Tourists be Gone!

While we toured the fortress in Salzburg, we came across an armory room. When we walked to the other side of the room, we saw that the spears were being thrown at a video of tourists!

Christmas Markets

As I mentioned in a previous post, we went to Salzburg for the Christmas markets and we spent lots of time at them. They were quite a bit bigger than Munich's market last year which was nice. The markets are also spread out around the old town. There is one main market that is by Dom Platz. However, there are also little markets/stalls around the city so you find little mini markets while wandering around.

It's beginning to look a lot like Christmas

In Salzburg as well as Dublin, that is. Salzburg was decorated beautifully for Christmas. There were Nativity scenes in front of the Residenz Platz and a few other places in the city. There were lights all over. People got to ice skate. John took the ice skating picture and that blur is a person skating.

Salzburg

Last weekend, we went to Salzburg Austria to check out their Christmas markets. The city was beautiful and we did a bit of site seeing as well. We were a bit disappointed that some sites closed quite early, though (like 2:30 early).

Tube feeding

Throughout my career, I have worked with a number clients who testing (called a video swallow study) determined weren't safe to eat and/or drink food. Usually, we then recommend to the parents that they talk to the doctor about having the child set up with non-oral feeds (tube feeding). Sometimes the families agree, sometimes they insist on continuing with oral feeding even if tests show it isn't safe. It is generally accepted that the parents have the ultimate decision. As a speech therapist, it is then my job to work with the dietitian to see how the client can be the safest possible and be as close as possible to meeting nutritional needs. However, sometimes there is no type of food or drink that is thought to be safe. In previous jobs, we have then required parents to come in and feed the children while at school because the school staff would not take on that risk (these are extreme cases).

Now, people often wonder two things about the decision making process for non-oral feeding. One, why would a parent protest non-oral feeding methods if oral intake isn't safe or enough to meet nutritional needs? The answer is that feeding/eating is often the one "typical" thing that a child can do. If a child can't eat/drink, then they are perceived as even more disabled. There are a lot of emotions around that. On some level, I think it also means that the child is/could be sick and could die. That is scary. Additionally, eating is a very social occasion. People who don't eat orally miss out on a lot of social opportunities. Finally, it is often seen as a quality of life issue. People frequently enjoy eating and caregivers think that we are "taking that away" from the client if the doctors put in a tube for feeding (usually a surgical procedure into the stomach).

The second thing people often wonder is why parents are given the control over the issue, especially if the child has recurrent pneumonia caused by aspiration (food/drink entering the lungs) or is malnourished. If a child is malnourished or not safe to eat and the parents are refusing treatment, is this then medical neglect? That one I don't really know the answer to. I can see that side of the argument but at the same time I see the family's struggle with the acceptance of the level of difficulty the child is having.

Also, for some children, this is how the child always was so it is perceived that the professionals are creating the problem. It is really a difficult balancing act between trying to do what is best for the child and helping the parents decide what really is best. Just because a feeding tube can be inserted and extend the quantity of someone's life doesn't mean that it always should be. Their quality of life may decrease (especially if they are sick or really enjoyed eating). The child may be medically fragile and a surgical placement of a tube may be too risky.

So adorable!

Since I have been crazy busy lately, I haven't been able to post pictures that I took about three weeks ago of the kitties. I need to focus on the Christmas show that I am organizing and the Christmas party...

Anyway, as I started saying, the cats get along really well. The pictures prove it. Aren't they so adorable?

Adventures in Problem Solving

 Part of speech/language therapy can be working on problem solving skills.  When working in the area of intellectual disability, the students/clients often need real life examples to teach the skill instead of verbal/picture examples.  Here is one of my favorite therapy "mishaps."

The activity was making smoothies.  The student read the ingredient page (we are also working on reading comprehension) and then needed multiple prompts to go get the stuff off the table. Finally, we get all the ingredients in the hand blender container. We then get to the "blend the smoothie" direction. The student took the hand blender and plugged it in. She then tried to stretch the cord to reach the table. Doesn't work. She tried again. Doesn't work. I ask her if the lead/cord reaches. She says "yes." So I let her try again. Still doesn't reach.

Since she wasn't understanding that the lead couldn't be longer than it was, I said that I would bring the container with the ingedients over to her. However, she pulled on the plug. The plug didn't come out. She pulled more. And more. The plug came out. However, part of it stayed in the wall socket! Yep, the hand blender broke.

