Quote of the Day: Nails

 PT edition:

So, today I was complimenting my patient's nails and so I ended up saying, "Her, your shirt matches your tail!"

I also seriously told her while she was doing a modified bird/dog to never make a fist around her thumb, especially if she's punching somebody.

Also, there's your common miscommunication with colleagues. 

"Don't forget the folded sheets"

"What feta cheese?"

Quote of the Day: Addiction

 Mom: "I only had three cigarettes this whole day!"

Me: "Wow, mom! Good job! How do you feel?"

Mom: "Horny!"

*mom closes the balcony door behind her leaving me stunned*

Quote of the day: Incest?

 Him: ...."It would be odd to meet up with my sister's husband's father more than a couple of times a year..."

Me: hmm, his sister's...father in law...?

Him: ...."It really should be my uncle who initiates the gatherings"...

Me: "Your uncle?" His sister's husband's dad? or....no. It's his father's brother!

Him: "uh!, so is your uncle your dad's husband?"

Him: ... 

Him: "Wait until my mom finds out about this."

A Good Day

Today was a good day. A productive day!

I set up my alarm to wake up early so I can clean as much carpet as possible before heading out.

I got the vacuuming done and half the basement, but then I ran out to kickboxing.

I treated myself with a very small cup of fresh squeezed mango, since my BMI is technically overweight.

Afterwards,  I went to the mall to do some henna as a fundraiser. It was so much fun!

But I hated that I had to leave early and rushed home after picking up dinner.

I also swept the garage and cleaned the toilet!

I finally rewatched Forrest Gump. I really thought it was boring, and never watched it, but turned out I watched it ages ago, maybe 15 years or more ago, because I remembered that scene where lieutenant Dan was swimming without his legs. Because up until that scene, I thought you needed your legs to swim.

The movie was great. Very somber, yet witty and funny and such likeable characters.

Minor set backs, I had shit sleep...as usual. I stubbed my broken toe against the sandbag, which hurt a LOT, and I clogged, but then unclogged the toilet!



Alright. Peace out,
M.D.

Childhood Emotional Neglect

Okay, the title may be a bit misleading.

If you're reading this blog to understand what Childhood Emotional Neglect (CEN) is, or whether you have it or not, then maybe my experience will resonate with you.

Last Tuesday, I found out something about my dad that, completely shattered my image of him. I won't discuss that in detail, at least not yet.

My sisters and mom knew for 2 weeks, but hid it from me, heck two of my aunts knew about this too. But, they were "afraid I won't know how to mask my emotions" which turned out to be true.

But, that isn't fair. because the way I found out, was waking up at 7:50 AM, on the second day of Eid over the sounds of my parents screaming. I pretended to stay asleep.

The fight continued until noon, there were breaks between the fights and by then Dana and mom explained to me what happened.

Needless to say, I didn't know how to process my emotions. Shocked, angry, betrayed.

But I kept calm, for the most part the first day. I was still trying to absorb it all and Dana was visibly upset by all of this since she spent the summer with him in Kuwait and saw more hypocrisy than I did. I took dana out to eat at Cora's since I didn't want to stay at home with dad alone and the air was too tense.

The plan was to go to the mall then to an Eid festival downtown. Dana wanted to get her charger from the house first, so we made a quick stop. I walked in with her. I did my best to control my emotions, but then he cried in my arms that afternoon saying: he did a mistake but didn't mean to hurt mom's feelings. That he played around and that he was sorry. That my mom asked for a divorce and she said the decision would be up to us (her daughters) whether we wanted our dad in our lives or not...not that he's even in our lives.

I let a single tear slip, but held myself together as my dad sobbed in my arms in a very surreal experience in my life. Dana ran upstairs to get her charger, but I heard her sob too.

I just stood there, wondering if these were crocodile tears. wondering why it was my decision to choose what happens to their personal life, wondering what he did exactly, how many times, why he was crying now. Was he crying because he was sorry or that he got caught. Then I got angry.

and angrier.

That anger built into an inconsolable rage over the week.

I was so angry, that I couldn't speak or even look at my dad. for an entire week, I avoided him. when he asked me a question, I told him to google it. When he walked in the house, I kept inside my room for hours, or kept myself busy planning my sister's henna party.

I was so enraged that I periodically would lash out at people. I couldn't contain my anger, and I had no outlet. I felt that all the guilt of spending money on myself over the years, has been for a man that spent hundred on his mom and mistress.

