3 days on (the weekend) then 2 days off, 2 days on, 3 days off (the weekend). Therefore, I am making an attempt to only bring stuff home to do every other weekend (the ones when I am on call). I always feel like I am just barely treading water to keep up. Alas, that is the way it goes - so back to charting.

Retirement?

I'm ready to retire. Now, the reality is that I will not be able to do this for a long time to come - probably 10 more years, but I am ready not to have to go to work every day. When I was off for my knee recovery, I thought I would go crazy, that did not happen. Instead, I did some work with photo shop. I sewed. I read. I got in shape physically and I got used to having my time dictated by my own timeline instead of punching the clock. Alas, I made a deal with my life mate and it is my 25 years to work, so retirement is absolutely out of the question. I really have it good. I love my work. I have a lot of autonomy. I think I'm good at what I do and except for the crazy hours it is pretty fun most of the time. I would love to travel, spend time with my kids and grand kids and generally lead an unfettered life. However, no work, no pay; no pay, no food, house, car, or clothing, so I think I have to go to work. I remind myself that I am fortunate that I have a job that challenges me both physically and mentally as well as emotionally. I am adequately rewarded for what I do (most of the time) and in times of economic distress, I am lucky to have a job.

On another note entirely, I love talking with my children and grand children. I talked with my daughter yesterday and my other daughter and some of my grandchildren today. It is always glorious to talk with them and find out what is going on and how their lives are progressing. They blog and I read their stories, but talking on the phone is so much more fun.

An under lying rumble

This year has been one that has been filled with lots of stuff. Nothing hugely bad or life changing, just a constant undercurrent of stress. In January I had my knee replaced and although this was an active choice, it was not without some fears and worries. The knee replacement went great and then came the recovery. I started in physical therapy my first day home after the surgery. Boy was I out of shape.

I missed work for 12 weeks. Now, I don't know where my head was when I took time off from work, but it obviously was not on my clients. There is a serious bond between the care giver and the pregnant woman and when you are not there for 12 weeks the bond goes by the wayside and the pregnant women turn their allegiance to the person who is there. The result of this is that my census dropped off dramatically. I had some serious mental adjusting to do when I got back to the office because everyone did NOT want me to do their deliveries. I managed to wrap my head around that and get straightened out and continue on with work and begin to build up my census again. During this time I was served with papers from a former client and discovered that I am being sued. What a drag. I got thru 6 months of recovery and physical therapy and was feeling pretty good about life with the exception of the law suit.

Then it was my birthday and my purse was stolen while we were walking on the beach. Then there was all the chaos that goes with re-establishing one's identity while monitoring to be sure that no one else is trying to become me. That is on going, but at least we have credit cards again.

Last weekend was hectic at the hospital and I did 9 deliveries in one weekend. It was like the bad old days before I had a midwife partner.

This weekend was my weekend off call and so I procrastinated about doing my stuff and Sunday came. I got up and worked out and then my partner and I walked down the hill to pick up the Sunday paper and when we returned one of our old trees had lost a giant limb and it had fallen across the deer fence, crushing it. Now, we own a chain saw but on this occasion we could not get it to work. We sawed and sawed and sawed by hand and made some progress but were no where near getting the tree off the fence when a neighbor from up the hill a ways drove by and stated that he had a chain saw that we could use. He went home and brought his saw down and in just a matter of under an hour the fence was freed and we were able to tack it back up to keep the deer out of our garden.

Then it was into the house for a shower and work, except I didn't really feel like working and so was not very productive. So as I look back over the past year I see that there has been a constant rumble. Nothing that makes me say life sucks, but I am surely aware that I need to be positive, functional, and up beat because if I am not I could easily get overwhelmed.

I've been robbed!!!!!

