Tuesday 26 January 2016

Y3 Summer Holidays: Settling into a new town

Welcome to Nelson!

Sunrise up Barnicoat Walkway, Nelson
This is part two of my 2016 summer holiday blog post.

New years at the Balmoral Street Flat, camping on a friends back lawn - it was similar to the University of Otago's orientation week 'Tent City', although on a much smaller scale. After New Years I shifted to the Scotia Street flat having been recommended and put in contact with the tenants there through a physio mate of mine late last year. With my New Years mates all gone, this was my new temporary family... and what an amazing family they were! I was very lucky to be one of their many travelling friends who have stayed at their flat (there flat is a legacy). We would later go on a few tramps and swims around Nelson... I've become a part of their adopted family.

I looked at a flat in Washington Valley over new years. I went down the wrong street thinking I was in the right place, and pulled my car up at the house number I thought was my destination to be greeted by an unfriendly voice hiding in the darkness of their garage. Needless to say I couldn't work out where the voice was coming from. They stated that I had better move my car before their mate arrived or else he would smash my car in. Great neighbourhood, right? [sarcasm]. So I promptly drove back to the street, rang the contact for this room for rent and discovered they were a block over. Thank goodness! I viewed the house, it was alright - there were a few alarm bells ringing there too [metaphorical]. On returning to the main road I witnessed a learner driver going slowly around the round-a-bout and a rough looking car behind them tooting, with a rough looking lady pulling the fingers out the window and cursing at this car. When this car reached their exit, they revved giving their car guts [planting their foot on the accelerator]. I was less than impressed with the area - I've decided it's the ghetto of Nelson (although I'm sure there are more welcoming people around the area).

Poverty is prevalent in New Zealand. It didn't take long for me to find the low socioeconomic areas of Nelson (obviously, they have the cheapest rent... alluring for students living on a budget). But more disheartening was to find people sleeping under bushes in the public gardens in Nelson, and by day sitting outside shops in the main street hoping for charity from passers by.

Tahunanui Beach - super warm and shallow to swim in!

10th Jan: I've found and moved into a house in Stoke, Nelson. I'm feeling stoked! [Pun]. One useful tip for getting a flat is to arrange the first viewing of the day, that way the nice owner feels obliged to give the room to you. Hah! I'm flatting with the owner and her brother, and a Canadian couple who are on a working holiday. The neighbourhood has a good vibe too. Hooray! The first day, before I had even moved my stuff in, we were off to the pub for an afternoon of introductions. Subsequent days at the flat were filled with home-baking / cooking and Monopoly - I think it's going to be a good year!!


My flatmates and I went to an an epic swimming location in the Lee Valley Stream...
Substantial drop, 5 - 6m (or more)



... Oh and if you thought that was high (I sure did) then downstream is a spot called suicide rock. This rock is probably greater than 20m above the stream.. My Canadian flatmate (Nick) jumped off it twice just to have two different angles recorded on his GoPro (he had concussion like symptoms upon getting out after the second jump) - I didn't dare jump off. Here he goes (image below)...




Aaron, another flatmate, took us 4x4ing along a river out at Appleby at 11pm one evening (we waited for Valerie, Nicolas's partner, to finish work).


Getting to know the Nelson area wasn't too hard. I was fortunate to begin New Years with mates who had their GPS on hand. Lucky for me, I had my own GPS once they left. I've since tried weaning myself of the GPS - trying to get to and from places without its use. Nelson has many round-a-bouts, which initially I found very confusing (I still take the wrong exit now and then!). I also took my bike out on multiple days to explore Nelson's awesome cycle network - Dunedin should take a lesson from Nelson's cycleways.




Walking around Nelson is another good way to get to know the area, and pick up on details like signs/shops/views that you would otherwise miss if you were biking or driving. I walked from Stoke to Nelson to pick up a capo and a couple of picks for the guitar and timed myself - 45min to the hospital and another 20 to the Nelson main shopping area. Good to know. On my walk in, via Nelson South, I passed a Maori lady and gentleman with three children whom I'm guessing were around 5 years old. They were picking up a box of smashed glass & pottery kitchenware from the footpath (near a round-a-bout... see, I told you there were lots of round-a-bouts in Nelson...). I stopped to ask if they needed any help cleaning up. The lady said somebody had gone to retrieve a brush, and continued to say that the mess wasn't theirs - they had only stopped to clean it up. She said "It's our community, we've got to look after it". I walked away feeling a sense of pride for their community. 

