U of T prof’s startup takes cancer therapy to clinical trials

Pionyr Immunotherapeutics raises $62 million in series B investment round

U of T prof’s startup takes cancer therapy to clinical trials

A biotech startup co-founded by Sachdev Sidhu, a professor in U of T’s Department of Molecular Genetics, has drawn in $62 million USD following a second round of funding, bringing its total investments to $72 million USD.

Pionyr Immunotherapeutics, which is now planning to take its anti-cancer therapy to clinical trials, initially began as a research collaboration between Sidhu and Max Krummel, a professor at the University of California, San Francisco School of Medicine. Founded in 2015, the California-based startup combined Sidhu’s expertise in antibody phage-display technology with Krummel’s immune system biology research.

This project is a collaborative effort with Toronto Recombinant Antibody Centre (TRAC), which was founded by Sidhu and Dr. Jason Moffat, who is also a Molecular Genetics professor at U of T. Housed in the Donnelly Centre for Cellular and Biomolecular Research, TRAC researchers are working to harness the therapeutic potential of synthetic antibodies.

Synthetic antibodies can be engineered to target a variety of molecules implicated in disease and they are key for drug development. Pionyr’s anti-cancer therapy, known as Myeloid Tuning, uses the high specificity afforded by synthetic antibodies to bolster the immune system’s defence against cancer by manipulating a tumour’s microenvironment.

The immune system uses T cells to detect foreign molecules to evoke a defensive response. Because tumours are created from existing cells in the body, they evade recognition by T cells, dampen the immune response, and proliferate uncontrollably. The key is to restore the body’s immune capacity to fight cancer — this is the premise of immunotherapy in oncology, better known as immuno-oncology.

“So the idea there is simple: you want to turn on a T cell, you simply find proteins that are inhibiting that T cell,” said Sidhu.

Myeloid Tuning achieves this by “alter the tumour microenvironment to favour immune-activating cells over immune-suppressing cells” and enhances anti-tumour defenses. “T cells are activated not by targeting them but by eliminating the inhibitory cell population,” said Sidhu.

Pionyr’s technology could also complement existing anti-tumour therapies like T cell checkpoint inhibitors. Checkpoints are regulators that mediate communication between T cells and the immune system. They are responsible for fine-tuning the body’s immunity and downregulating it when it detects native cells, which would otherwise lead to an autoimmune response. By incorporating checkpoint inhibitors, therapies can be developed to block a tumour’s ability to evade T cell detection.

Ipilimumab, commercially known as Yervoy, set the precedent by becoming the first United States Food and Drug Administration-approved therapeutic antibody against skin cancers and for ushering in a new wave of immuno-oncology. The drug, co-invented by Krummel, inhibits cytotoxic T-lymphocyte-associated protein-4, one of many checkpoints found on T cells. Similarly, pembrolizumab, or Keytruda, inhibits the checkpoint called programmed cell death protein 1 (PD-1).

“Anti-PD-1 binds the T cell and… activates it that way, and then we add another antibody that eliminates inhibitory myeloid cells, so you get double [the effect],” said Sidhu.

Sidhu says there is a critical question in field: does the rest of the tumour simply not have T cells that can attack them or are there additional yet unidentified breaks? These possibilities are not mutually exclusive and are already being investigated. According to Sidhu, the future of immuno-oncology is already here.

Myeloid Tuning is a very promising method, but it is not the only immuno-oncology treatment in the works. Currently, therapeutic agents being researched involve other immune cells like macrophages and natural killer cells that can be exploited for anti-tumour therapies.

“[There is] very little that is not being explored as far as immune cell activation,” said Sidhu. “It’s exciting in that, while only a subset of cancers responds to immunotherapy, the ones that do respond often respond tremendously.”

Are french fries healthy after all?

Rejoice, U of T scientists have published a study in defense of the potato

Are french fries healthy after all?

A recent study published in the online journal Nutrition & Diabetes authored by U of T’s Department of Nutritional Science has found that potatoes and potato-by-products may have garnered an undeserved bad reputation among the health-conscious community.