I turned 55 this month and my partner and I went to the coast for a get away weekend of camping and walking on the beach. We drove the 2-1/2 hours to the campground we picked, paid our fee, set up our tent and headed for a walk on the beach. This is a beach we have visited before and love because of the surf on the rocks and the sand. We parked the car, I got out my camera and clipped it to my belt loop. We put my purse in the trunk and locked the car. Off we went for a walk on the beach. We walked and talked for a while generally enjoying the peace of the ocean sounds and the company of one another. We don't get away too often because of my job so when we have a chance, it is really special. This was a premier weekend because it was my 55th birthday. We walked and talked and it started to get cool so we headed back to the parking lot and the car to get more clothes and our picnic dinner. As we came up the stairs we saw the car and my thought was "Did I leave my window open? What a ding dong." My partner said "Shit, someone has broken into our car." He was right on. They busted out the front passenger window. Now the interesting thing is that they didn't ran sack the whole car. They took my bag from the floor of the front seat - it contained my current hand work project (knitting) two extra skeins of yarn and several crochet hooks. They briefly looked into the glove compartment (this I know because the wind up emergency flash light was in the floor). They popped the trunk from the inside and took my purse. That is it. They left the wine, the geocacheing bag and accessories (thank goodness), the rest of the camping gear, etc. So we drive up the coast to the next little town and ask for the police department and are told that there isn't one in town that I will need to call the county sheriff. I get the number and do this. The sheriff's office tells me that they don't answer those calls that I need to talk with the state patrol. So, I call the state patrol and get a very polite officer who tells me that they will send some paperwork to my home for me to fill out and send back. She also informs me that this happens all the time and I need to be sure to cancel all my credit cards and notify everyone of the theft. Great!! This is not an easy task, because of course my cell phone is in my purse, as is my cash (and everything else)! I start to try and reconstruct the contents of my purse. We start calling credit card companies and canceling cards - it gets dark and subsequently cold. We get cold. We feel sick. We call every card I can think of. We go back to the campground, break camp, load the car and drive the 2-1/2 hours home. We get on the computer and do more checking. I am now truly mortified. I have given away (by virtue of the fact that the thief has the contents of my purse) my life and livelihood. The thief has my address, my phone number, my social security number, my children's names and information, my professional affiliations and licenses, etc, etc, etc. So now a new crisis evolves - that of attempting to stop identity theft. I also have to have the window on my car replaced. My credit cards re-issued. I must also continually be on guard now for someone who wants to become me or at least get loans, purchase goods, or establish credit for which I will be expected to pick up the tab. I also have to be concerned about leaving my home unattended. This truly sucks. I am saddened by the fact that my fellow travelers in this universe feel that robbery is OK. I am upset at myself for taking my purse on a camping trip. I am generally frustrated and sickened.

It sure is quiet here.

We had a wonderful visit with our children and grandchildren and now our home is so very quiet. Our oldest daughter and her 4 children arrived on August 5th to spend 3 weeks with us. Her husband arrived later and spent a week with us. Our youngest daughter and her partner spent the first two weekends of THE VISIT with us and we spent the third weekend of THE VISIT with them at their home near Portland. We had a wild time mixed with days of work for me when I would really rather have been with them. We had great insights from the kids. We had the therapy of family togetherness. We managed to sew a fitting bodice for the upcoming wedding of our youngest daughter. We managed to make jam. We laughed, joked and were generally boisterous and loud. We played games, drank some wine, and decided that the world would totally be a better place if only everyone would do things our way. I delivered some babies. I did some prenatal care. I solved other people’s problems and wished I was home with the kids. Now, everyone is back to their respective homes, the laundry is done, the toys are mostly put away, and our home is sure quiet. I am already looking forward to May, 2009 and the wedding because then everyone will be together again. I hope we don't have to wait that long, but it is a possibility. I'm thinking chaos is a good thing.

