Getting Stronger for the Summer

My gym plan went down the drain fairly quickly. I’m still going as much as I can, but I found my schedule conflicting with being a parent and working (evenings and night shifts mainly). Add to that a cold that just won’t go away and I missed quite a few days.

It’s weird starting at the bottom with the weights. Once upon a time, I was up to 145 lbs squats while I weighed 130 lbs. I had previously started at body weight (meaning 0 lbs, not 145 lbs thrown over my shoulders as I was referencing in the last sentence) due to bad knees. So, after too long out of the gym, I started with just the bar. 45 lbs. OH YEAH! Felt so hard core. After a break for the cold I suffered, I was able to do 85 lbs, which isn’t too bad. It’s an improvement at the very least.

Current 5 rep maxes:

  • Squats: 85 lbs
  • Bench press: 65 lbs (lol!)
  • Bent-over Rows: 70 lbs
  • Arnold Press: 50 lbs
  • Deadlifts: 95lbs
  • Pull-ups: 3
Well. Yes, I’m weak. I’m working on it, at least :)  The deadlifts should certainly be higher, but I can’t put too much strain on my back at that angle with my hips misaligned as they are currently (I have an anterior tilt on the right side and either a posterior or neutral tilt on the left side of my pelvis. Old SI injury from my last pregnancy).
I love the gym. Not only does it feel great when the workout is over, I have more energy for the remainder of the day, I feel more motivated, it’s time I specifically spend on myself, and it is making me stronger. It’s only a side-effect that I might end up looking better. Looks are the least of my motivational factors, which I think really helps with the motivation: Motivate yourself with lifestyle goals (energy, strength, health, etc.) rather than looks. You can feel the improvements before you can see them!  
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New Year’s Resolutions :: Or not. GYM TIME!

What is yours? It’s a little bit later in the month and by now, you’ve probably either started on your resolution or already given up.

There are a few common ones, most of which are related to self-improvement: Exercising regularly, eating healthier, maintaining a better sleep schedule, improving your relationship, being more confident, being more social…

All of these things are pretty hard to do if you’re not sure where to start. It’s not a resolution, but I recently started going to the gym again, three times per week. This is something I tend to do in the winter when the sun stops shining as much, the social activities are finished, and I’m just generally grumpy. Exercise helps my mental, emotional, and physical state.

So what do I do at the gym? An adapted starting strength workout routine. Free weights! I love them. I’m going to cover bits and pieces of the routine on this website in order to help other people gain a good understanding of the workouts… Mind you, I’m not a personal trainer. I didn’t do my practicum hours for it because I got into nursing, but I do have all the theory and knowledge of a PT ;)

This morning, I’m off to do squats, squats, squats, squats, squats (channeling the “Shots, shots, shots” song), deadlifts–assuming my gym allows them when it’s busy… January–, arnold presses, and body weight dips. My triceps have always been my downfall. I’m thinking Friday I will have to swap the dips for pull-ups to align the muscle group workouts better.

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North Island College Bridge-In: LPN to BSN/RN

Winter 2015 marks the first semester of the new program for LPN bridge-in students hoping to earn their bachelor of science degree in nursing. This particular program allows qualified LPNs to enter into the fourth semester of the BSN program. Assuming a seat opens up. I’m at the top of the waiting list so either I will get in this year or it will be put off for another year until semester 4 rolls around again.

The down side to this program is the bridge-in courses that are offered. I’m not sure why they made these courses a pre-requisite. The courses were copies of what I have already taken in my LPN course with no real new information afforded. Maybe other schools or teachers didn’t focus on the same ideas and lesson plans that mine did in 2009.

The other prerequisites were a few English courses–essentially, two courses of university/college-level English. And Biology 260 so that we are caught up to where the second year BSN students are at.

