Learning to Talk

Med school is a fascinating thing. In the words of my preceptor, "medical schools accept people who are generally very good at talking, interacting with people and are naturally patient centred individuals, and we turn them into biomedical machines who get stuck in conversations."

I am actually afraid of interviewing patients. Before medical school, I loved talking to people and getting them to tell me about their lives. That is honestly one of the reasons I like to fly so much, you never know who will be sitting next to you for the next 4 hrs. But now, I am paranoid that I will forget to ask something, ask too many closed questions, ask too many vague questions, say something wrong, or make an inappropriate facial expression. Talking to people just became one of the most difficult and nerve racking things I have ever done.

It's not the workload that is overwhelming, it's learning how to talk, act and essentially be another person almost overnight. And being a former athlete and somebody who has not had to struggle much to do really well in school or other things I have taken up, so I'm not used to being awful at things. Somedays it makes me question whether or not I am cut out to be a doctor. Everybody has told me for such a long time that I would make  a "great doctor" but not being good at the actual doctoring bit is really hard. (Note: nobody has told me I am awful, I just feel awful because it is such a struggle to do such a simple thing.)

Med school isn't hard because of what you need to study, it is hard because of what you need to learn to become.

This is how I feel all the time in clinical skills.

Interview Hopping

I missed the last Medical Monday because I was desperately trying to get to Richmond, Virginia before my interview at VCU. But lets back up a bit to get you up to speed about what has been going on for the last few months.

In January, I received interview invitations for 3 different schools in a span of three days. One for VCU on Feb 4th (my top US choice), one for Michigan State on Mar 28 (second choice), and one for Northern Ontario School of Medicine on Mar 29th (that one was a shocker). In that same week, I received an invitation to write the subject test for the Neuroscience MSc/PhD program in Göttingen, Germany. 7 days later I received an invitation for THE interview that I really wanted, which was at my home school, the University of Calgary.

February 3rd I left the frozen Canadian waste land to fly to Richmond, Virginia for my interview at VCU. Except, my flight out of Calgary was delayed an hour and half due to a mysterious light being on. When we landed in Minneapolis I abandoned my Canadian manners and full out sprinted about 2km from gate A to gate F where my flight to Richmond was departing from. I got to the gate, and the women in Delta colours told me the plane had just closed its doors, and wouldn't re-open them, and that I had been rebooked on a flight that would get me to Richmond at 12:30pm the next day. I had to be at VCU by 11am for the interview.

Me: "But I have to be there at 11!."
Delta woman: "Well, you won't be."
Me: "This is literally my future we are talking about, the results of tomorrow may very well dictate the rest of my life."
Delta woman: Fake smile
Me: "What about a flight to DC tonight?"
Delta woman: "Oh, yes. We could do that. The last flight closes its doors in 7 minutes. Its back at gate A."

So, I full out sprinted back to the exact same place I had just come from, but managed to sequester a nice man driving a Delta cart to get me there a little faster. I get to the gate just on time, and I get handed a boarding pass which indicates a 1st class seat (score!). I hurried on to the plane (nobody checked my passport by the way...I guess flights to DC aren't as secure as we thought), I was sweating buckets, clearly didn't belong in first class, and when I arrived at my seat, I noticed it was a window seat....right next to a very nicely dressed US Senator. I have never gotten such a severe death stare in my life. Upon arriving in DC (which is the scariest runway ever, it looks like you are going directly into the river), I was provided with a $300 taxi voucher to get me to Richmond, Virginia. I made it to my hotel by 1 am, after having to spend half of the taxi ride on the phone with the driver's daughter in order to get directions to my hotel because my taxi driver didn't know where he was going. End of story, I made it, I think my interview went well, and VCU blew my mind. I didn't think such amazing schools even existed. As an aside, if Delta had waited 3 minutes, they would have saved them approximately $700, and reduced my cortisol levels about 2 fold...this is why we Canadians love Westjet...they wait for everybody.

This past Saturday I did my interview for Calgary, I think I nailed 9/12 MMI stations, completely blew 1 (had an awkward 2 minutes of silence because you can't leave the room until the 7 minutes are up and I was totally done discussing the question), and 2 stations that I am a little unsure about. I hope it evens out...on to May 15th!

