Sunday, December 18, 2011

Latency in Stress-Induced Crohn's Attacks

Folks, grad school is on hiatus for the next few weeks, so there is about to be a lot of straight up Crohn's talk up in hur.

Like most Crohn's (and IBS) attacks, mine have perpetually been the post hoc ergo propter hoc artifacts of stress.  As I have mentioned... somewhere... there is so much constitutively happening during grad school that what time one would ordinarily find to spend stressing out, one instead spends steeped in exhaustion-driven apathy.  While this is generally good for me -- as it would be for anyone with a type A personality in an incredibly demanding job -- there are residual consequences.

For instance, as soon as I stopped working in my new lab and traveled to my most dear childhood home, I was interrupted by a fairly large-scale attack.  Right in the middle of the restaurant.  Then right in the middle of the theater.  Then most of the rest of the evening when we arrived home accompanied by butylscopolamine, peppermint tea and a heating pad.  It was the worst episode I've had since the summer (non-opiate-grade).

It appears that now that I'm not in the midst of academic turbulence, I am beginning to feel the after-effects of the stress that was suppressed during the term.  There are some very serious defects in my program that were, naturally, not apparent until halfway through the term, and which cause a ridiculous amount of unnecessary stress in all of the students.  I had a nightmare last night that a department committee kicked me out of the program (despite the NSF grant, the Badass Student grant that they themselves bestowed upon me, the now five first-author publications, and the fact that three PI's are currently vying for me).  Yes, this is a real fear for most of the first-years in my department -- some of the brightest minds I have ever encountered.  It's why the program is so prestigious -- failing is less than an A-, for which one is put on academic probation and potentially booted from the program.  I never looked at the grades I got on finals because they are so arbitrary that they mean almost nothing and it was an unnecessary agony that I did not need hanging over my break.

These are the concerns that are suppressed during the ebb and flow of the active term, and which are now showing their might through latent Crohn's attacks so that I cannot fully relax during this brief and precious vacation.  Despite really not thinking about school.  I attribute the attack last night to having been asked "how school was going" and making the mistake of actually talking about it.


Thursday, December 15, 2011

Crohn's v. Grad School Free Lunch

I don't know what all these penniless graduate students are complaining about.  Between the seminar snacks, defense sandwiches, Neurobeer meals and lab-mate bakers I hardly need to grocery shop anymore.  And that's in spite of only being able to eat half of the free food thrust upon the academic community that is my department.  Toss in a few holiday luncheons and it's enough to induce a constitutive state of Food Coma.

When I leave my house in the morning, I bring an apple, a bottle of water and a few tea packets.  Rarely are leftovers necessary to get through the day, for, invariably, lunch will provide itself.  There are instances, however, wherein I resist temptation to partake, knowing that I have a long 6+ hours of afternoon lab work ahead and will need to be able to stand upright.  Our department holiday luncheon this week was a tantalizing array of six different kinds of lasagna -- all with cheese.  Fail.  One poor tenured faculty member and myself were left sipping our [albeit, heavenly] lemony spiced apple cider alone while others bombarded the buffet line.

It's a slippery slope.  My inherent frugality and neurotic inclination to not let free things go to waste versus the Crohn's baby.  But even if I must decline lasagna and chocolate butter cookies, I am never starving.  And what's more, they have started to serve lactose-free hot chocolate at mini-seminars.  Soon there will be rice milk for my coffee... soon.

Saturday, December 10, 2011

Remicade... I've lost count.

This morning, on a clear 70 degree day in December (no biggie), I sauntered into the Cancer Treatment Center on the beach [sort of] no earlier than 10am.  Within forty minutes I was in my corral, neck deep in stem cell litricha and racing along at 140 mL/min.  This was a smaller corral than last time, with only three stations.  And.  Guys.  There was a huge window.

My baller nurse convinced me to let her do an inner forearm I.V., at which I cringed in reflection of the last time I agreed to this (it was ouchy enough to require a warm pad for the full 3.5 hours, and this is coming from someone who likes needles).


              Isn't that an insane spot?  I thought it was an insane spot.  Although I did end up requiring a "warm pad", it was only briefly.