Dr. G. Harvey Anderson,  executive director of the Centre for Child Nutrition and director of the study, would like to make it very clear that his findings do not give you the scientific green light to start inhaling as many french fries as you can get your hands on.

In fact, the key to results lies precisely in the fact that eating french fries will help you moderate your carbohydrate intake more effectively than alternative sources of starch.

“I grew up on a farm, [so] I’m a meat and potatoes person,” Anderson explained in an interview with The Varsity, “and you know I’m not young anymore, and I have no health problems. So I got thinking… if we eat meals, with [some] of those carbohydrates as a side — the french fries, deep fried or mashed potatoes, or rice, or pasta — which ones would stop you eating quickest?” 

To answer this question, Anderson and his team brought in 20 children, between the ages of 10 and 13, for a randomized crossover study to compare the participant’s caloric intake, blood glucose level and insulin production for three potato-based and two non potato-based types of carbohydrate.

The trick however, was that all the participants had to consume 100 grams of lean meat, in the form of meatballs, before they were allowed to start stuffing their faces with french fries.

According to Anderson, the ‘satisfaction factor’ of eating until you’re full had been frequently overlooked in previous studies on calorie intake, which is why the consumption of protein prior to the consumption of starch was such a key point of the study.

“If you have protein with your meal, protein is also satisfying,” Anderson explained. “…[T]his is often the problem with Italian pasta meals and so on, is that it tends to be all carbohydrate and not much protein, and so people get fat.” 

Ultimately, the human body requires carbohydrates to function. Yet not all carbs are created equal. What was most unexpected about the results, is that even french fries cooked in oil came out higher in the carbohydrate health hierarchy than pasta and rice. Mashed potatoes were the real winner, with children consuming 30-40 per cent fewer calories at meals.

The fried french fries (as opposed to baked french fries) lead to the lowest meal and post-meal glucose and insulin levels out of all the starches tested.

“The blood sugar for these kids went up quickly when they ate mashed potatoes,”  said Anderson, “and [although] it went to the same level as the rice and the pasta, but because it went up  quickly [for the potato starches], they stopped eating quicker. Somewhere on there there was a trigger.”  Anderson also pointed out that in addition to feeling satiated faster, starches consumed from potatoes rather than grains will fill your body with far more nutrients per calorie than those consumed from grains. 

“Potatoes have a better source of vitamin C than orange juice or bananas, and yet doctors recommend bananas… for potassium,” Anderson explains. “Potatoes are a very healthy vegetable — they’re a vegetable. Rice is not a vegetable, it’s a grain, and so is pasta.” 

Anderson emphasizes that young people shouldn’t be afraid of carbs — especially not potatoes. As all nutrition advice goes: all meals should be balanced, and all foods should be consumed in moderation.  “All I’m saying is that the advice is… don’t just eat pasta by itself or french fries by itself,”  says Anderson, “ make sure you have a protein. It could be tofu, it could be a vegetarian source, or it could be fish — it doesn’t have to be meatballs.” 

“Take the time to eat a meal, eat a combination, and then all your carbohydrates are healthy.”   

Five ways you can “clean up” your diet

The “clean eating” trend doesn’t have to be restrictive or expensive

Five ways you can “clean up” your diet

As it happens, the old adage, “you are what you eat” usually holds true. What we consume and how we consume it affects how the trillions of cells in our bodies function. For students especially, eating has the ability to influence our mood, sleeping patterns, energy levels, and immune systems, all of which can be affected by the lack of sleep, exam stress, and lack of self-care students tend to experience.

In order to optimize the functioning of our brain and body, we have to start with what we’re feeding our cells. This means cleaning up the way we eat.

The concept of “clean eating” emerged out of programs like the South Beach Diet and gluten-free trend which advocate for eating more or less of a certain type of nutrient — like carbs or protein. The basis of clean eating is to consume food in the most natural and unrefined state possible. Although the concept has received a bad reputation for being too restrictive and expensive, basic principles of clean eating — like choosing foods that are nutritious and unprocessed — are changes we can all benefit from.

