Goals for 2014

Here we go, the cliche post that all bloggers do every year.

10 things I hope to accomplish in 2014 (in order of priority):

1. Learn more about Buddhism and start practicing more mindful living
2. Go with the flow - what ever happens after graduation will happen and it will be awesome
3. Swim across the Strait of Georgia (more on that later, its a legit thing, stay tuned for more info)
4. Spend less time on facebook
5. Complete my 4th year with a 4.0 (so far so good)
6. Focus less on what I need to do to get into med school and just enjoy being 21.
7. Dance more
8. Eat salad for dinner at least once a weak
9. Bake something at least once a month and share it with others
10. Eat less sugar

Just swimming a long in a glacier fed lake in the Canadian wilderness

Torture

I won't name schools or anything, but this one school that keeps sending emails to the entire applicant pool about how they will be emailing us about interview invitations and rejections in the near future is really annoying.

Three years ago, rejection and interview invitation emails went out the last week of November.

Nov 29th: I see email from said school while waiting to see a doctor, I decide to open it to just get it over with, because it could either be great news or crush my heart.  All the e-mail was about to tell us that we will receive in e-mail in the next two weeks with regards to our status, ie interview or rejection. My heart rate when back to normal, but then come Dec 2nd, I start obsessively checking my email.

Last year, on the first Thursday of December, rejection emails went out. So...

Dec 5th: I receive an e-mail from said school, and I was devastated because I was 99% certain that it was a rejection email. I open said email, "This is an e-mail to all applicants. Due to the higher number of applicants this year, we will not be notifying you of your application status until next week. Enjoy the weekend." Enjoy the weekend my arse!

Now I'm just angry. This is the second e-mail where I thought that I had been rejected. Now next week I know for sure the e-mail is coming. I hate knowing dates of things because then I start obsessively checking, I would rather it be a surprise. I also hate said school right now for their stupid e-mailing. They need to just not. This also happens to be the only school I care about, the school that I have wanted to go to since I was in elementary school. For some reason not getting an interview anywhere else in the world doesn't bother me as much as not getting one at this particular school. I know I will be pretty upset if I don't get an interview.

Grrr, these two weeks are just awful.

21 Reasons

Today is a big day for me.

Today is the day I turn 21, and to honour this day in history, I thought I should make a list of 21 reasons why my life is awesome right now.

1. Today is my birthday, which just makes today great despite what may happen today.
2. I got a Macbook Pro for my Birthday, now I don't have to stress about having a computer that keeps crashing.
3. I have an amazing family, and they drove all the way to Calgary this past weekend just to celebrate my Birthday.
4. I have interview at Wayne State School of Medicine on Nov. 27th!
5. The global health conference that I have been planning for almost a year happens this weekend, Nov 9-11th. This is the biggest project I have ever attempted to pull off, and I am excited to help other students become passionate about global health.
6. I have some pretty amazing friends who are not only there for the ups in life, but who are also there for the downs.
7. All of my medical school applications are done!!
8. I got mounds of chocolate and food for my Birthday, so now I'm good until Christmas.
9. I've come to accept the fact I will likely never really race a bike again, and that cycling will become a pastime, rather than a lifeline, and I am okay with that.
10. I might be going to Tanzania in May!
11. I have super comfortable bed (this is actually pretty important).
12. I am completely okay with not getting to medical school this cycle. My plans for next year are actually awesome no matter what. If I don't get in, I'm going to work, and then travel to as many countries in as many continents as I can. Sounds better than dissecting cadavers right?
13. I have GF cake left over from my family Birthday party yesterday (cake makes life better no matter what).
14. I am actually doing pretty well in gross anatomy, even if it does feel a bit overwhelming sometimes.
15. I might be really behind on my research for my honours thesis, but my lab members are awesome, and I know that they will support me through it.
16. I don't have life figured out yet, and I think that is just fine, we don't always need a plan.
17. My parents brought my guitar from home. I haven't played since grade 9, but I am excited to get some more music back in my life.
18. It snowed this weekend! While winter is not as pleasant as summer, I like to appreciate all seasons for what they are and the gifts that they bring, like skiing!!!
19. I'm thankful that I decided to take the plunge and transfer from UoGuelph to uCalgary a year ago, it was one of the best decisions I ever made. I don't regret going to Guelph, I don't think I would be where I am today had I not started out there. Everything works out as it should in the end.
20. I'm a strong person, I've been through more than I should have after only being on this earth for 21 years, and I appreciate everything that I have learned about life through trials and struggles. It will make me a better doctor.
21. Being able to dance like nobody is watching. We can all do this, and doing it makes life way more awesome. You should try it sometime.

Life is great, even when it sucks sometimes, it is still pretty great.

The Wounded Healer

I am taking a class called "Psychosocial Oncology" and today's lecture was about palliative care. The two instructors giving the lecture were what most people would consider in medicine to have opposing jobs. One had a doctorate and was a member of the spiritual care team, the other was a physician and the director of the acute-intensive palliative care unit. Together, they helped me to redefine my notions of adult palliative care, and I was astounded by their abilities to interconnect their roles. Needless to say, I learned a lot about the process of dying, both from a medical perspective and spiritual one. 