Two.five hours later with my brain and veins saturated, I headed back out into the sun to find groceries and prescriptions.

Thursday, December 8, 2011

Rotation 1 closes; cue Rotation 2

Although I did not die of post-SfN sickness, I have [three weeks later] just now regained my ability to breathe lying down.  Kudos, Remicade.  Well played.

Never mind that I could have used this capability two weeks ago while preparing for journal club presentations, lab meeting presentations and finals.

My first rotation closed with a somewhat awkward bang.  After 72 hours of studying and final-taking, I presented some data to my lab.  I did not accomplish as much as I would have liked over the term, and yet when I presented my last piece of data to Dr. Spinal Cord, the lab manager and a Most Prestigious Collaborator, I was encouraged to stay in the lab so that I could lead the projects in the new joint grant that they are going to propose based on my data.

"Oh thanks, I'm so honored by this awesome opportunity that you're willing to entrust to me... but I still wanna to go check out this other lab that I might like better than you... kthx. PACE."

That was Monday.  I started Rotation 2 on Tuesday.

In stark contrast to Rotation 1 Lab, everything about Rotation 2 Lab is omgshinyandnew.  Also in stark contrast, I was able to get started on two pilot experiments immediately.  Since Rotation 2 Lab (forthwith referred to as StemCell Lab) is just getting going, its 5 active members work closely together to get everyone's projects under way.  And boy, is this a successful approach.  StemCell Lab is also not as big as SpinalCord Lab (n=16-18), so inveterate members have time to train and are invested in making sure everyone is comfortable and independent.  So far, so good.

Unfortunately, StemCell Lab does not have its own hot water dispenser as I grew accustomed to in SpinalCord Lab.  However, StemCell Lab's restroom is ~15 feet closer than SpinalCord Lab's -- critical.  If I stay here, the hot water dispenser is something I can barter for... Raga needs her tea.

Saturday, November 19, 2011

the post-SfN sickness

I don't like to be ill.  Crohn's attacks are negotiable; they are systematic enough that I have learned to function with them.  The cough?  The congestion?  These are symptoms so rare in their expression (kudos to immune system wipe-out) that when they do arise, I am made totally invalid.

I could already feel it on the flight(s) back from DC*, that cold and all-to-open airway.  For days I regarded it as little as possible, but this morning I awoke at sunrise to what can only be described as a "whooping" cough.  Preventative flu shot, vitamins and supplements be damned.  I can admit that when it's real, it's real.  I can also admit to relishing the rare excuse to sit on my couch from sunrise to evening sipping tea, reading and writing.

Cheers to you, post-SfN sickness, for waiting for the weekend so that I could get my surgeries accomplished.

On a side note: jeers to cruel professors with identity crises.  Professors should be allowed to teach graduate courses unless at least one of the students is rotating or staying with them.
 

*SfN-related posts can be found in How We Are Hungry.

Friday, November 4, 2011

Things I've learned in graduate school

1.  forgetting to eat is a bad habit

2.  forgetting to eat and washing down your day with three beers is a worse habit

3.  spending the evening vomiting bile because you are a Crohn and shouldn't be drinking beer in the first place is not ideal midterm preparation

4.  taking the most convoluted and poorly phrased midterm in the history of academia while hungover (from three beers) and exhausted from vomiting all night (from three beers) is even less ideal

5.   medical offices everywhere fail miserably at communication -- it wasn't just Kaiser.  no sooner did i escape the awful affliction of Mid-term-dom  than i received this call...

"Oh hai, btw: your Remicade appt tomorrow morning [Saturday] that you made with us 2 weeks ago?  Yeah, I'm gonna go ahead and cancel it because we don't know whether you have authorization through your insurance lolz!"

First of all, why did you wait until Friday afternoon before my Saturday a.m. appt to tell me that?  And secondly, my doctor's office was supposed to convey that information to you two weeks ago.  Who dropped the ball, them or you?  So two hours of my life were lost trying to figure that out (still dying of 12-hour-bilemania).  Ten minutes later:

"Oh haai!  Btw: you don't have authorization for your Remicade tomorrow so we have to cancel your appt."

