Wednesday, April 25, 2012

Second week of placement...everything becomes routine

Well I'm officially in the 2nd week of placement, and have realized how routine everything becomes...sigh. Everyone is nice and I am learning quite a bit, but to be honest I'm a little bored. Considering this is the placement I was most looking forward to, it is a little dissapointing. I've realized a long time ago that nothing is quite like what I imagine it to be, but it is still surprising.

From our crazy school classes, I imagined that half of the approach is trying to determine some rare diagnosis that the docs missed and then coming up with crazy treatments to treat the condition. Well, most of the time the diagnosis is already made, or is fairly obvious even to me which is saying something. The treatments are nothing like we learned in class, and most often consist of ultrasound, massage, gait correction, orthotics, ROM, and some basic mobilizations, in addition to giving basic exercises, acupuncture, and hot packs.

Now I can't say I'm any good at any of the above yet, because most of the things we're not really taught in class. I mean I have no idea how to give a massage, and am basically learning as I got. I'm still figuring out the parameters for the ultrasound, because they use it differently from what we were taught. I have a very basic idea of what to look for in shoes (avoid high heels, and apparently a rubber sole is better), let's see I'm guessing on gait analysis and correction, I'm still figuring out how to instruct on proper ROM, and the mobilizations are totally different from what we're taught and we basically have to take additional courses to learn properly. Plus acupuncture is not taught at all, more post-grad courses.

What is even more frustrating, is that a lot of the above treatments don't work, or take months to get even some basic relief. So the basic approach is to squeeze in as many treatments into a 30min session as possible, and of course not to go over the 30min session since there is another patient booked. What I've learned so far, is the most important part is actually not what you know, it is your customer service and socialization skills. The treatments have to provided in addition to very stimulating conversation. For the person to come back the person has to trust you, and for them to trust you they have to like you...now don't get me wrong, I actually don't mind making conversation with people, and I'm actually getting better at it, but to do a massage or ultrasound or to try to mobilize at the same time as trying to think what conversational topic would be interesting can be a little nerve wrecking experience.

Now I don't mind this fairly relaxed atmosphere, where everything is fairly predictably, where people are actually happy to see you, and where its not very physical work and won't injure me...but just a lot of other jobs it does get a little boring, especially after seeing the 5th non-improving person with back pain, shoulder pain, ankle pain. I mean I should be grateful...nobody is pissed off, or complaining about how they don't want to get up to go for a walk today, no gazillion notes to write, no running from one end of the unit to the other, no dangerous MRSA, VRE, TB, pneumonia, no 2.5 hour commute...and yet I'm bored...on the other hand at least I'm not trying to drink a bottle of wine after every day because of all the stress. I should know by now know that nothing turns out the way you want to, and at least I can actually physically do this job, because realistically I wouldn't last a month in either a hospital setting, rehab setting, or neuro setting, so that sort of limits my options...but that doesn't stop me from questioning my choices, and having to hide my previous goals of med doesn't really make it easier.

I keep thinking this is supposed to give me some kind of satisfaction in life, and in a way it does, but it definitely get's repetitive after a while. Oh well, back to my assignments, and continuing to question my direction in life, I mean what else is new, I've been at this for the past 6years!

Monday, April 16, 2012

First day of placement bittersweet

So I finished my first day of placement, and its been really good, considering everything its the opposite to all my previous experiences. I mean everyone is actually nice! what a concept! They don't mind answering my questions, and they want to teach, I couldn't believe it. The patients actually want to get better, I mean wow. I feel really lucky, and hopefully I won't dissapoint, and will learn quite a bit.

Why bittersweet? Well my good friend has turned out to have a really bad placement, and I feel partly responsible since I helped her choose the places. I know how much it sucks to have a bad placement, because I've had my share of them, and a long commute makes it that much worse, so I really hope it works out for her. Sometimes I really wish we could set up our own placements because that would make things 10X better, because then at least we'd be able to work with people we want to and actually get along with, not just a random luck with compatibility.

In other news, I still don't have the motivation to study for the national exam....oh well, by the weekend maybe I'll start to feel the pressure.

