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.

June!

I found this gem on the walk to pick up some groceries on the way home from work.  I am totally impressed with whomever put a bird house in a park.  It is very June.

I found this gem on the walk to pick up some groceries on the way home from work. I am totally impressed with whomever put a bird house in a park. It is very June.

It is June!

I know, it was June yesterday. But, yesterday was church day (for which I was on set-up duty), in-laws visiting day and finish my freaking molecular genetics presentation day. It was not a blog posting day.

I feel like the end of April and all of May was that brand of chaos that comes from having too much stuff to do all piled on top of one another in sequence. After my presentation today (ps, the molecular genetics of brain tumours is super cool), June feels like a reprieve. Journal club is the only bigish work project this month. Sure, we are getting my support group project ready for publication (I got two emails about it in the time it took me to write this). Sure, I am starting a new project looking at radiation for lung cancers. But, there are no giant epic mountains of manuscripts, presentations and exams to worry about. That could change if I failed physics. Let’s not talk about that.

In other things June not to talk about, there are the June bugs.  I don’t like shelled insects.  Exoskeletons give me the heebie jeebies.

I quite like June. It is my birthday month, but I’m not too huge on birthdays, so that isn’t really a big deal. It is the month where the weather becomes nice enough to go outside and do stuff. It is the end of the school year for Patrick. And it is the end of the residency year for me.

It is tough to believe that I am one day away from starting my final rotation of PGY-2 (so long as I pass everything) and thus also finish what is our ridiculously long rotating internship of sorts. And then I will be on-service. Agh. I don’t even know what I will do with myself when that happens. Crazyness.

Tonight, we celebrate with the Child and D survival of the insanity that was May and 2 days of June. We will eat (and eat and eat) and play Munchkin (which is an awesome game… Check out the Tabletop video below (and know that Tabletop is also awesome)).

Then maybe we will enjoy the fact that our house is not full of extra people for a little bit. We will enjoy that I am not continuously operating on a new deadline (realistically, that never happens in residency, so I don’t know why I dream that big). I can get back to the gym, although maybe not running quite yet (heck, maybe that darn toe will stop hurting).  Maybe…

Playoffs versus Sleep

Few things can make me stay up past my bed time.

Let me list a few:

  1. Call.
  2. Caring for a very sick relative or friend.
  3. Seeing a very special relative or friend for the first time in a while.
  4. A playoff hockey game.

It is the playoffs.  And my team… The Montreal Canadiens are still in it.  As a result, every Montreal game means that it is hockey night in the M household (during the regular season, I generally only stay up for whole games on the weekends).  That means I have to stay up late every other night for the last almost week.  It also means that I eat more junk food (not good given I can’t run).

Image from the Montreal Gazette.

Yes, I have to.  It is not an option.

Tonight, we cleaned the house.  I did an assignment for my Molecular Genetics rotation and worked a wee bit on my manuscript (almost done the submission for research day).  We are now watching the hockey game and it is around that time I would normally be hitting the hay.

I’ll be sleepy in the morning (and I have to leave extra early because my half crutch/half walk thing I have going on means it takes me about triple the time to get to the bus stop).

And yet, I don’t want this to end.  I will deal with the sleep deprivation of a good long playoff run (I would like to thank residency for training me for this kind of thing).  Preferably Stanley Cup kind of long.

I am a hockey fan.  What can I say?

 

Call Conundrums

This weekend is a call weekend. And tomorrow I am off (after 8 and once I give appropriate handover), followed by a trip half way across the country to present my research. I am excited.

My calls lately have had some odd streaks to them.

For instance, I had one that was, well, a complete surprise.

The program administrator sent me my schedule for the next block including my 5 dates for call in the next four weeks. I didn’t get a copy of the master call schedule, but so long as I knew when I was on call, that is all that really mattered. I could call locating to find out who the staff was.

But, then, I was in teaching one day when one of the staff docs came in and gave me a post-it note, said we were on call together and all his info was there and left. I though it was for when I was on with him that coming holiday Monday.

Then I read the post-it. It informed me that we had 2 beds available, the floor was quiet and that we were on together tonight.

But I wasn’t scheduled for call. So I thought.

Turns out I was according to the board in the nursing unit. And Locating. Apparently, they forgot to list one of my dates when they sent out my schedule. Fail.

So much for a date night out with Patrick.

Call is the worst when you aren’t mentally prepared for it. Even if it is home call. I was rotted.

This weekend, I was super tired Friday night and decided to go to bed early after a very quiet night. I went to bed just before 10 and fell asleep. I woke up to my pager just after 11 with a “I wanted to call before you went to bed” call. Little do they know I am like an old person and was already asleep for an hour.

Yesterday, I was in and out of the hospital much of the day. So much so, the security staff (two of them) got to know me by name.

Also yesterday, I had to go to the university library to use their computers to get access to SPSS, the statistics program I did the stats for my research on. This because I discovered the university only licenses the downloads for one year for staff. And both of my supervisors aren’t around to take the time to email computing services and get a new code for me this week.