Are you fucking kidding me?  I just spent two hours clearing this up.  You have the information in your system now.  Go ahead and turn your computer on.  Do it now while I'm on the phone so I can guide you through the process.  She's been checking that detail for the last 45 min... apparently their computers are made of bark.  Meanwhile...
"Oh hai there! Btw: your insurance wont be covering your Remicade appt because you were referred by your GI's office and not be the university health center!"
.................. is a referral by the doctor to whom I was referred by the university health center not by proxy a fucking referral?   I'm looking into it.  Because apparently their phones to other offices are also made of bark.  I'm sure I'll find out right after I get the bill.
6.  your PI and lab manager being in disagreement on the critical details of your new rotation project and failing to let you in on their decision 2hrs before your scheduled surgeries to use your mice for some other thing that came up... is just not cool.  serious demerits, y'all.

7.  TGI-take-home-midterm-F!


Tuesday, November 1, 2011

How to Suvrive in a Disorganized Lab

My first rotation has been in a large, renowned but chaotic lab.  We're about halfway through the term, and I have been mildly successful.

There is but one overarching rule for any student in a lab such as this (or any lab environment, for that matter):  be respectfully assertive.

This is an ubmrella rule that includes but is not limited to the following:

1.  Make sure that you are actually trained before you are sent off to perform experiments and obtain data.  It is a waste of everyone's time and materials (and dangerous if you are working with animals or viruses, etc.) to risk a new lab member collapsing an experiment because they were not properly trained*.  Seriously.  If your lab mentor is not up to the task, find someone who is or talk to your PI.  You can do this respectfully, with the understanding that your lab mentor may be distracted or under an unusual amount of pressure.

2.  Do not be afraid to ask questions and seek communication.  This seems obvious, but in certain labs it is difficult to gauge whose office/bay you can barge into with questions at any time, and with whom you need to set up an appointment by email to drop by for a 5 min discussion.  Find these details out early on in order to facilitate moving projects along.  Anyone in your lab should be happy to help you, or direct you to someone better equipped to do so.

3.  Your lab schedule will be dependent on the schedule of the person/people training you until you are self-sufficient.  And even then, you may have to coordinate sharing space/equipment and assistance on certain procedures.  Be respectful of the demands on the people training you, but do not submit to being trampled all over either.   

In my current lab, not many people typically know what is going on at any given time.  This is problematic as there is an extensive amount of sharing space/equipment, and many people participating in different elements of the same projects.  It's something they're [we're] working on... little by little.  It's something that I'm learning to navigate with mild success.




* experiments go awry often enough on their own without this variable aiding their demise.

Tuesday, October 18, 2011

Hamilcar!

I'm sure most of you thought this was possibly my lamest topic ever, but lookit!  Hamilcar followed us to the South!  A year to the week after his first appearance in our window!

He's not really the size of my neighbor's window, that's just retinal ambiguity.

Friday, October 14, 2011

Crohn's versus Grad School: Episode I

A fascinating new trend is emerging in my diet.  To bestow some background, the morning hour at which I eat breakfast is determined by when my nausea wears off... typically 2-3 hours after I wake up*.  As a research assistant, I got to work at 7am, pecked at a breakfast item between 8-10am and was totally stable until a 1-2pm lunch.

As a grad student, I wake up at 6am, "study" etc. until class at 9am, and still not being settled enough to eat, just forgo the breakfast entirely (gasp!).  What happens next is cruel punishment.  My stomach thundering in acidy mobilization by noon, I sit down to consume (very slowly) a sandwich.

Halfway through -- BAM! -- nausea is back, bitch.  "How dare you starve me and then gluttonously bloat me with half a sandwich?!", blathers the Crohn's baby.  And with my tail between my legs I slough off to make a cup of tea.

Clearly, the solution is to bring a granola bar to class so that the Crohn's baby doesn't start the afternoon hating before the morning hating has even subsided.  And sugar being my least favorite thing in the morning (this is an artifact of colonoscopy prep), I have to find a granola bar that isn't composed of nuts and seeds but is also not drenched in sugar.  Where does one find such an elusive creation?

