The Evolution of the Handshake

Some people wonder what I am doing with my elbow when they try to shake my hand. Let me explain...

The handshake is a greeting or parting tradition where two people grasp hands for a few moments. It has a long history dating back at least to the ancient Greeks (like everything else!). Its purpose is to convey trust, respect, balance, and equality.

In 405 BC, an Athenian and a Samian clasp hands in alliance against the Spartans.

There are cultural variations of the handshake. For example, in Anglophone countries it is often used to seal a business deal, which concludes at the end of the handshake. In countries like Morocco, it is accompanied by a kiss on each cheek.  In other countries, it may be followed by a palm placed over the heart.  In Asian countries, a weak handshake is preferred.

Other variations are the Bone Crusher, the Pumper, and the Long Grip. Mr. Trump's handshake that aims to establish control is sometimes called the Showdown.

Some people become concerned that handshakes transmit infections like bacteria, viruses, and parasites. Baseball Hall of Famer Stan Musial became concerned about the number of colds he was getting and started using a fist bump instead, and it gradually became more commonplace, especially in sporting events.

The Fist Bump

The Friendly Fist Bump, and the non-touch Namaste respectful bow.

President Barack Obama does the Elbow Bump to greet supporters.

Dr. Steve greets swim friend Candace with the Elbow Bump at the pool.

As you can see, I have adopted the Elbow Bump. It combines a friendly greeting with touch while restricting exposure to illness-causing germs. Very few people manage to sneeze onto the outside of their elbow. 

So I hope you will find your own way to greet another, maximizing mutual respect while minimizing contact with germs.

Six Year Check Up

Wow! Are we overdue for an update! Last week, I completed my 6-year follow-up post transplant. Yes. That is indeed 6 years! And all is clear. My doctors have now told me "You're not likely to see that one again."

Not that there haven't been bumps in the road. Last February I ended up in hospital for a week with bilateral pneumonia. I was found to have an immune deficiency as a result of my therapy. After antibiotics and weekly immune globulin shots, I have been infection-free. It helps to pull back from the walk-in clinic and focus on the family practice and teaching. And I have now returned to the sports I love.

Penticton Bike Trip

 Leo, the family cat, rescued a fallen bird from the ground, not once but twice, and then bonded with it. We nursed it back to health and launched it into the trees. We think we hear its trill periodically and wonder if it has found its clan.

Leo and his new friend, Tweety.

As some of you may know, Caroline and I have separated. Even good marriages with great kids sometimes take different directions. I am grateful that I now have a new special person in my life.

Steve and Sylvia

I went on to break two ribs doing sports (I know, I need to be more careful) and spent the summer healing. The best therapy of all was floating around in the Mediterranean Sea, eating good food and relaxing with family and friends.

Now, the summer smoke has abated, fall is here, and life goes on.

No man ever steps in the same river twice, for it’s not the same river and he’s not the same man.” Heraclitus 475 BC

Sunset swim in Skopelos, Greece.

“

Blood Sister Reunion - Part 2

Have you ever met a new relative for the first time? How about a new sister acquired by stem cell transplantation, who also happened to save your life? This happened last week and The Vancouver Sun and Upnorth Live from Michigan were on hand to document the joyous event.

The Vancouver Sun ran the story on the Front Page

Katie Karker flew in from Michigan with her mother-in-law Cindy and at 10 am on Wednesday May 11 in Richmond BC she strode across the hotel lobby and I embraced her. Five years earlier she had donated Stem Cells to a man in another country she had never met. Now she could meet the person she saved.

The Sun ran the video version of the story on line: Vancouver Sun

Far away in Traverse City Michigan, Kristin Lowe reported the story for the 6 o'clock TV news:

UpNorthLive

The next day was May 13. It was Katie's Birthday. It was also the date I was slated to present the keynote address to the annual convention of CSTM or the Canadian Society of Transfusion Medicine at the Bayshore Inn.

The CSTM Annual Convention attracts over 500 health care participants.

A video excerpt of the presentation:     CSTM Keynote Address

CKNW covered the story for  the Jill Bennett Show:CKNW News

                                                                                           Bayshore Birthday Brunch for Katie, hosted by family.

Sisters: Blood Sister Katie in my Right arm, Biologic Sister Michelle on my Left

My friend Jim Wright wrote about my transplant experience in the bi-weekly column in the  Richmond News ,
Digging Deep: Sisters

                        

                        Riding the Wizard Chair at Whistler.

                                       

                                                    Jade earrings & Birthday treats for Katie at Araxi's in Whistler

Remember, if you are between 18 and 35 years old, or know someone who is, you can register on line at OneMatch.ca. You too could one day save someone's life. 

Blood Sister Reunion

It has been almost a year since I last posted when I skidded into a hip fracture. The bones have healed, the bike has been replaced, and the wheels are once again rolling. Jason and Zoe both graduated from their respective universities and embarked on the next phases of their lives. I went to Greece and convalesced in the therapeutic waters of  the Aegean.

The wild side of Skopelos Island at dusk

There was a short visit to Arizona and a trek into the mystical mountains of  Sedona.

Mistletoe meets Oak in Sedona. 

The winter included celebrating Christmas with my loving family,  hitting the slopes, and building fitness.

Jason, Steve, and Zoe

 And spring is now here. At this time of renewal, five years since my diagnosis of lymphoma, it is fitting that my Bone Marrow Donor and saviour, Katie Karker, will fly in from Michigan to visit. We now share the same blood type and blood chromosomes, making her my sister by blood.

