London, part 2

Here are more pictures out an about in London.

London!

We have definately been bitten by the travel bug. Last weekend, we went to London to celebrate our anniversary. It was a wonderful weekend and I'll be posting lots more pictures (of course).

Layout of blog

I recently changed to the new blogger and I've noticed that my sidebar (the about me, previous posts, links, counter etc) sometimes shows up at the bottom on the right side instead of along side my posts.

Dear readers, please leave a comment for me if this is happening to you and what browser (Mozilla, Internet Explorer, Opera, some other one) you are using. This information will help me figure out what the problem may be or if it is only my work computer...

Salaries

Recently, I had dinner with a couple friends.  One, who is near retirement, happened to tell me how much she made.  It was not very much more than I made even though she has been in the field more than 20 years longer than me!  So, today I tried to log onto Impact's website to find the salary scale.  Impact is the trade union that negotiates salaries (they probably do other things also).  All speech therapists, Occupational Therapists, Physiotherapists are on the same salary scales and there are salary scales for various professions.  However, I couldn't access the salary scales since you need to be a registered member to see how much you should be earning or have the probability to earn.

Anyway, since I couldn't get the information that way, I just looked on the job postings board for the physiotherapist ad since we are on the same salary scale.  According to that posting, the salary scale tops out after 12 years!  So, after working for 12 years you have no real raise potential until you retire unless you a)change careers, b) go into management, c) work for a private clinic.  There is also a specialist post scheme intended to help income potential and recognize specialists in the field.  However, there are only a few of these positions in the country and none of them are in intellectual disability.  

So, when people ask me about attrition in the field, I now have a bit more of an idea why it is so high.  Also, what incentive is there for expierence clinicians to stay in the public sector?  How does the country benefit from capping salaries so early in our careers?

Blog Awards

Since I don't follow the Irish blogosphere, I've just learned about nominations for the Irish blog awards. If you want to nominate any Irish blog for any of the 21 categories, the form is found on the Irish Blog Awards site.

Hurry though because nominations end 11.59pm on Friday the 26th of January 2007 (Irish time).

Texting Mishaps

Sending text messages is quite common here.  Everyone seems to do it, I think partially because it is cheaper than talking to someone.  However, this sometimes causes confusion because you don't have the tone of voice of the other person and there is a different grammar/spelling.  I now can read most of them pretty quickly but every now and then, I'll get a message that I have to read multiple times before I understand it (usually because it is a bunch of letters strung together that I have to "say" in my head before I understand it).  

In December, I went on a course up in Belfast.  While there, I met a few interesting people.  One of the girls and myself swapped numbers.  I texted her a happy new year message and from that we set up a time to meet up.  While texting back and forth to each other, she said "AM available" on such a day.  Thinking in terms of texting abreviations, I thought she meant that she was available in the morning and she was suggestingbreakfast.  So, I suggested a morning time and a couple breakfast places.  She texted back asking (thankfully) to meet up later.  Later, I reread her original message and realized that she meant "am" as in "I am available" so I sent her a message explaining my error and asking if she wanted later.  She agreed but had reread my messages and asked if I still wanted breakfast.  After many many messages (it really would have been easier to ring her but I wasn't sure of protocol for it), we agreed to meet at a reasonable time for lunch.  And we had good fun with a three hour lunch!  

Yesterday, I got a text from a friend that we were supposed to see in a couple weeks saying she'd need to reschedule.  Again, after a few messages back and forth, we found a weekend in March.  I sent her a message with LOL, we have to schedule in March.  Well, she didn't know what LOL meant and asked.  It took me two messages to explain it to her and that I was expressing humor that we couldn't find any common times 
in February.

These two miscommunications highlight some of the difficulties of texting for me.  I still don't know the etiquitte.  I don't know when to abbreviate or with whom (e.g. don't codeswitch well).  Usually I write the whole message and then start abbreviating when the othe person does.  I know there is a social code here, I just haven't totally figured out what it is.  Some of it is person specific of course, some may be generational.  Anyone out there want to tell  me the rules?

Animal Adventures

On Friday, I had to take both cats to the vet. I (thought I) had arranged to leave them both for the day so I could pick them up after work. Darshin needed an exam and his yearly vaccines and Tiffin needed to be spade and have a microchip put in.

