Alternative

This article “What Do Doctors Say To ‘Alternative Therapists’ When a Patient Dies?” by Ranjana Srivastava appeared on my Facebook newsfeed yesterday.  I couldn’t resist reading it.  I think you should read it too.

First of all, it is clear I am a big nerd when this is the most eye catching thing I saw on Facebook.

But, the big reason it is eye catching is because I was curious what it would say.  And it said what I thought it would.  We say nothing.  We don’t talk about it with others.  We talk about it amongst ourselves.

It also echoed a lot of feelings I would describe having around alternative therapies.

I am probably one of the more “loosey-goosey” of the people in my department when it comes to alternative therapies.  I am touchy feely, I inherently trust people and I do believe that there is value in a lot of things we can’t or haven’t necessarily studied.  I’m that kid who did a presentation on medical marijuana in research rounds and concluded that it isn’t all bad and we really need to look into the stuff more because people are using it whether or not we think they are or should.

I ask people what they take over the counter or with supplements.  I explain why I ask.  You see, some products, although “natural” act in ways that counteract the actions of chemotherapies or radiation or other drugs.  Sometimes in terribly harmful ways.  Ways that make cancers not respond to treatments.  Or ways that make side effects worse.  I ask because I care.  Not because I want to judge you or make you feel foolish.

Actually, some of the drugs that we give people are “natural.”  Some chemotherapies are plant derived.  They are natural and very toxic, but when used appropriately can treat cancers.

I see nothing wrong with trying something different when nothing is working.  I see nothing wrong with adding things that have low risks of harms that may help.  I see nothing wrong with doing things that are healthy for you.

I do see something wrong with people who are encouraged to spend their life savings on a “miracle drug.”  When people risk their lives to procure enough cannabis to make the oil they were told online was a “cure.”  When people entrust their health to internet “doctors” and people who make a profit from preying on the sick and the scared.

Many of the “miracle” agents on the internet are anecdotes.  Sure, everything starts as an anecdote.  But, that is why things are tested, because we are often wrong and they are one-off events.

There is some laboratory in anecdotal data about cannabinoids.  I’m not refuting it.  I’ve read it.  But, there is no cold hard evidence for it as a cure for cancer in humans beyond the odd case.  Could it be coming?  Maybe… But that day isn’t today.  And there is cold hard evidence for other treatments in some cancers.

It scares me that some people believe the person that will make a fortune off of them buying their concoctions is more trustworthy than the person who makes the same amount of money whether or not they take the treatment.   It upsets me that people think I am the one brainwashed because I am offering medicine with evidence behind it, with the experience of time, the monitoring of governing bodies and the backup of provincial funding.

It terrifies me to know that supplements and some complementary therapies (not all) are not regulated at all.  In fact, often they aren’t even containing what they claim or have contaminants that can be harmful.    And people die from complications from these therapies.  Just like conventional medicine.  But in a lot of cases we don’t even know some of the risks.

When something claims to work almost all of the time or have no side effects… It probably isn’t for real.  Too good to be true is something I see a lot.  But people want it to be true.  And why not?  Some people have nothing left to lose.  But really, everyone has something to lose.

It also makes me sad that some of my colleagues think all complementary or alternative therapies are bad or dangerous.  It is scary to see people doing things we don’t understand, so I get it.  And it is hard to trust when people you cared for and gave your all for die, sometimes because they gave it all up for the wrong choice.

Miracles happen.  There are things we don’t understand how they work, but they do.  There are things we know do work and they scare some people because of misinformation or lies spread through all kinds of media.

When people forgo conventional treatments or risk counteracting treatments for something advertised on the internet or sold by an alternative provider, it makes me uncomfortable.  I’ll be honest.  When people die doing this, it makes me sad.

Complimentary and alternative therapies can be many things… I send people for massages, acupuncture, reiki and I think chiropractors do good work. I encourage spirituality and  and exercise.  I preach good diets and appropriate vitamin supplementation depending on need.   I think cannabis can be an option for some people for symptom control.  I am okay with you doing something else so long as it isn’t putting you or your treatment at risk.  I can’t stop you from doing something I don’t agree with or trust because you are your own person.  But, I can be honest and tell you why it is concerning.  I can review the evidence.  I can help you interpret it because I have a background in reading that kind of stuff when many people don’t.   I’d rather know than not know in any case because your health is important to me.  And I make no gains or losses by having someone take “my treatments.”