I get in to the library, which is strangely quiet and am working away when a random guy comes in and sits at the next set of computers away and starts watching something that was making horrifying screaming-like-someone-was-being-murdered noises and other bizarre sounds. I looked around and nobody else seemed to notice. I questioned whether I was part of a weird social experiment for a bit because it kept happening and he was making no effort to turn down his sound or plug in headphones. The sounds of murder had just stopped when my pager decides to go off. And I get a dirty look from some people.

Seriously? We just heard screams of death and other weirdness for the last 10 minutes and the 2 beeps of my pager it took to turn it off is what earns a look of death.

The cat picked up my pager by its “bungee cord” and dropped it in his litter box this morning while I was getting out of the shower. It was in a clean patch, thankfully. I think he hates it as much as I do.

Unique

The Top Ten Tuesday topic this week is the top ten unique books you have read.

Sounds cool.  Too bad I spent my evening trying to finish up my presentation for the conference I am going to in a few weeks.

Yes, I am that keen.  But, the real reason I am getting it done now is because I want my research supervisors to give me useful feedback and the only way to ensure they give me said feedback is to give them a fake deadline much before it is actually needed.

So, I spent much of my evening curled up on the couch with my laptop listening to the leak drip (yes, we still have that leak, although it has slowed) and watching television while creating a powerpoint presentation all about my research.  Which then reminds me I need to start working on my manuscript, but that is a challenge for another day.

My current “unique” is that I know a lot about current research around cancer support groups, education programs and mood scales.

In other “uniques,” the only book I could think of for the list in question was The Book Thief by Markus Zusak.  Because I LOVE death as the narrator.

I start my palliative medicine rotation tomorrow.  I am excited because I really like palliative medicine.  Also, it is the first rotation I have looked forward to since the Fall.    That makes me and it kind of unique.

The cat is unique.  He has a strange love of Q-Tips.  He carries them around and chews them and finds them a particular delicacy worth digging through the garbage for if they have ear wax on them.

I am uniqued out now.

Abstracts and Olives

Today was an exciting day for me.

Image from betinamanagement.blogspot.com.

I don’t think most other people would find it quite as exciting, but I take what I can get.

For starters, I finally submitted my research abstract to present at a psychosocial oncology conference in the Spring.  Good thing because they are due tomorrow.  But also good because that means my project is mostly done… Minus manuscript and post-hoc test doing.

Another check mark off the residency have-to-do list.

I just have to wait to see if it is accepted.  I hate waiting and wondering.

I really don’t like rejection.

But, at least it is done and now I can start hammering out the manuscript (I feel like I have things backwards) and my presentation for Research Day in a few months.

I have to start working on my next project soon, though.  The fun never ends.

In other exciting news today, Patrick bought me a Greek salad for lunch yesterday while he was picking up our food contribution for D-Group last night.  The whole lunch thing was pretty exciting, but what really took the cake is that said salad contains black olives.

Image from ilida.gr

I don’t like black olives.

But, I didn’t have salad dressing and the lettuce that had touched olive tasted better.  I accidentally ate an olive in my pursuit of flavourful lettuce (I blame working on questions for teaching tomorrow while eating on this error).

It was delicious.

Image from hanniebrithen.com

I became quite confused.  I mean, I love green olives, but I hate black olives.  I hate black olives on my pizza, so I guess I thought I didn’t like any black olives.  But this was good.  Really good.

I ate another.

I ended up eating all of the olives.

I am puzzled by this discovery.

Image from fanpop.com.

I feel like I need to test this whole black olives being delicious hypothesis next time we go out to eat.

What odds?

I just heard that another person in my med school class was diagnosed with cancer.

What is with that?

I feel like we should be a part of some sort of weird study or something.   Or that there is an unspoken “hit us” sign somewhere.

And no, I am not making light of the situation.  It sucks.

I mean, what are the odds?

There aren’t that many of us.  Something like 8% of our class in 6 years have had a new diagnosis.

That being said, I also know two people that I grew up with who both died of brain tumors in the last year.

No wonder people think cancer is getting more common.  And it is, kind of.  But also, the population is getting bigger and we are living to be older.

I found a whole report on the issue from the SEER data.

There was an increase in the incidence young adult cancers in the 70s-2000s, but now, apparently rates have declined slightly back to the incidence in the 70s.

Only 2% of invasive cancers occur in the 15-30 year old age group.  2%!!  That is it.

Some days it feels like more.  Today is one of those days.

I guess that is what anyone who gets cancer or any disease thinks.  It has to happen to someone, but we tend to ask, “why me?”  But, why them?

It doesn’t seem fair.

But then again, cancer isn’t fair.

The good piece is that many young adult cancers are very treatable.  Curable even in many.

There is still room to improve on things.

That is why I do what I do.

I think.

Posing for the camera

This one time, I went to a conference.

There, my fellow resident who I will call the Wizard did a presentation on his super fascinating research.

Then, I went to the awards dinner and sat way at the back with a bunch of strangers from the other side of the country.  The Wizard did not come.