Friday morning, I get ready for work. I then put both cats into the two carriers and leave the house. I put Darshin in the bigger, hard sided carrier. Tiffin got the soft sided one that can be carried over my shoulder like a bag. OK, so I had both cats in their carriers. I went down the stairs. I started walking to the train station. I got to the train station, was lucky that nobody was really guarding the entrance and snuck both cats on. We rode to the stop. And then the 20 minute walk began. It was a windy day and the walk would normally take 10 minutes but Darshin is really heavy and it is awkward carrying a cat in a carrier. Especially when he keeps moving around the carrier and changing the weight balance. I had to stop a couple times because my hands were getting sore from the carrier.

At 9:45 AM I got to the vet. That was the time that I was supposed to be able to drop the kitties off. I waited outside in the cold until 10:00 when they let us in. I then waited to check the kitties in. They took Tiffin away quickly and told me to wait with Darshin. I waited. And waited. And then the vet called us in. He examined him and gave him his shots and sent me home. Now, that would normally be fine except that I then had to go back home to drop him off and then go into work instead of just going into work.

So, I leave and walk the 20 minutes back to the train station. Because Darshin is 13 pounds (6.3 kilos), he got really heavy. I kept switching which side I carried him on. I put the carrier on my shoulder. I stopped for a rest a bit. Finally, we got to the train station, waited for the train and got off. I then had the 10 minute walk back home. Again, I had to keep switching how I carried him because my hands were so sore. When I carried him on my shoulder (the carrier, that is), people looked at him and commented a lot. People were in awe that I was carrying a cat around in city centre. Did they move out of my way, no. They just marveled at my kitty in his carrier on my shoulder.

Finally we got home, and I let Darshin out of the carrier. He purred and purred. I grabbed the paperwork for the cats that I had forgotten to take earlier, and headed to the bank and post office to pay my phone bill.

I got to work at 12:45 PM. Just in time for lunch. I worked until about 5:30 when I had ordered a taxi to pick me up to take me to pick up Tiffin. I had to wait about 20 minutes for it to arrive. We got to the vet's office and they handed me a very groggy Tiffin. I gave them the forms to fill out and at one point they take Tiffin back. She growled when she saw the vet tech. (Darshin also growled most of the time he was at the vet's and yes cats can growl). They took her away from me and I got to wait. And wait.

Finally I got her back and we left the vet's. Again, I walked to the train station but it was much lighter and easier with Tiffin because she was slung over my shoulder. The wind batted her carrier around a bit, though. When we got home, I let her out of her carrier to find her dripping wet. She had urinated in the carrier! The fabric carrier. I transferred her into the hard sided carrier because I didn't want her sitting in her urine and I certainly wasn't going to let her run around the apartment that way.

So, I text John to see when he'll be home so he can help me clean up Tiffin. He's still at the pub. He gets home about 9:00 and we eat dinner. Then we clean up Tiffin. By this time, the anesthetic has worn off and she wants out of the carrier. We had to lock her in the bathroom and I held her while John used a rag to wipe her down. We couldn't give her a real bath since she had stitches. So, she got her sponge bath but wouldn't cooperate with being dried off. We had to let her go still quite wet but she just licked herself dry. I felt bad, though, because I was told not to let her get cold or run around too much.

So now Tiffin smells like Caineal used to after a bath (all I had was puppy/dog shampoo or human soap) and has a shaved side and a small scar. She'll look funny for a while.

Sometimes, I really miss having a car...

Hospitals

No one likes to go to the hospital. Last week, my friend M was in the hospital. She went to swift care on a Monday with a really sore/stiff swollen neck and got sent to A&E (ER). She sat in A&E most of the day and finally got admitted. She got to the A&E in the morning and didn't get a bed until past 5:00 PM even though she was admitted to the hospital.

While visiting her in the hospital, I was struck by the differences in hospitals between here and home. Actually, and Norway for that fact. First, the standard "rooms" are less than private and don't really allow privacy of any sort. There were about 8 people in one room with only the possibility of a curtain between them. This is about what the ER was like when John went to the hospital at home. The room also only had 1 TV which my friend couldn't see if she had wanted to watch the television. No radio. While, these may not seem like big deals but if you are stuck in bed all day, what are you supposed to do? There was also only one bathroom for the 8 people!