Sir Stanley Whitehead walk track overlooking Nelson at sunset
 Things to know about Nelson
  • There's a street which is a large pedestrian crossing... in fact, there are lots of raised platforms around which serve as pedestrian crossings (local by-law - elsewhere in NZ pedestrians must give way to traffic before using these). Whilst on the topic of law, there are lots of police enforcing driving speeds.
  • There are three surrounding national parks: Nelson Lakes National Park, Able Tasman National Park, Kahurangi National Park... oh and I suppose Malbrough Sounds National Park and Richmond Forest Park should be counted too... so five surrounding national parks for tramping and outdoor recreation.
  • Lots of warm weather, sunshine, ants, bear feet.
  • It is rumoured that the further toward Golden Bay / Takaka, the more hippies there were to be found... and yes, this means a lot of Marijuana around that neck of the woods.
  • There are not many Chinese Takeaway shops in the Nelson area when compared to Dunedin.

Useful websites listing things to do in Nelson:
The local lingo:
  • Motuaka is called Mot
  • Kaiteriteri is called Kaiteri
  • Tahunanui is called Tahuna
Local walking tracks (that I've discovered so far):
  • Barnicoat Walkway
  • Grampian Hills
  • Centre of New Zealand
  • Sir Stanley Whitehead walk track
  • Maitai Valley caves
  • Airport perimeter walktrack 
Local swimming locations:
  • Maitai valley stream & Lee valley stream 
  • Tahuna beach & Rabbit Island beach.
Other summer activities in January.
  • Kite festival
  • Busking festival 

Buskers Festival
Buskers Festival
 ---
Centre of New Zealand at sunset (9minute exposure)

Cathedral / Church in Nelson
The rear entrance to the cathedral / church in Nelson

I was fortunate to be given a head start on making new friend networks. These guys have been absolutely awesome - taking me on a few day trips and hanging out in general.

Photos before entering the Maitai Caves
The Maitai Cave is a short drive from Nelson down the Maitai Valley
Sylvester Hut, Cobb Valley.
Lake Sylvester
Wrapped up warm after swim in Lake Sylvester!!

"Summer Movies El Fresco" Outdoor movies, under the stars, in summer!
For $2 you can attend an outdoor movie. I went along to Guys and Dolls (1955).

New Zealanders will be quite familiar with Grab-a-seat, an app for cheap flights around NZ. I've just discovered https://www.transfercar.co.nz/ which could be just as exciting - so much so, that I'm making it a goal to use their service for a road trip before 2016 is through. Check it out!

Forms, forms, physio forms. There are a few forms to be read, signed and dated - police vetting in compliance with the Vulnerable Children's Act, personal information for the DHBs (name, DOB, address, contact info, next of kin etc), information technology, codes of conduct, confidentiality etc... The easiest way to manage these forms is to fill them in and sign them electronically, then email them back to the sender.

More Physio Blogs I've stumbled across.
- PhysioJackThinksBlog
- BecomingMoreHumanBlog

I've had a good introductory taste of Nelson. My first impressions of Nelson are very positive. I could see myself living and working here after this year of placement... we'll just have to wait and see.


Monday 4 January 2016

Y3 Summer Holidays: The Road to P4

Results are out and I'm still a B average student. That news is not necessarily disappointing as I got two B+ grades for PHTY354 & PHTY355, the full year physio specific papers. I'm actually quite happy to have passed and able to proceed with my last year of study. With no more formal weekly lectures or labs (and associated assignments or exams), I'm pleased to say that I'm ready to begin 4th year physiotherapy. As a placement year (and research) I look forward to spending more time making people's lives better. It's a shame we don't get paid to be on placement... apprentices in the trade industry get paid to be an apprentice... oh well. No doubt I'll try to find some casual hours of employment in Nelson for the year.

Here's a summer bulletin of what's happened over this summer.

All Blacks beat Australia 34 - 17 in the RWC final.
Passing of Jonah Lomu, NZ Rugby legend.
Paris (France) bombings from Islamic extremists/terrorists.
NZ flag referendum.
TransPacific Partnership Agreement (TPPA)
... news bulletins are always so depressing.
As alluded to in the previous paragraph, I'm shifting from Dunedin to Nelson to complete my final year of undergraduate physiotherapy. Therefore it's appropriate that I share the road trip starting in Dunedin and finishing in Nelson.
Nelson Street.... In Dunedin. Ha!
Dunedin, the city with a country feel. Here's the view as we look back on the north bound highway.