I just want people to be healthy and safe.

Conventional medicine can’t save everyone.  Neither can alternative medicine.

It is scary, but things go wrong.  Alternative therapies (namely the various supplements and drugs and cleanses) can cause a lot of problems.  But, we don’t talk about it when things go right.  We also don’t talk about it when things go wrong.

Talking would be a good start. Regulations would be wonderful.

There will always be people out there trying to make money and preying on the sick and vulnerable. Sadly, these people give everyone a bad reputation and are the source of my distrust and skepticism.  I know there are practitioners out there who think they are doing good and maybe are not.  That is where better regulations and research could make a change.  And I know there are practitioners out there doing amazing work with the best interest of the patient at heart.

An open mind is good.  Educated professionals are better.  But, I think that opening up the lines of communication between professionals but also with patients could make a movement towards making a difference.  At least in some cases.

My new favourite vaccine mock PSA

Anyone who has followed this blog has had to put up with my intermittent vaccine rants.

Here we go again.

Jimmy Kimmel had a little rant on his show this week about vaccines complete with “real doctors” saying why vaccines are important.  I don’t often like Jimmy Kimmel’s humour.  He is sometimes a bit too much for me.  But, this was perfection.

Perfection.

Check it out.  Show your friends.

A Haunting Encounter

Today, I had a class on incorporating the humanities in medical education.  We were asked to write a short piece of prose or poetry on a patient encounter that haunts us.  Hearing what others wrote was way to much for my hormonal psyche.  I didn’t share mine because I was too busy trying not to let anyone see me cry about the ones that were shared.

I am not a poet, but it kind of has a poetic feel, I think… Here it is…

You did your best.  You knew something was wrong.  You were low risk, they said.  But, now, you are sit in clinic and don’t know how bad it really is.

You are angry and scared.  You cry when I review what is happening within your body.  I am gentle, but I am up front.  Medicine is so advanced, but so limited.  

Together, we bring you down off that ledge.  We have a plan.  You know what is likely to happen.  Then, I point out you need to meet my staff.  To keep in mind that a chance for second opinion isn’t gone.  

Gruff and curt, he approaches.  The plan changes and you are confused.  There is no explanation.  Just a closed door.

I try to help you understand.  I feel a sense of loss.  Like I am free falling in a place outside of my control.  It can’t compare to what you feel.

You don’t want another opinion.  You trust him.  Because you trust me.

In that moment, I don’t trust me.

I go home and review the literature.  I think and think.  I talk to another staff person.  I am right.  There may be more.  But, how does that get approached?  Who is willing to speak up?  

Everybody talks, but nobody deals.  That seems to be the way sometimes.  The questions are brought up, but I wonder if they were truly dealt with.  They get swept under rugs that some of us can’t help but look under.

This time, someone did say something.  This time, something did change.  Somehow, the suggestions were accepted.

I was relieved.  I want the best for you.  I want the best for all of you.  But still, the whole thing is unsettling.

In the long run, will it be enough?  Will you continue to get the care you deserve? 

If I hadn’t been there, if you didn’t trust me, would it be different?  Would you have made a different choice?

Maybe it is enough.  But, I wonder if we could do better.  I wonder if it is my fault.  That my being nice, that we “clicked” made you not question, not request that second opinion.

I won’t know.  I can’t help but wonder it is my fault.  And I’m not even sure what “it” is.

Teacher, teacher

I’m doing an education elective this month.

I have almost always wanted to be a teacher (and an author).  Well, after I got over the wanting to be a vet (my parents quashed that dream when I was about 4 when they informed me that if I was a vet, I would have to take a bath every day) and work at KFC (I was a chubby kid who really liked the way it smelled, despite the fact that I was informed I would no longer like KFC if I smelled it every day… I didn’t even have to smell it everyday to develop a dislike for KFC as an adult).  Honestly, medicine came much, much later in life.