No one was proud of me for paying for my masters degree by myself. If anything, my mom thought I was an idiot, for turning my dad's offer down. I thought he would be grateful that his money would go into the mortgage instead. the money went to his parent's lawyer, his brother's car, and his daily starbucks coffee instead.

Meanwhile, I was counting every penny I spent on food while I was studying 12 hours a day on campus and budgeting myself. Savings by working in a call centre that gave me anxiety or working in a job I enjoyed but pushed myself to 60 hours a week to save for my tuition.

I cancelled my trip to NYC to see a friend I only get the chance to meet once every 4 years because it coincided with him visiting Canada and when I hinted it to him, he guilt tripped me into staying.

So, throughout the entire week, I felt rage and guilt and resentment. I probably still feel all those things, but they're under a degree of control. I used to start crying every time my mom would talk to me about it. But she wouldn't talk to me about how I feel, she would scold me for talking to him a certain way, she scolded me for talking about him with such a venomous tone that she caught him crying alone in the car. She told me that the tone I used was so vicious, that she thought I was angry at her too.
For 5 days, I was crying several times a day.

Dana called me selfish for making this about myself. My older sister tried to tell me that it's their decision and personal life and advised I should not get involved. Mom told me I have unresolved anger issues and clearly (as I told her before) I was holding on to a lot from my dad and this was the last straw.

She asked me if there is anything that happened to me in my childhood that she doesn't know about. But there was none. I was never abused, never did I experience a traumatic event, everything I asked for I got.

Yet, I had intimacy issues, I had cycles of guilt and resentment, and I never remotely considered myself a "nice" person, because of the thoughts I hold. I mean, I almost told my dad to kill himself, but avoided him because I was so scared I would say it in such a venomous tone that he actually might.

The cycles of guilt and resentment didn't start now. It didn't start when I was studying masters in school either. The peaked with my first mental breakdown during the MCATS, but I had them before then too. Before my sister started her anti-depressants again. It was also during my bachelors, even though I was so happy with my accepting friends and the results I saw over my hard work. But I did experience a lot of resentment and guilt towards my older sister for resorting to me when she needed help in her schoolwork. I had them in highschool with racist Kuwaities. I'm not sure when I started living in these cycles, but they're becoming more apparent with age.

Maybe that's why I'm also very independent, or at least, feel extreme discomfort seeking help in anything, because I don't want to bother people around me.

I stumbled on CEN, the thing that never happened to you in your childhood.

Maybe it's an exaggeration, maybe I am being selfish, but maybe I really do have Childhood Emotional Neglect.

My dad was almost always out of the picture growing up. Either he was in a different country, at work, at grandmas, at the gym or sleeping.
When he would eat with us, he would often be on his phone. When I talk to him, it would be a lecture, or disdain to my topic. If he went shopping with us, he would get cranky and impatient to eat much like a child.

He was also verbally abusive, up until I entered 10th grade. That was when my older sister travelled to Canada for university. By then, I was heavily dependant on online chatroom platforms where I sought my emotional support, and still do.

My mom was an introvert, raising three daughters like she was a single mom. With a full time job, an hour drive to and from work, and coming home to cook and launder. She had enough time to smoke a cigarette, grab a bite to eat, and talk to us while she was helping us study or playing a game on her phone or on her laptop. 

When we were in Canada, between my older sister's depression and suicidal tendencies and my younger sister being a toddler, I felt I had no time with my mom, but I couldn't blame her, because she was doing her best. I remember when I made some stupid figures, I would gift it to her, but she would forget about them because "love is not expressed through words, but through actions."
A lesson, I honestly don't think I needed to learn at 10 years old.

So, maybe that was the trigger? That was the CEN? It was certainly unintentional, but maybe it explains why I hated hugs and kisses after coming back from Canada, why I spent my time reading or chatting online, why I'm so independent and wish to live alone, why I suppressed my tears growing up and still struggle with processing emotions I consider "vulnerable".

If the blue applies to you, maybe you have CEN too.

Care to share your experience in the comments below? I'm sure most east asians and Arabs can relate.

Peace,
M.D.

First Fracture

Two weeks ago, on a friday, I went kickboxing and continued to spar with some guys there after the class was over.

I told one of them casually that more or less, I'm not afraid of being punched. What I was afraid of, was concussions, broken bones, or missing teeth. Then I proceeded to kick his knee with my foot (AGAIN, see previous post) during sparring and stopped the match from the pain. I asked if he was okay since it hurt me so much. He was fine, so I continued to spar with him.
.
.
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Then I sparred with another guy, but ended the match quickly because I realized I couldn't focus on much else other than my foot. I figured I sprained it.