5 things I learned today about dying:
1. 93% of palliative care patients ranked maintaining a sense of humour to the end as one of the most important things
2. 0.5% of people in Oregon choose physician assisted suicide despite it being a readily available option
3. Palliative Care physicians are often more influential and important in the life of a person who is dying than any of their "active treatment" physicians
4. Palliative Care medicine actually involves a lot of "real medicine," its not just about pain control
5. Most people who are dying have little desire to confess their sins or wrongdoings  at the end, people do not consider them to be important to them any more.


When we were discussing the importance of physicians and members of the palliative care team to let down their barriers, show their emotions and connect with patients, this quote was on the slide:

"The doctor is effective only when he himself is affected. Only the wounded physician heals." - Carl Jung

I'm not sure how I have made it almost 21 years now with out ever seeing this quote from Carl Jung. I have been beginning to doubt whether or not I can make other well if I am not entirely free of illness myself. But I now feel again that strong sense of purpose, and what I guess you could label as "my calling" to medicine. I don't believe that everything happens for a reason, but I am grateful that this quote was on the slide today, it was exactly what I needed. Perhaps me being in pain, will allow me to heal somebody that others cannot. 

I will someday be a Wounder Healer.

Still Concussed

My last Medical Monday's post was back in August, and it was about the "little" crash I had at a local bike race.

I still have symptoms of an "acute concussion." I don't quite understand how it can be considered "acute" when it is over 2 months past the date of injury. But I'm not a doctor (yet). I can't ride a bike, or do any form of exercise, and school is more challenging than it should be. (Although, I think I did pretty well on my anatomy peripatetic today.) This is a really bad way to be starting off my final year of undergrad, with applications to finish, scholarships to apply for, 4.0s to maintain, a conference to plan and oh yeah, this thing called an Honour's Thesis.

Its going to be a long semester of headaches, concussion physio (I didn't even know that was a thing, and you think with this being my 6th concussion, somebody would have told me about this by now) and trips to the sport medicine clinic. I have a referral to "complex concussion physiatrist," I didn't even know that was a specialty. (Look all the things I am learning about medicine by having a concussion!!) The not exercising part is the worst because exercises is how I deal with pain, no exercise, worse pain, worse pain, worse grades. Apparently physiatrists have solutions for these kinds of dilemmas? I'm not sure if I will ever race a bike again...but I have other plans if I can't.

I hope you are all having a bettter Medical Monday than I am, one not filled with headaches and cadavers with pins in them and pages of anatomy questions. Now back to studying for the written portion of my anatomy exam which is on Wednesday (don't y'all just miss school??).

This is almost exactly what my concussion looked like (but with a helmet), conveniently thanks to Anatomy class I can identify all the structures in this diagram. Yipee!

Everything is happening at once!

I hoped that by submitting my AMCAS application on June 28th that I would have it verified by mid to end of July...It was verified this past Thursday, August 22nd. Now I have the issues of having to complete all of my secondaries for US schools, plus finish my application for Canadian schools...everything is happening at once!!!!!!!!!!!!

Arg. I planned it so that I wouldn't have multiple applications to complete at the same time, but the world has slammed that plan 500m below the earth's crust.

Here is to staring school and medical school applications at the same time! (Oh, and I also haven't finished my summer research project, so I have got that going on too...)

The Crash and the Road Rash

I went to a local criterium race last Tuesday, like I do every Tuesday, only this time, things went horribly wrong. I was working late in the lab trying to finish up nerve conduction on my mice and didn't finish until about 6:30. I debated whether or not to go to the race because it started at 7:30, and I didn't have much time.I ended up deciding to go, because I have been feeling pretty down lately and trying to internally work things through as they relate to cycling. I ran home, scarfed down a bowl of cereal, changed into my kit, and jumped on my bike.

Well, folks, on the second lap of the race, I crashed. And it wasn't just a little crash. I don't really remember what happened, but I know my wheels just went out from underneath me, I don't know why, or how, but they did. I hit my head pretty hard and smashed the front of my helmet in. All I remember is that sickening feeling when your bike starts to move out from underneath you, sliding along the pavement, and then sitting up to check my helmet. Then somehow was lying on the grass with all of these people looking around me. I don't know if I just can't remember how I got to the grass, or if I lost consciousness...either way, I ended up being surrounded by about 10 people lying on the grass at the side of the road.

Some nice guy drove me to the hospital, which was less than 5 minutes from the race, and the race organizer called my room-mate to come meet me. (We conveniently live directly across the street from the largest trauma centre in Alberta.) I spent 7 hours in emerg, 5.5 of which I was waiting to be seen by a doctor. I just sat there, shivering, bleeding and trying not to throw up on the person next to me. Eventually, when I was seen, I was declared to have concussion (duh) and severe road rash (double duh). They gave me a Percoset, referred me to the burn clinic and sent me home. They didn't even attempt to clean my road rash or put any sort of dressing on it. Normally I am a big advocate of Canadian Healthcare, but I'm seriously a bit pissed off right now.

I am super thankful that the ER doc had the sense to refer me to the burn clinic, otherwise I would be in so much pain. When I went to the burn clinic on Wednesday, and the nurse saw that I didn't have any dressings on any of the road rash (which is covering 10% of my body) and that it hadn't been cleaned she went ape sh**t.  The two worst burns that I have are on my upper right arm and right hip/pelvic bone. Because they didn't clean anything, or really look at the burns, nobody noticed that I had bone exposed on my right hip. (Yes folks, I spent 20 hours with a bone exposed from road rash without it being cleaned or bandaged.)Lets just say that the cleaning of the burns definitely makes my top 10 list of most painful experiences (and I have chronic pain...).

