In Memory of M

This post is dedicated to my cat, whom I call "M", also know as "sexy boy" and "chicken".

When I was 5 years old, my mom had brought home a kitten from a coworker whose cat gave birth to kittens. I was super excited because it was so adorable and soft. Unfortunately as a 5 year old, I had no idea how to handle it. More like mishandled it. Plus dad was never a fan of pets so the kitten was given back the next day. I was very sad. I then asked my mom when could I have a cat, and she replied "when you turn 10".

Well, 5 years later I still remembered that promise, and when I was nearing 11, I asked....where's my cat? She then had the look on her face like "oh crap, how did she remember?! I didn't even remember?!"

In December 1997, my brother, mom and I made a trip to the Humane Society and went to look for a kitten. There was a small area where all the kittens were held and on that day, they didn't have many selections. After browsing through, I couldn't find a kitten that I really liked. We were on the verge of leaving when the staff started bringing a few more kittens. So we waited until they were unloaded. We stepped in once again to see. In this one kennel held 4 kittens. 3 kittens were at the door meowing and pawing. I then saw one orange/white tabby and said "that one!" Well, "that one" was hiding in the back behind the 3 kittens up front. He looked about a month old or less. So tiny, but so cute. He was adopted and taken home.

And from that day on, we called him M, sexy boy, and chicken.

The first day we brought M home, we got him to get familiar with the environment. So M started walking up and down the stairs, sniffing out where his litter box would be, and his place of sleep, food, everything. When my dad came home from work, you can imagine what his reaction was. "WHAT IS THAT THING?! AND WHY IS IT IN THE HOUSE?!"

This time though, all 3 of us said we are keeping M. He is staying and is our newest addition to our family.

The first night was hard because we didn't want M to run around or scratch anything, so dad suggested we put him in the basement. The entire night we heard M howling. The next morning, we told him he is never being put in the basement again. We moved his bed upstairs, closer to everyone. Eventually as we got used to him, and seeing he wasn't peeing or pooing everywhere, we all left our doors open for him to sleep with us.

M used to love jumping on my bed and walk over to my table and knock things over as he tried to pass through. There were times he didn't mean to, and then times he purposely did it so I would get up to feed him. But generally speaking, M was a good boy. He wouldn't start meowing until my foot stepped on the floor. If I was still in bed, he would just stare. He also had a habit of walking across the pillow, but not actually touching our heads. In a way, it was his sign of saying "I'm hungry, please feed me".

As a kitten, M loved attention. He would climb up to our laps during meal times and plop himself down and start sleeping. It was the most adorable thing ever. He did that mostly with mom, because he knew that she was mommy. It was all the warmth that kept him so safe and happy. There were times I fell asleep on the chair, and he would climb up and plop himself in my arms and fall asleep.

I remember the first time I saw him plopped on my bed. I almost freaked out because there was going to be a bunch of fur everywhere. However, that's what lint rollers are for. So we all got used to it when we found him sleeping in our beds. We just had to make sure we cleaned all the fur off. During the early years, he would take turns sleeping with all of us on our beds. I think knowing that he was around one of us for the night made him feel safer and warm.

I taught him how to open doors, just for fun. I never knew he would actually catch on to it, but over the years it benefited him when he was scared of guests and wanted to hide. This is why we called him chicken. Because he was afraid of people he didn't know. As soon as a doorbell rang, he would run upstairs, go to one of the bedrooms, and start touching the closest handle. Eventually he got the door open and he would make his hiding place there. He then used that to learn how to open closet sliding doors to hide in as well. Over the years, he made the closet his sleeping place if he didn't want to sleep in his bed.

M is an indoor cat but we let him out during the summer months for him to get some fresh air. The first few times we accompanied him outside to help him get familiar with the backyard, and also taught him to not go under the fence. He never climbed fences. One day, we noticed he hadn't come back for some time and went out to look for him. He wasn't in the backyard. That's when all of us got all panicked. We called his name, looked under the tree and bush, but there was nothing. We went back inside and were trying to figure out what to do next when we heard this weird knocking sound coming from the front entrance. We went to the front door, opened it, and we saw him standing on 2 feet, pawing at the outside enclosure door knob. He must have went under the fence and realized things didn't look familiar to him. He found a door, and started to paw at the door handle. Thankfully that door was our enclosure door. Since that day, he hasn't repeated it. M was so smart.

