To treat… or not.

My dad was diagnosed with prostate cancer on his 82nd birthday. I expected it when his PSA test started increasing. He had a biopsy.  I couldn’t attend the appointment for the results but asked my mom to make sure she found out his Gleason score. When she called me on his birthday, I heard it in her voice before she said the words.
Cancer.
It’s considered an intermediate- risk tumor.  There is no metastasis. But given his advanced age and other co-morbidities, namely the Alzheimer’s, surgery is not recommended.
At his age, hormone therapy and radiation is recommended. Without treatment, he has perhaps 10 years.  But that means the tumor will get larger, he’ll have more lower urinary tract symptoms of obstruction and likely bone pain from metastasis.   Radiation is not easy.  It involves daily trips to the hospital for weeks;  20-39 radiation visits. That’s 20-39 days that my mother has to drive him to and from hospital and pay exhorbitant fees in parking. My mom went through  radiation treatment for her own breast cancer 15 years ago. She still remembers how hard that was on her. How difficult now will this be on my dad? He asks her several times a day what the next doctor’s appointment is for. Because he forgets. How difficult will this be for my mom to take him to the hospital day in and day out,  in his already semi-frail and de-conditioned state?  Is it cruel to put him through treatment? Is it cruel not to?
After meeting with his radiation oncologist and learning about a new treatment protocol involving only 5 weekly visits for radiation therapy, it looks like we will be embarking on treatment for my dad.  He seems to understand the side effects of treatment and that it means weekly visits to the hospital.  Of course, he’ll ask many times why he’s going but that is okay for now.  Five weekly visits is going to be much easier for my mom.  If and when it gets to be too much, we’ll make a decision to stop.  But for now, he/we are going to fight this.

Let’s Talk

January 25 is Bell Let’s Talk Day.

One day a year the world comes together to help end the stigma of mental illness.

One day a year, a large corporation donates $0.05 for every tweet and hashtag that says “#BellLetsTalk” towards funding mental illness.

Meanwhile the province I live in is underfunding mental health across the board.  I can’t get a delusional/psychotic patient timely access to a psychiatrist without sending him to the ER or placing him on a Form 1 (ie involuntary 3 day hold).  I can’t get the chronically depressed and suicidal middle-aged woman a psychiatrist to follow her and manage her 3 psychotropic medications.

So yeah, let’s talk about mental illness.

Why don’t psychiatrists actually do what they are trained to do?  Why don’t they follow patients and see those that need weekly psychotherapy? Why doesn’t the Government adequately fund mental health?

How about we talk about mental illness every day of the year and not just one day?

Let’s talk.

Long Run – Week 3

I am a day late in reporting in, but Monday got away from me.

I found a funny mole on my husband’s back over the weekend so that meant I had to get him in to see the Dermatologist on Monday morning to have it removed.  Thankfully, the dermatologist didn’t think it was bad but took it off anyway.

But back to Sunday.  I finally got out for my long run in the mid-afternoon.  I headed east for the first time in forever and ran out 3.5 km and back.  7 km done! The wind was in my face on the way out and to my back on the way home and somehow I ended up with a few negative split kilometers by the end.

Overall pace was a bit faster than the last two weeks and I felt it in my legs a bit. I have to remember to try to keep these longer runs slower!

Long Run – Week 2

Yesterday’s long run almost didn’t happen.

After a wonderful evening with my best friend and her partner, after eating prime rib and Yorkshire pudding and 3.5 bottles of wine among us, I woke up Sunday morning with a slight hangover and a tummy that was not happy about all the food. I hate to get graphic but I had a very upset tummy that morning, well actually, more like in the middle of the night, reminiscent of the stomach flu but thankfully no vomiting.

Remember, hubby and I have been on a healthy eating kick.  We have small dinners of protein and veggies, no dessert and no booze.  My system clearly didn’t appreciate the high fat and alcohol all at the same time.  So Sunday morning came and I was like, “Long run? Not a chance.”

Instead we took the kids out and ended up at an aquarium store. A couple of hours later, we came home with a companion for our mama crayfish, a new aquarium for the two and a fire eel!!!!

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Mama crayfish is the red/orange one. Royal blue crayfish is her new companion.  The rainbow pebbles were chosen by our daughter. 

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We found the eel hiding under this rock a few hours after putting him in the tank. He is a bottom dweller and likes to hide.  I think his little snout sticking out is super cute.