I realized as a teenager that I hate kids in mass, so perhaps teaching elementary or middle school was out of the question.  I also realized science was very fun.

Once I hit medicine, though, I came to this crazy realization that maybe, just maybe I could “have it all.”  Who knew doctors teach?

Probably most people.

But, the fact that it could be my reality blew my mind a little.

So, I have always thought teaching was important.  I tutored in med school, mentored new students, all that stuff.  And now, I am doing an education elective and launching some new education related stuff in my department.  It has confirmed that I want to teach more.  I think I might even start working on my masters in the next year or two (depending on how this whole juggling residency and baby thing goes).

The funny thing is about the elective is that, for the first time in a long while, it is like being a student again.  Sure, there is no call and my hours are a bit more set, but I have assigned readings and projects and assignments.  Plus, the studying/prep for my usual program academics.  I forgot a bit what it was like to be a “real” student.  I have a love-hate relationship with being like a “real” student.

My focus is suboptimal.  Lectures from 8-12 and 1-4:30  That is a lot now.  Friday afternoon half-day is like torture and that is just 1-5 one day a week.  Plus, the degree of interaction is much more than I’m used to.  Group work?  Heck, usually my whole program is the size of a group they have me working with.  Non-clinical assigned readings are novelties.  Doing assignments and writing papers are things I do much more rarely now, but they are becoming regular occurrences.  Presentations and teaching practice prep is similar, but different.  And then there is switching focus completely to study for my usual departmental half-day stuff and exams.

That being said, it is neat to learn more about being a better teacher.  And knowing that it is something I can do.  And will do.

Seeing the enthusiasm of the Med 1s in tutorial and how everything is challenging and exciting is super cool.  Learning about what always seemed to be the top secret world of designing OSCE stations and training standardized patients makes me realize how much goes in to our learning.  Finding ways to make things better for newer trainees is encouraging.  Even figuring out how and why I learn the way I do and how to make that work for me is useful.

Most of my friends are teachers.  Heck, I’m married to a teacher.  And I am realizing that in more ways than I originally thought, I am a teacher too.

I know, I’m a huge geek.  But, I’m okay with that.  Just humour me.

Seeing redemption in my world

In my small group (or D-group as they are affectionately known here), we take turns telling a “Redemption Story”.

Sounds cheesy?

I thought so.

But, this is my third year here and I actually really like that part. Because it isn’t just a hokey “I was bad and then I got to know Jesus and now I am good” sort of thing that you hear on TV. It is more like saying because I am in Christ, I am being convicted of my sin. Things are happening and changing and they are really subtle or really big and I want to share about it, so the others in the group know and can pray for me and be encouraged by what is happening.

The thing is, nobody is perfect. And no human on this Earth is without sin. It breaks my heart to see how high and mighty we all get with ourselves from time to time. It is easy to get caught up in comparing yourself up higher than others or down lower than others.  It also kills me to see the hurt that comes from it.  That isn’t real love or grace.

Sometimes, it is nice to step back and identify areas that you are struggling in or that you have struggled in and see what is happening. It is okay to be a work in progress. It is okay to feel like you aren’t making progress, because at least you know there is a problem and can seek help. Because it isn’t about the past. It is about the present. What is happening right now.

I think that makes it more relevant. I think it, for me, makes redemption more real, more tangible.  It frames it in a way my concrete mind likes to see it.

There has been this Classic Crime song stuck in my head called “Glass Houses.” For me, it illustrates that struggle to identify those areas that we ignore or don’t even realize are there and how judgemental and hurtful we can be of others. It also points out how things fall apart when we start “playing God” with ourselves and others. How hypocritical we can be.

I’ll admit that I am broken. That I have all kinds of faults and flaws and that sin is in all kinds of little places in my life. I’m thankful that God is working that out in me day by day. And that he stuck me in a community that pushes that along without throwing stones.

24 Weeks!

Today is the magical 24 weeks.

Hello, “viability”!