Next up on the interview schedule is Göttingen, Germany next Monday. I didn't study for the subject test, and figured my chances of getting an interview were pretty much 0 as I guessed my way through the 40 physics and chemistry questions. But apparently not...or I just failed less than the other 300 people who wrote the test. The program is paying for my travel and accommodation, which is awesome, worst case scenario is that I have a free trip to Germany :).

But here is my dilemma. The only reason I applied to the program in Germany is because I thought I had no chance of getting into any medical schools that I actually wanted to go to after not hearing from VCU, Michigan and being rejected from UBC. Now I am worried that I will get into a top choice medical school (or any at all), plus the program in Germany. I was hoping to not have to make any decisions. It will be hard to turn down a 3 year PhD program at one of the top scientific institutes in the world (and in Germany), but I also don't know how I could possibly turn down medical school. Best case scenario, I get to defer for 2 years and do an MSc in Germany and come back to a medical school spot. But, its pretty rare to get more than a 1 year deferral.

Also, my thesis is due in 18 days and I am no where near finished. I don't have time for Germany...but I can't not go...

Side note: check our Waves for Women blog, which my friend Caryn and myself will be chronicling our training and fundraising journey for our 35km open water ocean swim in July to raise money for Women's Cancer Research.

The first week of the end of my degree

I think title says it all, but this is the first week of classes of the last semester of my undergrad degree. Come June I will be happily not walking across the stage to receive my degree in Health Sciences because I will likely still be in Tanzania. (Who would want to sit in stuffy gymnasium for three hours when they could be deep in the Maasai region of Tanzania at a field camp with giraffes walking around?) Needless to say, I am pretty excited that this is the end of my first degree and that I get to finish off with a pretty awesome global health research studentship to Tanzania.

The unfortunate part is that I will be starting yet another semester with post-concussion syndrome. You may remember this post from October, well the saga continues. I still have daily headaches, yet they are mainly orthostatic (I get them when I sit up or stand up, but if I lie down they go away). This has led the concussion specialist physiatrist that I am seeing to suspect I may have a CSF leak (which is what I asked about a week after my concussion when I threw up every time I stood up and the ER doc told me it was impossible to occur unless there was a skull fracture). Soo... I have to do a radionucleotide cisternogram (say that thee times fast) in two weeks, which essentially involves a lumbar puncture, an injection of some radioactive nucleotides and me lying on a table in the angiogram suit for 6 hours. I'm not excited...and I think that if it shows I don't have a CSF leak, I likely will have one after this procedure (every time a needle goes into my epidural space I end up with a CSF leak that doesn't resolve its own). From what I am told, this the best test to check for a CSF leak, and apparently they can't do a blood patch (the procedure done to stop CSF leaks) unless there is indication of leak, which there will be no matter what after this procedure because I am 100% certain (based on past experience) that I will end up with one. Some rules and systems don't make any sense and in this case will likely cause unnecessary patient suffering. This procedure seems pointlessly expensive (to taxpayers of course, GO CANADA) and I am fairly certain I will end up needing a blood patch in the end regardless of the test outcome.

And for further updates, I got wait-listed at Wayne State SOM (which was better than I though based on the strangeness of my interview) and rejected pre-interview by UBC by 0.5 (they give you your application score and the cutoff score for interviews). The UBC thing really upset me because BC has a huge shortage of doctors in rural areas, yet they reject rural applicants at higher rates than those from urban areas (they publish these stats). It has to be recognized that opportunities to build up extracurricular activities in a small town are limited (like there are none), I made some of my own, but even that was a struggle. Anyway, if i don't get in anywhere this year, I know my GPA will be high enough to put me above the interview cutoff for next year for UBC.

On another note I spontaneously decided to apply for graduate school in Gottingen, Germany. But sadly if they like me I essentially have to repeat the a German version of the MCAT (in English thankfully) so now I have go back to studying plant ecology, physics and chemistry.

Who wouldn't want to get a MSc or PhD from here? 

Despite all of these emotional up and downs, and headaches caused by the physical ups and downs, I'm excited for what 2014 has in store. This year represents a void of the unknown and not knowing what is going to happen is always exciting. It also represents long hours in the lab trying to finish my honours thesis on time (so I can actually graduate) and the challenge of fulfilling these 10 goals. 

I hope your 2014 is filled with moments of joy but also full challenges that help you realize its okay to not be in control, and of course, many Medical Mondays (12 to be exact).

