MCAT Prep + Racing

I raced 2/3 stages of the Rundle Mountain Stage Race this past weekend in Canmore, Alberta. We started off the morning at with a time trial at the Nordic Centre. The race was on their roller ski paths which was amazing because you didn't have to worry about traffic or anything. Unforunately, on Friday I took my bike into get my gears tuned up a bit as they were shifting a bit un-smoothly, put it in the car and didn't ride until Saturday morning before the TT. I don't know what they did to it, but I only had a choice of 3 cogs, middle, top and bottom. Safe to say my TT didn't go well, but when I was able to max out my gearing and put the hammer down, my legs felt strong. It was nice to feel strong again and feel like the power I put into my legs actually gets to the pedals.

In the afternoon was the Crit downtown. It poured for the women's race. I got dropped about half way through, but stuck it out in the pouring rain. There were a lot of crashes, both in my race and all of the other categories. At least 2 bad crashes per race, some had more than 5 guys crashing out. Even though I didn't place very well, my body still felt pretty good and I felt pretty strong. A lot of people after the race told me I was amazing because I pretty much rode half the race by myself in the pouring rain, and I didn't just ride, I rode hard.

Sunday night I went to the Mother Mother concert at the Coca-cola stage at the Calgary Stampede (100 years!) with a friend from high school. It was one crazy mosh pit...and if you know Mother Mother, you know that they are considered an 'alternative band' not a screamo mosh pit crowd surfing kind of band. Anyway, bye the time the concert was over, at least 3 people fell on my from above, I was covered in mud (it poured and the standing area is/was grass) and I had to throw out my shoes. It was fun, but also very, very painful. I can't count the times somebody stepped on my foot wearing cowboy boots, those things should be band from mosh pit like situations...

MCAT? What MCAT? Oh, right, the one I should be studying for instead of doing all of the above activities (including writing this blog). I am so screwed... starting to feel sick to my stomach about it actually.

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

Ummm, so awesome??

I just finished my skype interview/meeting with Dr.Z, and it went really, really well! If I get into U of Calgary I will be working his lab and shadowing him during clinical rounds. He also said that there is a very good chance that I will be able to get my name on a major paper that will be published in a highly regarded journal and even a possibility that I could publish on my own (although that is pretty rare).

This all so amazing that I am know deathly afraid that I will not be admitted to U of C. I think I will be absolutely crushed if I don't get in. I almost want to e-mail them and tell them that one of their lead researches is going to be taking under his wing and that they would be stupid to not let me in!

This is both awesome and frightening at the same time.

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.