*Although the nausea is also bested by coffee, the Crohn's baby does not accept coffee without ample absorptive carbo load, and also if I'm handling animals or microscopic pieces of fragile tissue there is just no inviting the Caffeine Shakes.

Thursday, October 6, 2011

the conundrum: rotation saga part III

Week 2 into the fall term, it becomes apparent to the first years in my department (n=6) and to those in the interdepartmental program (n=14) that there are several new labs entering Neurobiology and Behavior.  Instantaneously upon disseminating this news, we are all clamoring to get some face time and possibly a rotation with some of these new labs (R2 = madness).

Yours truly had had it all figured out: fall in a renowned histology lab, winter in a renowned molecular genetics lab, spring in a budding molec/e-phys/histol lab.  But then, there was an opportunity to rotate with Dr StemCells.  Three exciting labs for the remainder of the year, and two terms.  Not cool.

It was not easy to make a decision, and honestly my stomach is still churning somewhat (or perhaps that's the caffeine).  After two weeks of soliciting the philosophies and suggestions of graduate students and PIs alike, I chose to forfeit the renowned molecular genetics lab in favor of the budding Dr StemCell's lab.  Ultimately, it came down to this:

1) Dr Molecular Genetics runs a very large lab and is very inaccessible.  We're talking up to 18 month gaps between private meetings, unless you are her co-PI.  She is a remarkable woman, and I would do a post doc with her in the blink of an eye, but students just do not graduate from her lab in less than 7 years and I require the guarantee of semi-regular one-on-one time (things tend to move more quickly that way, in this department's labs).

2)  The three labs under consideration all collaborate with one another on some level.  It's not like I would be abandoning an opportunity to participate in a hot project.

3)  Although it certainly puts a feather in one's academic cap to be spawned from a renowned lab, it doesn't hurt to be part of the creation of one either.  Newer labs (again, in my department) tend to publish more frequently and use more shiny high-tech toys.  I would speculate that this is because a) budding PIs need to lay golden eggs to stay funded, and b) budding PIs tend to still be in that rosey-eyed optimistic stage of their careers.

Naive Raga has chosen to try out two fledgling labs after a term in the current renowned one.  What will be, will be. 

Wednesday, September 28, 2011

things that keep me up at night

1) do i have the huevos to officiate the wedding of two of my most favorite people this summer?

2) what if a "real" handicapped student needs our apartment next year and my housing complex kicks us out?

3) how in the world am i going to explain to a PI who i like and respect that i don't want to rotate through her lab next term after all?

Saturday, September 24, 2011

Neurobeer: an orientation week finale

As it turns out, I do in fact have a small amount of terminal ileum inflammation, but not enough to stop me from eating salads on a near-daily basis.  Or biking after boozing on Friday afternoon...

After an agonizing week of general grad and departmental orientation, I am pumped to actually start in with courses and a regular class/research schedule.  The little that I've gleaned of my incoming classmates has been stellar; we are all from different backgrounds and excited to share our expertise and learn from that of our peers.

It also turns out that 3 of the 5 of us (and one other incoming in another department) want to rotate with a particular assistant professor who was just given a lab just this summer and who I just learned about last week (more on his situation after our meeting next week), so my rotation schedule has been jostled into upset and I am just shy of frantically lunching and coffeeing with PIs and grad students in order to re-prioritize.  My 3 comforts are as follows:

1) schedule upset is a defining characteristic of academia, and this compulsive organizationalist naively invites the challenge as if she might actually conquer it;
2) I am confident enough in my enthusiasm for finding a rockin' project and publishing/collaborating through it that I don't feel reliant on a PI having an established and renowned publishing record;
3) I have a NSF grant, ergo, I'm a free-be, ergo, I'm not in the same kind of competition with other graduate students for space in a lab of my choice.

After four days of mind-numbing introductions, patronizing trainings (and I was prepared for this process, but having your entire breadth of background disregarded and being made to start back at zero is frustrating no matter how prepared you are), stressful reconfigurations of research rotation fates, and a Remicade infusion, there was Neurobeer.

Yes,  I am part of a neurobiology program that treats its family to beer and free cuisine each month.  And by cuisine, I don't mean wraps and cookies -- I mean Mexican, Indian, Asian cuisine.  And by family, I don't just mean the grad students -- I mean us, recruits, post docs and PIs.  All chillin' in our courtyard with a beer (or wine, or soda, as you prefer).  I lubs it.