  • Shifting flat gear back to my parent's place in Waimate for storage... and why not take a few pictures of the aurora while I'm there. So I did.
Aurora view from parent's farm in Waimate.
Aurora from Waimate Shed on State Highway One.
Went for a walk up Mt Studholm, Waimate
  • Running around in a new car as my previous car's motor died [sad face]. Brought this vehicle off a newly graduated physiotherapy student.



  • Caught up on some new release movies, like Everest (2015). A film about New Zealand mountaineering guide, Rob Hall's tragic and heartfelt last ascent of Mt Everest. As it turns out, my mother worked with him at Mt Cook in NZ before he left to guide people up Everest. Great guy, an excellent tribute, a must watch.
  • Trip to the stunning scenery and tourist magnet, Milford Sounds, to chill out having brought a discounted tour of the Sounds a month ago. Milford sound is actually a fiord.



  • Heck, why not do a bit of tramping whilst we are there.
Lake Marian.
Earland Falls, Routeburn track.

  •  I went on a few other photography "expeditions"

Catlins, New Zealand!!






McLean Falls, Catlins conservation area (South of Dunedin).
Bluff, bottom of the South Island!!

Around Dunedin!!

Sunset on Moraki Boulders, north of Dunedin
Sunset on Moraki Boulders, north of Dunedin

Sunset over Tunnel Beach, Dunedin.
  • I attended the South Island Sevens tournament as a sports medic on the 27th November '15. It was a full day of Rugby Sevens action held at Alpine Energy Stadium in Timaru. The weather was hot, gusty and I got sunburnt. I was working alongside South Canterbury Sports Medic, Andrew Stratford. A couple of teams had a team physio which made the day easier for us! Between Andrew and I, we saw around 20 patients. One point of interest for me was seeing how many officials / referees needed treatment.
Alpine Energy Stadium, Timau.
Team benches, officials and SkySport... pitch-side view from the medic tent.
Scored a free cap for volunteering!

  • Employment over summer is important too... 
"It's about who you know, not what you know"

... Then again, your work environment may leave you with a few health problems. So here's a quick case study: "Asthma-like attack without actually having asthma".

Background: After only three days of starting a new job (two days working with the product) I checked myself in to the emergency department. I was working in a factory with fine powders and spores / fungicides. I had been using an industrial face mask in the high risk areas. I was having trouble breathing on the night of my second day of work. I felt much better in the morning so I rocked up to work and increasingly became more short of breath, so much that by 3pm I bit the bullet and told my boss that I was having breathing problems. I was at a panicking stage and I felt claustrophobic in the mask. Any mild physical exertion left me even more short of breath. I would rip the mask off, even in the higher risk areas, just to calm myself down. We did the first aid thing, letting me sit down in some fresh air for a while. It became apparent to me how necessary our lungs are for speaking. After a few mask tests and practising some relaxation techniques, I was able to help out a little bit to finish off the days work. Then I checked myself in to ED at the Hospital around 5:30pm thinking I was having some allergic reaction to the spores.


Emergency department: The hospital staff are super friendly and I was admitted without any waiting around. They had processed around 120 people, since lunch, on my arrival (nb. it was only Wednesday)... busy bunch!! I gave them the run down between gasping for air. They had a listen, pushed some  fluids (IV line), hooked up 12-leads, took some bloods (AGB), and a picture (CXR) as well as dosing me up from a few different inhalers.

Shortness of breath, HR 145, RR 20, BP 135/79, few fine crackles R) base.
ABG: pH 7.61, PCO2 21, PO2 53, HCO3 21, lactate 1.8, O2Sat 93%
 CXR: increased interstitial marking R) base.