Canadian healthcare has both failed me and saved me since my injuries on Tuesday. I am grateful that I get to wear $200 worth of silver bandages, and that I get to have them changed and cleaned everyday other day without paying a dime. But also super pissed off that the ER doc didn't do the job that I waited 7 hours for him to do.I get that they were busy, but come on, you still have to provide necessary care.

I also feel really awful about the fact that I caused the crash, and the the woman behind me who is an amazing bike racer broke her wrist and can't race this weekend. She didn't seem up set about the fact that I was the reason she broke her wrist, which is good, but I still feel awful about it. Crashing is an unfortunate part of cycling. 

For a long while I have been thinking about giving up cycling for good. It is insanely hard to try and train and race at the level I need to be at without having a functioning lower right leg. It is like I am riding on jello. I might be eligible for para-cycling, but I have essentially been waiting about 9 months to get medical documentation and a proper neuro assessment. I still want to ride my bike because I love it, (well, not at this moment) but racing is not something that I can do right now. (The Tuesday night criterium series doesn't count as racing because it's just for fun.) I am getting super depressed about not going to Canada Games (which are going on right now), as it has been my goal for the past few years, and that goal has essentially been crushed. I am not at the level I need to be to competitive at Canada Games, and I am fully aware of that, it just sucks that it is all because of a medically unnecessary surgery when I was 15. In a way the concussion makes me feel a bit better that I am not going to Canada Games, because even if I was set to fly to Quebec next Saturday, I wouldn't be able to compete with a concussion.

I guess all this time I am spending sleeping and not exercising will give me more time to reflect on what I want to do with cycling, and also time to finish up my application for UBC's School of Medicine. It's just unfortunate that somebody had to break their wrist, and I had to lose a lot of skin and smash my head into the pavement to take this time to reflect.

(This is also concussion number 6 for me, so I should probably get off this computer.)

I think I want to be a Surgeon.

To Spencer,

For a long time I have wanted to be a surgeon, probably since I watch the first season of Grey's Anatomy when I was 12. While Grey's Anatomy is pretty unrealistic (but a girl can dream right?), I still had difficulty wrapping my mind around how a person could operate for 10-12 hours straight. How is it possible to focus for that long without eating or going to the bathroom? I feel like I need to eat every 37 seconds and go pee at least once every 3 hours.  (Lets just say I find exams challenging...)

But this week I had to do 20 sciatic nerve crush surgeries on mice, and each one takes about an hour. For two days I did 10 hours straight of surgeries without eating or going to the bathroom. I got the lab at 8 am on Tuesday and left at 9pm, and on Wednesday I got there at 8am and left after 10pm. I have the new record for longest time a summer student has ever spent in the lab. I'm pretty sick of looking at mice and I still have to inject them until the 8th of July.

This experience has showed me that I actually might be able to be a surgeon. I really quite enjoy the tedious and fine motor skills aspect of doing surgeries on mice. I am the only one in the lab able to do it without aid of a microscope. I can see details that others can't see with a naked eye. Perhaps surgery is in my future.

This post is dedicated to Dr. Spencer McLean., who sadly passed away on June 24 from kidney cancer. He had just completed his orthopedic surgery residency and passed his boards two weeks prior to his death. He was my ski coach for 3 years as a child, and every year I hoped that I would be assigned to his group. Spencer was my absolute favourite coach, and he always will be for he taught me a lot more than just how to be fast on a pair of skis. He taught me that skiing makes you one with the mountain, it makes you a part of something magnificent. He taught me that you must first love what you do, be passionate about what  you do, and then you must work hard in order to become great.

From what I have heard, he became an amazing surgeon, dedicated to his patients in every way. He loved what he did, he was passionate about it and he was great at it. I think I have always wanted to "be like Spencer," he was the perfect mentor. He is a person I will never forget and who I will think of often as I begin my journey to becoming a physician, and hopefully a surgeon.

Thank you Spencer for inspiring me to reach high, work hard and to enjoy the ride.

Sincerely,

A Yiper

Shadowing

I had a pretty impressive morning of shadowing last Wednesday, followed by a somewhat less exciting afternoon of looking at mice in square boxes, cleaning up their excretions and testing their grip strength. But I am sure, you don't want to hear about what I do with mice...back to shadowing.

I shadowed my PI in the neuromuscular clinic, and it was needless to say a really great learning experience. I wasn't too sure how good of a teacher he would be, but he turned out to be pretty great. He explained all the cases to me, what each part of the neuro-exam looks for, the EMG results, and patient histories (some which were more complicated than mine). The first patient we saw was a younger women (early 40's) who had massive file and extensive history. I empathized with her because it seemed like she had been through a similar experience as me when I first got sick. She has seen pretty much every specialist in the city (a neuroimmunologist? I didn't even know that existed), has had extensive testing, has been "combative" towards doctors demanding tests/medications, and at one point wanted to go to the Mayo clinic. Her story seems kinda like mine (I was never combative though, but definitely frustrated). I almost wanted to just give her a hug, and I really wanted to tell her that I truly understood what she was going through, but alas, I was but a mere shadow.