Monday, September 5, 2011

Remicade and identity theft

H.K. has finally experienced colonoscopy prep Raga.  Something about not being nauseous or half conscious (as I have been in my previous three) makes a liquid diet and 4 liters of electrolyte concentrate so much more irritating.  I survived only for the promise of a teriyaki chicken burger.  Which was devine.  And for his part, H.K. was utterly delighted when he was handed picture copies of my lower guts.  All of his suffering from the last 36 hours vanished.

As dreadful as the prep was, the results may have been worse. 

At my follow-up appt the next day, it was concluded that my Crohn's -- at least the lower bowel Crohn's -- looked fantastic.  Scars smaller than ever, inflammation gone, no ulcers, no abscesses.  So where is all the pain coming from?  IBS, says Dr. New GI.

Nuh uh.  IBS?  In my 13 years of Crohn's, no one has ever mentioned that some of my pain may be coming from IBS.  I feel almost slighted.  Remicade is doing beautiful work in my lower tummeh, and in doing so stealing my identity as a Crohn.  I don't know how I feel about this.

You're thinking, "you should be cheering, wtf is the problem?", am I right?  And I am.  Yay.  It's like this, though.  When you have a creature inside you for 13 years and you're told that that creature may now either be hibernating or dead, there is a feeling that you've lost a part of yourself.  Not quite like when a Trill's symbiont dies, but similar.  Especially when the loss of your creature doesn't actually change anything about your life(style).

First of all, for those who have been following the journey, it was decided that despite all the side effects of Remicade that I've been accumulating over the last 2 years, we're going to keep me on it.  Because, well, my inflammation is gone and my scars are no big deal atm.  So we're redirecting the energy of the mission into full mobilization against the psoriasis, the dermatitis, the hives, the fatigue, the rotting teeth and the chronic infections.

That said, Dr. New GI has not ruled out any activity in my upper tract.  So we're checking my sedimentation rate and I may be doing the camera pill in the near(ish) future.  Rock on.

Is this it?  Am I still a Crohn if I'm just battling the Remicade?  I had a small identity crisis last night before realizing... if I still feel like shit, and my immune system is still functioning like shit, nothing has really changed, has it?

Monday, August 29, 2011

first lab mtg: part II in the lab rotation saga

I sat in on my first lab mtg in rotation lab #1 this afternoon.  The first thing I observed was a very amiable dynamic... laid back, even.  There was a scalable project undertaken over the summer which was presented by two of its major players.  I was pretty quiet, mostly observing how people interacted and how information was presented.

Being only vaguely familiar with the study, I suppressed my myriad questions which would have mostly been helpful to my own clarity and not contributory to the conversation.  Mostly, though, I was not interested in coming off as that jackass who comes in and blindly tries to push their experience without understanding the particular design/choices of the lab.  I do understand that a lab mtg is not a seminar, and that plenty of detail, being familiar among the post docs and grad students, is not reproduced.

That said, one very curious observation was how disjointed some things seemed.  For instance, the summer study involved some cell counting.  After the presenter discussed her counting methods and findings and seemed somewhat unsure as to how to interpret them, Dr. PI chimed in and very amiably pointed out that the presenter had set parameters for said counts that made her results jumbled and irrelevant, and she should try measuring several new parameters in the upcoming weeks.

During this part of the discussion, my brain was asking, "why weren't reliable parameters discussed before they were carried out?  why weren't the specific cortical layers of interest identified separately and compared instead of being clumped into one group?  why was the cell size not defined as part of counting parameters? could double-staining be done to elucidate cells of interest more clearly?  what would you speculate this outcome might mean?"... etc.

This is why I shut up.  Questions better saved for a one-on-one with my grad student mentor in a learning environment as opposed to a lab mtg.  From what I gathered from the rest of the lab's input, this was somewhat standard.  There was a, "let's try this and see if it works, and if not we will exclude the approach in future" attitude, which I love.  But I also got the feeling that students were very much on their own in terms of project design, and methods were not cleared with a higher authority or guide before conduct, which is a foreign concept to me.  My instinct is to approach every study as if it were publishable, and to optimize the design as much as is feasible in order to produce a result that could contribute to a manuscript.  It did not seem that this was the general perspective in rotation lab #1.