To get everyone started on their journey to optimum health, here are five ways you can clean up your diet.

1. Avoid packaged foods

Although not all packaged foods are bad, like chickpeas and oats, most foods that come in a package are heavily processed. Many processed foods contain additives, preservatives, excess sugar, and sodium. These can have negative effects on our health — not to mention our waistlines. One way to distinguish between “good” packaged foods and “bad” packaged foods is to look at the ingredient list. If the list is full of ingredients you can’t pronounce or is longer than 10 ingredients, it’s best to leave it on the shelf.

Tip: Prepare your meals at the start of every week so you don’t feel the need to buy something fast or pre-packaged when you’re running between classes.

2. Hydrate with water

Juice and soda may momentarily quench your thirst, but these beverages cannot replace the superpowers of water. It’s very easy for students to get caught up in busy routines and forget to stay hydrated, but drinking regular amounts of water throughout the day is important for optimizing your health. The amount of water you should drink in a day depends on your activity level, but the standard is generally eight to ten glasses. Staying hydrated with water is crucial for eliminating toxins from your body, keeping your energy high, and your mind sharp.

Tip: Carry around a large, measured water bottle so you can keep track of how much water you’re drinking throughout the day, making you more conscious of staying hydrated.

3. Fill up on veggies

Vegetables contain essential vitamins and nutrients that are necessary to keep us looking and feeling our best. They also contain fiber, which is not only vital for maintaining a healthy digestive system, but also helps you feel full longer. Besides the nutritional value, one of the advantages of loading up on veggies is that they’re low in calories, so you can eat large portions without worrying about the scale. Adding a serving of vegetables to each meal will do wonders for your body and immune system.

Tip: Vegetables can be cooked a number of different ways and can be mixed with a variety of other foods, so get creative and experiment with different recipes!

4. Satisfy your sweet tooth with fruit

A crucial part of clean eating is reducing your sugar intake. Anyone with a sweet tooth knows how difficult avoiding donuts or cookies can be when you get a wicked craving, but swapping unhealthy sweets for nature’s candy is a smart way to curb that craving. Fruit is rich in fiber and essential nutrients. It also contains natural sugars, which makes it a sweet and healthy snack.

Tip: If you find eating plain fruit boring, try mixing it with Greek yogurt and granola, and turn it into a nutritious parfait.

5. Focus on the composition of calories, not just the number of calories

Unfortunately, it’s become mainstream to obsessively count every calorie consumed in a day. 100 calories of candy is very different from 100 calories of vegetables, and your body knows the difference. Rather than focusing solely on how many calories you’re consuming each day, focus on the nutrients you’re consuming. Incorporate a balance of healthy fats, lean protein, and complex carbohydrates within your daily caloric intake and your body will thank you for it.

Tip: Shop the nutrient-rich perimeter of the grocery store, and avoid roaming the isles stocked with packaged and processed foods.

Go big or go home

Students and their love of supplements

Go big or go home

Professional athletes and weightlifters have been using supplements to increase muscle mass and help with recovery for a long time. ‘Iron Guru’ Vince Gironda was known to drink a concoction of raw eggs, protein powder, and heavy cream after working out, and athletes like Oklahoma City point guard Russell Westbrook and professional race car driver Danica Patrick are both spokespeople for the supplement brand Six Star Pro Nutrition.

Although you’d be hard pressed to find a student who drinks raw eggs, U of T does have a multitude of students who use supplements like protein powder or creatine as well as other pre-workout and post-workout blends. Bolstered by the popularity of protein shakers, the supplement industry is booming and students are some of its top customers.   

Realizing that the student demographic is increasingly in-demand of workout supplements, Jacked Scholar an e-commerce supplements provider has created a place for students to shop for, and buy their favourite supplement brands. 

Travis McEwan, founder of Jacked Scholar admits that, “the market in this demographic has never been bigger.” Jacked Scholar has even gone so far as to employ more than a hundred “campus ambassadors” for the company. 

According to the global consulting firm McKinsey, knowledge-based consumers are driving the recent attention to supplements. In their study of supplements, the company notes that 96 per cent of adults who use the Internet have used online resources to help them make decisions about their health and fitness choices. 