The last patient we saw was a woman in her 50s who had an ethanol induced neuropathy. She doesn't take the vitamins that she needs (B1) which can reverse the neuropathy, she continues to consume alcohol, won't go to physiotherapy and doesn't have a family doctor. She had so much muscle wasting that she looked like a person with muscular dystrophy, and she can no longer straighten her legs so she is wheelchair bound. Non-compliance has committed her to a death sentence from a curable disease. Because of her, I witnessed for the first time what it is like to tell somebody that they will die, and soon, from a condition that is in fact reversible.

It is going to be interesting when I finally become a doctor, I think I am going to see myself reflected back to me in the experience of patients. In almost every patient we saw, I recognized something of my own story in the story of the patients. I empathized with the frustrations of one, the research tenacity of another, the ability of one patient to push through the pain, and realization of a grim future of another. I hope I never lose this empathy. At the same time though, I would give anything for my condition to just disappear by taking some vitamins, most people would, so I don't know how I am going to react when I encounter non-compliant patients. I see non-compliance as selfish, and I feel it makes the role of a doctor almost meaningless.


Needless to say, shadowing was an enlightening experience, which motivated me to submit my AMCAS application on Friday (even though I am still waiting for one transcript to arrive at AMCAS). I also started my application for UBC and the rest of the Canadian applications open up in a couple of weeks. The ball is rolling, and I have started to have nightmares since I submitted my AMCAS application. Looks like it is going to be a long wait until May 15, 2014....


PS Happy Canada Day!!!

The Flood of 2013

My city is flooding.

This morning I went to neurology/neurosurgery grand rounds, and everything felt completely normal. They had two crazy cases they discussed, and I walked out feeling awesome. Then I went back to my lab, and saw what was going on in the city. I felt like I was being punched in the stomach. This can't be real. This stuff doesn't happen where I live, only on the TV in distant lands.

I have spent my entire life watching other cities all over the world crumble in natural disasters such as earthquakes, tsunamis and floods, but never have I ever had to live it, that was until yesterday. My city is flooding and there is nothing I can do about it. I live on top of a hill, or as they would say in Ontario, on top of an escarpment.  I'm safe, I don't think the river is going to rise over 100m, yet I also feel the panic. So many people have been forced to evacuate, and the entire downtown area has flooded. The upside is that I had to leave work at 11:30 because they shut the power off in our building (I still don't know why...), but the rest of the hospital is fine.

I went to go buy water at the store today...and of course its all gone. I then went to target, and thankfully got four 1L bottles. I didn't want to buy more than that out of fear of being too greedy in this time of disaster. I brought 2 L to my grandmother, along with an umbrella. As of yet, our water and power are all on, but I fear that it may change in a few days. I also bought more food, such as a dried goods, canned things, 4L of milk, a crap load of juice because I couldn't find anymore water, and some more fruit. I have never had to respond to a natural disaster before, so I am new at this stocking up on supplies thing...I was proud that I remember to buy a flashlight though.

I feel very trapped here. I get that feeling on a normal basis, but when I do, I just drive back to the mountains of BC to my parent's house or to one of our cabins. But those roads are closed and/or completely washed out. So I am trapped in Calgary. I HATE FEELING TRAPPED!

I just want to go home....(which is also flooding, but I feel safer in the mountains).

I will change things, I promise

I just made a pretty big promise over twitter, to a fellow canadian who suffers from chronic pain and lack of access to doctors willing to help her. I promised, that if I get into medical school (and graduate) that I would change things in health care.

I don't know how yet, but it needs to be fixed. Health care (in my humble Canadian Socialist opinion) is a right. It is not a business, it is not a luxury, but it is a basic human right that we are entitled to all over the world. Your medical diagnosis, your medical history, your financial status, your sexual orientation, your religion and your race should not dictate whether or not you receive medical care. Sadly, this is not the case, and it makes me angry, especially when I hear about Canadians who are denied access to a supposedly universal system.

I will change things, I don't know how, or when, but I will. When I make a promise, I keep a promise. 

The AMCAS Dilemma

On Wednesday, May 8th, just two days from now, I will be able to start my AMCAS application. This is the summer where I officially apply to donate the rest of my life to the practice of medicine, to the art of healing. I'm almost more scared of what will happen if I do get in than if I don't, and if I get into an American school, and not a Canadian one.

Most Canadian schools (or the ones I am applying to at least) drop your worst academic year. The University of Calgary drops your worst year if you have completed 3 full time years (yippee for me!), and UBC will drop your worst year if you have 120 credits (ie, you have completed 4 years). This is where the problem begins. I am in third year, so uCalgary will drop my worst year, but UBC will not. My best chances for admission are at UBC (if I had my worst year dropped, ie the year I spent in the hospital), which would only happen if I applied in the NEXT cycle, not this one.

So, if I complete my AMCAS application, and I apply to the 10-12 schools I have a chance at in the US, and I get into one of them, but not a Canadian school, do I go, or do I wait a year and reapply? If I wait a year, UBC will drop my first year and my GPA will increase (likely) to above admission averages, but my GPA alone won't guarantee me admission. But UBC has a large rural assessment component to the application (which is very much in my favour as I grew up in a town of less than 4000 people), and my extra curricular activities will only improve with the addition of one more year on my application. So, my application, if I were to apply in the 2014/2015 cycle would likely be much stronger, and my chances for admission are higher.

Back to the dilemma, do I submit an AMCAS application? If I get in only to an American school, do I go? My intentions for the past year was that I would apply to US schools, but that was on the thought that UBC would be dropping my worst year, and now that they won't be, I am second guessing. I want to cover all of my bases in Canada, and ensure I have the strongest application possible submitted to Canadian schools before I hop across our southern border.