Saturday, April 14, 2012

Back to previous feelings of insecurity

So as a quick update, I did go today and volunteered for a run, and was outside for 2 hours, and yes don't laugh, that's a big accomplishment for me. I feel okay so far, although my throat clearing is a little worse, but nothing too bad, and of course I needed a 2 hour mid-day nap to recover sigh. Hopefully, this will give me the motivation to continue to go out and actually do the stuff that I encourage other people to do. I mean it is one thing to say, 'It is very important for your health, wellness and recovery to get about 30min of exercise every day', and it is sort of hypocritical when I don't do it myself, and fear going out for a 20min walk, or am terrified of starting my weight training scedule. I mean I'm supposed to do what I preach...but instead of actually getting off my butt and doing something, I sit in front of the computer for hours reading forums and news, and then I go downstairs and watch tv, and I hide behind the fact that well I'm not better yet...but really it will a long time to get better, and if I'm not studying anyway, I should try to do something active.

In other news, I've been really really lazy about studying for my national exam for the past while, and have had no motivation whatsoever. Again I use the excuse that I'm still sick, but really, how long can I use that excuse. The problem is though that I was doing really well, and feeling better and more optimistic and even going out, and then I get sick, and its sort of like I took 3 steps back, and am feeling tired, pessimistic about the future, and have the renewed nagging feeling that I won't be able to do this job because I'm too weak, and that I'll be constantly sick or on eggshells fearing getting sick, that I'm not athletic enough, don't have the communication skills...etc. I need to somehow break out of this cycle and soon, because hey I'm starting my internship in 1 day, and the boards are in 1 month, so I have to try to force myself to study.

I don't know if its the fatigue, still being semi-sick, but I even after these last 2 years I still don't quite see a future. I mean a lot of people I know would kill to be in my shoes, but the truth is I have to keep fighting and I'm getting tired of fighting. I look on job boards, and yes there are jobs, but the fact is there are possibly 70 jobs across ontario and a lot of them are part-time, and realistically that's not enough for the 250 new PT's that will graduate this year. I mean, yes, I'm jumping the gun, I need to actually finish first, and yes across 5-6months, most people will most likely end up with something, but it still I think mostly depends on luck and personality, and I don't know if I'll be that lucky, considering how bad I did on my previous placements, and the fact that I'm naturally not as outgoing as a lot of other people, and don't have the athletic and coaching background and don't have a good memory. Now worse comes to worse, I do have the option of buying a practice and just trying to learn on the job, but fear that I would make a lot of mistakes, and wouldn't do a good job at all without at least a bit of mentoring...

Oh well..off to bed, and hope that tomorrow is a better day.

Friday, April 13, 2012

Why I have poor social skills..and moderation in life

So as an update, I am feeling better, although still having 3 hour naps in the afternoon, after a good 8hour night sleep...so still a little frustrated, but hey it is a process..albeit very very slow.

So this flu/cold, made me think, why do I have poor social skill? Why do I have such a hard time networking and having fun, and letting loose, and often have to really think what is/isn't appropriate in different situations and when in doubt I just remain silent?

Well I realized that socializing takes practice, nobody's really born with it, its through observation and trial and error, usually in school that people learn what to do/say, and how to let go and be fun, although it does come more naturally to some than others, and I'm definitely jealous of those people. But anyway, thinking back, I didn't really socialize with others, didn't attend that many parties, only went to club 2 years ago after which I got an ear infection (long story). In elementary school when I got sick, I would be out for a long time. In high school, it got a little better, but then of course when I did get sick, I would go to fairly extreme measures to get better faster and not miss any class, and would thereby not be completely well for months. To this day, I dread september, because I know that with the end of sunshine, the germs come out.

By the time the winter hits I'm afraid of even talking to people...and it all goes back to the last 3 weeks...that if I do get sick, it takes me a loooong time to get better, and this has conditioned me to avoid any situations and people that can cause me to become sick. It is a little crazy considering that this is the first bad time in about 5 years, but for my brain, the fear is still there, if I go to this party and talk to many people and get drunk, I will get sick for a month. Now its semi-true since the last time I went to a wedding, I got food/alcohol poisoning after 1 drink and 1 piece of salami and was indeed sick for a week.