I don’t recommend working full time with a full course load, for whatever it’s worth. Especially with kids and moving, and a flooded basement, and… And… :P

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Shore Fishing in Comox Valley

Coho Outside KingfisherComox Valley Fishing

My first coho, caught off Royston

The Coho came around late this year and they were lazy buggers. Here, I stand with my first Coho whom I named George, caught on October 2nd. He was a decently big fellow with healthy, vibrant color inside and out. I’m used to trout fishing and wasn’t sure if this guy was a coho that I was allowed to keep. He wasn’t fighting much… And this might really bother some of you seasoned fishers, but after two whole runs, this guy swam beside me like a dog.

I waded (shore fishing) over to my boyfriend to see if this was actually a keeper or not. He took one look at what I was doing–casually strolling around with a coho salmon hooked on my line, swimming alongside me like a pet–and his face dropped with momentary panic before he told me to get it to shore. ha.

He ended up picking up the salmon for me and taking it to shore. There wasn’t a lot of fight in the salmon. I caught him beside the Kingfisher off of Gartley Point in Royston.

A few days later, I hooked another Coho after a blind cast, but was instructed to “quickly!” Get it to shore… in a moment of adrenalin-induced panic, I of course yanked the line to bring the salmon to shore (a mere 4 feet from me). It snapped. Pfth.

A few days after that, I caught my second coho. Another lazy one with very little fight. She was a beauty, though. I spent a few more days blind casting, but only spotted a few Chum Salmon in the area. I’ve retired my fishing rod for salmon for the year. It’s time to let them spawn up the rivers and get ready for another exciting year of fishing in 2015! I love salmon. Can’t wait.

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Making Money Online: June 2014 Update

When I find the time to do it, I hop onto mturk.com to make a few bucks. I leave it for a long time, not really checking my balance and once a year or so, I am able to buy something I wouldn’t regularly be able to purchase guilt-free.

For Canadian users, MTurk is not going to make you a decent living wage. It won’t pay your bills. In fact, you can only cash out into gift cards for Amazon. Still, it is a great way to do a little something for yourself. Just be wise in the HITs that you choose.

I only submitted two hits in June of 2014 and made a whopping $2.00. Extravagant! But if average $2.00 a month, come December, I’ll have $24.00 of spending cash I wouldn’t ordinarily have. That said, I usually spend more time on MTurk and average between $6 and $10.00 per month. It’s the little things :)

Sign up now (not a referral link) and start making some spending cash.  It’s probably one of the easiest ways to make money online if you are located in Canada.

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Gold River Fishing

The entire Gold River baseball tournament was overcast and rainy. This, however, is fairly expected weather in that area. Last year, the sun was out all weekend and I came home from the four-day tournament tanned. I never tan. It was great!

That said, the weekend was full of new memories made. Bad weather doesn’t have to mean a bad time. The first night, it rained outside. It rained hard. It rained inside the tent. I guess that’s what happens when you rush to set up your tent after you arrive at 9:30 AM and have a toddler to feed and have an 11:00 pm baseball game. Yes, that’s right. One of the best things I love about the Gold River Slopitch tournament is how there is no limit as to when your games might be scheduled. The last game of the first night was scheduled at 12:30 AM.

We managed… I mean, Rob managed to fix the tent’s fly for us the next morning while Keagan and I had our breakfast at the local coffee shop (Clayworks Cafe and Gallery). That coffee shop almost turned into our second home in between baseball games and our tent. Our wet, wet tent. It has great coffee and good food if you are ever in Gold River, please check it out. I hope to purchase something from there next year to take home with me.

 

Our team ended up placing in B-division and we placed fourth, I believe. There weren’t as many teams this year because Canada Day did not fall on a Monday or a Friday this year, making it a regular two-day weekend as opposed to a three-day weekend as it has ended up in the past. Last year’s 80 teams dwindled down to a mere 17 teams this year. It was still a blast, however.  

The boys and I finished our baseball marathon with some fishing and a swim in one of the beautiful lakes there, which I will leave unnamed. It is ours :)   The weather was, of course, gorgeous.