M gained weight during his early adult years and the heaviest was around 23 pounds. His appetite was really good. But we knew he had to start shedding some pounds as it was not good for him. We played with him more and made him run around more. M is just like a little brother. He was always so happy.

M never scratched furniture, never made a mess on the floor, never attacked anyone, never went through garbage and made a mess. He did drink out of the toilet bowl a few times, so we had to make sure the top was completely covered. After that he stopped doing that. But he was never a bad cat. He was a good boy who listened and he learned to not repeat the same mistakes.

A few years ago we noticed him throwing up undigested and digested food. At first we thought oh maybe just hairball, or maybe just cleaning out his system. But it became more frequent. The vet diagnosed him with hyperthyroidism, and they also noticed a slight heart murmur, because his heart rate seemed a bit faster than normal cats. He was put on thyroid medication, and dosing would have to be adjusted according to blood work results. In a way, it was like a human getting old and having to take pills for their health issues. It was sad because then it hit me...M is aging just like the rest of us. To me, he was still this small kitten we took home years ago. But as long as he was on the medication, he would feel better and live longer.

With hyperthyroidism, when the "T-4" levels become very high, it overstimulates the body's organs. It speeds up metabolism so M would eat a lot but would lose weight. His body was not absorbing the important nutrients and calories. It overworks the heart, which meant his heart was beating faster and working faster. It can also affect the kidney, which can lead to kidney problems. Thankfully his kidneys were normal. We saw M drop from 23 pounds to 8 pounds in less than a year. That's like saying someone who weighed 200 pounds dropping to 80 pounds. It was a huge ratio. But after starting the medications, his diet slowly improved and he started to gain some weight back.

Even on medication, he was still a happy boy. He wasn't as active or playful as when he was younger, but he was still so cute. Every time he saw me, he would try to run, or he would give up and lay down on the floor because he knew I was coming to carry him. Because I loved him so dearly. As I got older and busy with school, I was not able to play with him as much as when I was a kid.

M was there through many of life's milestones. M saw me graduate from elementary school, from high school, from university, saw me achieve my piano diploma, my first job, and the start of my career, my first real relationship, my first car. M saw my brother get married, meet his "nieces" (because we always joked he became an uncle), saw him start his career as well, his first house. M saw my parents both retire, birthday milestones, anniversary milestones. M was truly like a little brother and a son to us. We have been so blessed that we could share many milestones with him.

On November 26, 2015 (the American Thanksgiving Day), I noticed him laying on the floor, very weak, and using his accessory muscles to breathe. Few days before, he didn't look as sick, but he was always sleeping. He walked mostly to the washroom, or to eat or drink. But most of the time remained in bed. And that's the thing, cats are good at hiding their problems. But this day was very different than the rest. We took him to the vet, and the vet found he had some fluids in his lungs. He gave him a Lasix shot to make him pee out the fluids. He was also prescribed a heart medication along with Lasix to help the fluid control, and to also help his heart. And that if he wasn't taking the medications, he would have to come back the next morning to get another shot.

He was brought home and urinated. Then he went back to his bed and started to sleep. But then his breathing was getting worse. He would be very restless, using all his accessory muscles to breathe. He would climb out of his box and lay on the floor, to be in various positions to help him breathe easier. Eventually he crawled to the vent. He knew there was air shooting out from there, and was putting his face over the vent to breathe. We took him to the hospital as this was a terrible thing to witness and experience. He was going into congestive heart failure, and it was affecting his lungs. They put him on oxygen and IV drips to help calm him down.