Companies like Jacked Scholar target the university demographic, hoping to entice students with cheaper prices on name-brand goods, and out-compete both local supplement stores and chains like GNC. It makes sense because e-commerce can provide a better price on a given line of products for students. 

Annette Latoszewska, a U of T student and former Jacked Scholar U of T representative, uses various supplements when she has the time to commit to a workout routine. “I like to complement [my routine] with supplements. Cellucor C4 pre-workout, not picky about my protein so it’s whatever is decent and cheap for post-workout and then I’ll use Cellucor SuperHD twice a day for fat burning,” she said.

Latoszewska also explained her duties while affiliated with the company; she was tasked to “promote the brand to generate sales. When your discount code is associated with the sale online, you get the credit [commission].”

Despite the fact the Latoszewska did not purchase supplements from the company, citing “cheaper options” she does admit that there is earning potential for those willing to put in the requisite time and effort. 

Nevertheless, McEwan is confident that the market at universities only has more room to grow. “We’re getting to the point where we can be pickier about the type of students that we accept into the campus rep program,” he explained. 

Another advantage of having supplements on campus is that it provides for an innovative testing lab. According to the McKinsey study, “new products will be offered as fads [and] go in and out of vogue.” Because U of T is like a Mecca for diverse groups of people, campus-specific supplement companies have the perfect ecosystem to observe what supplements work and what supplements don’t. 

Whether or not students will be interested in the long-run is an entirely different matter. Danny Lee, an economics student at U of T is aware of the campus presence and is firm when he advises students to “follow a workout schedule and eat right. Protein powder is like icing on top of the well-disciplined cake.” 

Supplements represent more of an idea to students than a reality — the idea of what’s possible. The truth is in the name. These producst are intended to supplement your normal, healthy diet, not replace it. So at the end of the day make sure that what’s at the end of your fork is more important than what’s at the bottom of your supplement bottle.

Don’t be a dope

Part two of a series explaining the significance of doping and drug testing in sport

Don’t be a dope

For many North American athletes, whether Olympic hopefuls or professionals, collegiate athletics is the first step to a professional contract or gold medal. Shifting from amateur athletes requires an increased amount of time dedicated to more intense training regimes, and it also brings with it stricter rules: especially when it comes to doping.

Any athlete who is a member of either of the two major collegiate sporting bodies in North America, Canadian Interuniversity Sport (CIS) or the National Collegiate Athletic Association (NCAA), is required to follow the world anti-doping code, established in 2004 by the World Anti-Doping Agency (WADA).

This code covers many different classes of substances, and perhaps most importantly, emphasizes the fact that it is the athletes themselves who are ultimately responsible to ensure that they are not violating any of its policies. If an athlete is found to have violated any part of the code, whether intentionally or not, they may face serious consequences.

So what exactly do the CIS and NCAA do in order to help educate and protect their athletes? The CIS, in conjunction with the Canadian Centre for Ethics in Sport (CCES), have created an anti-doping program for all its athletes. The program consists of courses the athletes must take in order to be cleared to play. Each athlete’s CCES account also gives them access to further educational resources, including the Canadian Anti-Doping Program (CADP), a quick reference card on the policies in place, and the ‘prohibited list,’ taken directly from WADA’s website.

Blood doping paraphernalia. Nathan Chan/THE VARSITY

Blood doping paraphernalia. Nathan Chan/THE VARSITY

The NCAA has a similar practice in place. Each athlete must sign a consent form at the beginning of the year indicating that they understand the rules, and that they give their consent to be tested at any time. If they do not sign this form, then they are not able to play. Finally, NCAA athletes must submit a student athlete statement, which provides the NCAA with more drug use information.   

Both organizations also warn against taking any nutritional supplements due to the fact that they are poorly regulated and may contain banned substances, which could lead to violating the code for an athlete. On their websites, the CCES and NCAA provide additional resources which athletes can consult in order to determine whether or not something they are taking is classified as a banned substance or not.