 

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Gold River

We are packing up to head out to Gold River. It was supposed to be a kid-free weekend, but the kiddos’ dad is packing up his house in preparation to move on Tuesday, so he had to cancel his visitation weekend. Fair enough! My little lady will be staying with her best friend/my little sister and my mom. My little guy will be coming camping for the baseball retreat. It will be interesting trying to entertain a 2.5-year-old while camping beside a river and playing numerous baseball games.

I had planned on being irresponsible and drinking a bunch since I get two weekends like this per year, but this will now be a super responsible weekend where I will be stressing out over the well-being of my little guy. I guess it’s par for the course of being a parent. I just wish I could cancel without bailing on my teammates since I haven’t had time to think of nor prepare toddler activities. Ack!

I’m sure the memories I gather will be ones I will laugh hysterically at later on in life, especially as I share them with my little guy’s future romantic interests. Aw yes.

I have two days to figure out some frugal toddler camping activities! I’m also looking to see what knitting projects I can bring along with me and what kind of photographs I’ll be able to take this time.

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Lyme Disease Serological Tests

I wrote a paper for my college course on Lyme serological tests. Here it is, complete with comma splices and some missing information. But I’m a student, so what do you expect? :)

 

 

The Need for New Borrelia Burgdorferi Serology Tests for Diagnosis

Introduction

In Canada, the number of Lyme Disease cases has been steadily increasing since it became a nationally reportable disease in 2009 (“ Lyme Disease Frequently Asked Questions,” 2013). The bacterial agent for Lyme Disease in North America is known as Borrelia burgdorferi and is a unique and complex bacteria. In Canada, our current serological tests are used to detect the presence of human antibodies to the bacteria. This presents a number of issues, including the inability to detect the bacteria, itself. Being unable to detect if the bacteria is present essentially renders the current serological tests useless in a number of cases, allowing many sufferers to go untreated. This paper will look at how the current serological tests work and how the B. burgdorferi bacteria is able to elude its host, potentially resulting in negative serological tests.

Serology Tests Detect IgG and IgM Antibodies

In order to understand how serological testing works for detecting Lyme Disease, the response of the immune system must first be explored. Initially, when a bacterial agent is introduced to a mammalian host, its immune system responds with specific antigens in order to try and fight off the infection. The first antibody that is released is the IgM antibody, mainly found in blood and lymphatic fluids. After initial infection, it can take weeks or months for the secondary antibody to be released, which is the IgG antibody. Currently, the Public Health Agency of Canada uses a 2-tier serological test for laboratory confirmation, which detects the aforementioned antibodies. Unfortunately, the presence of B. burgdorferi in its host is not always detected by the immune system and thus antibodies might not always be present. This is in large part due to the complexity of the bacteria which allows it to switch off its surface lipoprotein intermittently in order to evade the host’s immune response.

The 2-tier serological tests proposed by the Centers for Disease Control and Prevention (CDC) and adopted by the Public Health Agency of Canada (PHAC) uses an enzyme immunofluorescence assay (ELISA) in order to initially screen potential Lyme Disease patients (“Two-Step Laboratory Testing Process,” 2011). If that serological assay returns positive, it is followed by a western blot. Both of these serological tests must return positive for a laboratory confirmed diagnosis of Lyme Disease. The western immunoblots can be used to detect either IgM or IgG antibodies, depending on the laboratory and which test strip is used. The ELISA can also be used for detecting both the IgM and IgG antibodies, although it has less specificity. Prospective studies have found that the 2-tier system has a 100% sensitivity and a specificity of 99% in patients with later Lyme Disease (Aucott, 2013), which sounds great on paper, but this continues to dismiss that it is detecting an immune response to the bacteria rather than an actual infection. An immune response can be detected for years after an active infection, or can be altogether missed due to the bacteria possibly assuming a cyst formation or using “neutrophil calprotectin [to] induce a dormant state” (Stricker, 2007, p. 150). Some doctors and infectious disease specialists dismiss positive readings based on an assumption that the infection has come and gone already based on faintness of the reactive bands on the test strips, or assume that the disease was successfully treated at an earlier time and thus the infection should no longer be present (Chang, 2012).