Moving on

My solution for dealing with stress and stressors in life has always been to move. Yes, to physically pick up and leave one area and travel to another area. This was facilitated by the fact that my husband was in the military, so we moved a lot. Now he is retired and we have been in the same place for 9 years and I am thinking it is time to move, and move on. It is such a mixed deal for me because on the one hand I really love what I do. On the other hand there are things about my situation that drive me crazy. My ideal solution would be to move someplace new and reinvent myself thus leaving all my stress behind and of course taking on a bunch of new stress in the process. I'm not sure that this is a sane idea, nor one that I'll act on, but it sure looks attractive right now. Of course, it would mean leaving the house we built and the yard we are working on. It would also mean we had to pick a new place to live and I would have to find a new job. I'm pretty sure that there are not many jobs as good as the one I have right now, even if it frustrates the heck out of me sometimes. I guess I better just stay put, but the inclination to move is there and strong.

Crazy ideas

I had a post partum visit recently with a woman who was fussing and complaining because there was no way to attach the breast pumps to her chest when she was using them so she had to sit and hold them in place to express milk. She was so offended that she is creating and marketing something to hold the pumps in place while expressing. This will allow her to "do things" while she is pumping out the breast milk so that she can feed her baby with a bottle. Now, I asked the obvious question "Why don't you just nurse your baby at the breast and then you won't have to worry about pumping?" Well, my patient replied that she just couldn't get the hang of it and by pumping and bottle feeding she could be "doing something" while her baby is eating because she could prop the bottle and of course once she perfects her pump holding harness she will be able to "do something" while pumping her breasts as well. I cannot imagine it is more efficient to pump the milk from the breasts and feed in a bottle (going thru the middle man as it were) than to just learn how to put the baby to breast and have the milk go directly from the manufacturer to the consumer. I just shake my head in wonder and dismay. Perhaps I am getting old and cynical. I think breastfeeding is a unique and wonderful way to feed a baby/child while establishing a bond of closeness and demonstrating to said child that you have time to meet said child’s needs and that "doing something" is not more important than the child or the child's needs.

Thoughts on instant gratification

I have been thinking for a long time about the role of breastfeeding in infant development and growing up. I have come to an interesting insight. When formula feeding, the moment the bottle is in the mouth there is food coming out - instant gratification. This happens from the first feed forward. There is no wait and no no learning. With breastfeeding, the infant goes to breast and has to work to suckle, there is the comfort of being close to Mother's heart and touching Mother's skin but there is not an instant food reward. In fact, there is a lot of suckling that goes into getting the first little bits of colostrum out and there is a lot more suckling that goes into bringing in the milk. In fact, it is work to get the breastmilk out of the breast. Now, we know that breastfeeding helps decrease infection. Breastfeeding also helps with facial development and eye development. At this point, I am thinking that breastfeeding also helps with learning that instant gratification is not the way of the world. Breastfeeding lays the foundation that one has to expend some effort in order to receive pleasant things (i.e. food). So not only does the breastfed infant learn to feel safe at the breast, the infant also learns the very basic idea that one has to work to gain things one wants - there is no instant gratification.

My first birth on my new knee

I am recovering nicely from my total knee replacement. My midwife partner is burning out fast working alone for 11 weeks doing all the births and taking all the call. In order to save her and ease myself back into the practice slowly I have been taking all the call from the answering service and working in the office half days for a couple of weeks . Friday afternoon I went on call at the hospital to do births on my new knee. I was on call all night Friday night and Saturday until 6pm when my midwife partner returned and saved me - boy was I tired. However, I did have a wonderful birth while I was on call. The patient was over due and she really wanted an unmedicated birth. We got her wish. She was awesome and pushed the baby out just beautifully. Dad helped deliver and a great time was had by all. It was a fantastic first birth back and my knee did great.