When my friend wanted to call a nurse to raise or lower her bed (no electric beds that raise or lower head/feet by pushing a button), she had to reach a good way out of the bed and could have fallen partially out! She also had to wait ages after hitting the call button. My friend finally got a private room (which she had insurance to pay for it) by shedding a few tears to the ward sister and begging. I am willing to bet that the hospital will charge for the private room.

On many days, this team of doctors came around to examine M and monitor her progress. We were there one day when they came in. They went around to each bed, sometimes pulling the curtain, others not. When they got to M, we left to give her privacy. When we came back, M reported that the doctors asked a few questions of her and the talked about her case and her like she wasn't there! So much for patient centered care.

Another issue I have with hospitals in Dublin is the cleanliness. One that I went to appeared to have dirty floors. Nurses didn't wear gloves. People were so close together that germs could easily spread. The one that M was in had hand sanitizer all over for people to use. It appeared clean and they sanitized the bed before M was given it. That is reassuring since the winter vomiting bug and MRSA are pretty common in hospitals here.

In Norway, John's room was private and they brought an extra bed for me. They brought food for me (since he couldn't eat). The doctors talked to us and they even assigned nurses who spoke English to his case. They explained everything well. They also wrote a letter and sent his records with us to take to his doctors. The best part was they had no idea what the cost of the treatment/hospitalization were because they never charge citizens. About a month later, we got a bill and it was about 3,000 for 2 nights in the hospital, a CT scan, various blood work, and IV fluids/pain medicine!

At home, most people I know who have been in the hospital had private or semi-private room. They all have their own TV, radio, and beds that they can raise and lower themselves. Call buttons are integrated into the bed so there is not straining to call a nurse. Doctors talk to you, not about you in front of you. Nurses come to check on you and take your vitals (this didn't happen much for M or the client I visited in the hospital: he barely even saw doctors). The rooms are clean. The floors are clean. People wear gloves and follow Universal Precautions. And it costs. A lot.

Sunday Misadventure

John has wanted an elliptical for a long time. He likes the workout it gives and if we had one in our apartment, we would exercise more. And I do think we would exercise more. So, we did our online search and found a couple models that we thought we may like to test out to see which one we want to buy. Last weekend, we went to one of the Elvery's Sport shops in town. They only had a couple models and none of them were the ones we were looking for. They suggested that we go to the Liffey Valley shopping center store.

Today, we woke up and decided to visit a friend who has been in the hospital since Monday. We took the bus up to see her and left her about 3:00. We got into a taxi to get us to Liffey Valley since the only way to get there on public transit would have been to go back to city centre and then back west. So, we got in our taxi and 30 minutes (of slow, jerky motorway driving) and 35 Euro later, we were at the shopping center. We wandered around looking for the Elvery' store. When we got to the end of the mall, we stopped and asked a security guard if he knew where the store was. He said it wasn't in the mall and gave us vague directions.

So, off walking we went. At about 5:30 we made it to Elvery's. They only had three ellipticals. Again, none of them were the ones we wanted. I asked the sales guy about the ones they had and if they had any more. He asked if we had seen the one up in the front of the store and said that it was a popular one, a good name, and the most expensive one they had. He was shocked that we wanted to spend more for a more durable machine. After being surprised that their selection wasn't "good enough" for us, and us trying them out and not liking them, he gave us the name of another store to try.

A bit after 6:00 (I looked at runners also which I couldn't find any I liked), we walked to the bus stop and waited a bit. Then we took the bus to the city centre and decided to try a Chinese place we wanted to try. It actually had good Chinese food and they were able to tell us which dishes had MSG and made mine without it! That made me happy so I shouldn't have a migraine tomorrow.

After getting home, I looked at Elvery's website. They don't carry any of the ellipticals we want to see. :( I looked on the other store's website and they don't carry them either. The only place that seems to have them is Argos and you can't try things before you buy there. I guess I should have looked online BEFORE heading out shopping...

Detoxing

I went back to work last Friday. While talking to a few mates, they mentioned that they were "off the drink" for January because they drank so much during the holidays.

Friday evening, we went out to dinner with a couple friends. We went to an Indian place and all during dinner, the other couple kept saying how well beer and Indian go together. They were aching for a drink. However, they are "detoxing" for the month of January because they too drank too much over the holidays.

