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

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!!

The Circle of Life

As some of you may or may not know, my Grandpa passed away two weeks ago. He had an amazing life, did amazing things for people and ultimately left the world a better place.

Today was his "Celebration of Life," which is basically just a happier version a funeral and sans burial.  My brother and I both spoke, and neither of us cried! We both even managed to make a few people chuckle and few people cry. It was a really great service, and the pastor at my Grandparent's church is simply amazing. It was a bit exhausting though....having to constantly meet people and have them tell me how wonderful he was all day...it was constant reminder that he is gone. I will miss him, but I am trying to remember that this is a time to rejoice in the difference he made in the lives of others rather than a time of mourning.

Yesterday, (Friday) I went to Vancouver to see my surgeon, Dr. B, again for a follow up. He was a bit puzzled by the fact that it is still swollen to the point where you can leave a thumb imprint in my ankle (it literally stays there for 5 minutes...its kinda freaky) and the fact that I have throbbing pain...but overall pleased that my nerve pain is better. He said that it could be possible that the nerve is growing into my bone....great. He is sending a e-mail to Dr. S Mackinnon in St. Louis who first preformed the procedure to see if she knows what might be going on...she is also pretty much my hero.

Dr. B saw that I was studying for the MCAT (I was working through the 1001 MCAT physics questions before my appointment), laughed and said that he can't remember anything from the MCAT because he blocked it from his memory. So...I guess it is that bad...

Racing the Tour de Bowness Crit on Monday morning, wish me luck! (Not crashing would be nice, but this course has some pretty nasty pavement and a hill section.)

Side note: I gave an elderly homeless man on Robson St in down town Vancouver (it is the shopping street of the city) $50. I don't really know why, but I even went back and re-crossed the street to give it to him. I haven't really ever felt compelled to give somebody that much money before for no apparent reason, but I just felt like I really needed to. Maybe it was my Grandpa talking...I don't know.

Peace like a river

Gone? Never?

I don't think I have CRPS...at least I hope I don't, but my pain never really seems to go away. I had one month of relief the first month after the surgery...but while my nerve pain is less (but slowly creeping back) it has been replaced by this deep awful throbbing pain.

Does pain for people like us really ever go away, or is it just something that is going to be a part of my life until I die? I know nobody can answer this question, but I wish they could. I really wish they could.

On a happy note, this is my first post from my new Dell XPS 14! Yeah, I know what you are thinking...why didn't I  buy a Mac? Well, you see consumers of the world, Apple has one of the worst CSR policies on earth. Not too long ago there was a fire at one of their factories in China and people literally burned to death because there were bars on the windows and they couldn't get out. My concious won't let me buy an Apple product...they may be cool, but so is my new Dell...which also happen to come in enviro-friendly bamboo packaging. Way to go Dell!!

Peace like a river.

The Swell

I haven't posted in a while because I have been super busy with that thing called work and that other thing called the MCAT, neither of which I fully enjoy. I have been spending a fair amount of time on my bike and the weather is beginning to look a bit more like summer...which is nice because I had clean my bike 4 times a week there for a while.

I bet you are wondering about my good ol' leg eh? Well, truth be told, so I am and so are my doctors. My whole leg below the knee is swollen and spongy like (yuck) with some nice vascular changes (aka my veins are popping out) and a heck of a lot of pain. Now, I know what you are thinking...I should probably stop riding my bike right? Wrong. Cycling doesn't make the pain any worse or any better, but it keeps the muscle spasms in check and keeps me from going insane, so really I don't see any good reason to stop riding.

I have another appointment with my family doc this week...I have pretty much seen him or his locum every week for the past month. There is something not right about what is going on, after the neuroma resection 2 years ago (almost exactly) I knew something wasn't right and everybody just kept telling me it was fine. Then I almost had a below the knee amputation...I don't want to repeat that, this time I am not settling for "don't worry."