Finally, there were about seven undergrads at the mtg getting a feel for whether they'd like to become part of the lab in the fall.  Also very new, since there were no undergrads at the teaching hospital from which I hail (only summer students).

It's going to be a very exciting term.  I cannot wait for Sept. 6th.

Thursday, August 25, 2011

cold feet: a lab rotation saga

Two weeks away from beginning my first rotation, I am awake nights thinking [mostly unproductively] about the decisions I’ve made since January of this year and how badly I may or may not be screwing myself over.  You would think that having already acquired two prestigious fellowships would set my mind at ease... and you would be wrong.  I have narrowed the cause of my anxieties to one thing: fear of change.

Having been highly invested in a certain area of research for the past four years, and particularly after publishing four first-author and two co-authored manuscripts in the last year, I am loathe to abandon what is now a great love.

I have the opportunity in my first New Home Base rotation to work on a project in an area of research very closely kin to my Great Love.  However, this project is very likely the end of the line, as it is not my rotation advisor’s main vein.  Therefore, during said rotation I plan to also learn (or at least shadow) other techniques used for the Main Vein so as to familiarize with what I would most likely be doing if I remained in this lab for my dissertation.  The first problem here is the unknown and limited amount of time I will actually have for Main Vein learning alongside my own rotation project.  If I’m going to abandon my Great Love in this new lab, I want to be thoroughly introduced to what new delights I am getting into. 

I can’t help but revert to the knowledge that if I had stayed with Boss Man, I may not have gained experience in a new research environment, but I would have learned a new (and sexy) technique on a fine set of projects and continued to grow at my current momentum.  I discarded that option for lesser known opportunities in a strange and uncertain new world.

There is another lab at New Home Base which is collaborating with my rotation lab on my rotation project, so it is possible that though the line of study will not be continued in one lab, I might continue it in the collaboration lab during second rotation and forward.   Of course, I presently have no idea how likely this may be.  In addition, the PI of Collaboration Lab, although frequently published, has not published a manuscript as a senior author since 2009, and that was the first incidence since several years before.  This is concerning as a PhD student hoping to land a strong (or at least desirable) post doc position down the line.

Yet a third lab does work somewhat similar to my Great Love, but this PI does not publish in journals of the prestige that I hope for, nor would I learn any new techniques.  They are widely read and strong journals, to be sure, but I have already published in several of them and had ambitions for a more powerful impact factor for my dissertation.

Ambitions high and will strong, I face these options with cold feet.  Fear of diversion from my Great Love (which would not be wise should I want to come back to it as a post doc or PI), fear of entering a less prestigious lab and hoping that in it I will be able to improve the trends of the last four years, and fear of losing the momentum which I have established in my last four years.  Just because I am beginning to pursue a PhD in a new place does not mean I intend to take any steps backward in the career I have thus far developed.  And I have a way of meeting my intentions in at least some recognizable form.  Fear of change be damned; it can be done... maybe.

Tuesday, August 16, 2011

the traveling Crohn: displacement

Oh, hai.  Just checking in.  Not dead.  Still kickin'.

After a pleasant and leisurely road trip from the PNW, stopping pretty much everywhere in the Bay Area (BA) to see the in-laws and such delightful people as Kara from Sempre and some of H.K.'s childhood friends, and a quick stop in the BA ER for some I.V. and CT scan action (because who could resist?), we did eventually make it to our southern destination last week.  We dragged little bro-in-law down from the BA and unloaded in 1.3 days, and were completely unpacked and settled in after 5.  Relocation machines.


 Good bye PNW.

 
 BA R&R.

Apart from the disaster that was transferring my medical ID and records from PNW Kaiser to So. Cal Kaiser (now 1 week late for Remicade and nowhere near being ready to change treatments as planned, thank you), I am floating head above water in the sea of graduate school entrance paperwork.  No department can seem to agree on what I need to do and in which order... so I just kind of dowhatIwant, and lo' and behold, it's all getting done.  The nice thing about So. Cal is that none of the hassle is really too much of a bother, because, well, the sun is out.