I want the best chance possible at becoming a doctor and I don't want to miss an opportunity to fulfill my dream, but waiting one more year and getting in to a Canadian school would mean that I would be at least $200,000 less in debt and be able to get a residency spot in Canada. (Plus, I don't have to write step 1, or go through the silly basic science courses that US medical schools force you to go through.)

WHAT DO I DO??? I just want to be a doctor! (Preferably in Canada, and if not Canada, Washington or Oregon state because they are the most similar places to Canada other than of course Canada itself and New Zealand.)

Reflections of Explosions

I was 8 years old when the twin towers fell. I remember that day because up until that morning at school, I didn't even know what the twin towers were, and I pretty sure most of the adults in my town didn't either. I remember waiting in the classroom, practicing my times tables (I was nerd back then too) getting ready for our daily quiz because our teacher, Mr. Collins, was unusually late. When he walked in, he walked in somberly, and slowly. Somebody asked "Mr. Collins, why do you look so sad." Then he told us what had happened, and we were called to the gym for an assembly. I didn't understand why anybody could possibly do this, but what I didn't understand even more was why people were blaming Muslims...how could a religion hijack a plane and fly into office buildings in New York? When I got home from school that day, my parents reassured us that we were safe, and my dad made it a specific point to tell us that it was individuals that caused this attack, not a country, not a religion and that it was not a reflection of the world we live in.

Today, while I was studying for my GI physiology test, I had twitter up on my screen. The first tweet I saw was from CNN, "Explosions at Boston Marathon." When I read the word "explosion" I immediately thought of fireworks or firecrackers, because who would set off a bomb at the finish line of a marathon? Within seconds, new tweets came up that replaced the word "explosion" with "bomb" and then one "bomb" became two, injured became dead, pictures of debris in the streets became pictures of blood in the streets...I felt like an 8 year old again, watching in awe as the world exploded.

As the day passed, and as I continued to follow on twitter, I began to see pictures of people helping people, rather than pictures of carnage. Tweets and facebook posts from all over the world showing support for Boston steadily increased, offers for blood donations, restaurants opening their doors and people offering their couches and spare beds to complete strangers began to trend. This is a reflection of the world we live in. A really awful thing happened today because of the choices made by a few select individuals, these choices have changed people's lives and the world forever, much like 9/11. But I choose to see the world as a whole, because the number of good people will always outweigh the bad.

Bombings like this happen almost weekly in other countries, and I am not trying to belittle what has happened to day in Boston, but a bombing in Boston is no more tragic than a bombing in Baghdad. The people of Boston are as strong, generous and kind as the people in Baghdad. So as we mourn and try and reflect on this day, let us remember that people all over the world have felt the same confusion, sadness and loss as we do today and as we did on 9/11.

Let our prayers for Boston resonate throughout the world to all of those affected by senseless attacks on humanity.

Pain and Sleep

I am a very high functioning young adult with chronic pain. Seriously, how many people do you know with straight A's, who volunteer 10 hours per week, and ride a bike 16 hours a week who have chronic neurological pain? (If you do actually know somebody, please let me know, I would like to meet a this person.) I somehow manage to do things that most normal people, let alone people with chronic pain, can't do. To be honest, I have no idea how I can ride a bike, but somehow I do.

When you have chronic pain, you struggle to sleep, some people struggle to fall asleep, and some struggle to stay asleep. I am a member of the later group, I usually fall asleep within seconds of hitting the pillow, but I wake up about 4 hours later. My pain gets worse when my leg is still, so when I am awake my leg is in constant motion, but when I am in a deep sleep I don't move (like a normal human) and then my pain gets worse and I wake up in a grip of pain. On occasion, I actually sleep through the night, which means I get 9 hours of sleep. I usually go to bed around 10:30 and get up around 6:30-7:30 in order to maximize the potential amount of time I might be able to sleep. This tactic works pretty well because usually out of the 9 hours I spend in bed, I am asleep for 7 of them, meaning on average I get more sleep than my peers. So, strangely, chronic pain probably makes it so I actually sleep more....weird, huh?

My idea to write this post came from this article: "Extended Sleep Reduces Pain Sensitivity" And, as the title suggests, sleeping more means less pain. So, maybe the reason I am able to do all this stuff is that I actually experience less pain than my fellow nerve pain suffers because I sleep more? It is a possibility.  And, even if you don't have chronic pain, sleeping more may help you recover faster from that flu shot, dental procedure or surgery pending in your life. In the world of cycling, those who train hard and sleep a lot are generally the fastest. So if you don't have chronic pain, and are not predicting pain, sleeping might in the very least make you a faster cyclist.

On another note, I crashed riding in the ice/snow yesterday on a corner and sprained my thumb pretty badly. It isn't broken, but I think there is some ligament damage, hopefully the doctor will give me the verdict tomorrow. The worst part is that exams start next week, and it is my dominant hand. Maybe sleep will make it hurt less?

I learned how to tape it via youTube...it worked!

Advantage of Being a Woman in Science

I went to an amazing lecture yesterday given by Dr. Jeffrey Mogil, a pain scientist from McGill. He lecture was titled "Mice are People too: Social Modulation of and by Pain in Rodents and Humans."