On a completely different note, I almost had a heart attack today (not really, but my heart rate went to about 205). I was out for a ride on my usual 65km route, I was just starting up a bit of a hill when all of a sudden this giant thing ran out of the forest 20 feet in front of me, across the road and into the forest on the other side. That is the first time in a while that I have seen a bear whilst out on my bike. It scared me a lot because it wasn't very big, meaning that mama bear might be around waiting to pounce and I was going up hill with a head wind having only spandex for protection. I live in a rural area (obviously) and bears aren't exactly a new phenomena (I'm really not afraid of them) but today seeing that bear with nobody but lil' me around made me realize how vulnerable I really am on my bike.

Pro tip of the day: Bring bear spray when riding in the BC Rockies.

Summer?

Its not even close to being summer weather here in the Canadian Rockies. It has been raining for the past 2 weeks straight and there are flood warning across the Southern BC/Alberta Rockies. It also snowed in Canmore today for the Iron Maiden XC race, fortunately, I was not racing, but from the pictures, its looked pretty nasty.

All this rain is keeping me from riding outside, which at this point is probably a good thing. My ankle pain has been increasing lately, not nerve pain, but a deep throbbing pain. It is still pretty swollen, and I feel like it should be looking  bit better by now, it has been 6 weeks since the surgery. I tried to get into see my GP...but you know how it is in Canada with the doctor shortage and all. I don't think an appointment in 3 weeks is really going to help me too much.

Also, this whole MCAT studying thing is really starting to get to me. I don't want to study anymore, but this is after all one of the most important tests of my life. Its seems stupid that there is an aptitude test for medicine, just because you know how to answer an obscure question doesn't make you a great doctor. If it did, then we wouldn't have any crappy doctors in N. America...Stupid MCAT, I just want to be a doctor!

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

Shhhh! You might jinx it!

I haven't used a crutch in 2 days and I haven't taken a pain killer in over 24 hours (I'm still taking my usual Lamotrigine) and....I am not any pain! It aches a bit, kind of like a tired muscle pain, but nothing that I would even consider taking a Tylenol for. And when I say 'no pain' I mean no pain, like my right and left foot feels the same...except my right foot has a giant bandage, is still dyed red and is significantly larger.

In a way, I am scared to believe it is true, because everything I have tried in the past has only been temporary and then its devastating when the pain returns. I'm finding it hard to trust that something may have finally worked.

On another note, I have my interview tomorrow with Dr. Z at the Uof C. I will have the house to myself to skype with him, so at least the interview will be somewhat private on my end. I am scared of what he might ask though, I have been trying to read as many of his paper as I can, but so much of them just go straight over my head. I understand it until he starts talking about the immunochemistry and Westernimmuno blots...I actually can't understand a thing in those sections. Hopefully he doesn't ask me detailed questions like that!

I made Gluten -free cookies today

Surgery, Smurgery

My surgery is done, and I am alive!

On Friday afternoon, I arrived at the hospital at 11 am and by 12:45 I was in the block room with a lovely anesthetist who did the popiteal block (a nerve block that is done behind the knee to freeze both the sural and peroneal nerves, thus numbing everything below the knee) on my leg before the surgery. She was incredibly nice, actually talked to me like a human being and reassured me that I will get into a medical school in Canada because (and these are her words) I am reasonably smart, I will probably do reasonably well on the MCATs, I can talk to people and I have a good story. Its always nice to get a reassuring pep talk from a doctor. After she did the block on my leg, she let me see the ultrasound of where tibial nerve divides into the the sural and peroneal nerves...which was pretty amazing! I love learning things when I go into the hospital, its like getting a sticker after a shot when you are a kid. This anesthetists even called me this morning to see how I was doing (unfortunately it was at 7 am and my phone was off) and left a message with her phone number to call her if I have any questions or concerns. Who does that? She is awesome! Is there a new doctor that I want to be like? Yup, I think so!

Anyway, after the block I was wheeled to the OR, where a resident anesthetists took over. I asked him which kind of intubation he was going to use, and he showed me the two different kinds and explained why he was going to use the tracheal one. It was cool, to finally be able to ask questions and have them answered like I was an intelligent adult, and not just a silly patient.

I threw up a bit after the anesthetic when I woke up in recovery, but it was all settled with some Maxeran.