Thanks for stopping by!!

(I should also share that I get to snag link up spot 1 because I am in a different time zone,  so technically it is still Sunday here. There are some perks of living in mountain time, in addition to the mountains and -20°C weather.) 

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.

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 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.)

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. 

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.)

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!

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). 

The First Cut

Today I preformed my first surgery, I made my first cut through skin, isolated my first structure and sutured my first wound. It was amazing, and I thought my hands would begin to shake, or that I would falter or feel faint, but I didn't. Probably because this surgery was on a rat, but on Monday when I watched the demo of the surgery, I felt pretty sick. But there is definitely a big difference between watching somebody cut the skin and actually putting the scalpel blade through the skin your self. Even though his heart was beating and he was breathing (and anesthetized), it wasn't as hard as I thought it would be when I made that first cut. 

I completed my animal surgery certificate course today, I assisted my partner with a surgery on Monday, we did post-op together on Tuesday and today was my time to be in the spot light. All I had to do was isolate the jugular vein, which really wasn't that difficult. And those veins are surprisingly stretchy and resilient. The hard part was the suturing, doing the inner layer of tissue was just fine as it was a discontinuous stitch, but doing a continuous buried stitch on the outer layer of skin was really tricky. I kinda suck at it...but it was my first attempt at ever stitching anything ever!!! I'm pretty stoked on life right now though, mostly because I didn't know if  could ever handle doing surgery. I like it, I'm not good at it right now, but I like it.

After my rat was euthanized (I'm not totally okay with shoving a needle full of anesthetic into a rat's heart yet...) I got to isolate the sciatic nerve. Honestly, it was the first nerve that I have ever really seen. Maybe on day I will get to repair one.

I'm pumped to keep studying, get on with my research project (mice officially ordered) and become a doctor! Surgery might still be in my cards, but I need to practice suturing, so, I bought this:

My first suture kit

 The only problem is that I only have 2 packs of sutures, one for fascia and one for skin. So if you know anywhere I can buy sutures, let me know!!

Training

I pretty much completely stopped training August and then September wasn't so great either, but now that I am part of the High Performance program at the Olympic Oval, I'm back into 100% full bore training plan. I can see what my coach is trying to do, build up the endurance side of things before it snows, then do some testing and then jump into a winter of interval training. But my legs hurt for real after riding 3.5hrs on Saturday and 3 hrs on Sunday. Today is a rest day, and then tomorrow we are back on the bike with another 3 hr ride.

I did actually manage to finish that health and society paper that I wrote about last Friday, and I did learn a few things about myself.  I am one of those people who don't employ any method of coping strategy to deal with the pain, which likely means that I have accepted that it will always be there and that there is no point fighting. I just live my life like I don't have pain, even though I'm pretty sure if somebody was actually using a scalpel to cut open my leg right I wouldn't be able to tell.

Wiriting About Pain

I had to chose a topic for my Health and Society unit research paper. I thought about the whole shabang of health related issues (okay, I didn't think about all of them because that would take FOREVER), and I ended up settling on what I know best, Chronic Pain. I started off wanting to focus on the young adult population, but there is far more research on the adolescent population. And lets face it people, there is no point making an assignment harder than it should be, sometimes you just have to start writing and go where the sea of journal articles takes you.

It is interesting writing on a topic focused on a population that only two short years ago I belonged to. I didn't have chronic pain until my last year of high school, and it was brutal. As I wind my way through the research articles, there is one idea that keeps on coming up, adaptation to pain. People who have lower perceived quality of life and higher scores on depression scales are focusing their lives around ending the pain, rather than living with it. I can attest that focusing completely on the pain and finding new ways to get rid of it consumes your every thought. The pain starts to literally rule your life, and that's how it was when it first started for me. For the first two months, I avoided wearing shoes (I wore flips flops in December and January, and yes, I live in Canada) I rarely went out for our team group rides and I was less involved with my school life. Then one day I woke up and decided that enough was enough, that no matter how much it hurt I wasn't going to stop doing something. Even though my pain levels increased, I was happier.

They call this adaptive behavior. Rather than avoiding the pain, you adapt your life and actions to include the pain. Its like your annoying little brother that follows you around all day, you can't get rid of him, so you have to do things that also include him.