The initial serological tests are recommended up to 4 weeks after possible disease onset, however, at least one retrospective study headed by A. Steere suggested that the IgM serology test periods should be extended by several weeks after the study had found patients with Lyme Disease were continuing to receive false negative serological results (Steere, 2008). This simple oversight in the current testing recommendation can easily lead to false negative results for individuals actively suffering from Lyme Disease.

To further evaluate the efficacy of the serological test, an article written by doctors and infectious disease experts John Branda, et al. took blood samples from patients with clinically confirmed Lyme Disease infections and found that the standard 2-tier tests only detected 27% of Borrelia burgdorferi infections in the acute phase of stage 1, 57% in the convalescent phase of stage 1, 40% in stage 2 Lyme Disease, and 100% in the final stage 3 (Branda, 2011, p. 543). This means that 73% of early stage 1 Lyme Disease were missed in this study and 43% of diagnosis were missed in the convalescent phase of stage 1. In stage 2, 60% were missed and it wasn’t until stage 3 that the tests were 100% accurate.

Borrelia Burgdorferi as a Bacteria

Borrelia burgdorferi is a spirochete bacteria most commonly transmitted to humans in North America through the bite of an ixodes scapularis, also known as a deer or blacklegged tick. Borrelia burgdorferi can cause chronic infection, persisting in an infected human despite humoral and cellular immune response. The bacteria is understood to have the ability to evade the immune response for long periods of time, however, it is not known exactly how the bacteria is capable of doing so. Numerous outer surface proteins of B. burgdorferi have been identified over the past two decades, which are likely contributing factors to its ability to evade its hosts’ immune response (Seemanapalli, 2010).

Borrelia burgdorferi is unique in its extensive amount of genetic sequences and numerous outer surface proteins. The pure abundance of its gene sequences—over 1,500—allows it to continue a fluctuation of outer surface proteins, continuing its ability to evade the hosts’ humoral response, sometimes even evading detection for extended periods of time. The outer surface protein C (OspC) is expressed upon infection of a mammalian host, which is theorized to aide the bacteria in evading humoral response. After establishing itself in the host, Borrelia burgdorferi then switches its surface lipoproteins, including the VIsE and BBF01 while also down-regulating its OspC, allowing it to further evade the mammalian’s humoral response (Seemanapalli, 2010, p. 6).

Due to its ability to evade the humoral and cellular immune response of its host, B. burgdorferi is not easily detected, especially in serological testing where detection of the immune response is required for positive readings. Despite this newer research, the blood tests which were recommended in 1995—the 2-tier serological tests—are still used for diagnosis of Borrelia burgdorferi infection before treatment can begin.

Lyme Disease Stages

Lyme Disease is divided into 3 main stages: Stage 1 includes an acute stage and a convalescent stage which occurs a few days to a few weeks after being infected. Stage 2 starts once the disease begins to spread throughout the body, infecting spinal fluid, blood, parasympathetic nervous system, the central nervous system, muscle tissue, and/or joints. The last stage, Stage 3, is when the bacteria has successfully spread throughout the body.

In stage 1, sufferers may not know they have been infected. This stage is where the typical bulls-eye rash shows in patients, however, 16% of early Lyme disease patients will not present with this rash (Aucott, 2012). Along with the potential erythema migrans rash, sufferers will likely experience flu-like symptoms during this stage of infection. The current 2-tier serological testing will only diagnose 27-56% of these patients (Branda, 2011). If the infection is caught during the first stage, antibiotic treatment will more likely be successful as the disease is still localized and has not yet begun to spread from the site of infection to the rest of the body. In stage 2, the disease begins to invade other areas of the body. As it spreads, the bacteria can cause its sufferers meningitis, paralysis of facial nerves, headaches, radicular neuropathy, cardiovascular issues of varying degrees, muscle pain, joint stiffness, joint swelling, and the flu-like symptoms of stage 1 may continue. Now that the bacteria has begun to spread, antibiotic treatments might not be as effective. Stage 3 is the last specified stage of Lyme disease. In this stage, the B. burgdorferi bacteria has successfully infiltrated the host’s body. Once the infection gets to this point, it is referred to as Late Lyme Disease and can lead to symptoms that may not be reversible.