At first I thought, ok it must be a poor immune system, that must explain it, so its not really my fault....and I can keep avoiding everything because I don't have immunity...well that's not really true, as I can go on the transit system and interact with a whole class (some of whom are sick) and get 4hours of sleep for weeks and still not get sick. Of course when I finally stop being stressed, start showering, shopping, and 'gasp' exercising, and start going to friends, I get sick. I think I'm going to change my thinking and think its more luck than immunity. Sometimes I'm just not lucky, no matter if I get the flu shot, try to avoid all sugar and processed food, and get enough sleep, sometimes I'll just get unlucky and get the bug going around...and yes be out for 3 weeks...but should I keep being a hermit and avoid all social contact, just to possibly slightly reduce my chances of catching that cold?

I've realized the key is to try to get a balance of some sort, since for me it seems it's either all or nothing. I either completely overdo it, like the week before I got sick by trying to do everything (shopping, studying, eating cake, exercising, running!!!), or I avoid going out and just stay home (study). This past 3 weeks have reminded me that I do have to be careful and can't do everything, I really do have to pick and choose, because even if immune system is okay, my lungs are not happy when I do get a cold, and it turns into bad bronchitis within 3 days, and then they need a loong time to get back to their normal state. But that doesn't mean that I should go back to doing absolutely nothing, I just have to be smart about it, and that means not doing 10things in one day even if I really really want to. If I want to go shopping, that's okay, but that's it, not to add exercising to that day. That also means I could go out and go socializing, but that day has to be light in everything else. That also means exercising (weights) only 2-3 times a week, because starting off at 4-5X is just setting myself up for failure.

I'm still unsure if running is a good exercise strategy for me, I mean yes its a great activity, good for endurance, but..last time I tried it, I literally felt like I was going to pass out from a lack of air after only 3 min, and was coughing and wheezing for an hour afterwards. And the fact that I don't use a rescue med, just makes the problem worse, because my lungs constrict and there's nothing I can really do besides meds to fix it, and meds cause my palpitation to get worse. So without the rescue meds, I think I'll leave out running, and try some other endurance activity like biking or tennis that isn't as bad for my lungs. But it is frustrating because I know I used to be able to run just fine it doesn't make logical sense to me why after only 3 min, I feel like I'm drowning, yet can bike for hours with no problems, or can even play tennis for 1 hour with little issue.

The moderation thing I think is the most important, I mean we learn all the time that with many chronic diseases its really important to pace yourself and if you do end up doing too much that's just going to make you bedbound the next day and is counter-productive. So I think I should take my own advice, and try not to overdo it. No more shopping + exercising, and avoid exercising + going out. I have to learn its okay to say no, even though its sometimes the hardest thing to do because when I'm feeling well, I want to do everything, because I don't know how much longer I'll actually keep feeling well.

Also I have to stop comparing myself to other people that can study, exercise, go out and work at the same time. I can't period, and I'm not the only one, and that's okay, because as much as I say and convince myself I don't have asthma, the wheezing and instant bronchitis sort of confirm it, and that means that I have to take care of myself more than other people. Also I have to get over the poor social skills, I mean yeah its not perfect, but considering how much school I missed in grade school, and how terrified I was about going anywhere, its a miracle they're not worse! I have to move forward, not constantly be looking back and that means accepting some of my challenges and learning to live with them and overcoming them.

So with that, tomorrow I'm actually going outside for a few hours, and hopefully my lungs will cooperate.

Over and out.

Saturday, April 7, 2012

Organ Donation and staying positive in the face of illness

I blogged about organ donation a year ago, about a young mother with cystic fibrosis, who received a lung transplant in the nick of time. Well today, 2 years later, that same young mother is enjoying life with her healthy lungs and 2.5 year old daughter.