So, it took about 10 minutes to get her to understand that the blender was broken and we couldn't blend the smoothie. I ended up having her put it in the bin to help her understand because she kept trying to plug it in. Since we still wanted a smoothie, I got the idea that we could use the bottom part of the hand blender to mash the fruit (it had a blade). I showed my student how to do this. She asked for a turn. She lifted the part of the blender we were using and plunged it down into the container. Liquid splashed everyhwere! On the floor, on the counter, on my student, everywhere. After prompting, she cleaned up the floor. Then we tried to mix more.

About an hour after we started, we were drinking and cleaning up half mashed "smoothie." Yet, somehow, I stayed clean, which was good since I had an important meeting right after the session!

Euthanasia for infants?

According to this BBC "health" article, the Royal College of Obstetricians and Gynaecologists in the UK are apparently requesting that the Nuffield Council on Bioethics consider "more radically about non-resuscitation, withdrawal of treatment decisions... and active euthanasia, as they are ways of widening the management options available to the sickest of newborns." The Nuffield Council on Bioethics is an independent body that examines the ethics of the advances in biology and medicine.

I only know what the BBC article says, which isn't much, about the Royal College's request. However, it still raises some serious ethical issues for me. First, how would they define seriously ill children/infants? The article cites the increase of premature babies surviving and having significant disabilities as part of the reason for the request from the Royal College. However, no one can predict accurately which premature infants will have profound disabilities and which will end up being healthy children. Granted, trauma at birth such as a hemorraghe indicates a high probability of future disability but not always. Still, many people have had poor health or major health problems at some point in infancy or early life. Does that mean that we should euthanize them? I would say no.

So, no one can predict at birth who will survive and lead a healthy life and who won't. That goes for infants not born prematurely, also. A seemingly healthy infant can have seizures later. A child can have a head injury. An otherwise healthy baby could die from SIDS.

The other part of this issue is the stress on the family that having a member with a profound disability can cause. Having children is stressful. Having a child with a disability is even more stressful. However, that does not mean that the families or children have a reduced quality of life? A child with a disability can have a good quality of life. We may not judge their quality of life as high or good by our standards, but if the people are happy, isn't that good quality of life? I know, happiness is only one quality of life indicator. But how do we really judge someone else's quality of life?

Further, how do we judge the worth of someone else's life, at any age? And isn't that really what the Royal College is asking the Nuffield Council to do?

Girls night out

After lunch one day, I had coffee with a couple of the girls and then went on my way. At 5:00, I got a phone call that quite a few of my mates were at the Porterhouse Central. When I met up with them, I found out that they had been there since 2:00 PM and were quite happy!

I ordered my hot whiskey to help my sore throat and the others kept drinking. And drinking. They tended to drink 2 for my one! About 10:00 PM, the music started and we started dancing. And some mates kept drinking.

About 12:00, I noticed that that staff were looking at us a bit differently, as were some of the other patrons. I stopped drinking and switched to water. After a while, one of the guys that was with us asked what we wanted for the next round. I said that I was cut off and that one of my friends was as well because she was quite drunk (pissed). However, he said that I couldn't cut someone else off. He then turned to a third friend and asked what she wanted. She said that she was cut off and so was the girl I said was cut off. He still didn't seem to like that but I think he allowed it. I guess it isn't socially appropriate to cut people off here. I was just trying to look out for my friend.

Dublin Marathon

Today was the Dublin Marathon and we watched parts of it. We woke up to hear clapping and it looked like there was a wheelchair race at the beginning. Since my camera batteries were low, we only got a few pictures from our apartment which was at the first mile line. Later we went along another part of the course and watched/cheered people on.

Two Russians won in the men's and women's races, with the man breaking the record.

Eicom and/or blogger are apparently having issues since my connection keeps timing out. So, here are a few pictures and I will try to post more tomorrow.

Signs of Winter

This week, I have noticed that it is getting dark considerably sooner than it was even last week. There were a couple of days that I came home in the dark and the latest I worked was 7:00 PM. This morning, I left the apartment at 7:40 AM. It was dark out. While on the train, I got to see the sun rise. I cannot remember the last time I saw a sunrise. Sunset, yes, sunrise, no. It was quite pretty coming over the water. I wasn't very happy that I was awake before the sun rose, though.

There have been other signs of winter here lately. First, the leaves are changing color and falling off the trees. I know that is really a sign of autumn but autumn means that winter is coming. Another sign is the temperature variation throughout the day. The mornings and evenings are fairly cold as I have been wearing a scarf. The daytime can still be comfortable, but I have had to turn the heat on at night.

