The Flood of 2013

My city is flooding.

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

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

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

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

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

I will change things, I promise

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

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

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

The AMCAS Dilemma

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

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

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

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

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

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

Reflections of Explosions

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

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

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

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

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

Pain and Sleep

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

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

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

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

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

Advantage of Being a Woman in Science

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

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

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

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

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

Para-Cycling?

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

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

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

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