Closer to home, and in addition to completing the online courses through the CCES, many Varsity Blues athletes attend anti-doping seminars during orientation week each year. This seminar is organized and run by members of the David L. MacIntosh Sport Medicine Clinic, and it serves to further inform the athletes about anti-doping policies and the potential dangers of doping. If an athlete is caught, they can face a number of consequences, including but not limited to being suspended, being stripped of their title, or being banned from competition.

In a 2013 TEDx talk at U of T Doug Richards, medical director of the David L. MacIntosh Sport Medicine Clinic, and an assistant professor in the department of kinesiology and physical education, mentioned that the culture of risk that is associated with the ‘winning at all costs’ mentality in sports can lead to using performance enhancing agents. “Look at the behaviour of athletes in respect to doping” said Richards, “they’re willing to take dangerous substances, subject themselves to potential bodily harm, they’re willing to cheat and potentially get caught and kicked out all in the name of increasing their probability that they might win.” Doping is not only a choice an athlete makes in order to increase their chances of winning, but it is also an extreme reaction to the culture within sport where winning has traditionally been the only predicator of success. 

So why do athletes dope in the first place? Well, the short answer is to increase their chances of winning. With over 284 purported doping cases in professional sport in 2014 and the recent state-sponsored Russian doping scandal, it doesn’t look like anti-doping education is as effective as it can be. It is clear that doping is a very complex issue in collegiate-level and professional sport, but the system could potentially benefit from an overhaul by changing the emphasis on the individual to focusing on the sports community to take the pressure off of winning.

Until that point, we will have to rely on information sessions and tests to commit athletes to ‘playing true.’

New Year’s Fitness Resolutions

How to ensure another resolution doesn’t go out the door by mid-February

New Year’s Fitness Resolutions

Now that it is the end of January, many of us will have realized that the resolutions we made in the lazy haze of the holidays aren’t exactly coming to fruition: the chances of someone following through with their New Year’s resolution for an entire year is slim. The most commonly broken resolution is losing weight. At U of T it’s easy to fall into a routine of going to class, studying, eating out, and staying up late — conditions that aren’t exactly conducive to keeping up a health-related resolution.

If you’re serious about improving your health and bettering yourself for next year, while still maintaining a steady GPA, here are some tips and tricks to help you make the most of your 2016:   

1) Join a fitness class

It’s okay to step out of your comfort zone by joining a new club or fitness class to change up your workout routine. U of T’s athletic facilities offer different types of classes like: kickboxing, yoga, Zumba, pilates, and many more. Changing up the traditional free weight and cardio machine workouts can also help your body resist plateauing, and if you take a Zumba class, you may even dance away with some new moves to show-off the next time you go out.

2) Hire a personal trainer

If you’re excited about working out but the thought of going into the gym without knowing what to do sounds about as appealing as cutting your own arm off, then U of T’s personal training services can help. U of T athletic services offer one-on-one sessions with personal trainers who are certified, and usually U of T students. Their job is to help you develop a workout routine that suits your personal needs and goals. They will also show you how to use the different machines in the weight room, guide you through cardio exercises, and give you pointers on eating better, and help you adjust to a healthier lifestyle.   

3) Say no to junk food

Probably the biggest hindrance to your weight loss and fitness goal is your diet, so cutting back on buying fast food is crucial. Although this is probably one of the hardest changes to make, eating healthier doesn’t have to constitute a complete dietary overhaul. Try packing a lunch or a few snacks that will come in handy when you have a long day on campus. Start off with once or twice a week, and work your way up to packing a lunch daily. Invest in a good quality water bottle and take it everywhere; this will help you cut back on sodas and juices, plus you can make use of U of T’s hydration stations. 

4) Set goals 

There’s a difference between a resolution and a goal. Resolutions are more generic — for example, lose weight or become fitter — whereas goals are smaller milestones you can set in order to fulfill your resolution. Achieving small goals makes your resolution more attainable, because seeing regular progress can be the best form of encouragement. It can also be helpful to keep track of your progress by using a fitness app or journal; writing down your progress will get you that much closer to achieving your goals. Talking about your future goals with people that are close to you can also help you keep them.