The instructor came to check on me and why I was leaving so soon and I told him it was nothing, that I kicked a knee, but can still move my toes. I wiggled my toes at him for proof!

He seemed concerned but waved it off.

I couldn't put my aching foot in my shoe, so I drove home bare footed. It really hurt to drive back home, seeing it was my driving foot that hurt me so much. but there was no time to complain! Once I reached home, I threw some ice on it while heating the oven and preparing the food since the boys were coming over any minute now.

There was no time for pain, I quickly showered and crossed heat and cold on my foot. I didn't feel anything when the boys came, I was limping, sure, but it certainly didn't hurt near as much as my severe period cramps. When I bumped my foot on the stairs, I did find myself on my hands and knees from the pain which alarmed one of the boys a bit, but I again, quickly shook it off. I drove them home very carefully.

The next day (day 2), I woke up in pain at 7 am from my foot. It was very swollen, red, and quite inflamed. I continued to ice it, but the ice burned my foot so I just elevated it, and it seemed to work. Later that day I went to my friend's house. I limped all the way there, since I couldn't weight bare on that foot at all. I genuinely considered crutches. The boys, and my friend told me to get it x-rayed. By then, I started taping the pain with sports tape. I called 811, an RN picked up and told me to get it X-rayed ASAP.

I went to a walk-in clinic on Monday and X-rayed my foot on Tuesday (day 5).

The results should be given to my family doctor and given to me within 24 hours.

I had to call my doctor to get the results, it was broken.

"undisplaced avulsion fracture" of the 1st proximal phalange of the right foot. I broke my toe!

I won't get into explaining what that all means, but the doctor told me to continue what I was doing, taping, icing, and reducing weight baring on it.

She told me to take pain killers and wear a boot if the pain is too severe, but I couldn't feel any pain by then. Sure, it hurts when I put weight on it, but I just walked on the blade of my foot and off loaded my toe. Plus, I found this sleeve to put on it to cushion my steps in my placement.

I can't believe my cramps hurt more than this, but possibly due to decrease of nerves there? who knows.

I am currently still hunting down my X-rays. Both my doctor and the walk-in don't have my X-rays! I'm determined to see it for myself, or at least, see the follow up X-ray!

Peace,
M.D.

Kick Boxing

So, boxing was a bit too boring and difficult when you fight men and you're a 5 foot something woman with no upper body strength.

I also felt a longing to kicking, since flexibility is an advantage I have and decided to join Kick boxing.

The instructor recommended I jump ahead to advanced muay thai, since I have experience in karate and I'm apparently not scared of being punched.

Day three into it, and I think I sprained my toe! I limped my way around my second placement. I also have several bruises, and quite frankly, I'm unsure if the pain in my sides are due to muscle soreness or further bruising.

The workouts are so intense, I end up wheezing for air sometimes, and by no means do I have any asthmatic condition!

God bless,
M.D.

First Clinical Placement Reflection & Review

At the hospital ward, my patients were mostly liver transplant patients, IMCU, acute care, or AKI/dialysis patients. There were also the general surgery patients that occasionally dropped by in IMCU/ step down. I spent the first couple of weeks observing and taking in the many different procedures patients underwent, the process my preceptor used to see and prioritize her patients, and assisting a little bit in mobilizations of X3 assist patients.

During my placement, I familiarized myself with charting progress notes in the form of SOAP notes. I learned a lot about my treatment options and procedures.

For a day, I observed two surgical procedures; 1) a lateral thoracotomy for a mass removal of a benign tumour. I got to hold the tumour at the end, it was bigger than the size of my fists. It looked like an organ of its own as it had blood vessels growing all around it. It was a surreal experience, and at times, I did consider if a path as a surgeon. especially since the MCAT score has been lowered as a prerequisite. It made me feel rather gloomy for a bit, but then I looked at the facts. Doctor spend a lot of time behind paper work, much like physiotherapists, and they spend more than double the time studying and in debt prior to work. I can barely handle this two year program. 2) I witnessed a VATS procedure for a pneumocotomy. I then followed the tumour to the labs and watched the pathologist cross freeze sections of a metastasized tumour. I lowkey contaminated her office with the tumour too. yikes!

Over the six weeks, I went through a radiology tour to see how patients get cast fittings for radiology treatment and watched a couple of CAT scans. I also attended two weekly rounds, liver transplant rounds and patient ward rounds.