What do I mean? I mean the point in gestation where most North American hospitals consider infants born to have enough potential to live that they will try to resuscitate them. It ranges from 22-26 weeks, but 23 or 24 is the point I was taught.  Plus, at 24 weeks, at least half of the little ones born survive with the help of modern medicine.

As a crazy medical person, this is significant. Because I like my kid and want to keep it around. And because I know how the medical system works and fear the choices I would have to make or have made for me before this point. And yes, there would still be tough choices now and even at 40 weeks. Things go wrong. I know too many bad things. But, I also know the probability of good things increases on a weekly basis from here on out.

So, hooray for babies the size of an ear of corn. Who kick and roll around and grow at a good pace. Who give their mothers lumberjack sized appetites.

I hope this little one keeps cooking.  Because we are literally nowhere near ready for a baby to actually be in the house.  And I still have rotations to finish (and have a (what some people consider) lofty goal of working to 40 weeks).  And like many others, I fear childbirth and want to put it off as long as reasonable.

On a related aside, I’m obviously not a photographic/blog pregnancy documentarian. Those sorts of posts were a strange mix of fascinating and heartbreaking to me before, so I am choosing to skip them.

But, this was a milestone I looked forward to most after the disappearance of the mind numbing morning sickness and the 20-ish week ultrasound. So, I thought I’d share my joy.

Just another day (and a “normal” one, at that)

It is Valentine’s Day.

Surprise world!

Image from nerdier.com.br

I know, you were oblivious.  I mean, if the ads and heart shaped crap everywhere didn’t give it away, it if your *apparently* love sick friends who post how awesome their spouse/partner/child is and how much they love him/her.

Last year, we had a friend text us saying thanks for not being so in your face and annoying about our relationships.  That she knew we loved each other and that she appreciated our not flaunting it all over the place.

We laughed, but I appreciated it because sometimes, I think people think I am a terrible person because I am so not sappy.

But really, you can show you care about someone without being all dramatic and in-your-face.  There is no reason to  try make everyone jealous or show off your great relationship.  To me (and this is my opinion), sometimes, the best proof of a good relationship is when people get along and function on a day to day basis.  Not just because of a made-up holiday.  In fact, Patrick saw an article earlier this year that said that couples that “flaunt” relationships are often statistically less happy than those who don’t (no, I can’t site the source… I am far too lazy for that).

Image from someecards.

Also, I need to point out that I hate public displays of affection and the creation of a “holiday” to share love.   Even though love is great and should be shared.  I just think it shouldn’t be so commercialized and sexualized.

So, this day drives me as crazy now as it did when I was single.

But, today was a good day.  I had band and went to the gym and cleaned.  We got to spend time with the lovely Child and D and play “Ticket to Ride,” which is an awesome game, in case you were wondering (check out the Tabletop video below).  Seriously.  It was easy to learn and efficient to play.  Also, it was one of the least disruptive games we have played (we tend to get kind of loud and aggressive), but not in a bad way.

Now, it is hockey night in the M house (if I can stay awake for the whole game).  And I get to drink from my new mason jar mug and enjoy flowers (because my romantic husband intentionally ignores my dislike for the holiday).  I also am having a skip the homework day today with the exception of submitting my abstract for a conference next fall that I probably won’t go to because flying across the country with an almost 3 month old seems like a not so good idea.

Today was like a normal people day.  I like those days.  I don’t need dates or fancy things or mush to be happy.  I just like being able to do things I enjoy and having a clean house, good food and friends.  I’m grateful.

Water Pressure

The M household made an exciting household renovation this week.

We got a new shower head.

I know, we aren’t exciting at all.

Since we’ve moved in here (almost 3 years ago), I have noticed that there has been a small leak where our shower head connects to the pipe.  I also thought our water pressure sucked.

Thursday, when Patrick got home cold and wet from picking up our car from Canadian Tire in the rain/snow craziness that cancelled school for him (he only worked 2 days this week, lucky bugger), he decided to shower to get warm.  He tried to move the head and the hole got epically bigger.  Like non-usable bigger.