The attending vet came to us to deliver some bad news. His prognosis was very poor. He had multiple issues that even with all the tests and medical interventions, he can't guarantee he would live until the next morning. We had a couple options. Either keep him there for the night and pay all the fees to do the tests to sustain his life, or euthanize him. This was the most difficult decision of our lives. It hurt my parents and I that we had to come to this agreement and conclusion in a short time. There were many tears, and many uncertainties but yet we still had hope that he would pull through. That he would still be with us for a little bit longer.

Eventually we made a decision, but it was none of the above. We wanted to take him home. If he passed away, we wanted him to be at home and not in an unfamiliar place with a bunch of tubes and machines, and with no family beside him.

Of course the vet and technicians kept trying to tell us that was against medical advice. I didn't care. I signed the papers to release him. When they brought him back out in the kennel, they guided us to a smaller room, because they were still trying to convince us to put him out of his misery. It was at this point that we opened the door, and saw our sweet M laying there, his condition unchanged. He seemed to be breathing a bit louder than before. I saw his poor arm, bandaid up from where they inserted an IV. By this time I had lost it. I started to cry non stop. My parents were the ones consoling M, petting him, and telling him we are going home M. You're not staying here but we're bringing you home. And I think M understood because he tried to move his head so he could see us better, but he was so weak. We saw a tear shed from his eye and roll down his furry face. It was the most heartbreaking thing to witness.

We got him loaded up into our car and made the 15 minute journey home. Along the way, we kept telling him we are going home, we are going home. We are almost home M. We love you. We love you very much. Be a strong boy. You are a fighter. We love you.

About 5 minutes from home, as I was driving, I heard a loud sigh. And then silence. And I knew...I just knew at that point, he was gone. But they say, hearing is the last sense to go. So we kept telling him we love him. When we finally got home, we rushed inside to open the kennel. Unfortunately, M was already gone. But he was home. And that's the most important thing. We cried, we caressed him, and we told him he was so brave. He held on for so long, because he knew he was coming home. He was happy and relieved he wasn't staying in hospital. He was coming home to be with his family.

M died approximately at 10:25pm, November 26, 2015 at 18 years old, with us by his side.

Words cannot describe my sorrow and hurt. Here I am writing in tears, because I am still mourning. But I am hoping this would at least release some stress and sorrow. I want to share my experience of having a pet to people, because they are not just some animals that you feed and take care of. They become part of your family. And M was part of our family for over half my life, starting at a very young age. He had a very good and happy life being with us. I know things get better over time, and to look at the positives, but it becomes hard when you see them struggling during the last hours of their life.

But I do know one thing, that M is finally home. He's sleeping peacefully. And he will be watching over us. He loves us and we love him.

TTC & "You're too Young!"

TTC. The Toronto Transit Commission. Or what a lot of people like to call: Take The Car. I like to say Take The Chopper. To The Cars! Tik Tok Crap. Tick Tick Come-on!!!!!

It has been years since I took the TTC as an everyday transportation to school and clinical. I remember my dad telling me that when he took the RT about 30 years ago everyday to work, he said the tracks would freeze in winter, so shuttle buses would always take forever and were always crammed. Well, surprise surprise. 30 years later it's still the same.

I remember those days and it was not that long ago. 6 years ago! I remember the pain of waking up super early to get on the RT, transfer to the underground subway, and then transfer again, get off at my station, and then walk to school. It was best to wake up super early in case there was a delay in transit.

And that's the problem with TTC ever since it started operation. There are always delays. Signal issues. Old infrastructure. People cramming into the doors and then it further delays everyone. It goes on and on. The worst is fare increases almost every year. WHAT! IS! THAT! CRAP!

You get customers to pay extra every year, and the service remains the exact same as 40 years ago. CRAP. You would expect some sort of improvement after each fare hike, but it seems like things either remain the same or is just overall getting worse. Yet media keeps encouraging people to take the transit, save the planet, don't pollute. But why should I be paying for that and waste my time in delays when I could just walk or drive?