After that I dressed myself (which according the the nurse was quite impressive) and was out of there by 5:30! The surgeon recommend (or agreed to my suggestion) that we start driving home right after the surgery in order to milk the nerve block for all its worth. So we made it to Kamloops and stayed overnight there. I expected to wake up at 1 am in severe pain from the block wearing off, but I didn't. In fact, when I woke up at 5:30 am I still couldn't feel my foot or move it in anyway...such an odd feeling trying to wiggle your toes but nothing happens. Seeing as it was still numb, we hit the road and I didn't start to have any pain until 2.5hrs from home! That anesthetist did a darn good block! It wore off completely sometime last night, so now I'm in pain.

The doctor gave me Oxycodone (whoohoo) but I am slightly allergic to it, so I have to take benadryll which makes me even more sleepy. Oxycodone doesn't work so well for nerve pain, but it does make it so I don't care that I'm in pain...

The surgeon said that both the proximal end of the nerve (the one that was implanted in my muscle) and the distal end (the end near my foot that is only an axon not attached to a cell body) both had sprouts growing off it. So he removed those from the proximal end, crushed the nerve and put it into a 5mm drill hole in my fibula. The distal end is another story. Not only did it have sprouts growing off of it, but it also had grown an entirely new branch...this is pretty much impossible according to what we know about neurophysiology. The distal end was not attached to anything (the proximal end is still fully intact with a cell body somewhere in my spinal cord), so the distal end would not be receiving any nutrition or regulation from the cell body, yet it still managed to grow an entirely new branch. I apparently have an unbelievable ability to regenerate nerves (which is unfortunate in my case), so lets hope I can translate that biological ability into the ability to do so in a lab!

Alright, time to go back into an oxycodone stupor. Sorry for all the spelling mistakes...its not me, its the drugs.

Here we go

On April 20th (last Friday) I finished my last exam which was Biochemistry, a class I actually like and at 10:15am on Friday I officially finished my second year of university! This fall I will be in my 3rd year...which in case you are wondering, means I am officially old and should have my life together. I don't feel old enough or mature enough or responsible enough to turn 20...I still need my mommy!

Anyway, because I had to study for exams, I didn't really start to pack anything until about 12 pm on Friday...and I had a lot to pack. Like 2 bikes, books, cloths, hats, bike stuff, bedding, and other random things that I have no idea why own, but couldn't seem to part with. Thankfully my friend Mike helped me pack or I totally would have missed my plane!! He also kept me going because I was so exhausted from exams and the fact that I woke up at 3:30 am to study...so a he deserves a shout-out for helping me get home!

Usually, my parents come to pick me up at the airport in Calgary...except they decided that my brother could use my car (which was stored at my grandparents house in Calgary for the past 8 months) to pick me up at the airport with my mass amounts of stuff and then I would drive myself home. It was odd driving myself home...I have never done that before. I mean I have driven the 3.5hr drive between Calgary and my town plenty of times, but I have never done it just after getting back from school. It was kind of nice in a way, to just drive, listen to my music and not have to talk to anybody or study.

Now onto the real news. I am leaving tomorrow at 7am to drive to Vancouver (its a 12hr drive) because I have my pre-op appointment on Thursday (April 26) afternoon, and then my surgery is on Friday at some point. I don't have the time yet.

I will try and post up an update when I get back home though!

First bike ride of 2012 in BC! I kinda look like I am grimacing, but its hard to take a picture with a Blackberry when you are riding up hill at 32km/h!

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.

Its a date! (maybe)

I'm not talking about the kind of date where you go out to eat dinner with a male counterpart, but the kind where your leg gets cut open.

April 27th is the day my surgery is scheduled for. Except in BC anesthesiologists are working towards a new government contract...and as per usual the government is not responding to said desired contract. If things are not sorted out by April 2, anesthetists are going to refuse to preform any non-elective procedures. My surgery is elective, and therefore will be cancelled.

Seriously, don't anesthetists get paid enough already? I did not 'elect' to be in chronic pain! This makes me angry. Patients before profits?