I always wondered why the pain doesn't seem to get under my skin (that often), and it's because I somehow learned to adapt to the pain. I will probably never give up on new ways to try and get rid of the pain, but in the mean time, I know how to live with it.

I found this book conveniently on display in the library today, so naturally I signed it out. Its odd holding a textbook about yourself...

Ready or Not?

Tomorrow is my last day to study, as per the recommendation of Examkrackers I shouldn't even be studying tomorrow, but I have few more things to review. Really, I could review until I'm 30 years old and I still wouldn't feel ready. 

I'm hoping for a 30, and if I could manage a 32 I might actually have a heart attack. I'm going to give it my best shot on Saturday, and I know that no matter what my score is, it was the best that I could do given the time that I had to study. There is no shame in needing to write it more than once, I would just prefer not to have to go through this torture again. 

In other news, I meeting with my lab supervisor and one of his new MSc students on Friday to go over what my research project will be. Its looking like something along the lines of a tumour suppressor knock down and then looking at the function recovery of an injured nerve. I'm really hoping that I get USRP funding, otherwise my move to Calgary might have been for nothing. (Missing out on the Human Anatomy Dissection class at Guelph is a bit of a bummer, but I am going to get into medical school someday and I will get to learn anatomy the way it has been taught for centuries.)

If you have any extra available brain power on Saturday between 8 am and 2pm  Mountain Standard Time, please direct it my way.

Peace Like a River

Just a wee update

Sorry I haven't posted anything in a while. Started my summer job on May 7th, and the 9 hour work day starting at 7 am has been a bit rough on me. I'm exhausted by the time I get home at 4, but having every other Friday off and weekends makes it tolerable. I also started studying for the MCAT which I am writing on Sept. 1, the physics section is going to kill me! I got a 14 on the Verbal Reason section though that I did on a practice AAMC exam (I did the exam before I even opened a study guide), so that is really promising seeing as that is the only section that really, really counts. (Unfortunately, all the sections count, but Verbal is the most important.)

I started biking exactly 2 weeks after my surgery (May 12), and the first few rides were a little uncomfortable especially on the bumpy sections. I saw the surgeon for a follow up appointment on May 18th in Vancouver (I had to leave my house at 4 am, my mom drove me through a legitimate snow storm 3 hours to the Calgary airport after my flight was cancelled in Cranbrook at 10pm the night before in order to get there), and he was surprised at how well I was  doing at three weeks, but not surprised that I started biking exactly 2 weeks after the surgery. (To be fair, he said no activity for 2 weeks, and I followed that exactly!) He did say though he was a bit shocked during the surgery to find the distal end of my nerve had not only failed to degenerated but had grown a 2cm branch...according to biology and physiology, the distal end of a severed nerve should degenerate after 48 hours of being cut. So I'm apparently a freak of nature when it comes to neurophysiology.

I still don't have any nerve pain going up leg, which is amazing and the surgeon was pretty pleased to hear that. He did say the nerve pain in my foot should get better, and at the very least not worse. I can handle that!

I also did my first road race since the surgery on Sunday, it went okay, it was pretty painful near the end. My ankle is hugely swollen now though, and at physio yesterday my physiotherapist put on some hot pink kinesiotape like Lance Armstrong used in all 7 tours that he won. It actually made it feel a bit better and the swelling is a bit less (but of course this could all be in my head too). At the race though, the Para-Cycling coach from National Cycling Centre -Calgary came and talked to me, and there is a chance that I might qualify as a para-athlete, which means I could compete in both able bodied and para events. Which could possibly be an opportunity to represent Canada at worlds and the Olympics...something I need to look into!

One more thing, I GOT IN TO THE UNIVERSITY OF CALGARY!!!!!! Yup, that's right friends, KP will no longer be out east anymore. I have an appointment with an academic adviser on Friday to sort out transfer credits and then I get to visit the lab!!! Its pretty cool because the lab and the "O'Brien Centre for Bachelor of Health Sciences" is at the Foot Hills Medical Centre which is basically biggest and most advanced hospital in all of Alberta, and it part of the Faculty of Medicine. Its going to be awesome to be around doctors all the time in an educational manner instead of being the patient! I'm super stoked!

Peace Like a River

Its On like Rocket Ron

So my surgery officially will not be cancelled! The anesthesiologists of BC have decided to revoke all previous intentions of withdrawing services. I was a big moment of relief yesterday when I found out that it wouldn't be cancelled, now I can just focus on studying for my last exam and packing.