Then there was the not so fantastic. I also had an induction for placental insufficiency which turned into an unnecessary cesarean delivery. We brought the patient into the hospital for a slow induction so we didn't stress the baby. The family got all hot and bothered because the baby didn't come the first day we worked on it. We discussed plan of care with them, let Mom eat dinner and have a good sleep and then start the induction up again on day 2. Oh NO - the father of the baby was all in a fit and stated that the patient needed a cesarean section because this was taking too long. My consulting physician immediately said yes and told them it would be later in the day, today. So this woman who has successfully delivered vaginally twice before at term with easy fast labors is having a cesarean section on demand because the father of the baby is tired of waiting. When I talked with my consulting about my discomfort with cesarean on demand he said that if we forced her to have a vaginal delivery and anything was wrong or the baby was not perfect she would believe she had grounds to sue us because she had asked for a cesarean and we did not comply, we made her and her baby endure labor. So he feels that if a patient demands a cesarean delivery we are better off capitulating to that demand and doing the surgery. I am frustrated. On the one hand, physicians are painted as talking people into cesarean deliveries and on the other they feel they will be sued if they don't honor the patient request for cesareans on demand. I know from past instances that this woman will probably be sorry that she chose this route, but by then the damage is already done. Now we have to wait for enough women to realize that they made a stupid choice and become verbal about it in order for the pendulum to swing away from cesareans on demand.

Back to work

I put myself back on call for non hospital related stuff on Wednesday. So far it hasn't been bad. My midwife partner is quickly burning out and I thought that if I could give her a bit of a rest, she would appreciate a break. I start back at the office on half days, on Monday morning 4/7. As I am working with clients on the phone and using the electronic medical records, it is starting to feel like I can successfully go back to work. I really didn't miss the psychic drag of dealing with other peoples problems and I have loved the time with my husband. If only there was a way to maintain my current standard of living without working - hum this is the issue for most of us though. As I return to work I am going to valiantly try to maintain my autonomy and not be consumed by the work. I do want to continue to do a good job and to continue to be admired/desired by my clients but I don't want to be tired all the time and have no life outside of work. This is a new juggling act to learn as prior to this point I just dedicated myself totally to my work. Now, I want to have a good relationship with my husband and I have to maintain my body to keep my knee flexible and strong and this requires time and energy. I'll have to work this thru. Today it seems like I can do it, we will see what Monday brings.

Recovery and travel

I am 8 weeks out from my knee replacement and life is good! We went out to visit our daughter and the grandchildren in Virginia. We hiked in Great Falls National Park. We spent a day at the National Zoo. We visited the National Geographic Museum. We visited the Museum of Natural History. We did Geocaching with the kids. We had a wonderful time. The kids are a blast and my knee did great. I had NO PAIN in all my adventures. I took exercise walks daily and rode the bike on the trainer to maintain my flexibility. We had a wonderful time.

On the return from the east coast we stopped in Colorado and had a brief interlude with my sisters and my Mom. It was Mom's 75th birthday and we had a surprise party for her. It was great. I spent several weeks prior to the trip doing an electronic photo album for her on an electric picture frame. So far she is not using it at all (bummer), but I have hopes. There was a slight change of plans as my sister (who had an emergency hysterectomy 3 weeks prior) developed a DVT (deep vein thrombosis) and was on bed rest and anticoagulation therapy. Because of the DVT we were not able to go to the cabin in the mountains, but we still had a good time and Mom was pleased and surprised.

We visited with our other daughter and her partner in Portland on the way home and spent a day doing wedding dress shopping. That was an adventure and she didn't find anything that she really fell for so I am making a muslin dress for her to try on in a style that we didn't find while out and about. Hope to get that done this month.

I visited the office yesterday to pick up my paycheck and see how everyone was. I had them start booking me with patients for Monday, April 7th for half days 9-noon. So the grind begins again. Since I have been gone my partner has been doing 20-25 deliveries per month. I know that she is looking forward to having some time off. I'm not sure that I'm looking forward to returning to the grind. Both my children expressed concern that I'll get too tired and burned out again and that I will not have energy to be "Mom". They both voiced the opinion that they liked the fact that I had my knee fixed and that I was full of energy and get up and go just like they remembered. I hope it is the new knee and that I will be able to maintain the positive attitude and the energy. I guess I'll see how it all goes once I'm back in the saddle full time. I return to full time April 28th and I will return to doing deliveries at that time too.

