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!

Great ideas that aren't mine

I constantly have these ideas about how nerves grow or about how to best manipulate them to grow. My latest one involves exercise. There has to be a reason why my nerves won't stop growing, and there is one thing that I do a lot of that most people with nerve damage do not: exercise. Then last week I read an article about how getting rats with nerve damage to exercise significantly reduced their pain levels. The researchers thought that it was likely do to a reduction in inflammatory mediators as a result of exercise. And I was all like, OMG! Maybe I am on to something, maybe the reduction in inflammatory mediators not only reduces pain but improves axon out growth!!

So then this week, I decided to pub med "exercise and nerve regeneration." As it turns out, I am not the first person to think of this, and there are a lot of journal articles published surrounding this idea. Granted, I did think of this entirely on my own, which I guess is a good start, but the world of neuroscientists has already beat me to it.

I would love to be able to in someway come up a novel idea on my own, to be the first one to think of something, to be the one that figures out how to make nerves grow. If I can do that, then maybe all this pain hasn't been for nothing. I don't believe everything happens for a reason, because there is no reason a two year old needs to get cancer or that I need to have chronic pain. I do believe that you can take any situation, even awful ones, and make something good out of it.

I'll keep thinking, and maybe someday I will figure it out.

Thoughts

Everyday there are certain things that I think about on an almost clock like cycle: eating, homework/school, ways to regrow nerves, eating, biking, eating, and homework. You would think that my mind would be constantly focused and consumed by the pain I am in every minute of every day, but its not, I rarely think about the pain. Yes, I perceive agonizing pain every waking and sometimes sleeping minute of my life, but I don't actively think about it. I find that odd, that I am somehow able to block out my ability to reason why I am in pain. I figured it was because I have just come to terms with the fact that my leg will feel like its being cut open by a scalpel forever, but I don't think that is true. Lately I have been thinking about one thing more than I have been thinking about food (which might explain the weight loss),  amputation.

I know my options for treatment are running out, and I don't want to spend the rest of my life in pain knowing that there might have been a solution to end my pain, even if it means hacking off my leg. Every time I think about it, (which has been a lot seeing as it have now surpassed my thoughts about food) I weigh the positives with the negatives. They always end up cancelling each other out, leaving me at a net score of zero. Then I forget about for a few hours, and then come back to it trying to approach the idea at some sort of new angle, trying to add in pros and cons to maybe tip the scales. So far, I end up with a score of 5 for hacking and 5 for keeping, which is a tie.

Unfortunately, we don't have shootouts in decision making.

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.

Everybody, their mother and their brother's dog has a blog

Okay, so I used to be the only one out of my friends that had a blog, but now it seems every person I know is blogging! So I figured I should start again...and I guess the new is year is as good as time as any.But I have decided that while my room-mate Sarah's blog is pretty cool and my friend Maggie started an  awesome blog about her journey through the bible from Genesis to Revelations, I am going to do a semester in pictures starting from the first day of Classes on Jan. 9 to my last exam. I don't know what my blog will become after the semester ends, but I can't really think more than 4 months ahead anyway.


In some other news, I saw a plastic surgeon on Dec. 19 in Vancouver, and he said that instead of having CRPS (Chronic Regional Pain Syndrome) I have a Neuroma Syndrome instead. Which in a way was a relief for me because 1) it means that there is hope that this pain might end and 2) a Neuroma Syndrome better explains my symptoms than CRPS does. In April, after exam are finished, I will be heading down to Vancouver to get my leg sliced open once again, but this time it just might work. Apparently, if you crush the nerve that has a neuroma (intentionally causing injury) and then implanting into tissue such as bone or muscle (bone in my case as I requested it, my nerve being in my muscle doesn't really work out so great with me being a cyclist). It will be painful recovery I am sure, but short term pain long term gain right? Hopefully. This surgeon is the only one in Canada who does this surgery, so lets hope it works!

Oh and tomorrow I will be having all 4 of my wisdom teeth removed! I also won't be sedated, so it should be a fun next few days.

So keep checking this blog daily starting on Jan. 9. It is my new years resolution to try and and take a picture everyday for 4 months.