Max, Katie, and Wyatt Karcher

 Her donation and the impact it made north of the border have made her a bit of sensation in her town of Kingsley and she will be bringing the local press. Together we will present our story at the upcoming Canadian Society of Transfusion Medicine Conference in Vancouver and make our pitch for more Stem Cell donors. If you are between 18 and 35, or know someone who is, consider registering at OneMatch.ca., and give someone else a second chance at life.

That Moment of Inattention

How often do we let our minds drift off while we are doing something? Usually the results are benign. But sometimes they trigger a jarring setback. Mine came while I was riding my bicycle alone. My brain and hands were not focused on my handlebar, and when my front wheel encountered a dead rat, I turned abruptly and slammed into the roadway.

xrays after pinning of trochanteric hip fracture

After a week in hospital, there was a week in convalescent care at my parents' home in Vancouver. Then home to Surrey and re-deployment of my helping army. No shortage of work. Cooking, cleaning and driving. I continued to phone in to conferences and hold meetings in my living room. Office practice was out, and Dr Oriee kindly took over my patients for the next 3 months while she was building a practice of her own.

Recovery was complicated by infection, skin reaction, and high-dose antibiotics and steroids. But recovery did occur, and soon I was on my stationary bike and swimming in the pool.

Riding towards the light

During this time, there was ample opportunity to reflect. I was told, "You didn't get it the first time". Reading, planning and sleeping became the order of the day.

Greek Easter with lamb roasting on the spit

Peace Arch Foundation Fundraiser CODE BLUE

I'm now getting back to work, armed with new lessons learned.

Instructions for living a life. 

Pay attention. 

Be astonished. 
Tell about it.

― Mary Oliver

The Gift of Neuroplasticity

The lifesavers called chemotherapy and radiotherapy have side effects. One is chemo/radiation brain, also known as brain fog. If you get both treatments, as I did for lymphoma, that effect can be greater. 

So, what happens? We know that some of the connections between neurons—brain cells—are lost. That leads to losses in concentration, short-term memory and multitasking.  The effects may be compounded by depression and/or post-traumatic stress disorder as patients come to grips with their new reality. 

Functional MRI showing changes in the brain after chemotherapy

I certainly experienced this after my therapy and release. After four months in hospital, I was thirty pounds lighter than when I went in, and I could barely climb the stairs, let alone deal with complex cognitive tasks. Good nutrition and daily exercise enabled me to return to work after another year, but I was not up to my usual speed.

Then something happened. I changed my bike route, a trail through the Watershed Park that I routinely took for daily exercise. When a fallen tree blocked it one day, I took a different trail. As I rode along, a memory appeared, a joyful recollection of riding along that path years before with my then-young son. A connection to my earlier life had come back. I tried another trail. Same thing, that time with a painful memory of falling off my bike and dislocating my finger.

I explored trail after trail until a flood of memories overwhelmed me. It told me that the key to full brain recovery is rooted in stimulating old memories and challenging the brain in creative ways.

That led me to research. In the past, it was thought that damage to the brain is permanent. Over the last decade or so, the concept of neuroplasticity has gained traction. Neuroplasticity is the ability of the brain to adapt and change by modifying existing neural networks and creating new ones. The neural network is a pattern of connections of neurons that fire in sequence and allow us to accomplish complex tasks. "Neurons that fire together wire together" (D.Hebb).

The complex network of trails in the Watershed Park. Using a variety of trails has revived a variety of connections. 

The complex network of neurons in the brain (schematic). Using a variety of pathways strengthens a variety of connections.

This brings us to BDNF, or Brain Derived Neurotropic Factor, a protein that supports the survival of existing neurons and encourages the growth of new neurons in the brain. We know that BDNF is increased with regular exercise and the ingestion of omega 3 fatty acids as found in oily fish. It looks like that effect is far greater when the exercise challenges the body and mind in new and interesting ways every day.

So let's get out our old Eric Clapton albums or get out and Zumba or take some new old routes.

Steve with Al Jenkins after R2S 

Re-Entry

When one re-enters life after family death or divorce, one can crash and burn. Or one can float gently into the arms of Mother Earth, and that is how I wanted to come back after recovering from cancer. But even parachuting in, there can be an unscheduled landing on bystanders, who become casualties.

It is now three years since the bone marrow transplant that enabled stem cells from my donor to banish my lymphoma. I have gratefully returned to work in my family practice and community, and I have resumed most of the sports and activities of my former life.

I had promised myself a longer trip to Greece this year,  and I went for the month of August. After joining up with family I immersed myself in the golden light and honey taste that is Greece.

I was able to affirm life and love by connecting with my parents, my sister and her kids,  and extended family and friends.

I also spent time with my own kids, who are preparing for entry into a world without the familiarity of home and university.

Re-entry from cancer therapy is fraught with pitfalls, unexpected challenges. I came back to changed relationships and professional obligations and a temporary dip in my health. The landscape had  shifted while I was gone, and it jolted me out of my siesta and into a new focus. And that's okay.  One just needs to make space.

Though I've flown 

One hundred thousand miles,

I'm feeling very still,

 My spaceship knows which way to go.

Our commander comes back down to Earth,

and knows.

(Thanks to David Bowie, Commander Chris Hadfield, and Beth Johnson

view video https://www.youtube.com/watch?v=poZCINzxzrQ)