As you can imagine, the lecture was about mice, and how they perceive pain. Turns out that they actually have similar facial expressions that infants do (eye narrowing and cheek bulge) and then of course things like wiggling their whiskers and ears which we has tiny humans either do not have or cannot do. He then went to on to divulge the social interactions of pain, when we are in pain with the presence of somebody we do not know, we experience an analgesic effect, or the stranger effect. This hold true for both mice and humans apparently. Conversely  when we experience pain with the presence of a friend, there is increase in the amount of pain we experience, which is known as the empathy effect. This was all pretty interesting, and actually made sense for me. I definitely feel less pain when I am in socially new or uncomfortable environments  which I suppose goes back evolutionary to the feeling that this new person might try to eat you, and you do not want to show any weakness in front of them. 

The most interesting part of that lecture though was the fact that Dr. Mogil's group found that men, or the smell of males (any species other than mice) also exerted a analgesic effect. This means that the presence of a man, or a man's T-shirt in the room will cause mice to become stressed out of fear of predation. This effect only lasts for about 30 mins, but during that 30 minutes these mice show lower amounts of pain, and then after 30 minutes they apparently realize that the male is not a threat and the effect wears off. It hasn't been proven in humans yet, but the effect was shown stronger in female mice than in male mice, and there is a good likelihood that it is also true in humans.

So how does this relate to the title of my post? Well, if the presence of a male stresses out the mice, then it actually throws off the accuracy of a lot of our experiments. Even when we euthanize a mouse to harvest its DRG neurons for analysis, if there is a male doing the euthanasia or in the room at the time, it could skew our results. This is even more pertinent when we do behaviour testing, especially for sensitivity and pain perception testing. Basically, in this one circumstance  it is better to be female scientist than a male scientist. 

If Dr. Mogil's theories also hold true for humans, this gives us a unique perspective for medicine. Perhaps, women truly do make better doctors or more perform more accurate patient assessment because the patient's pain would not be skewed by the examiner ..unless of course the doctor has never met the patient before and then you would have the stranger effect take place. 

Para-Cycling?

When I showed up for training at 8:30 am this morning, there were more people around than usual. Then in passing by, I saw my coach who told me the national team para-cycling coaches were running a mini-camp. I knew they were coming sometime in March, but I didn't know when.

The head coach at the cycling centre, SB, is also the para-cycling coach and he coaches a few of the HP para-Olympians. We have chatted a bit about my situation before, and we couldn't come to the conclusion if I was classifiable or not, and he wanted me to meet with the coaches when they came down (ie today). SB had a family emergency to attend to, and because he was gone I thought my chance of meeting with the para coaches was gone. I guess today was my lucky day!

The development coach ran through a few things with me, like the heel to toe walking tests, running your foot down your shin...you know, all of those neuro tests. I did them before and after riding. He said that riding or exercise brings more symptoms out in people, and if that happens, they have a good case for classifying. It happened to me. So, it looks like I might have a chance at classifying either C4 or C5 (hopefully not C5 because most people in that category have only upper are impairments which really has no affect on your ability to put power into the pedals).

The next step is to do some testing with a physiotherapist immediately after a hard workout. Maybe, just maybe, I will classify.

Global Health

Welcome to my Medical Mondays Post!

I'm pretty exhausted today after spending my entire day at the Children's Hospital and then going to class...I don't understand how doctors actually make through the day. I guess now is as good a time as any to start improving my stamina and work on looking enthusiastic about everything and my all day happy face.

Anyway, in two weeks time, I will be heading over to Montreal to attend MonWHO, a World Health Organization Simulation conference. I went last year with my previous university, and this year I obtained funding for myself and 5 other students from Calgary to fly out to Montreal to spend 3 days debating, learning and sometimes fighting about global health issues. The theme of this year's conference is "Corruption in Health Care Systems," and I am the Transparency International delegate, which should prove to be a very interesting and involved role. I am also pretty excited about being able to see some of my friends from Guelph who are going and whom I haven't seen in almost year.

The main reason that I was actually able to get funding to go, is because next fall, we will be hosting the first conference of its kind in Western Canada. We are calling it CalWHO, which coincidentally sounds like "Yahoo" which is actually the traditional Calgary Stampede exclamatory phrase (it is not "yehaw" like everybody thinks). Myself and my friend U are the co-Executive Directors, founders and first ever presidents of CalWHO. Before Christmas we had an application process to select 4 more students to form our core secretariat responsible for putting on CalWHO next fall. So while we are headed to Montreal to attend the conference (and eat awesome food, potentially go shopping and maybe hit up one of Montreal's famous night clubs), we are mostly there to learn everything about the conference so that we can recreate it here in Calgary.

This is a massive under taking, as it will be the first student led conference in my faculty and one of two in the entire university (the other is hosted by the faculty of education students, most of whom already have at least 1 degree). I am a bit scared....but at this moment,  I am just really excited to go to Montreal and spend a weekend trying to solve problems that affect the health of people world wide.

Also, happy March from Calgary! I love Canadian weather! (Said no one ever.)

Insanity

I can't even begin to describe the past two weeks. Two weeks ago today my computer crashed. That week, I had 3 midterms, a lab report, a presentation, all of my summer studentship funding applications were due, mice habituation and nerve conduction training. Like most university students, my life is on my computer and no, it wasn't backed up.

I made it through all of my midterms even though I was missing all of my notes. I majorly crammed for everything, and I wish I knew how I did on my stats exam...but some of the questions didn't have any correct answers...