And this is exactly why I went from transit to car. I'm one of those rare chicks who actually love to drive. I am fortunate enough to have my own ride and to have enough funds to pay for gas and parking. So of course if I can save time and get to some place faster or at my own pace, then why not? I rather do that than cram myself into trains that need a desperate wash, or rather, people who have no idea what perfume is.

I am fortunate that I have the ability to rely on my own means to get from one place to another, and not on some outdated transit system in one of the most expensive places to live in Canada. Frankly, I am quite embarrassed to be living in a city with one of the highest cost to live in, and having a not-so-good transit system that is the only link between downtown and the suburbs.

Another thing I'm not a fan of: people telling me that I'm too young to have _______.

And what I mean by that is something medical. It can be something minor or something major. For example, I had a corticosteroid shot to my wrist because of an ossified loose body that was causing a great amount of pain when I moved my wrist. It came to the point that I could not grip onto a piece of paper properly. I could not twist the tubes at work. I couldn't untie my work gown because it was that painful. I just could not move my wrist.

Corticosteroid shot was one of the interventions, aside from physiotherapy and arthroscopic surgery. I knew physio was not going to help my situation, so it was recommended that I took the shot. I was told it would not be painful so I didn't need anesthetics, so I went along with it. I must say, getting an injection into a joint is PAINFUL. If you know of anyone getting an injection into a joint, ask for anesthesia. The pain lasted for about 2-3 days where I could not move my hand. After that, it was a lot better. Corticosteroid shots usually last about a year (at least for the wrist) before symptoms could return. It's been over a year, and my symptoms are slowly coming back, but at least I'm still able to move my wrist and do my daily chores.

When people hear that, they say "but you're so young!" Ok, yes I get it. But that doesn't help my situation. I already have a problem, I need to solve it. It really doesn't matter how old you are at this point. Point is, you have a problem, you need to fix it.

Same with when people come up to me and ask me to work 16 hour shifts. I think for a moment to see if it's worth it (i.e if I'm off the next day or for the next few days, then I would probably consider it). The part that I hate the most? "Oh but you're still so young,  you can do it! When I was your age, I pulled 16 hours all the time!" Thanks but this is 2015, not 1950. I know the limits of my body and when my body tells me it's burnt out, then I better listen to it and say no to a 16 hour shift. Plus I've noticed all the younger staff are actually burning out a lot faster than middle aged people. They are getting injured more, burning out, and having lingering long term effects on their health.

It's the whole perception of the older generation telling the young ones "well you're still young, you can do this. When I was your age..."

But when I look at the Generation X and Y in particular, I noticed a lot of the younglings pulling way longer shifts, not making more than their older counterparts, and yet burning out because they strive to become like their parents/older generation one day. We look at the older generations and how they managed to balance so many things, yet still work so hard, raise a family and not be crippled with medical issues. Why is it now that the younger generation is going through more burnouts and crippling issues?

There are probably many things that are contributing factors, but one of them that I really dislike and one that needs to stop, is this whole "you're too young" crap. Define what "young" means. Is there a specific age gap that we should all be looking out for? That if we fall under this "young" group, then we shouldn't have particular medical issues? We should always work 16-20 hours? No, I hate it when people say I'm "too young". It really doesn't make me feel any better. It actually makes me feel much more guilty because I can't do as much as other people. It doesn't encourage us; it discourages us.

So for everyone out there who are telling their younger generation that they are "too young" to be experiencing medical issues, you need to stop. You are not helping the situation. The person already has an issue. What's the point of rubbing a useless comment like that in their face when they are trying their best to deal with their situation? Just shut up please. You look a lot better with your mouth shut than uttering a sentence like "you're too young."

Pray for Paris

Friday November 13, 2015.

A group of Islamic State extremists took part in a series of bombings and shootings around Paris, France. The goal: to kill as many innocent bystanders as possible.

As of this day, 129 lives were cut short. Many more have been injured, and are still recovering in hospital. Some are in serious condition. Most of the fatalities occurred in Bataclan, where Eagles of Death Metal band (an American band) were playing a gig. The rest were at popular night spots for young people, and restaurants. 