Today, another young lady was lucky enough to receive a double lung transplant, after being diagnosed with pulmonary fibrosis, which is a condition that causes permanent scarring of the lungs. Hélène Campbell is truly an inspirational person, since unlike what a lot of people (including myself) which is feel depressed when they are ill and ask 'why me' she made a goal of raising awareness, and got the attention of Justin Bieber, Ellen Degeneres, and was able to show how life-changing it could be if more people became organ donors.

Every day we read more and more about the negativity in the world, and it is rare to learn about a person that is so positive and wants nothing more than to help others that it made me (a very pessimistic person usually) believe there is hope, kindness still present in the world. We often focus on our busy lives, commutes, problems present, but don't really think about what would happen if we did indeed had a significantly shortened lifespan.

It made me realize that I really should be thankful for what I have, and to try to look on the positive side more often. I also need to stop asking 'why me' with my bronchitis and asthma, and start enjoying life more, going outside, meeting new people, because hey you never know when it will end.

Here are the links to a few of her inspirational sites:

http://www.alungstory.ca/a-lung-story-blog

https://www.facebook.com/pages/A-Lung-Story/163425797101073

http://www.youtube.com/watch?v=YO7703V3XPY

http://www.thestar.com/news/article/1158099--why-we-re-all-cheering-for-helene-campbell-s-new-lungs?bn=1

Friday, April 6, 2012

Fatigue during/after a cold

The hardest thing to overcome after being sick for me is the long-lasting fatigue. I always think, what's fatigue? Why can't people just shake off that feeling and go to work right? I mean there's no conclusive explanation for it, and people can overcome anything right?

Yeah, I realize now, that its not always about 'overcoming' something, the fact is, if you have no energy to actually get up out of bed, where you're so sleepy all you can really think about it going back to bed, when getting up is possible but walking feels like your muscles are protesting every move and your knees are semi-collapsing, and after even some small chores you feel so exhausted you need to have a 2 hour nap.

Yeah I'm at the border of almost feeling well, but the coughing, mucus, sniffles, and the fatigue is keeping me from crossing over that line. Yesterday I probably overdid it by studying for 8 hours and walking outside for a whole 10min, and today I felt awful. Woke up at 9am, helped vaccum for 10min, and then went back to sleep from 11-12...yeah...definitely frustrating. I shouldn't be too surprised since it hasn't been quite 2 weeks yet, and it was a bad flu with a fever and spending a week in bed is definitely not helpful for my fatigue and energy level, but I only have a week to go before I have to start my placement, and basically be on my feet treating people for 8hours a day. In addition, I really need to seriously start studying, since I'm already behind the schedule I set for myself...

I think this is why I'm usually very careful, and try my best to avoid being sick, and one of the reasons why I avoided and continue to avoid going out to parties, and to clubs, and even to restaurants, because if I do get sick, I'm out for at least 2 weeks, and that's if I'm lucky. I can't even take any meds such as tylenol, or buckley's to deal with my symptoms because they give me palpitations and then I have problems falling asleep, and end up not getting enough, so it is counter-productive.

Hopefully the weekend improves at least a little...

Others Happy Passover and Happy Easter to everyone!

Monday, April 2, 2012

Progress in getting better...

So I'm finally out of bed! Believe it or not, that is a big accomplishment for me, considering I've been living in my bed for a whole week, its actually feels really nice to be able to sit in my chair at my desk, and type on a solid surface. I feel a new empathy for hospital patients who are so frustrated being in bed.

Slowly but surely and of course with the help of antibiotics I feel myself getting stronger and I was able to go downstairs today a couple of times without gasping for air and without the somewhat scary wheezing sound that my lungs make when they're very unhappy. Now I'm not completely better yet though, still have a very runny nose, still have the occasional cough, and still very fatigued, but I know that will take time to resolve, and with lots of rest in the next 2 weeks, I'll hopefully be well enough to start my placement with more energy and not feeling so depleted.

My main issue now that remains, is how to organize myself to study for the national exam and try to review some relevent information for my upcoming placement, and while some information does overlap, unfortunately a lot is not different.

P.S. Can you believe that my posts are actually starting to be more optimistic, even though I'm sick? Must be something in the water...

Well time to get back to the books!