            I spent most of the time with patients who were assist X3 and later became competent enough to lead the mobilization of an assist X4 wheel chair to bed using a hoyer lift. I feel confident using the hoyer lift and organizing lines, drains, and tubed from the sheer volume of them I had worked with. I wrote new consults for new patients, and collaborated a lot with the staff in the hospital, specially the nurses in IMCU. I visited and worked four days in the ICU with acute care patients, respiratory failure patients, etc. I saw one patient progress from ICU to IMCU to a general ward room, and I saw a couple of patients regress due to deconditioning and multiple surgical procedures. For one day, I joined another physiotherapist in the thoracic and oncology units I set up goals with a demotivated patient, in which she followed afterwards. I sat in on my CI’s liver transplant outpatient meetings, in which I noted the effects liver failure has on patients such as jaundice, unfocussed eyes, muscle wasting, etc. I’ve been exposed to a wide variety of patients and cases, except paediatrics.

            I definitely feel confident and competent in mobilizing acute care patients from stand by assist to X4 assist. I did not, however, see or use enough breathing techniques, secretion techniques, or auscultations. Also, my subjective history taking skills have a lot of room for improvement. I was told by my preceptor that my soft skills are all there, communication, professionalism, compassion, etc. and that my hard skills will take some time as I gain more experience. I would definitely recommend this placement and my preceptor for future students, because I enjoyed this placement a lot. There were so many learning opportunities, but I feel that I learned the most I can by the end of it. I do wish I could have seen even more surgical procedures, they were the best.

It also worked out beautifully that I went at 8:20 am and left at 2 pm during Ramadan! I spent a lot of time sleeping, that's for sure.

Peace,

Peace,
M.D.

2018

I have not posted anything in this year, despite it being a great year.

As I stated in Despair, between the call centre job, the job and masters' applications, volunteer, grieving, and self worthlessness I was feeling, my mental health detoriated.

I continued applying to jobs, maybe a 100 applications were sent. I got accepted into a "financial services industry" which I might discuss more in five more years.

In this job transition, a man was interested in me, but I rejected him within two weeks.

Once accepted in the new job, I quickly quit the call centre.

I learned I was an INTJ personality, which was mind blowing for me. It really helped me shape and understand who I am and normalize my behaviour and emotions.

The hard work, hours, and efficiency I put into my job earned me the position of supervisor within 6 months.

I could have gotten there faster had I been more aggressive. Something I loved in that job, was I was being so appreciated. I was encouraged to be more aggressive and assertive instead of criticized for it.

But it wasn't perfect, and it had a glass ceiling.

I learned a lot in that job. I took many skills I never thought I would learn, such as reading computer cookies, and tracking accounts and activities through these cookies. I worked in Security and Investigations and I loved that it was challenging.

I ended up teaching it to others too and getting privileges in the company.

I also travelled to Hamilton for an interview, met with an online friend and got accepted at both Masters' programs I wanted from the very first application cycle, despite being late to both interviews.

I had given up on myself, but God hadn't given up on me.

Once I got accepted in the program, I talked to the director of the company. The only person higher than him, is the CEO himself.

He let me know that I'm welcome to work part-time, a position that did not exist in the company. He told me that he was surprised and disappointed with management that I wasn't promoted already. And that he was impressed with the comments I made in the group chats.

Managers I worked with were also impressed by me, and quite shocked to discover I'm a woman (communication is done through chatting and I have a unisex name). This always made me laugh in the office as it happened several times.

I just loved being appreciated, learning new things with minimal pressure/stress, and being useful to others.

I passed the first semester in physiotherapy through the skin of my teeth. It was not easy for me, as I do not have a kin. background, nor did I do honours. 15% of the class had failed and was asked to reapply the following year, but I wasn't one of them.

The isolation I felt from my classmates during the first semester only magnified in the second. However, I passed this semester too and onto placements!

Key messages: Be yourself, shamelessly. It too, shall pass.

Peace,
M.D.

First Physiotherapy Placement

Let's just say, it was not half as stressful as the course we took.

The first placement is a cardioresp. placement. It's in acute care unit in the hospital.

I was so anxious about it that I've been dreaming of falling teeth and professors for the past couple of days, but it wasn't stressful at all.

I need to write down my objectives, hit up some errands, and stop being so pushy.


Tomorrow, we will watch Avengers: Endgame.

Peace,
M.D.