Today, we went to the Porterhouse for dinner. Much to my surprise, there were plenty of seats/tables available. Granted, it is a Tuesday evening but it was well past 7:00 and in the past it has been busy at this time. During dinner, John told me that a few of his mates are "off the drink" for January also.

My question to you, dear readers (especially Irish ones), why do you need to "detox" from alcohol during Januaray? I thought the Irish could handle their drink. :) Otherwise, you could try drinking 3-4 pints a night instead of 10. It seems silly to give up the sauce.

Disability issues

I can't seem to stop thinking about the Ashley treatment and why her parents would do what they did. After making my last post, I realized that I may have missed it a bit. I shouldn't be outraged at Ashley's parents' actions (even though I am still processing it). Instead, these actions are a reflection of the society we live in.

There are a few larger issues that I think are well worth a lot of discussion and consciousness raising at the heart of the Ashley debate. First, the rights of people with disabilities. As I can see it, there are two sides to this debate. One saying that because Ashley has the cognitive abilities of an infant, she cannot make decisions about her body and therefore her parents have extra rights over her and that she herself loses rights that typically developing people would or wouldn't have (like who would give a typically developing healthy female and elective hysterectomy?). The other side says that all people, regardless of ability have certain civil rights and dignity which is inherent in being a human being.

I tend to fall in the camp of the second group. I strongly believe that all people, regardless of ability, have a personality, desires, etc. They may be at the pre-intentional level of communication but they are still a person. They still have basic rights. They still should be treated with dignity and respect. People should talk to them as if they understand. Because we don't know. We don't know what they know. We don't know what they understand. We just don't know and don't have a way of knowing at this time. Therefore, wouldn't it be better to error on the side of dignity than to assume they don't understand and to say derogatory things about them? What harm is it to use the term "depends" or "incontinence products" than nappies or diapers? Babies wear diapers or nappies, adults do not. I know this may seem like a small "language" or "PC" thing but language makes a difference.

The second issue is the difficulty of parenting a child with a severe/profound disability. As I have mentioned, supports are available to parents. However, they are often difficult to obtain. Unfortunately, funding for special needs devices is one of the first cuts made in government. The Irish government did not increase special education funding even though this funding is desperately needed and many were surprised by the lack in increased funding. Parents have to wait for a long time to get the devices they need and there are even longer waiting lists for in-home help. However, the government isn't providing additional funding. Even when there is funding, qualified people are often difficult to find.

While in college, I worked as a personal care assistant in clients' homes. I did a similar job while in graduate school. For both jobs, I got paid between 7-8 dollars an hour. For a student, that isn't bad money. If you are trying to do it to make a living and doing it full time, that isn't really a livable wage given that health insurance and taxes come out of that.

I guess the difficulties of parents is part of the larger issue of societal views of people with disabilities. There seems to be this automatic de-valuing of people with disabilities. There also seems to judgements made by appearance. When people see someone in a wheelchair, we make judgements. When we see someone with Down Syndrome, we again make judgements. The problem is that these judgements are often based on ignorance. Ignorance based upon a lack of interaction with people with disabilities. This lack of interaction is in turn caused by a lot of societal factors such as limited accessible spaces and a long history of "locking away" people with disabilities.

Ok, tirade done for now...

The Ashley Treatment

Earlier this week, the BBC reported about Ashley, a nine year old with severe/profound disabilities who lives in the US. In 2004, her parents elected to have what they are calling "Ashley's Treatment:" a hysterectomy, removal of her breast "buds" and hormones to slow her growth. Recently, there has been a lot of press about the issue and a lot of blogging by disability rights people.

When I first read the BBC article I was outraged. I then did a google search and couldn't find the parents' site, hoping that it provided more insight. I then did a blogger.com search and finally found a link to her parents' site explaining their actions and why they took these extreme measures. It took me two days to get through the site because I would get outraged and have to stop reading. This morning, I finally finished reading and here are my reactions.

First, there are some medical concerns on the part of the parents. However, they gloss over these because these are not their primary reasons (but probably the ones that got them ethics approval). There is a history of extremely large breasts in the family. The parents say that this would cause discomfort when lying down and also would cause problems with the harness system on her wheelchair. There is also a history of fibrous growths in the breasts of women in her family. But to remove the breasts before they develop?? That still seems extreme.