5) Buy workout clothes

A trick that works especially well for broke university students is investing in workout clothes. For most university students, money is scarce and OSAP is cruel, so the thought of wasting money is sickening. Buying workout clothes will motivate you to go to the gym — not because you’ll look good, but because you don’t want to waste the money you spent on those Lululemon or Nike leggings. A good workout apparel starter-kit includes: running shoes, thick socks, leggings, and a T-shirt.   

The five stages of stress fractures

A glimpse at life on crutches for those who are always on the move

The five stages of stress fractures

I didn’t realize how much I loved running until I broke my foot.

I’ve been running casually here and there for exercise since I was a teenager, but an intense increase in my running routine last summer called for a shift in identity from ‘occasional jogger’ to ‘athlete.’              

Unfortunately, my awareness of my new runner status, along with all the advice, coaching, and budgeting that comes with it, was realized too late. A poor choice in footwear and an overly ambitious schedule put an end to my short-lived career as an athlete; just one month into my new intensive routine, my foot started hurting. The pain increased slowly but consistently throughout the course of the summer, until I was finally forced to see a doctor.              

After two months of consistent foot pain, I was diagnosed with a stress fracture — the smallest, yet most inconvenient of all sports injuries; dreaded by runners everywhere and generally considered one of the most frustrating injuries out there. Before I could come to terms with what my occasional jogging was doing to my body, I would have to go through five stages of grief. The following is a warning to all about the hazards of uneducated athleticism; learn from my mistakes.

1. Denial

Mirka Loiselle/THE VARSITY

Mirka Loiselle/THE VARSITY

The denial began halfway through the summer when my right foot started hurting, and I chose to do nothing about it. It was only when the semester started, and I realized the symptoms weren’t going to go away by themselves, that I disgruntledly made an appointment with the David L. MacIntosh Sports Medicine Clinic for athletic injuries.

Stress fractures are very difficult to detect via x-ray, and my scan brought up nothing. As stress fractures are mainly caused by the repetitive application of force, the sudden increase in my running routine and lack of support due to improper footwear were considered evidence enough of my true diagnosis. The doctor’s treatment course involved quitting running entirely for up to two months and walking less than 15 minutes a day.

For a person like me, who lives their entire life on their feet, this was no small order. The walk from my classes at the Victoria College campus alone are more than 15 minutes away from my classes at the physics building. In my mind, the doctor clearly didn’t understand how busy and active my life was, so I chose to ignore his advice and continued carrying on as I had. This, as I’m sure you can imagine, turned out to be a mistake.

2. Anger            

Mirka Loiselle/THE VARSITY

Mirka Loiselle/THE VARSITY

It was a couple of weeks into my diagnosis, after changing nothing about my activity level except substituting long runs for long walks and my symptoms still refused to improve. If anything, they were getting worse: the rest of my body compensated for the pain in my metatarsals (bones in the ball of the foot), as the pain spread to my ankle and then up to my knee.

By now, I was getting irritated and started making an effort to exchange some of my walking commutes for biking ones. There is only so much laundry and groceries that can be hauled around atop a bicycle though, and the increased stress of adjusting my life so drastically was only making me miss my long anxiety-relieving jogs even more.

It was only after an incident where I attempted to carry coffee with me on my bicycle by stuffing a falsely labelled ‘spill-proof’ thermos in my backpack with my laptop, when I snapped entirely. A tiny split in my foot bones, too small even to show up on an x-ray, had now taken away my laptop, my ability to run errands independently and, two months of my running routine. With the pain in my foot ever increasing, it was time to start pleading with the authorities.

3. Bargaining   

Mirka Loiselle/THE VARSITY

Mirka Loiselle/THE VARSITY

         

While I was previously determined not to let a silly injury take anything away from my already tight student budget, I now had no choice to give in and see what money could buy me. I purchased a pair of proper (and expensive) supportive running shoes in a vain and useless attempt to rescue my capacity to move.