So it was around 5:30pm when we were done setting up the homes of our new family members and I decided it was now or never to run. So I suited up and forced myself to go out. I’m so glad I did. Though it was super slow, it felt great to be back out there pounding the pavement.  I didn’t increase the distance too much, I had planned 6.7 km (10% increase from last week), but finished at 6.5 km due to general fatigue.  Still, it’s in the books and I feel good about it overall.

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Success!! 

Two months ago, I started tracking what I ate with My Fitness Pal.  My husband and I had both gained weight, or more accurately, were not losing weight, and he wanted to start eating better and exercising more to see if it would help his chronic kidney disease.  So together we decided to put an end to our big dinners and wine during the week.  We started eating more protein and veggies at dinner and minimized the carbs – ie. no pasta, no bread – and less deep fried foods.  We also stopped having dessert every night – no more Halloween chocolate, no cookies after dinner, etc.  Wine is only on Friday and Saturday night now.

After a few weeks husband started noticing a difference and with me tracking my calories and trying to adjust my macros, I started seeing subtle differences in the way my clothes fit.  He is running more during the week when the kids are at school and I am back on track with my running as well.

Now, I won’t lie, the nasty stomach flu I had over New Years’ certainly did help with the weight loss but surprisingly, the weight is staying off and well, I am pretty excited about that.

Since starting the healthy eating plan and tracking my diet, I have now lost 10 lbs.  I can’t remember the last time I was this weight – well, yes actually, it was before I got pregnant with my 3rd child.  My clothes fit better and I feel better.  We both do.

He says I don’t need to track my food intake anymore, but I can’t deny that it has become a habit for me now and the scientist in me is enjoying the process.   I can’t wait to see how the next few months shape up!

 

Monday Accountability

In an effort to blog more often I decided to make Mondays my accountability day, specifically in regards to the weekly long run. So, every Monday from now on, I will post about the long run I did the Sunday before.

Now, I am by no means a great runner but over the past two years I have seen the benefit of incorporating a weekly long run into my schedule.  One of my major goals for 2017 is to run more consistently (ideally injury free!) and maybe, just maybe run a spring half-marathon.

So yesterday was the first Sunday that I felt well enough to start the long runs again.  It was only 6 km but it was enough.  I started out slow and kept it slow – for me that’s a pace between 7:40-8:00 min/km. I was able to stick to my 1 km run: 100 m walk for most of run and only stopped to jog on the spot for a couple of traffic lights.

It was very cold, -9˚C without the wind, and with the wind, well if felt more like -15˚C. I bundled up with a balaclava, a toque and a fleece neck warmer.  I had winter running pants on underneath windbreaker track pants, a long sleeved winter running top with a short sleeve as well.  My fleece lined running jacket rounded out the outfit and I was off.

Overall it was a pretty decent run. I kept warm for the most part and the sun shining certainly helped.  I completed 6.1 km in 47:37 for an average pace of 7:43 min/km.  Not too bad for the first long run of 2017.


And best of all, the legs today feel great!

2017 – with a vengeance.

2017 came in with a vengeance, for me at least. New Years Eve day started out with my three-year-old up chucking his applesauce then spiking a fever for most of the afternoon. While the older two kids were on their way to my in-laws, it was touch and go whether the baby would be staying home and changing our NYE plans or going to my mom’s for the night. Thankfully with some Advil and Gravol, he perked up enough to be sent there for the night.

As my husband and I prepared to go to our friend’s place for the evening, I had a fleeting thought of “What if I’m the next one to get hit with the stomach flu?”  I forgot to mention that my eldest got hit with the stomach bug two days before.

The evening started out great. We brought all the fixings for a cheese fondue and it turned out great but shortly after starting to eat I felt the distinct uncomfortable rumblings in my lower stomach that signaled something wasn’t right.  Sure enough, an hour before midnight I was hugging the porcelain god and wishing I were dead.  The stomach virus that gently hit my children assaulted me with a vengeance.  Minutes after midnight I was lying in an upstairs spare bedroom shivering with chills. So much for my new year’s eve plans.

Why is it that the holidays bring on such horrible illnesses? This is the second year in a row that my family has been plagued with a stomach virus over the holidays. I myself have had more of these bouts of illness in the last 5 years than I can remember for most of my life. Is it the kids?  Are they the germ factories?

It’s downright awful.

Even after spending almost the entire day in bed yesterday and sleeping close to 14 hours I am still not 100% today and feel like I could be on the verge of intimacy with the porcelain gods again.  As I write this I’m lying in bed with three children arguing for my attention.

Time to sign off …

Adios, 2016

It’s time to reflect on the year that was 2016.