This year I am sort of looking forward to winter. I like to wear my thick sweaters/jumpers and it is nice to have a soft scarf wrapped around your neck. I also like my long winter coat. I only hope that Christmas is snowy this year at home so I can truly have a white one, unlike last year where the snow melted a couple days before Christmas.

accents

Today I took a taxi out to the airport to meet up with a friend who had a three hour layover on her way to London. I brought us a bit of breakfast and we chatted until she needed to go through security again. While chatting, she told me that I am starting to get an Irish accent. I of course wanted clarification. Apparently, the accent modification is two-fold. First, it is word choices and usage. These have been changing since I moved to Dublin. Second, it is slight pronunciation differences. That would be the vowels. I guess all the speech sound work that I do is rubbing off on my speech also!

Ahh, navigationally challenged

I had a 9:00 AM meeting far away. Well, not that far but far enough. Since I didn't know of any bus routes going to where I needed to go to, I hopped in a taxi. I told the driver where I needed to go. Well, first I gave him the wrong name of where I was going. I corrected myself on that but had the wrong neighborhood of the suburb. So, we are driving around and making some wrong turns because I am directionally challenged and don't know where I am going even though I have been to this place numerous times already.

So, we are driving around and the taxi driver decides to ask someone. The guy we asked had never heard of where I was going. We end up at a place that the driver thought was where I was going but it wasn't. The taxi driver again asks where the place I want to go is and we get vague directions. After asking another person, we finally find the place. However, the taxi driver pulled into the side so I didn't recognize it at first. He gave me his card and asked me to ring him to tell him that it was the right place so he wasn't just leaving me in the middle of nowhere.

Thankfully, it was the place and I went in to have my meeting and I was only 10 minutes late. That meant that the meeting hadn't started yet. After my meeting, I had a cup of tea. Shortly after I got my tea, all the staff left. I was lone with the person I met with. So, I was sitting in silence drinking my tea. And we don't get along that well since we have very different ideas of how things should work and what different people's responsibilities are. Then in walks a priest. He had a laptop with him and showed the person I met with some ads that he had seen in Germany. He explained what the pictures/drawings on the ads meant. The person I met with seemed a bit uncomfortable during this interaction, possibly because the priest was making a couple off color comments. There was one add that the priest didn't understand. It was for airfare to Koln. I thought that he didn't know where Koln was so I said where it was. He then said that he didn't know what the picture meant. I said most likely the Cathedral. After telling one more story, the priest left.

Silly airline

John and I are trying to figure out if we can go to a Christmas market this year. I have a week long course the first week of December in Belfast. So, I looked up the Belfast International airport because I thought that it may make sense to fly back to Belfast instead of Dublin.

So, I looked up where the good markets are. I then looked at where flights out of the Belfast airport go. Then I looked up which airlines fly in and out of Belfast. continental was listed so I looked up a one way ticket from Berlin Germany to Belfast. I was shocked to see that the cheapest price was 1,880 Pounds Sterling!!!! You might wonder why it is so expensive. Well, it is because the flight goes from Berlin to New York and New York to Belfast!! The travel time would be almost 23 hours (it should be about 3 hours)! Why on earth would Continental fly to New York to go to Belfast? Why not stop in London and then go to Belfast????? Why not stop anywhere else in Europe for that matter?

It's beginning to look a lot like Christmas

In the stores, that is! I noticed a couple weeks ago that one of the stores had some Christmas stuff out next to the Halloween stuff. Today when we were out shopping looking for a wedding present for a friend, every store had Christmas presents out! It is only the middle of October. Isn't it a bit early to have Christmas ornaments for sale?

It is somewhat ironic that the Christmas stuff is out in many stores because I have been thinking about Christmas already also! However, I have had to think about Christmas because I am coordinating a Christmas "play" and need to start practicing soon. We also need to start working on the decorations and the set. I have to pick music and buy bits and bobs for the set...

In a fun day's work

I thought that I would post a fun story about being a speech/language therapist. As part of therapy for a client, we experimented with different foods and played with food. One session, I brought in bananas and whipped cream. We mashed a part of the banana with our hands and then tried to get the student to taste it. Then we decided that we should put whipped cream on our hands and mix it in with the banana.

I squirted out a bit of whipped cream from the can and rubbed it on my hands. I really didn't like the feel of it but I did it. Then we put some on the client's hands. And he clapped. This sprayed whipped cream all over. We then decided to spray some on the plate. The student had a difficult time getting the cream to spray out so I decided to see what happened if the can was upright. No, I had never sprayed a whipped cream can upright before. Well, a bit of cream squirted up and then some air came out. When the student did this, the can kept spraying cream out. It was in our hair. It was on our clothes. It was on the table. It was on my glasses. It was on the floor! Everywhere! After spraying the cream all over, we played a bit with it and then cleaned up.