To remove her uterus so that she cannot become pregnant if abused or to alleviate menstrual issues? First, protect your daughter. Not having a uterus does not take away the potential for abuse. Unfortunately, all people with disabilities are at higher risk of being abused, whether they appear "sexual" or not. There are far less extreme ways to manage menstration than removing a uterus (like continuous dosing of the pill, the implants, Depo).

About slowing her growth. There are hoists and other ways to lift. Many people with disabilities are included in their families. Parents don't talk about their child's size as a reason for them not being included. They tell me lots of other reasons but size has not really come up. Well, it has in that they need new seats for in the car or parents apply for funding to get an adapted van, etc. But Ashley's parents keep talking about how boredom is her main issue. I just don't see how these medical interventions will alleviate that (social) problem. If boredom is her main problem, she needs more stimulation and different kinds of stimulation.

Reading about the issue, I keep thinking, how were the parents allowed to engineer their daughter? Removing perfectly healthy tissue and giving her hormones to keep her small and manageable. I think that the people saying this is a medical solution to a social problem are absolutely correct. Even though I think it is mutilation, I can understand on some level why the parents would want to keep their child smaller and less developed. However, I think it stems from their perceptions of their daughter and their own grief. They refer to their daughter as a "pillow angel." I know some people may not find that derragatory, but I do. When they speak of their daughter, the talk of her like they think she is a doll.

According to George Dvorsky, a doctor who supports the parents' decision:
"Moreover, this girl is severely disabled enough such that her self-awareness is virtually negligible. She is barely engaged with her outer and inner worlds. Nonetheless, like an infant, she requires care such that she remains comfortable and finds herself in a loving environment. Ultimately, however, the estrogen doses are not so much for the girl as they are for the parents. Aside from the enhanced care that she will receive from her parents as a result of the treatments, the doses will have no bearing whatsoever on the girl given her permanent condition."

In this statement, a few huge issues arise for me. One, the medical intervention was for her parents. When did we start having medical interventions for other people??? Two, the idea that if she grew more, the parents wouldn't be able to care for her at home. This idea is rubbish to me. There is plenty of adapted equipment out there to make caring for a child at home possible. To the best of my understanding, it is funded by medicaid, a U.S. fedaral program, in the U.S. and the health service here. Charities also help with funding in the U.S. Parents all over the world make modifications to their houses to keep their children at home. They don't give them surgery to make it more convienent for them.

But that is not the main issue that I have with this doctor's statement. It is the comparing her to an infant. Many people have sited her intellectual capacity as rationale with this. Ok, she can't take care of herself. Yes, her intellectual functioning tests very low. However, we have no idea how people with cognitive impairments of this level process the world. The parents say that they aren't sure if their daughter recognizes them. They aren't sure that she doesn't. She is still a human being who is able to process the world in some manner. She still should have basic human rights. It just feels like the parents are engineering their daughter to stay the way they want her. I don't get the impression that they see fully as a person.

Now, I have to have a caveat here that I have encountered many people who do not see people with cognitive impairments fully as people. They think of them in terms of their tested cognitive ability, not in terms of who they are, what their preferences are, and as people able to exert some control/express preferences in their world/life. But that is a (large) social problem.

Public Transport Woes

In my interview for my current position, I asked about public transport in Dublin. The interviewers said that it wasn't a very good system by European standards and most people have cars and they are quite affordable. Hah!

First, cars are not affordable in Dublin. The cars themselves aren't really more expensive than other places but operating them is. Insurance is outrageous and petrol is also quite dear. However, more importantly, driving in Dublin is insane. Drivers tend to be quite impatient, traffic lights are timed to increase road congestion, and the roads aren't built to handle the number of drivers on them. Parking, especially in city centre, is also a pain and expensive.

So, we don't have a car and take all the available forms of public transportation to get to/from work. And since it is January, the rates are going up. According to the Minister of Transport, the bus and train company wanted to raise fares by 10%!!! They weren't granted this increase, but asking for 10% is outrageous, especially considering the buses don't run on time, are packed during rush hour, and frequently the buses have seats that aren't attached to the frame! So, buses are a mess and not a great value but only buses go to one of my work places.