It is better

I am now almost 5 weeks out from my knee replacement. I am walking 2 miles on relatively flat ground, pedaling my bike backwards for 10 minutes and forwards with almost no resistance for 15 minutes twice daily and going to physical therapy 3 times per week. It is getting easier. I am shocked at how out of shape my body got while my knee was deteriorating. It is appalling to realize I let myself get so out of shape. I am also facing the return to work quandary. I really do love baby catching, but I do not want it to rule every waking moment of my life. I do still want to work, but I don't want to work 80+ hours a week. I am so much enjoying being with my husband and having time to be silly and be rested. I admit that "training" (getting back in shape and getting the use of both legs equalized) is not tough but it does take a lot of time. When I go back to work I want to still have time to work on my body and be with my husband. I'm not sure where that fits in with working 80+ hours a week. Right now my midwifery partner is doing it all (taking all the call, doing all the births, doing all the visits, assisting with all the cesarean deliveries), when I go back, I'm so going to owe her time off and that means that I will be doing it all. I'm not sure how that is going to work out or how I really feel about that. I guess I'll have to keep thinking about it and see what works out.

On a brighter note - in one week we leave to go see the Grandkids and their Mom & Dad. I am so excited for that I can hardly wait. It is going to be a blast!

YES, I can!

It has been a joyful 24 hours. My youngest daughter phoned last night to share that she has gotten engaged to be married. We are very excited for her and wish her all the best. She and her guy have been together a while and have decided to tie the knot.
Today at physical therapy I was able to pedal the stationary bike all the way around! This is truly exciting because I am 15 days post total right knee replacement. I do not imply that it was fun, or easy, I merely state that I previously had not been able to do it and now I can. I am very excited. I am also exhausted. I didn't realize that pedaling slowly for 5 minutes with no resistance could make one so tired. It will get easier, It will get easier, It will get easier, It will get easier, It will get easier, It will get easier, It will get easier.

Life continues. . .

Yesterday, I went to the office for the first time since my surgery and enjoyed visiting with everyone. I got very tired and came home and took a nap. I was saddened because just as I arrived they had confirmed a term fetal demise in one of our patients so my midwife partner was busy with that, and we didn't get a chance to visit. I just gave her a hug and told her I was sorry. She went to the hospital with the patient to labor sit and ultimately deliver this stillborn baby. She called later in the day to say that it was all over, but she was really sad. There is nothing I can say or do, I can just reassure her that I know it is hard.

On a more positive note, I get to go visit my grandchildren on the East coast during my convalescence. We got our tickets and I am so excited. It will be great to be with them, and it is spring break, so the older kids will be out of school. My granddaughter told me on the phone the other day "We will go to the National Zoo. We will take the Metro because it is very exciting. We will walk and walk and see all of the animals when you are here." I told her that sounded wonderful but that we would have to wait and see. I will be 6 weeks post op when we fly out. I am not sure about my strength or mobility. Speaking of which, I am using a bike to increase my flexion and extension, it is fairly painful, but everything I have read assures me that this is just stretching the muscles. I cannot make the pedals go all the way around yet but I get closer each time I work at it. I try for four separate "practices" everyday. I think it is working. Today, I was able to go down the stairs alternating feet, which I have not been able to do in years. That is definite progress and for that I am pleased and excited.

Baby steps

I am post op day 12 today. I can now walk without a limp (when not too tired); climb stairs alternating feet not using crutches or aides (can't go down without assistance yet); I have 85 degrees of flexion and almost complete extension. The residual rash from the anesthesia reaction is almost completely gone. I am feeling better each day. I am trying to work hard at my physical therapy but sometimes it is hard as it hurts. Now, intellectually, I realize that I have to work to stretch out the muscles and regain years of lost flexion and extension; however, emotionally I keep asking myself why I am causing myself pain. I have no good answer. Tomorrow I will go to a carry in lunch at the office after my physical therapy. Then of course it will be home for a nap, but then what can one expect.