The beautiful venue of the dinner where I played a bit of pretend...

The beautiful venue of the dinner where I played a bit of pretend…

As it turns out, the Wizard won an award for the best presentation.  Because he is awesome.

I was the only other person there (other than the person presenting the award) from our institution, so I had to accept it on his behalf.

I got to parade through the masses of tables and collect it.  While my table full almost entirely of just-about-strangers cheered me on.

Then, they (as in the conference people, not my table) took pictures of me and the other winners (most of whom were also proxies… I guess all the cool, smart kids skipped dinner).  I was the Wizard stand-in.

I think it is rather bizarre how they had the stand-ins in the photos.  I mean, sure, have someone grab the stuff to give it to the person, but now, my face is in pictures?  Weird.

Posing with my pretend award for yet another camera.

Posing with my pretend award for yet another camera.

It does make for a bizarre story.

They said we need to be memorable in this job market.  I wonder if they will remember the girl who pretended to be the Wizard for the night and forwarded their complements about his wonderful research and stuff will be sufficient?

 

 

 

Thank You For Research Month

 Yesterday’s prompt with the daily post was to be thankful for something or someone.  Because the internet is full of rants.

I like it.

So, here goes some day late (or month early) thankfulness.

I am thankful for research month.  It means a time of actually getting sufficient sleep, having a chance to see my husband and cat and friends without as many time limits and opportunities to do things like go to appointments.  It is an opportunity to set my own schedule (kind of).  I get to focus on my research (kind of).  It is almost like being a student again.  Or a normal person again.

It is a lovely concept.  I am sad it is now half done.  But thankful that it means I still have half to go.

The 3 Rs… Recreation, Research and Randomness.

I feel like it is time for some updates of randomness.

Patrick decided he is going to do Run or Dye with some men from the church.  He is going to the gym with me today for the first time.  Jeter may become orphaned later this September.

On a Run or Dye note, training is, well, going.  I did previously think that I would die, but I am almost to our team’s goal of doing the 5k in under 40minutes.  Now, to do it outside.  I hate the elements.  Just saying.

I am actually starting to enjoy running.  * Mind blown! *

Patrick and I went out on a date night last week.  His birthday is later this month, but we had a family party while we were home recently and everyone got him Chapter’s gift cards, so we went on a Chapter’s/Starbucks date during which he spent all of the gift cards.  It was exciting.  We even got a couple books I will read too.photo

While on this date night, we bought the fabulous card game, “Squarrels.”  I had bought this for a Yankee Swap a few years ago with our small group and it provided us with endless hours of semi-violent entertainment.  The Child and D were over last night and we played our new game and it had a similar result (poor Jeter nearly had a stroke with all the table slapping and yelling).

Yesterday, we went to our favourite beach for one last swim.  Interestingly, the water was probably as warm as or warmer than the air.   The waves, as usual, were epic and the beach was pleasantly empty (because not many people decide it is a good idea to go swimming in September).

This is our new favourite beach (as seen in July... Not September).

This is our new favourite beach (as seen in July… Not September).

On Labour Day weekend, we went to L&C’s trailer again.  There, we had Mountain Dew as a beverage option.  Now, I have never been one to drink Mountain Dew (at least not as an adult).  We discovered that the stuff can make you crazy.  I was a giggling fool for most of the night.  We then decided that this will be our beverage of choice when we finally attempt to play “American Drinking Game” like on the show New Girl as our beer substitute because we just don’t actually drink that much.

Photo props to the Child.

Photo props to the Child.

I found out that the research assistant who helped with the first part of my project failed to send out a chunk of surveys making that chunk data kind of, well, missing.  I am unimpressed by this fact.  It means that I may not be able to look at the long-term effects because it likely has screwed up how the study was powered.  On the bright side, I still have lots of useable stuff, just not in the same way we planned.

I went to a research meeting where I discovered the above.  The supervisor from my department couldn’t make it, so it was me and the other researcher.  She called me Diane the whole meeting.  Not sure why.  But, I didn’t correct her the first couple times because I thought I misheard her, or that it was a one-off thing.  Then, when she kept doing it, it was past the point of it being okay for me to point it out.  So, I spent the hour as “Diane.”  She emailed me immediately following the meeting and called me Trish.  Guess she figured it out.  Whoops.

I have a new obsession with playing Spider Solitaire.  I blame my Research Methods course and my Mother.  The first has been really boring.  The second has a similar addiction that introduced me to the game with our first Windows XP desktop back in high school.

The coffee place at the market at the hospital on Friday did not have lids for their coffee.  So, I had a giant coffee filled to the brim that I then had to maneuver back into the building and up two flights of stairs and down a hall.  I was covered in coffee by the time I hit my desk.  The Child pointed out I should have a thermal mug for these occasions (I did… It got lost in the hospital, so now I am back down to one).  I realize in retrospect that half the problem would have been resolved had I taken the elevator.

Image from crazedpw.blogspot.com.

Fall is coming.  I love Fall.  I hate the cold.  Last night was the first night I had to crack out an extra blanket.