 I spent 6 hours on Feb 17th doing baseline functional behavior testing on my mice, and then this past week was reading week. Usually people take some much needed time to fulfill Canadian stereotypes by going skiing, playing pickup hockey, sledding, or chilling with friends during reading week. I wrote an organic chem final on the 20th, then spent all day on Friday operating on my mice, and finally, after 12 days without a computer go my laptop back. I was at school by 8 am yesterday to inject my mice, then I went to training, then I wrote an essay...then I discovered my computer is not fully fixed. Today, I was at school by 7:45 am to inject my mice, then I had get over to grandmother's house by 10 to take her to church, then after church I discovered her car had a flat tire, and I had to deal with that, then it was back to injecting mice, and then back to calling Dell about my computer and then back to essay writing.

I'm so exhausted...reading break was not a break.

The good news is that I am less afraid of mice now, and my suturing skills have improved. By the time I get to medschool I will be a needle driver rock star. Speaking of which, this weekend was MMI interviews at my school, I have never been around so many nervous people before. I had to walk by their little gathering in the medical school before their interview to get to my locker and I felt I was the only one who had missed seeing the headless horseman. I hope I don't look that next year...

Medical Extremes

I think this is my 4th  Medical Monday blog post, and thought I would write about an interesting medical contrast that I experienced today, which I feel really reflects on my own personal experience as a patient. If you are thinking I'm going to tell you about some really cool medical condition, then you should probably navigate yourself away from this page and check this out instead.

This afternoon I spent time in the emergency department of our city's children's hospital as part of the Pediatric Emergency Medicine Research Team, but prior to that I spent the morning volunteering in the palliative/respite care area of the very same hospital. I went from an area that was focused on ensuring that kids who have terminal illness have the best times of their lives while they still can, to an area that was focused on getting kids in and out of the department as fast as possible.

The energy between the two places was extremely different, and while you may not expect this, the doctors, nurses and parents who are taking care of kids in respite care (none of the kids currently under palliative care are actively dying) were way more cheerful, happy, fun loving and honestly just more kid friendly. People were focused on enjoying life, and making sure the kids laughed more than they cried. But in emerg, it is the exact opposite. Nobody is focused on making a kid smile, rather just figuring out what is wrong with them, treating them and moving on to the next patient. We expect that when we set foot in an ER, a doctor will asses us, treat us with modern medicine and then send us home cured of what ever aliment brought us to the door.

As I stood and waited for the bus to take me back to school today (by waiting I mean pacing, I'm a pacer) I began to think about these comparisons and how I have started to shift my own expectations of what medicine can do for me. I'm palliative, not in the dying sense, but in the sense that there is basically nothing anybody can do that will "fix" me, only make the pain a little less intense. Yet, I still expect that a doctor will be able to "fix" me, on the outside I portray that what I am looking for is a diagnosis and curative treatment. But deep down, I'm not. There isn't a cure, there isn't away to fix the pain I have all night and all day. The only thing I require from medicine now is for it to help me live the best life that I can, for it to help me give everyday %110. 

Highs and Lows

In my first year of university I was part of a bible study that we called "DG" (discipleship group), and its where I met most of my really good friends, and a few of them became my room-mates in second year. We met once a week, tucked our selves away in a corner, ate a lot of candy, and talked about God. At the beginning of our meetings we always did "Highs and Lows" where we would each say what a high was for the week and what a low was for the week. It really helped to put things into perspective when you were having a bad week because it forced you to also find the good things that happened.

So, I'm linking up with "happies and crappies" again this week, because I feel like this a helpful exercise when I am feeling a bit glum.

Happies:

- I met with my PI to discuss summer studentship funding, and I am almost done my applications

- I made it to all of my training sessions this week

- I finally got an MRI of my ankle on Monday

- I went home last weekend (because of said MRI) and got to spend some time with my family. Because I went to boarding school when I was in the 10th grade, and then did my first 2 year of  university thousands of km from home, it was the first time I had gone home on a non-holiday weekend since the 9th grade.

- I made my grandmother very happy on Monday when I brought her flowers, which in turn made me happy to see her so happy (and surprised).

Crappies:

- I haven't slept very well in a few weeks. I keep waking up throughout the night (usually at 1 am, 2:30 am, 3:30 am and 4 am) because my leg hurts. I wake up after I have a dream about something happening to my leg, like it gets cut off or like last night, when I dreamed I was shot in the leg. 

- I'm super tired of doing spin pyramids at training

- I almost died driving to my MRI on Monday due to black ice and a freak snow storm, thankfully the big guy was looking out for me.

- Because I went home I got less work done on the weekend

- While this probably doesn't seem like a "crappie," I was disappointed that I only got 91% on my cardiovascular exam in physiology. One question that was marked wrong, is in fact correct based on our lecture notes, so now I have to argue with my prof which I hate doing. I don't like grade grubbers, but when things are marked incorrect when they are actually correct, it makes me upset. 

That is all! Have a good weekend!

"Do not let the pain make you hate"

I wish I had the strength to follow these simple rules.

"Do not let the pain make you hate." This is a really hard thing to do, for me, its more a physical pain that makes me hate, but I know that is not the case for everybody. I hate that I have to deal with things that everybody else deals with, and deal with the pain. My life would be so much easier if I could just sleep through the night, not spend most of the day feeling nauseous from the pain and not spend huge amounts of time faking to the world that nothing is wrong. I hate that I can't do anything about these things, and I hate that the pain makes me hate things.

