Less coffee?? You must be nuts!

 

Photo by Christian Joudrey

As I sit down with patients and discuss smoking cessation, I actively try to stay open and to hold back any judgment. I hope for an honest discussion on their part as well. I share with my patients that everyone’s journey is different and there is validity in their struggle. Smoking has a physical, social and psychological aspect to it.
I am not a smoker and have never been addicted to nicotine. Could I truly be empathetic to a smoker? Sure! I believe we all can be more empathetic without going through the same experience by listening to people.
Coffee is my addiction.
I have been drinking coffee since my first year of undergrad. It began as a necessity to allow me to read through pages of Kinesiology and Psychology notes at York University. Drinking coffee continued even post-graduation. Again, it became my crutch while studying respiratory therapy at school, during my clinical rotations and while working as a staff RT at an acute care hospital. Even when I stopped working in the acute care setting, every day I drank a total of two medium Tim Horton’s cups of coffee.
As a self-awareness and reflective process, I decided to limit my caffeine.
For the past three weeks, my caffeine intake has been limited to decaffeinated coffee. Even within the first three days, I experienced some expected changes. I felt more tired in the afternoons. My heart rate was lower and didn’t have the sensation of beating at the “top” of my chest. My ongoing general and social anxiety has reduced to almost non-existent, and I urinate less frequently.
I have also experienced two elements that I did not predict or expect. First, I expected to have some irritability or withdrawals but experienced none. This may be due to my daily consumption of decaffeinated coffee as it contains a small amount of caffeine.
Second and unanticipated to me, I began to have more dreams! In the past, I would wake up once or maybe twice a week knowing that I had dreamt. Now I wake up every morning, knowing that I have! It is my guesstimate that with a medium size coffee in the morning and one in the afternoon, caffeine’s six-hour half-life never had a chance to clear my system in time to allow me a restful sleep.
Literature and studies go back and forth on the benefits of coffee, and this post will not attempt to cover that information. The goal of this post is not to change your drinking habits (unless you experience general anxiety associated with an increase in heart rate and have a pattern of low quality sleep).
What did I learn from this “experiment”? In this self-awareness exercise, I had the assumption that greatly reducing my caffeine after 15 years would be very difficult. Also, that it would lead to severe withdrawals over the first few days. Luckily that was not the case.
I did not decide to suddenly stop drinking coffee and instead, settled for decaf because I really enjoy the smell and taste of coffee! Sometimes it is hard to change the social, lifestyle and behavioural patterns and routines.
Did this experience lead to a groundbreaking insight and further deepen my empathy with my patients who smoke? The truthful answer is not really. I felt that I already had a supportive mindset toward my patients. While this exercise did not necessarily make me a better clinician, I do enjoy the personal benefits of limited caffeine consumption. I still occasionally drink regular coffee but almost all my coffee and tea is decaffeinated. The reduced heart rate and associated lower anxiety symptoms and increased dreams are great benefits.
I encourage you to identify and challenge some of your held beliefs and routines. If you are on the right path, then it will re-confirm your choices. If not, you can explore new possibilities.
Through self-development, hurdles, struggles, and victories you can be more aware of the processes involved in change. Sometimes awareness itself can make one more empathetic.

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RTweek18

It is becoming an annual tradition for me in the RT Week to write a quick note to express my gratitude to those who have made a difference in my career and professional life over the past year.

Thank you to (in no particular order):

Nancy Garvey and Dilshad Moosa who continue to support my growth with RTSO. Thank you RTSO for allowing me to be part of the family.
Dr. Mika Nonoyama, who gave me a unique opportunity to teach on a topic that I am passionate about.
The CSRT team who continue to motivate and support me in my drive to help the RT community. One of my first supporters and I will be forever grateful!
Eric Cheng, one of the founders RTWB, for introducing me to Annette who shared her amazing perspective on working in Kenya.
Tom Piraino, Tony Kajnar, Carolyn Greer, Shawna MacDonald, and Annette Lievaart for taking the time to answer my questions for my recent blog posts.
Bernie Ho, Tony Kajnar and Dr. Shukla for always being willing to answer my clinical questions.
Christina Sperling, Kathleen Olden-Powell, Kathleen Frame and Carolyn McCoy for being open to hear my thoughts and to guide me with their wisdom.
Novus Medial Inc team for always being open to my technical questions. Also, awesome T-shirts at the Vancouver CSRT2018 conference!
John Meloche and MeloTel for giving me the online space to operate and run my website! One of my first supporters!
Christiane Menard, Noel Pendergast, Rachel Allen, Shawna MacDonald, Mieke Fraser and Katherine Tran for their ongoing support of my online presence.
And of course, the ongoing support of my girlfriend and family.
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ASBESTOS

Canadian government is taking steps to limit the use of Asbestos. While this is not a complete ban, and some exceptions exists, it is still a step toward the right direction.

Occasionally at the PFT lab we have individuals who have been exposed to Asbestos, and we perform the testing to rule out interstitial lung disease.

CBC has a piece on this which you can check out at:https://www.cbc.ca/news/politics/trudeau-asbestos-cancer-regulations-1.4867684

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RA

At the Pulmonary Function Testing lab we assess and monitor patients who have Rheumatoid Arthritis (RA).
“Interstitial lung disease may be a manifestation of RA or may be a complication of RA therapies, such as methotrexate and leflunomide.” -Daniel Aletaha, MD and Josef S. Smolen, MD.
If you want to learn more about RA, check out:
Diagnosis and Management of Rheumatoid Arthritis-A Review. Oct 2 2018
https://jamanetwork.com/journals/jama/fullarticle/2705192?guestAccessKey=4054e5dc-45b4-4fd7-bec5-e6a9a4c14a87
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Cannabis

Recreational marijuana use is becoming legal in Canada in just few days. With the political, legal and financial debates aside, there are health concerns that the public, users and healthcare providers need to be aware of. I have attended few talks on this topic and have read few articles that cover this issue in details. While I did not become an expert, I have noticed a common message:

Inhalation of marijuana can lead to temporary and permanent damage of respiratory system.

  • Review and share this collection of Questions and Answers by CBC: ok https://www.cbc.ca/amp/1.4856021
  • Avoid and limit your inhalation of airway irritants.
  • Please do not drive under the influence!
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