Lyme Disease patients in Aucott’s Post-Treatment Lyme disease syndrome study found patients to have increasing symptoms after treatment once they got to stage 2 and 3 of Lyme disease. Although Aucott and his team of researchers discovered a drop in symptoms in their stage 2 & 3 Lyme disease patients during treatment, within 4 weeks the patient-reported symptoms began rising. By 6 months, the patients were reporting symptoms higher than before treatment began (Aucott, 2013, p. 80).

Conclusion

It was discussed how the early stages of Borrelia burgdorferi is difficult to detect with the currently recommended 2-tier blood tests. Statistically, the tests are 27-56% effective in stage 1 of Lyme Disease. As outlined, Borrelia burgdorferi behaves in a unique way that allows it to evade immune response, likely causing the low efficacy of the serological tests. In continuing to use the recommended 2-tier test, doctors are unwittingly allowing stage 1 Lyme Disease to progress into stage 2 and 3. Once in stages 2 or 3, the bacteria is already infiltrated into multiple body systems and treatment is less likely to keep symptoms at bay, leaving patients to suffer from prolonged symptoms and sometimes even developing “substantial disability” (Bratton, 2008).

With a potential for 100,000 new cases per year in North America (Aucott, 2013), having better serological testing is important for early treatment and prevention of numerous patients suffering needlessly for prolonged periods of time.

References

Aucott, J., Crowder, L., Kortte, K., & Rebman, A. (2013). Post-treatment Lyme disease syndrome symptomatology and the impact on life functioning: is there something here?. Quality Of Life Research, 22(1), 75-84. doi:10.1007/s11136-012-0126-6

Aucott, J., Seifter, A., & Rebman, A. (2012). Probable late lyme disease: a variant manifestation of untreated Borrelia burgdorferi infection.BMC Infectious Diseases12173.

Branda, J., Linskey, K., Kim, Y., Steere, A., & Ferraro, M. (2011). Two-tiered antibody testing for Lyme disease with use of 2 enzyme immunoassays, a whole-cell sonicate enzyme immunoassay followed by a VlsE C6 peptide enzyme immunoassay. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America53(6), 541-547. doi:10.1093/cid/cir464

Bratton, R., Whiteside, J., Hovan, M., Engle, R., & Edwards, F. (2008). Diagnosis and treatment of Lyme disease. Mayo Clinic Proceedings83(5), 566-571.

Chang, Z., Cox, M., Ndukwe, N., Seriburi, V., & Wormser, G. (2012). High frequency of false positive IgM immunoblots for Borrelia burgdorferi in clinical practice.

 

Kenedy, M., Lenhart, T., & Akins, D. (2012). The role of Borrelia burgdorferi outer surface proteins. FEMS Immunology And Medical Microbiology, 66(1), 1-19. doi:10.1111/j.1574- 695X.2012.00980.x

 

Lyme Disease Frequently Asked Questions (2013, August 15).
Retrieved from
http://www.phac-aspc.gc.ca/id-mi/lyme-fs-eng.php

 

Ogden, N., Lindsay, L., Morshed, M., Sockett, P., & Artsob, H. (2009). The emergence of Lyme disease in Canada. CMAJ: Canadian Medical Association Journal = Journal De L’association Medicale Canadienne180(12), 1221-1224. doi:10.1503/cmaj.080148

 

Seemanapalli, S. V., Qilong, X., McShan, K., & Fang Ting, L. (2010). Outer Surface Protein C Is a Dissemination-Facilitating Factor of Borrelia burgdorferi during Mammalian Infection. Plos ONE5(12), 1-8. doi:10.1371/journal.pone.0015830