Our hearts, thoughts and prayers go out to those who have been affected by this tragedy. We unite as one big family to support each other through these times, as a global unit. We weep for all the lives lost in such a terrible way. No words can describe the horror of what they had to go through.

Massacring a huge amount of people is not the way to gain control of the world, nor is it the right way to do anything. What do you gain from taking people's lives? Nothing. 

The Prophet Mohammed was used in satirical cartoons and broadcasted to the nation. Extremists became unhappy so they killed those responsible for misinterpreting the prophet. And now they decide to go after countries who go against the prophet, and their nation as a whole. 

Let me tell you one thing. People make fun of Jesus Christ more than the prophet. People use Jesus' name in vain on a daily basis. You don't hear people saying "Oh my Mohammed!" or "Prophet Mohammed!" when they accidentally burn themselves or drop a knife on their foot. When something surprises someone, the automatic response would be "Oh my God!" "Jesus Christ, seriously!" 

Do you see a bunch of Christians coming together and plotting to set fire to the world? Do you see them plot ways to kill a bunch of random people at once? Because they hear everyone using Christ's name in vain? No. We get hurt inside yes. But does it give us a reason to act in a selfish way? No. 

In 1 Peter 3:15 (NKJV) it says: But sanctify the Lord God^[a] in your hearts, and always be ready to give a defense to everyone who asks you a reason for the hope that is in you, with meekness and fear.

What in the world does that mean? It just means if people ask about God's existence, you are to prepare to give a defence. Not a war defence group, but an intellectual conversation. No where in the context does it say to gather an army and go kill everyone because they made fun of your God. 

I think people get annoyed with Christians because of the constant verbal arguments and disagreements when it comes to talking about God. People just want to avoid the topic all together. It's funny how we question or forget about God during our happy times, but we all turn to God when something tragic happens. And then blame Him for all the bad things, that US humans did against each other. 

I'll leave off with this one verse from Romans 12:21 (NIV): Do not be overcome by evil, but overcome evil with good.

Pray for all those lives lost in this tragedy. Pray for those who have to live without their loved ones for the rest of their lives. Pray for the ones who believe in false idols, who are misinterpreting what is being said and taught to them, so that they may one day find God, and realize what they did was wrong.

A Clear Explanation

When someone is diagnosed with a chronic illness, it takes quite a bit of time and explanation for them to understand what they are dealing with, and helping them cope.

One of the most challenging aspects in working with people diagnosed with a chronic illness is compliance of treatments. As health care professionals, when we see patients refusing to accept treatments or not coming to treatments on a frequent basis, we get frustrated. Because we know the dangers if they don't comply with treatments. We think they are the stubborn ones. We think we have tried our best to tell them to come but it's their fault if they don't accept our help.

But we clearly missed out one basic step that we have all learned in medical or nursing school. Verifying with the patient if they understand what they were told.

In our current society, too many of us jump to conclusions based on one thing we see. In this case, because we see patients skipping treatment, we automatically assume they already know the side effects of missing treatments. What no one really does is following up with the patient the next time they come back to see if they understand the consequences.

Now, some patients do understand the consequences and are prepared to deal with it. But I would say most are not ready to deal with the ultimate consequence: death.

There are times that I have worked with patients and they start asking basic questions. Questions that should have been answered by the doctor when they were initially seen by them. Yet they are still asking me basic questions. But understanding a disease process is not like 1+1. It is anatomy and physiology complicated with pathophysiology. It will take time for someone to understand what is going on with their bodies.

As a health care professional, I have an obligation to teach and educate patients. I answer the basic questions that have been asked many times. Each person is different in their knowledge in the disease process, and each person will need a different explanation to help them understand it.