So, Patrick did what any good man would do, he Googled how to fix it and when he realized we didn’t have the appropriate plumbing tape, he tried electrical tape (it was stormy out).  Jeter helped.  They both got wet.

Thus, when Patrick picked me up from work that night, he informed me that we needed to make another trip to Canadian Tire.  I was concerned for the car.  But, no, it was because he wanted to replace the shower head (I’m pretty sure our building people would do it, but that would mean waiting a good day or two).

So, in the beginnings of storm of the week number 3 or 4 (depending on when you start counting), we trekked to Canadian Tire (which we have started calling CT for short because it came up in a few texting conversations this week). We selected a shower head (you would not believe the selection).

We came home and installed it.  Jeter supervised.  I got a bit wet, but only because I’m the fool who wanted to check out every setting while standing on the edge of the bathtub while Patrick kept worrying that I was going to fall.

The next morning, I had the best shower at home I’ve had since we’ve moved in.  Seriously.  I didn’t even fully realize what we were missing.  (Poor Jeter is down a leak to sneak water from, though).  It made the morning so much better (despite the heaps of snow and ice outside).

Then, today, I get a text from Patrick while I’m at the gym informing me of how awesome our shower is.  I know.  So freaking awesome.

So, that is our big excitement.  We have water pressure we didn’t even know we had!

Big News (especially for my teenage bookworm self)

Yesterday, I went on Facebook and my newsfeed was blown up by news that I actually cared about that doesn’t involve the vaccination debate or the inordinate amounts of snow my hometown is getting.

Harper Lee is publishing a new book!

If you haven’t heard, then check out this article from the New York Times.

Okay, a new-to-the-world book.  She actually wrote it many, many years ago.

I promptly “reposted” an article on my friend V’s wall.  Because she is someone who shares with me an unhealthy obsession with the wonderful novel that we coined “To Kill a Bird” in grade 10 IB English.  We did presentations that were way overdone with excessive bristol boards and background research.  We finished the book before we were supposed to and re-read it and loved the movie.

I’m excited.  I know other people are too.

And I don’t usually even like sequels that much (although I do have to read them for closure).

As a big nerd, I must admit, this is a book that I am looking forward to more than many other books that I have excessively looked forward to.

Top Ten “Classic” Novels I Can’t Believe I Haven’t Read

This week’s Top Ten Tuesday list with the Broke and the Bookish is “the top ten books from genre x I can’t believe I haven’t read.” I feel like I can make a list in many genres, but I am going to go with the “classic” book genre.5f1e1-toptentuesday

I like to think I am well-read. That I have read all kinds of stuff because I want to and like to, but really, there are just so many more important works that I still haven’t read and many, many people have.

  1. Catch-22 by Joseph Heller. We actually got this as a Christmas gift from a friend. Patrick has now read it, but I still have not.
  2. 1984 by George Orwell. I see this intermittently on sale shelves at Chapters or hear it referenced in TV shows and movies. Still haven’t read it.
  3. Animal Farm by George Orwell. Another Orwell book. Clearly, I am avoiding him. I feel like a lot of people read this book in high school. I skipped that step.
  4. The Catcher in the Rye by JD Salinger. This is another book that gets referenced all the time by different people because seemingly everyone read it in school except for me.
  5. Lord of the Flies by William Golding. Another high school miss.
  6. Sophie’s Choice by William Styron. I almost bought this with part of our Christmas Chapter’s gift card haul. But I opted not to because I know it will be easily found in the library because it is another popular and well-referenced work of literature.
  7. Dr Zhivago by Boris Pasternak. It sounds interesting and sad and right up my alley. Yet I have not read it.
  8. The Scarlet Letter by Nathaniel Hawthorne. Sometimes I wonder what I really did read in high school/university given the theoretically great books I have missed out on. I still sadly don’t really know much about this book other than what movies/TV refer to.
  9. Moby Dick by Herman Melville. This is one of the few books I picked up and then put down after a few chapters.   It is shocking I actually gave up on a book.  I want to try again.
  10. The Picture of Dorian Gray by Oscar Wilde. I got this as a free ebook on my e-reader. I need to actually read it.

What “classics” do you have yet to read?