Life's little inconveniences

Today I am post op day 8 from a total knee replacement. The first week sucks. I'm told the second week also sucks. By the third week, things are supposed to be looking up and getting much better.

I'm officially off work for 12 weeks and my hospital requires that I take a medical leave of absence, giving up my clinical privileges until my surgeon releases me back to work insuring that I will not be a hazard to my clients thru impairment because of drugs or pain. What a bureaucratic mess. Like I didn't have pain on a daily basis prior to the surgery (duh).

The surgery itself went well and I came thru that without a hitch. The recovery has been interesting. I had a severe allergic reaction to the narcotics that were used to control pain (there was very little, so they probably worked well) but I broke out all over my body with a blistery rash and it felt like fire ants were constantly biting me (my skin burned and itched fiercely). Oh boy, that was fun (not). I took Benadryl for the itching which made me comatose. I came home on post op day 3 (Superbowl Sunday). I live in a two story home that you have to go up a flight of stairs from the garage to get to the first floor or up an outside stair-filled walkway to the front door, so just getting in was a big deal. Of course, I was up to the challenge (there was no other way) and got home and got settled in the loft where I slept the rest of the day away. I started physical therapy Monday. Tuesday I had a melt down and cried multiple times. Wednesday I had physical therapy and the rash started to abate, I began to feel much better. Wednesday night I got my foot caught in the covers and wrenched my knee jerking awake with agony and terror. Thursday, I was tearful but did OK. Friday, I went shopping for a new refrigerator and then to physical therapy. Now why would someone 7 days post op from knee replacement surgery go shopping for a refrigerator you might ask - I know I ask myself what I was doing. The answer is that the refrigerator at the house has been broken for 3 weeks and the repair guy came Friday morning and let us know that basically the cost for repair was $800-900 and perhaps we would like to consider a new fridge. This became ever more necessary when the repair guy told us that the new compressor would be delivered FOB, take 2-3 weeks to arrive and cost another $200-300 shipping and installation. So that is how I ended up shopping for a new fridge 7 days post op.

One of the biggest challenges is that I don’t' have a good mental image of how the rehabilitation will go. I'm a true believer in the adage "I create the dream, I make it happen." However, my dream for the rehabilitation is really, really fuzzy and this is causing some problems (crying and carrying on). I keep working on the patient, persistent, strengthening vision, but it is really weak. I see hiking, biking, traveling, and working (end view) with vague pictures of baby steps learning to walk. I'll keep working on the vision day by day.

So now it is just a regimen of exercises and strengthening so that I can get back to the birthing barn and catch those babies. Right now my partner has control of the practice and is doing all the births. I bet she is tired. I know I was before she came to be part of the group. I'm starting to miss it, though.

SNOW

This weekend I was off call and I had an appointment in the city with the physician who is going to do my knee replacement. After that appointment we drove to spend the weekend with our daughter. We had a delightful dinner with them and visited for a while (it was raining), then went to bed (it was raining). We woke (it was raining) and cooked the cinnamon rolls we made last night had tea and generally enjoyed not rushing (it was raining). In the late morning we gathered ourselves and went on an adventure to the IKEA store (it was raining). When we arrived back at our daughter's house it was still raining and the prediction was for freezing rain and snow. We talked it over and decided that the best course of action was to cut our visit short and get home. It rained the entire trip home, but as we headed south, the temperature got warmer it was 34 degrees when we left our daughter's home and an hour or so south it was 41 degrees, we breathed a deep sigh of relief and kept driving to get home safely about 10:30 (it was raining) where we spent some time unwinding and then off to bed (it was raining). Wow! We woke to snow and snow and snow. I just talked to my midwife partner (who is at the hospital) and she said that the OR crew has been called in to just hang out and that ambulances are not doing transports because of the weather. She has been really busy this weekend. I told her that I'm not sure that I will be in tomorrow, because I don't know if I'll be able to make it down the hill. I live in the mountains above the town where I work, and there may not be a safe way into town. Oh darn - a real snow day!