I also gave in and booked an appointment with the pedorthist at the MacIntosh clinic, per the recommendation of my doctor. Surely the combination of expensive footwear and fancy orthotics would heal my foot and preserve my ability to continue to live a mobile and independent life.

Alas, none of these things could save me. I began scrolling the web for another way, but all I found were links to forums where people discussed their stress fracture lasting for weeks or even months past the predicted recovery date.

For me, that was it. The perseverance that had helped me push through so many miles of jogging over the summer had now abandoned me entirely. I clearly wasn’t going to change my ways without a limiting factor to force me. I explained my failure to adjust my lifestyle to the MacIntosh doctors, and begged for an air cast and crutches, which I received. I was almost ready to accept my fate, but I had to weather one more stage first. 

4. Depression            

Mirka Loiselle/THE VARSITY

Mirka Loiselle/THE VARSITY

The cast and crutches, as much as they were intended to restrict my movement and force me to submit to my new lifestyle as a couch potato, almost put me back to square one. Now that my foot was off the ground permanently, I took great advantage of my new found freedom of mobility to crutch-walk wherever I pleased.

At one point I even attempted to go for a leisurely stroll (or in this case, a leisurely hobble) through Trinity-Bellwoods Park with my headphones, as I used to do uninhibited so many months ago. Needless to say, this was not what I was supposed to  be doing at all. The extra weight of my left foot was pushing me to move forward, and after just a few weeks of being in the boot, my left foot started hurting as well.

This pain spread up my leg to my knee, just as it had done before when I was originally injured. By the time the dim but chronic pain started creeping into my hands, I realized that I had opted for the wrong solution yet again; I was going to have to make serious lifestyle changes or I would never heal.

Finally, in mid-November, I bought a TTC pass. I also downloaded Uber onto my phone, and applied for a bursary to compensation cab rides, so that I could take a taxi to get in between classes on campus where the TTC couldn’t reach.

Using the TTC on crutches is easier said than done. There was one occasion after an exhausting work day and a 15 minute wait for a crowded streetcar where no one would get up to give me a seat, when and the streetcar hurtling forward caused me to lose balance, and I accidentally stomped my crutch into an old lady’s foot.

This was too much for me; my foot wasn’t healing and I was spending all my money on transportation and buying meals away from home, due to my inability to purchase groceries. By now, exam stress was setting in, and I was having difficulty leaving the house entirely. Where I had originally been told my foot would heal in six weeks, it had now been three months. It was time to accept the fact that some serious lifestyle changes would be in order, or I was never going to heal.

5. Acceptance           

Mirka Loiselle/THE VARSITY

Mirka Loiselle/THE VARSITY

 

No one ever said that a full lifestyle turnaround was going to be easy. For me, it started with accepting that I wasn’t going to run again for a long time. Once I realized that my previous coping mechanisms weren’t going to return to me any time soon, it was time to find new ones. This is where everything started to come together, albeit.

After exams were over, I took the streetcar on my crutches to the Eaton Centre to buy a swimsuit and signed up for a yoga pass. For a person who has always deeply identified as being active, having had no exercise for an entire semester had caught up with me, and it was time to turn it around.

I put my identity as a runner at the back of my mind and started viewing myself as a calmer, more reflective person. I began lane swimming at the AC pool, and took up yoga lessons for the first time. Instead of vapidly staring into space, I learned how to use my commuting time on the TTC to finish readings or even just relax and listen to music.

My lifestyle changes were quickly reflected in my attitude. I caught myself high-fiving other people in casts as I crossed them hobbling up and down the stairs to the subway. I smiled at the old people who were slowly but steadily making their way across hectic Toronto with their canes. Instead of pushing myself to go for longer and further runs I learned how to breathe and reflect when life was overwhelming.

Most importantly I learned how to ask for help. My father started carrying my laundry to and from the laundromat for me and brought me groceries on busy nights of studying. My friends, upon request, were surprisingly quick and happy to participate in quieter dinners and brunches instead of nights out dancing and at busy bars.

Although my foot has not yet fully healed, I no longer spend all my time waiting for change to occur. I have accepted that it will not happen by itself, but I also can’t force it to.