Here is a case study (this is to also help others who are in similar situations or need ideas to help patients understand what is happening to them):

A patient who has Stage 5 kidney failure (GFR < 15) and new to hemodialysis comes into the ER, short of breath, having chest pain, has edema in both lower legs and ankles. Blood pressure is high, at 180/110, heart rate of 98. Oxygen saturation is 90% on room air. Bloodwork shows Potassium: 7.2. Creatinine: 890. Urea: 25. Upon further questioning, you find out this patient has missed 3 of 8 treatments. The patient states he is new to dialysis, and each time he missed a treatment, he says he wasn't feeling well. So therefore he wasn't comfortable in getting treatment because he was too ill to go to the hospital.

The nephrologist has tried explaining to the patient blatantly that if they don't seek treatment, they will die. They will also not qualify for a kidney transplant because they are non-compliant with dialysis.

As a nurse, what do you do?

I can tell you the first thing of what you DON'T do. And that is assume. Do not assume the patient already knows everything. Do not assume they understand everything. Assumptions are the worst thing in health care, and it could get you into a lot of trouble.

The first step is to talk with the patient. Identify who you are (RN, RPN), and explain what you will be doing (I will be giving you dialysis treatment today because your blood work levels are very high). You then ask the patient open ended questions to see if they understand why they are getting the treatment. The best way to ask is: What has the doctor told you regarding the treatment? Tell me what are some things that the doctor told you.

This is a lot better than asking closed ended questions (Has the doctor talked to you? Do you understand it? Do you have any questions?). A lot of times, patients get anxious and scared to ask questions that they will simply nod. That is why it is up to the health care professionals to keep the questions open ended and keep the conversation going.

In this situation, the patient had stated he was new, and he didn't know what was going on. The first day of treatment, the nurse took him in and he was hooked up to the machine. And that was it. Now, sometimes it's also up to the nurse's judgment to see whether they are lying or telling the truth. We also have to look back at the 5 stages of grief:
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance

When a patient first learns about their chronic illness, they will deny it. How can something like this happen to them? Why me? The next would be anger. They will get angry at anything and everything, even blame God for their illness. Then they will bargain. If I start to change my diet or exercise more, maybe this illness will go away and I'll get better. But when they realize this is a life long illness, they will hit depression. Eventually, they will accept the fact that this illness is real. They have it, and will have to live with it.

Now I can't say which stage the patient was in when he first came into treatment. But in the very beginning when everything is new, the patient will NOT remember everything that was said to them which include doctors, nurses, pharmacists, dieticians, social workers and coordinators. Everyone can say they already told the patient and taught the patient whatever needed to be taught, as well as paper handouts for them to read. But if the patient is in an anger or depression stage, do you think they would want to sit down and read all those papers? No, definitely not.

My first step is to ask the patient what they understand about their illness. See what they already know. Then you can assess what they don't know. And a lot of times, there are misconceptions or misunderstandings.

Explaining to a patient a disease process should not include difficult terminology. It has to be explained in a way that they understand, even draw out pictures if needed. The patient understood that being compliant to treatment is important, yet he still skips it. Why? The patient clearly said he wasn't feeling well. Because he felt unwell, he figured it was best to not force himself to get treatment.

Now comes the part of explaining what happens if they skip treatment. I used the blood work and his symptoms as a big picture. You can break it down to mini parts and then link it all together. For example:

1) Potassium is an electrolyte responsible for cardiac tissue (the heart). When there is an imbalance of potassium in the body, it will affect your heart. Your levels are way too high today (hyperkalemia; 7.2) hence why you feel chest pain and you are short of breath (hyperventilating). Too high or too low will result in your heart overworking and it could stop, leading to death.

2) Your kidneys are responsible for excreting potassium and other toxins in the blood. When your kidneys stop functioning and you stop peeing, the toxins build up, and you start to feel unwell. Hence why your potassium is also high. Because you have skipped out on treatment. There is no way for all those toxins to come out.

3) Since you have been feeling unwell at home, and constantly drinking lots of fluids (as we are taught to drink fluids when we are sick), your body is unable to get rid of the excess amount of fluids, hence why your legs are swollen. It is important to limit your fluid intake to 1L a day (show them a 1L bag of saline as an example).

4) Your blood pressure is very high because of all the excess fluid inside your body. It is important we get rid of that extra fluid to bring your pressure back down.