Your man, your woman

In Dublin (maybe all of Ireland, I don't know), people make reference to "your man" or "your woman." The first time I heard it, I was quite confused because it was a friend complaining about a friend of hers. She was talking about "your man" and what a worthless boyfriend he was. Now, my boyfriend is wonderful. He is not worthless at all. After a couple times using the term, I realized that she was talking about her friend's boyfriend, not mine. So, not "my" man, "your man."

Since I first noticed someone using it, I have heard others as well and its actually a pretty common phrase. It a way to refer back to someone who has already been mentioned, an alternative to "he" or "she." However, it isn't quite that simple. It usually is said in a derogatory way. So, if you are complaining about someone, they are "your man." If they are good, they don't seem to be "your man" as often but may be. I still haven't gotten all the nuances down for its usage.

The second key thing about using the phrase is pronunciation. Even if I get the context right, people look at me confused when I use this phrase. It is because I am saying "your woman" instead of "yer woman." The accent is on the second noun (e.g. man or woman) and not on "your" and notice the pronunciation of "your." It is said as "yer."

So, after a year, I am still learning the nuances of the Dublin accent. I wonder when I will be after getting it down.

Adventures in shopping

Today John and I wanted to go hiking. However, the weather didn't quite cooperate. So, instead, we decided to go shopping to get John some new work clothes which he has wanted to get for a while. We headed to Mark's and Spencer to look for trousers. While shopping, I noticed that some of the trousers had hips on them on the hanger! When did they start making men's trousers with hips? Why do men need to appear to have hips? Many of these trousers were slim through the hips and thigh and then got full, much like the cut of women's trousers.

Not deterred, we found some trousers in the size we thought John needed and he went to try them on. While I was waiting for him to show me how they looked, I watched the lady at the men's department dressing rooms. She was laughing at the men often. She was laughing because the men would come out and show the women that they were with how the clothes fit. The women would then evaluate the clothes. One even made the young man (I think it was a mother and son) turn around and she commented on how the bum made him look and the cut, etc. It was actually quite funny.

Since none of the first round of trousers fit, we tried another size and and found some with a slightly different cut. Since they were cheap trousers again and tend to only last a few months, we are planning on stocking up on trousers when we go home for Christmas.

Since we weren't too disheartened after going to Mark's and Spencer, we then went to the only store in the city centre that sells shirts to fit John. So, we got to the men's section and they had two shirts in his size. We bought them and a tie tack and then went grocery shopping.

We tend to go grocery shopping on Sunday afternoons lately because we are too lazy to go on Saturdays. Last week, the Tesco that we go to was out of most items. We wondered if the stock people were on strike or something. This week, they were also out of a lot of items like bread, eggs, and flour. How does a grocery store run out of bread, eggs, and flour?????????? They are a grocery store. They are supposed to have these things. Oh, they were out of the yogurt that I eat, too. Actually, they were out of most yogurts. Maybe we should start grocery shopping on Saturdays again...

The good, bad, and ugly

As I have written about before, I have worked in a variety of different settings. In my work with children who attend mainstream schools, I have consulted with teachers and principals. They frequently ask me for suggestions and ways to carry over therapy goals in school. Sometimes when people ask for suggestions on how to work with a child, they then tell me why my suggestions aren't doable. Other times, they appreciate what I have to say and I think that they will carry over goals. I try my hardest to give practical suggestions because it makes it easier for people to carry over and easier for my clients to learn the concept because it is in context.

Then there are the people who are difficult to work with. They question everything. Now, I don't mind when people ask me what my qualifications are. I will happily tell them. I do have an issue when people tell me that I can't possibly be good at my job because I don't have children of my own. Or when they question every little thing that I do. Or my personal favorite: that I am not old enough to have the experience necessary to work with a child! I don't take these things personally. I try my best to reframe the questions and try to figure out if I think they are really asking something else, which I think they usually are.

Dublin's Expensive

This weekend someone told me that Dublin was the most expensive city in Europe. I found this hard to believe because it was only 13th in the World last year so I leveraged the power of the internet. I found the Mercer Human Resource Consulting website which lists the world's most expensive cities as well as those with the highest quality of life.

Dublin is the 18th most expensive city in the world this year. New York is is 10th while Moscow is the most expensive city. According to Mercer, Zürich residents have the best quality of life with Zürich coming in second. Apparently Germans tend to have a good quality of life also, with three cities in the top 10. Dublin ranks 24th in the world for quality of life. The top US city is Honolulu at 27th. New York ranks 46th while Chicago ranks 41, tied with Washington D.C.

So, Dublin is expensive but apparently it is a good place to live and Dubs have a better quality of life than any Americans. I do find it interesting that Europeans seem to have better quality of life than Americans. I'm not entirely sure how the rankings are made but I do have a better quality of life here than I did back home. I think part of the reason is because I work less and have made different choices.