 

Steere, A., McHugh, G., Damle, N., & Sikand, V. (2008). Prospective study of serologic tests for lyme disease. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America, 47(2), 188-195. doi:10.1086/589242

 

Stricker, R. B. (2007). Counterpoint: Long-Term Antibiotic Therapy Improves Persistent Symptoms Associated with Lyme Disease. Clinical Infectious Diseases, 45(2), 149-157. doi:10.1086/518853

Two-Step Laboratory Testing Process (2011, November 15). Retrieved from http://www.cdc.gov/lyme/diagnosistesting/LabTest/TwoStep

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Life Update

As always, I’ve been pretty darn busy. Currently, I’ve stepped down as the PAC Secretary for my daughter’s school because working casually just doesn’t afford me the luxury of planning ahead. Casual work is essentially getting a phone call a few minutes before the shifts start and being asked to come in at 7:00 AM, 3:00 pm, or 11:00 pm for 8 hour shifts… Usually. Sometimes the shifts are 5 hours long (short shift). It’s very hard to swing if you haven’t slept appropriately for the indicated shift. Especially those night shifts. And especially on night shifts where there is a one hour commute home after you’ve finished working them. Dangerous without adequate sleep.

Sometimes I will go days without getting a call and sometimes I’ll get a call and not have any daycare available, so work is at times very sparse. Very stressful. Especially when your BCHydro bill quadruples without any warning. Thanks, BC Hydro. Thanks for thinking of us little guys while your top earning executives are bringing in around million dollars per year. I’m looking at you, Thomas Bechard, the Managing Director.

If you missed that link, it’s a publicly available PDF file outlining the compensations of their executive members. Click here to view.

Okay. Mini rant out of the way! I’ve also started bridging in to earn my Bachelor of Science in Nursing through North Island College’s LPN to RN bridge program. In completing the two bridge-in courses, I will be able to enter their BSN program half way through the second year. If I get a seat in the program next winter (it largely depends on if other students currently in the program do not continue on with their education for whatever reason), I will be set to graduate in 2017. Coincidentally, this is the year that the new VIHA hospital will be opening for the Comox Valley. Sweet!

Working, school work, keeping a semi-active social life, and managing extracurriculars for the kids… I’m running on fumes, but enjoying it regardless. Life is good.

I just have to try and earn $3,000 within the next few months. No biggy… D:   (new tires, Rx glasses, BCHydro bill, and course fees). Odd jobs and working more shifts ought to cover it. Just a big price tag hanging over my head lately.

Onto happier thoughts! I will likely be starting work on CVFishing.com soon as the trout season looms for freshwater anglers. I also hope to start working on the practical nursing subsection of this website. Review, review, review :)

I might even get motivated to make a new knitting pattern… What should I knit? I’m thinking maybe a beer cozy since slopitch baseball season is almost upon us here on Vancouver Island.

Until next time! Cheers :)

 

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VIHA “Replacing” LPNs with Care Aides?

What is everyone’s thoughts on this? I remember preceptoring and having my practicums in a VIHA hospital and the nurses were already understaffed and overwhelmed with work load. A lot of the work entailed RCA work, however, a lot of it also entailed head-to-toe assessments that were ongoing; Urinary catheters, dressing changes, medication administration, monitoring patients for reactions to said medications, IV maintenance, hanging fluids, pulling drains (if so delegated and trained), communicating with the doctors, transcribing orders, picking up blood for transfusions… All things that care aides do not have within their scope, nor are they licensed to do so.

The biggest difference between LPNs and Care Aides is that one pays for yearly licensing and undergoes continual education in order to keep their license. LPNs take a national exam then apply for licensing through a regulated body. In BC, this regulated body is the College of Licensed Practical Nurses of British Columbia.  Care aides take a course and apply for registration through a non-regulated body.

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