Rehabilitation: “Embracing the Gift of Second Chances”

This week, I was fortunate to visit the pain clinic at Mount Sinai Hospital in Toronto. It was an incredible opportunity and allowed me to explore my future direction in specialization and research. Dr. Rebecca Titman, a physiatrist, leads a unique pregnancy pain program there. As my focus is on pregnant women and children in both research and clinic, I am thrilled to have made some valuable connections during my visit. 

I recently learned that WHO has outlined guidelines for children with chronic pain. Shockingly, between one-quarter and one-third of children may experience chronic pain. This not only affects their physical well-being but also their emotional, psychological, and social development, as well as their families’ overall well-being.

Children are unique, both physically and developmentally, compared to adults. Consequently, they require different pain care approaches. As I embark on my journey at SickKids and continue working on my PhD thesis, I can’t help but see the immense value of improving diagnostics and treatment measures for these young patients, whether dealing with infectious diseases or rehabilitation.

Antibiotics treatment: Balancing Benefits, Risks, and Resistance

Group B streptococcus
Picture from my experiments. Incubation of whole blood with added bacterial challenge.

So, still working on the interactive (neonatal) infectious disease case…Today, I want to dive into a topic that often leaves some us scratching our heads: Antibiotics treatment!

Starting or not starting antibiotics is like walking a tightrope between not wanting to jump the gun and wanting to nip that infection in the bud. We worry about unnecessary antibiotic use, but we also don’t want to risk the infection spreading or getting worse. It’s a tough call! We need to weigh the severity of the infection, consider the patient’s medical history, and rely on good old medical judgment to make the right decision.

When it comes to stoping the antibiotics. It’s a balancing act between ensuring a complete recovery and avoiding unnecessary exposure to antibiotics. It’s almost like playing detective…Has the infection been fully eliminated or are we just temporarily putting it to sleep. All the while, the fear of antibiotic resistance lurks in the background, reminding us not to overstay our welcome with these powerful drugs.

Lastly, we have to take into account the specific bacteria causing the infection and its susceptibility to different antibiotics. It’s a delicate process that requires expertise and a deep understanding of microbiology. Thank goodness for the amazing healthcare professionals who guide us through this maze and make informed choices.

It’s like a never-ending puzzle with high stakes. But fear not! We’re getting better at tackling these challenges.

Conquering Deadlines

Salsa festival

As usual I find myself juggling multiple responsibilities while also taking time to experience the vibrant cultural festivals here in Toronto.

One of my major focuses recently has been working on an exciting PhD article about experimental group B Streptococcus maternal vaccines. It’s fascinating to explore a vaccine that has the potential to protect both mothers and their newborns from harmful infections. But let me tell you, diving into the world of immunology and conducting research can be quite the adventure! 🧪🔬

I am also reviewing some comments on a paper regarding a maternal sepsis model. Receiving comments from peer-reviewers is in many ways an enlightening experience.

But it wasn’t all work! Toronto is known for its vibrant and multicultural atmosphere, and I couldn’t resist immersing myself in the city’s cultural festivals. This past weekend, I had the chance to attend the Salsa Festival. The food, energy, music, and dance moves were simply mesmerizing!

Tommy Thompson Park – view from bike trail

Experiencing these cultural festivals served as a reminder of the importance of balance in life. Amidst the rigorous demands of academia, it’s crucial to find time for joy, exploration, and connecting with diverse communities.

The Fascinating World of Neonatal Radiology Rounds

Toronto is a city that never fails to captivate! From strolling through the charming streets of Kensington Market to exploring the iconic CN Tower and experiencing the cultural richness of the Distillery District, there is truly something for everyone.

As a health worker, my recent visit to this captivating city included both delightful experiences and professional responsibilities, including the mandatory tuberculosis (TB) screening tests.

Today I had the opportunity to participate in virtual radiology rounds at the NICU. These rounds involved discussing various X-ray images and unraveling the mysteries behind the conditions affecting newborn babies. It was both a humbling and intellectually stimulating experience, as we delved into the world of differentials, debating whether the condition was infectious or congenital.

Interpreting X-rays in newborns proved to be an entirely different challenge compared to my own scans. The intricate nature of neonatal anatomy, coupled with the range of potential abnormalities, requires a keen eye and deep understanding. However, it is the collective effort of the multidisciplinary team, including radiologists, neonatologists, and other specialists, that truly make a difference in deciphering these conditions and providing the best care for these precious lives.

In clinical practice, having adequate time to carefully assess a patient and consult with experienced colleagues improves patient outcomes. Similarly, in research, a dedicated team working together with shared expertise is crucial for analyzing data, developing new insights, and advancing medical knowledge.

As a doctor and researcher, I am no stranger to the demanding nature of my work. Long hours, challenging cases, and the pursuit of scientific breakthroughs can easily consume one’s life. However, my colleague’s untimely passing has prompted me to reflect on the importance of finding equilibrium between my professional and personal spheres.

Severe neonatal infections and the Global Health Challenges

During the Pediatric Grand Rounds, I had the opportunity to attend a presentation closely related to my own PhD research on the diagnostic and prevention of severe neonatal infections. The speaker, Dr. Alasteir Fung, is currently pursuing a PhD in Clinical Epidemiology and Health Care Research at the Institute of Health Policy, Management, and Evaluation. His research aims to develop a prediction model for infant hospitalization by utilizing clinical features assessed by community health workers during home visits in Dhaka, Bangladesh.

In my own project, I am focusing on metabolic profiles. By exploring the potential of metabolic profiles, I aim to contribute to the development of more targeted and effective strategies for managing neonatal infections, ultimately improving the health outcomes of this vulnerable population.

Exploring Walk-In Clinics and Engaging in Virtual Rounds

As a PhD student, I have developed a deep appreciation for the Norwegian health care system. Recently, I experienced firsthand the importance of having health insurance. I required Tuberculosis immunization screening tests, and the expenses without insurance are evident. 

In addition to exploring walk-in clinics in Toronto, I have been fortunate to receive access to virtual teaching sessions for resident doctors at SickKids. This has proven to be an invaluable opportunity for me while awaiting my credentials. I had the opportunity to expand my knowledge about the Pierre Robin sequence (PRS). PRS is a condition characterized by mandibular micro- or retrognathia (abnormally small or receding lower jaw) and glossoptosis (downward displacement or backward positioning of the tongue), with or without a cleft palate. Clinically, it manifests as intermittent upper airway obstruction (UAO), potentially causing breathing difficulties.

In approximately half of the cases, PRS is accompanied by other malformations. However, when PRS occurs in isolation without other malformations, it does not seem to directly impact neurodevelopment. Nonetheless, it is important to actively intervene and address the UAO to mitigate the risk of neurocognitive impairment.

Supergood and getting better!

Managing a variety of tasks as a PhD student in Toronto while fulfilling obligations in Norway can be challenging. While I cannot claim expertise in this matter, I learned a valuable lesson during my niece’s Martial Arts class. The instructor asked the children, “How are you doing?” and they enthusiastically responded, “Supergood and getting better!” Inspired by their attitude, I have adopted the mindset of striving to be supergood while continually improving.

During these past few days, I have embraced this approach. I have had the opportunity to witness and enjoy the Canadian celebrations of July 1st (Independence Day). Additionally, I dedicated time to working on the systematic review related to GBS and the GBS interactive case. Tomorrow, a new adventure awaits as I embark on orientation at the SickKids hospital, where I will be visiting for the next two months.

Though I cannot predict the exact challenges that lie ahead, I am committed to approaching them with enthusiasm, a willingness to learn, and the determination to excel.