Career

I started a second job at a private health care facility this summer.  I still have my family practice but I needed something more, something different, and I’ll be honest, a large part of the reason was money.  Our government is destroying pubic health care and I feel paralyzed to do much about it.  One the one hand, they are asking physicians to “Choose Wisely” in ordering tests, but on the other, they are vilifying front line workers for creating huge wait times for appointments, tests and surgeries. The right hand has no idea what the left hand is doing.

So, I decided to branch out and see how the other half lives. Private health care is comfortable, timely and compensates me well for my time. For the most part, I am regarded highly by the clients and am appreciated for my work.  This isn’t always the case in my family practice. Sometimes even doctors need their egos stroked every once in a while.

I don’t plan on leaving my family practice any time soon. I am committed to the patients I have and will strive to do my best for them as I always have.  But they have to be held accountable for their own health care as well.  Seeing multiple doctors at walk-in clinics for the common cold is a strain on our health care system and is entirely necessary.  I know you don’t feel well and can’t take any more time off work and for that I’m sorry, but you can’t hold up the emergency department, or see 3 different physicians at 3 different walk-in clinics, then come to see me the next day because you didn’t trust those physicians’ judgement.  And people wonder why there’s no money left for public health care?  If the government instituted a user fee for non-emergent visits to the emergency department, you better believe wait times in the ER would plummet.  People will start to think twice if they are charged $50 up front for walking in to an ER expecting to see a doctor.

But what do I know?  I’m just a doctor. I’m not a politician or an activist. I’ll leave the politicking and the activism to my colleagues who are far better suited for it.

Death

Wow, this year sucked on the celebrity death front.  In no particular order:

  • David Bowie
  • Alan Rickman
  • Glen Frey
  • Nancy Reagan
  • George Kennedy
  • Patty Duke
  • Anton Yelchin
  • Garry Marshall
  • Gene Wilder
  • Alan Thicke
  • Prince
  • Debbie Reynolds
  • Carrie Fisher
  • George Michael
  • John Glenn
  • Florence Henderson
  • Harper Lee
  • Rob Ford
  • Muhammad Ali
  • Kenny Baker
  • Leonard Cohen
  • Janet Reno
  • Zsa Zsa Gabor

On a personal note, the loss of my medical school classmate, fellow mother, runner and friend has left a particularly dark note on 2016 for me.  Her loss was a devastating blow to all those who knew her, to her young children and her parents in particular, but also to the medical community at large. She was a shining star and I have no doubt was going to do a great many things had she lived.  As her parents learn to cope with their new life without their daughter, as her children grow up without their mother, as her patients find new care with other physicians, we must always remember her and say her name.  Elana.

Now is the time for justice. Justice for Elana. Her murderer must be punished and I hope it will come soon, for her family needs closure.  We all need closure.

Domestic violence never touched my life until a month ago.  It won’t soon leave me. I will look for it every day in the eyes of my patients, in their words, in their gestures.  Something good must come from Elana’s brutal death.

Running

What can I say? 2016 kinda sucked on the running front.  My total for the year was 614 km. The year started off with a slump. My dad was hospitalized, it was brutally cold and I lost my mojo.  It took almost until March before I found my stride again, only to be sidelined with injury again.  Shin splints affected me most of the year.  I tried to cross-train with weights and stationary bike but it didn’t seem to help that much.

I did still manage several races this year – 2 x 10K, 1 x 16K, 2 x 5K, 1 x 8K.  No personal bests or personal records for me.

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Ahead to 2017

My goals for 2017 are pretty straight forward.  Run more than last year!  Stay healthy, fit and injury-free.  I would also like to try for a spring half-marathon and if the running gods are with me, a fall half-marathon as well.   I have been on a healthy eating plan with my husband for the past two months and will continue this well into the new year with the aim of losing 10 lbs which dammit, after three children and 8 years of no sleep, I will achieve in 2017! Come hell or high water!

Happy New Year to you all.

Haunted.

Her image is burned in my memory.  Smiling and appearing happy.

How do you reconcile that image with the next one of her coffin being lowered into the cold ground?

How do you move on when a colleague, a classmate, a friend, a mother is taken from this life in a moment of violence?

How do you stop thinking and imagining what those final moments of her life were like? Did death come quickly? Did she suffer? Was she afraid?

How do you honor her memory when now the focus is on the man accused of her murder? Purple arm bands and purple pins just seem so futile.

How do we ensure justice is served?

 

#SayHerName

For Dr. Elana Fric

And every single woman in this world who has been a victim of violence.

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This week I am wearing purple every day to honor my colleague, my classmate, a mother, an advocate, a runner, a friend.

My heart aches.