They weren't completely sure what was going on, but explained that they would like to keep me under observation and do a few more tests. By this time I was feeling much better but thought it was the best option. So I was admitted as an inpatient. That night I was woken up every few hours... to be fair, I wasn't feeling very sleepy after taking Prednisone before bedtime. One of those times I was awoken during the night was to produce a urine sample, so I did. Whilst in the bathroom I realised my face was looking very dark and dusty - no better time for a quick face wash before filling up my specimen container. In the morning I enjoyed breakfast and a few yarns with the three very sociable gentlemen sharing Ward 7A. One of which had attended the School of Physio Chronic disease exercise class at Unipol on Wednesdays - we had a good chat about that. Later that morning I done some spirometry tests (albeit a struggle to complete without coughing) - got a good refresher on the procedure and using a ventilator from the respiratory physiologist taking me for the test. I then came back to a cooked lunch and was discharged an hour after that.

Pre-Bronchodialator FVC 96% predicted, FEV1 91% predicted, FEV1/FVC 79% predicted.
Post-Bronchodialator ~1-2% change (nb. I wasn't having any shortness of breath at this time).

I was diagnosed with a reactive airway dysfunction syndrome... obviously my lungs weren't too happy about the air quality at work. I'm feeling pretty good now apart from a very persistent dry cough. Now what? Oral medication for 10 days (prednisone) followed by flixotide inhaler twice daily for a month, then a check up with the respiratory specialist in Nelson and I guess I need a new summer job. ...So that was an interesting experience. The good team at Dunedin Hospital made me feel very well looked after from admission to discharge. My aim throughout my career is to give my patients that same high level of care.


12 Lead ECG setup!
    Arthurs Pass (en-route to  Hokitika for Xmas)
  • I spent Christmas with family in Hokatika. Whilst there, I went on a tramp to Newtons Hut, went sea kayaking (a play around in the surf), biked to Lake Kaniere and Lake Mapua (swam in Lake Mahinapua), done some greenstone carving with my uncle (at the Mahinapua Hotel) & generally chilled with the family.


Morning bike ride to Lake Kaniere

 ^Above: Tramp to Newton's Hut (via Arahura river track near Hokitika)



Looking across to Mt Newton
  •  New Years with Mates in Nelson

New Years dip, Nelson
New Years gathering, Able Tasman National Park (Anchorage)

Bit of fun (flying fox), Kaiteriteri
Nelson Lakes (Eels under the jetty... we fed them chicken bones)

Nelson Lakes
Sunset on Nelson Lakes (Lake Rotoiti)
  • Many of the fourth years were selling and giving away their physio uniforms. Their banter was as good as last years 4th years. Here are a few messages to sell their gear.


Last year I coded each post Y3S1W1 for Year:Semester:Week. Medical students refer to their years as M1,2,3,4.. so I'm going to call my final year P4 (physiotherapy, 4th year)... copy cat, right?! For my final year, because we won't have semesters, I'm going to be coding each blog post as P4R1W1 for Year:Rotation:Week. There should be 6 weeks in each rotation, and a professional studies week(s) before each rotation - for me, this will be in CHCH.

My expectations for Nelson?
  • Friendly people.
  • Excellent placement opportunities.
  • Stunning beaches and tramping opportunities.
My expectations for P4?
  • A mix of fun, hard work, expanding my comfort zone, applying knowledge to real world situations, being independent and meeting new people.
  • A long year, long hours, after hours study... but to take time for myself too. 
  • A few road trips with peers to CHCH... probably getting lost in Christchurch.
  • Get along side the supervisors to get good grades.
  • Be prepared to be on a baking schedule/roster for each placement... apparently the quality of baking will contribute to overall grades too haha!!
My expectations for myself?
  • Get to know the Nelson culture. A previous colleague from Knox Rehab jokingly suggested that Nelson was a place for hippies... so we humoured the idea of cultural competence needed to be successful in Nelson. We concluded that Yoga, acupuncture, aromatherapy, meditation and bottled manipulation energy preserved in water (possibly could be diluted to a 1% solution) and topically applied were the most appropriate methods. Shoes would no longer be necessary. And "gardening" would be the single most common patient goal. So I might need to brush up on physical demands of using hydroponics! Haha! All jokes aside, I will need to fit in with the community - whatever they're like.
  • Join a club or get a part time job.
  • Go for day walks and explore nature.
  • Get a letter of recommendation from each of my placements to add to my CV
  • Pass the year and graduate in December.
My expectations for my peers?
  • They had better visit me in Nelson! Lots of tramping to be done!
  • Pass all the modules to graduate with me in December 2016.
  • Have their phones and computers ready for some catch up time and problem solving conversations.

The next post will cover prep for P4 (more forms, about Nelson and my flat hunt)