Keeping it in simple terms helps the patient understand what is happening to their bodies. Telling them they are experiencing hyperkalemia will not mean anything to them unless you break it down into simpler terms. It takes patience and a lot of feedback to help the patient understand. But telling them simply "they will die" will not help them take initiative to attend treatments. Scare tactics do not work on these patients. They need education and teaching.

After a complete breakdown of what dialysis is and what it does, and what kidney failure is, the patient was grateful that he finally learned the basics of his illness. He was able to tell me what I said, and stressed the importance of not missing out anymore treatments for his sake. It is the team's responsibility to follow up with the patient and their compliance to treatments. The teachings and education still need to be reinforced each time.

To wrap up, patients need a clear explanation of what's going on. Do not assume anything, but engage them in conversation to assess their understanding. Clear up any misconceptions or misunderstandings that they may have. Don't just lecture, but engage them and ask them questions as well to see if they understand. Lastly, as a team, we all need to work together to make sure patients remain compliant to treatment, and follow up with them to see how they are doing.

Asian Bus Tours

Do the names Taipan Tours, America Asia or Safeway Tours ring a bell? If you haven't been on those Asian bus tours, you should totally try it out one time.

And then you'll start hating it.

I remember taking my very first bus tour when I was about 5 or 6 years old. It was with Safeway Tours back in the 90's. It was one of those USA tours where we went from NYC - Boston - Atlantic City - Washington DC - and I'm pretty sure a few more but I can't remember exactly. All I remember is there were a lot of buses. The 90's was the time that Safeway Tours boomed in the tourism industry. There were a lot of places to visit but I remember they allowed us a lot of time to look around, take pictures etc. The time on the bus was long, but at least there were frequent stops.

Fast forward to the current year. They are all still in operation but I've noticed Safeway has been "beat out" by Taipan. I have taken both companies in the past few years and I've noticed Taipan has more tours offered than Safeway. They are both still very fast paced, so I wouldn't recommend very young toddlers or children to take these tours as wake up calls are ridiculously early (some as early as 5:30am).  Also, the very elderly people. I don't know how they do it, but I assume because most of the trips are on long bus rides, maybe that's why majority are all older adults.

Which comes to my next big peeve when it comes to bus tours. Mannerism. A lot of the bus tourists are older generation who have immigrated from countries like Hong Kong and China mainly (some Taiwan) so what they think is normal may not be "normal" in our younger generation's eyes.

For example, when the tour guide is talking on the speaker, you will have people chattering. When the bus is still moving and trying to park, you have a bunch of people start standing up in the aisle, grab bags, and waiting to get off. When people are getting off the bus, they cut you off or don't allow you to enter in front of them. When it comes to attractions and line ups, they will bud in front of you. It's like they don't know how to form a line.

The best one is going to popular attractions and going to their washrooms. They have signs in the stalls where there are two pictures. One that says NO! and a sign with a person squatting on the toilet seat. The other one says YES! and it has the person sitting on the toilet.

It has come to the point where places in Canada and the USA have seen the unsanitary ways of using the public toilets that they have put signs up. It's embarrassing to those who are of Asian descent because when we see it, we totally know it was from "our people" from the older generations. We think it's gross. But to them, it was the way they were raised and taught as normal.

And that's the thing with multicultural countries like Canada. When we see people spit on the streets, take a piss in the bushes in full public view, squat on the toilets and make a mess on the seats with muddy shoes, or squatting in public roadside taking a dump in the sewage, our thoughts are "EEW NASTY! Immigrants!" But what we don't realize is that's probably how they were taught back home as totally normal.

The only thing I can think of if I see someone doing that or know of someone who does anything "weird" to my eyes, I would just say in this country, that is inappropriate. Maybe back home it was normal, but here, it is considered inappropriate. Just a head's up. Whether they choose to follow Canada's mannerism, that's up to them. But with older generation, it is very hard to change their ways. So don't be too surprised when you see any one of the above being done in public.