Speaking of exams, I just finished a week designed by the lord of the underworld. I had 4 exams in 4 days, 3 of which were in 24hrs and two of those three were back to back with no space between them. I have never studied like this in my life, I am not good at cramming, it doesn't work for me at all...except for this time. I have never been at the library so early that it hasn't even opened yet and I have to stand outside, I have also never been at the library past 9:00pm. This exam period changed all of that. On Saturday morning I woke up at 4 am to study for my Cell Bio final, got the library just before it opened at 8 and studied right up until 11:20 am, and then ran to my exam which started at 11:30. Usually the night before I feel very confident about what I know, and then the day of my exam I don't spend more than an hour studying...for my last three exams that I just wrote on Friday and Saturday I didn't feel confident about any of my exams up until about 10min before they started, and even then, I was a lot less confident then I usually am. I didn't even study for my Pathology exam really...but I think I did really well (mostly because it was very similar to the practice final our prof gave us).

One more exam to go at 8:30am on Friday,  but I am so exhausted from studying, and from the amount of caffeine and lack of sleep on Saturday that I can't really find the motivation to study.

The Next Stage

Next week is the last week of my second year of university, which means that I am almost halfway done my undergrad. I'm scared, because this means that I really need to get my stuff together, I'm not supposed to be naive anymore, I'm supposed to have a plan for my life and be independent. I still feel like I rely on my parents for everything, when something goes wrong or I don't know what to do, they are the first people I call. Essentially I still feel like a kid, even though my age says otherwise (although I can probably still pass for 14).

At this time last year I wrote a post called "So Close I can Almost Taste it" about what my first year was like and how I was amazed that I made it through despite having a curve ball thrown at my head every five minutes. This year seemed a bit easier, but at the same time, I haven't achieved what I though I would be this time in my life. I though I would have a sweet research position this summer, I don't, I'm having surgery and working the same old boring summer job that I had last year. I though I would have been involved in some sort of awesome volunteer gig, and actually be contributing to the world...volunteering at the Bike Centre and being on the Human Rights and Social Justice Council doesn't seem like anything worth talking about. I though that university would be a time when I could thrive, be who I wanted to be and do what I wanted to do. So far, that hasn't happened.

I'm still waiting to hear whether or not I got into Calgary, and word on the street is that I won't know until May. Its major stressing me out and making it much harder to focus on things that I need to like training and school. I 'm about to ship all of my stuff home, only to have to ship it back to Ontario to live with random people that I won't know next year. Also not knowing if my surgery is a definite go is really stressing me out.

I wish things would just work out how I had planned and hoped...I never thought that I wouldn't like UofG, or that I would still need another surgery, or that my surgery may be canceled, and if its not, it may not work.

This post is drastically different from the one I wrote last year, this post isn't full of hope and inspiration, and I'm sorry for that, but this year has pretty much just been one let down after another. So far nothing awesome has happened, I keep think that the awesome thing is coming, but it doesn't seem to.

So here's hoping that I do well on my exams and that I get in to Calgary.

MonWHO

This past weekend  I had the privilege of traveling to Montreal to attend the MonWHO conference. MonWHO is a World Health Organization simulation conference held in Montreal every year. The College of Biological Sciences Student Council (CBSSC) sponsored 11 student to go. The theme of this year's conference was Refugee health, and it was super fun!

It was the first time I had ever been to Montreal before, so it was pretty exciting for me just to be there. I was the Merck & Co. pharmaceutical representative, which as you can imagine had its ups and downs. I have discovered that I am really bad at being self centred, hording money and just generally being evil. We spent most of the weekend inside, arguing over policies, what is important and debating, but we did get to spend a little bit of time shopping (1hr in H&M) and seeing some sights in Old Montreal.

Check out some photos from the weekend!

Artsey group photo...science student have their creative moments too.

Guelph biological science students go Ninja style

Notre Dame Cathedral

In "Western Business Attire" after the first day of Regional Blocks (sweet name tags!)

The NGOs...and yes, we know our placards are inverted

What should we eat? The menu is in English, French and some Asian language all at the same time.

Da roomies! Went from not knowing each other to sleeping with each other in 12 hours.

Science rules!