I don't know why I have this idea in my head, but I feel like if I ever get into med school that my worries will just disappear. I have no idea why I think this will happen, because likely my worries will triple once in med school. Maybe its because my goal of trying to get into medical school has been the only thing that makes me keep on going despite the pain. What will happen if I don't get in? Well, I think my pain will make me hate the world even more than I already do.

I need to go see my family doctor about sleeping pills....I hate asking for drugs (and there we go again with my pain making me hate things).

Home for a Rest

This is the first weekend since the 9th grade that I have been home that is not part of a school holiday. Its weird, usually I don't really  have any homework to do while I am at home, but this isn't a holiday, so I do. Its just so odd being at home right now...

The reason I came home is because I have an MRI tomorrow, which is scheduled at our regional hospital. The MRI is only there for 5 days every month (its a mobile MRI), so it took me 6 months to get this appointment. Oh the joys of rural medicine! Its also 1.5hr drive away from where I live (which in turn is 4.5hrs away from where I go to school), so that is still pretty far...

It was nice to go cross country skiing on the trails near my house today though, its a good change from rollers. 

5 for 5

I decided to join this link up:

I think it's pretty self explanatory, so here it goes.

Happies

1. My mice arrived! 

2. I am starting a conference at school, it will be the first student lead conference in my program

3. I had an awesome time in Tucson riding bikes with Team Alberta a few weeks ago

4. I got an A+ in pharmacology last semester (its the only one semester course I have, so it is my only grade from last semester). 

5. I like most of my classes this semester

Crappies

1. I don't have access to get my mice out of animal care My PI just had a grant proposal emergancy and needed the mice, so now I have no mice.

2. My schedule is so full I am starting to panic

3. Reading a stats text book is horrible

4. I'm too busy to study

5. One of my prof's is a bit of a bigget from Georgia (no offence to anyone from Georgia, but this particular individual from Georgia is rather sexist and racist). 

Looming Medical School Applications

On Christmas eve we had some family friends from the US come for our Christmas dinner (they are originally from Poland, but the used to live in our small town about fifteen years ago). Both of their kids are in medical school (one is in OD school I believe) and they told me that there are a fair number of Canadian students in their class. This gives me hope, because I will be applying to the US (lets face it, I only really have any chance at 3/11 Canadian schools, and that doesn't leave for many options).

It was interesting talking to them about the application process and I was surprised to learn that they both applied to about 30 schools! We don't even have 30 schools in Canada! My plan was to apply to 10 US schools and 6 Canadian schools, which would total to 16 applications. Basically, I will be spending what ever I earn this summer on medical school applications. I also found out that in the US, you might receive offers of admission before the end of October!! Our applications don't even close until October. 

I wouldn't mind going to an American school, it would be better than the Caribbean...I will just be paying student loans until I die....and health insurance might be a bit of an issue for me.

I feel like I am steadily starting to build up my application though, even if I am about a year too late. I was just accepted in a program called PEMRAP - Pediatric Emergency Medicine Research Associates Program. After I go through training all of this month and next month I will be enrolling patients in emergency medicine related studies. I'm pretty excited about it, but it does mean I will be spending 8 hours of every Monday at the Children's Hospital. Good times!

Cycling also going pretty good too, I just spent the last week in Tucson at a provincial team training camp. We rode a lot...and I'm exhausted, but ready for the first day of classes tomorrow. For some reason we start the semester on a Tuesday...but I'm all for it! I spent the entire day yesterday travelling, and I haven't unpacked my bike yet...I hope it still resembles a bike after the whatever trauma United Air inflicted upon it.

Team photo on the last day at Colossal Cave Park

Training Camp

My legs feel like jello.

In the past 3 days we have ridden over 13hrs...and collectively we have gotten 17 flat tires. I got my first today when a thorn from a cactus pierced through my tire and tube. I thought the weather would be warmer in Tucson, but last night it went below zero (in Celsius of course). Yesterday was pretty chilly because it rained all Sunday night. Who knew it rained in the desert?? I sure didn't, I remember being told in elementary school that it never rained in the desert, but in all honesty I know only slightly more about US geography than  most Americans know about Canadian geography (okay, maybe a lot more, but I apparently know nothing about deserts).

I received some new Speedplay cleats in my "Santa box" (aka stocking) for Christmas and I used them for the first time on Sunday. My right cleat (my right foot is the one with the nerve pain issues) was locked so that not only was it nearly impossible to clip in, but I had no side to side play in my pedal. So I rode 3.5 hours with my foot locked into a position that should not have been in. As a result, I now not only have way worse nerve pain, but my right knee along the joint line is in some pretty serious pain right now. Essentially, my whole right leg is in pain at every single joint....and all of my muscles hurt. We still have 4 days of riding to go (tomorrow is a rest day, but we still have a 1.5 hour ride to do), with Mt. Lemon on Thursday...I don't know if I'm going to make it...

I don't have any pictures because I have been too busy trying not die on the rides and too tired after the rides to do anything other than lie in bed. On the plus side, my Netflix (or m Dad's I should say) is a American!! If you don't know, Canadian Netflix cowers in the shadow of American Netflix. Americans get Grey's Anatomy episodes!!!

Hopefully we will grab a few pics tomorrow in the park. Wish me strong legs, I'm going to need them.

Peace like a dry Arizona river bed.