The train system is a bit better. They at least have boards telling you how long you have to wait and sometimes tell you why the train is delayed. Also, if you believe the ads from the train company, about 95% of trains run on time. I am not sure if I buy that because it seems my trains tend to be a few minutes late quite frequently. Well, except for the 8:00 AM one to Balbriggan. The trains themselves tend to vary a lot. Some are nice, others seriously need a makeover and cleaning.

Now, the Luas, which is a tram system. This is by far the most effective and possibly popular public transport system in Dublin. The Luas has very limited lines as it is the newest form of public transport. However, it runs on time. It has a board telling you how long you have to wait. It is quite frequent. It is nice. It is comfortable if you get a seat. It is usually full. And it runs a profit ahead of schedule. So, in the company's infinite wisdom, they are going to increase morning rush hour fares to discourage people from using it during rush hour!!!!!! How else are people supposed to get to work? Does the company want to encourage them to drive on the already overcrowded streets? Should they take the unreliable, but cheaper, bus system? Does the company think people can really flex their work hours that much (fare increase from 7.45-9.30 AM)? Or, is this simply a scheme to make more money? It seems to me that they are targeting people who depend on them the most.

People in this city need a reliable, affordable public transport system. An integrated one where you could buy one ticket to use on all systems would be helpful also. However, since there are three companies running public transport, that is unlikely to happen anytime soon. Either way, we need a reliable way to get to work and get around the city. Additionally, if there was a reliable, affordable transport system, I think it would alleviate traffic on the road. I do think the transport system needs to be off the roads. Part of the problem with the buses is that they get stuck in traffic. Yes, there are bus lanes but bikes and taxis also use the lanes. Actually, cars use them also. Further, there aren't always bus lanes. So, you can be riding along nicely in the bus lane, then it ends, the bus has to merge with traffic and everyone slows down again. Until the next bus lane...

The Lull

Exhausted, I lugged my suitcases onto the bus. It was already full so I made my way to the back and sat down, willing myself to stay awake after the overnight flight. Sitting in a daze, we arrived at the O'Connell stop. Once again, I pulled my heavy suitcases off the bus and start to walk towards the River Liffey.

Slowly, I pulled them down the street. In my haze, I noticed that the streets were almost empty. It was about 10:00 AM. It was Thursday. It was not a bank holiday. Still, there were as many people out as on a Sunday morning before the shops open (for anyone who has not been in city centre on a Sunday morning, that means it was empty). I checked my watch again. Yes, it was after 10:00 AM. Yes, it was light outside but still grey. No, there wasn't really anybody on the streets. I don't know if it was my exhaustion or the city's, but the city felt almost solemn. Maybe it was the greyness. Maybe it was the heavy, humid Dublin air that I quickly forgot about while I was home. Whatever it was, I felt like I was in a deserted town, not the city centre of Dublin.

Finally, I get to my apartment, unlocked the door to the building and then began to try to carry my heaviest suitcase up the three flights of stairs. Eventually I made it and then went back down for the other one. I guess that is what I get for bringing back the weight of a supermodel between the two bags (a heavy supermodel if you count my carry-on). I just couldn't resist the shopping at home...

After bringing up the second bag, I noticed that the streets were still empty. I turned on the TV and watched it for a while. And dozed. I periodically looked out the window. The streets were still deserted. It wasn't a bank holiday. It wasn't Christmas anymore but many of the stores were still closed and the people elsewhere, probably still sleeping or spending time with family.

Friday, I woke up about noon, looked out the window and noticed that the streets were still empty. I looked outside throughout the day and it was the same. Daylight but grey. Empty streets. Dark by 4:30 PM. Deserted town.

Saturday, I decided that I had to leave my apartment because I needed food and hadn't left since I got back on Thursday and I didn't know if the stores would be open Sunday or Monday. In the afternoon when I finally woke up, I went grocery shopping. Finally, I saw people. People! Shoppers! It looked like a pretty average Saturday. I was actually kind of disappointed because it was difficult to carry the two large bags of groceries around the people. Many of them also seemed oblivious to the fact that I had two huge bags on my shoulders. Eventually, I made it back, unpacked my food and then made some dinner. I stayed in the rest of the night.