Hullo desert.

H.K. and I bike somewhere new (or new-ish) every day, which is great for my mind and all-too-out-of-shape corpus.  And I fear we are in a never-ending feud as to whether I should drop my PNW roots and start wearing up-the-crack shorts (hoochy mama shorts, I believe they're called) like the rest of the New Home Base community.

Today is the first time I've sat down and really taken a breath.  And by taking a breath I mean worked on my conference poster and discussed experiments [in which I no longer have a hand] with Boss Man, naturally.

Best of all?  The ants know their place here.  They stay outside.  And.  The squirrels that run rampant in the PNW?  They're bunny rabbits here.  Everywhere.  As being displaced from the land and people you love goes, it's glorious.  Bring on the science.

Sunday, July 31, 2011

the traveling Crohn

The adventure, three days in, has already been packed with thrills, chills and hospital billz [yo].  On a mild Sunday evening in the Bay Area, I find myself with a moment to reflect on the first phase of this great adventure.

The back story is very important here.  I have never lived more than 1 hour away from my childhood home, in which 20 nigh consecutive years of my life were spent.  When I went to college, I was an hour south.  When I went to work, I was half an hour north.  Although I have traveled some, I have never done the "big move"; and the "big move" includes a three-bdrm apartment of stuff that I didn't have before getting married last year.  With that in mind, let us begin.

I had planned for Wednesday the 27th to by my final full day at work, giving me a little buffer room to wrap up final minutiae.  Come Monday evening, and after accepting that the newly deposited moving POD is probably too small for what we need, I receive word that someone very dear has been addicted to narcotics for the past three years and is now ready to seek support in deciding the next steps toward recovery.  As if I weren't stressed enough -- if you ask H.K., "freaking out" would be his word choice -- this was pretty much icing on the cake.  Or fondant, if we're going for the full-blanket "heavy and surprisingly not good" analogy, and I am.

Tuesday morning during a short tea with Boss Man, I announce that I will be finishing up everything today and that I will be leaving early to be able to devote some time to Loved NA before I disappear.  Emotions abound during good byes and I flee the lab and go directly to Loved NA's abode.  It is pertinent, here, that I have not eaten much/well in several days because nausea and evening Crohn's attacks have become frequent and increasingly more painful.  This made the evening spent with Loved NA et al much less fun than it could have been.  However, it was a productive evening and I was sure that I could leave knowing that Loved NA was in good hands and of good-ish mind.

H.K. has already spent Tuesday packing up his small business into the POD, and Wednesday morning brings my involvement.  We get the thing a bit less than halfway packed before retiring.  I spend the night in and out of the Thunder Dome (ya like that?).  Thursday morning is blur of half-consciousness and sore limbs (does it come as a surprise to anyone that I'm totally out of shape but still lifting boxes and furniture twice my size? no.).  Loved NA is over helping a bit while kept a close but friendly eye on.  My mother has come as well with a repeated strain injury in her wrist and still clambering to help so I am delegating her to very small items.  Bless their hearts, delegating is the last thing on this earth that I want to be doing.

Wednesday evening, happiness arrives in the form of Minister Man (*totally unaffiliated best bud who kindly got ordained solely to hitch H.K. and I).  At this point, my diet of saltines, broth and beans has rendered me Throughputless, and I indulge in salmon and rice.  Then, I die.  The next morning, H.K. and Minister Man take over the heavy lifting as my body is near useless.  Mid-morning, I get a call from Loved NA, whose "watcher" has been called away and who is in need of a safe place.  I drop what I'm doing (which in honesty is not much), and leave the boys with the packing burden for the next hour, the poor things**.

Eventually on Thursday evening, our lives sans the trash and recycling bins and a dragon flower plant are packed, the apartment is in better condition than we received it despite the gaping cement hole and Frankinsteinian counter in our kitchen.  Without the extensive help of Minister Man, my mother, my sister and Loved NA... there is no way in the world that this could have been accomplished in two days.  No friggin way.  H.K. and I spend the night at my parents, where I [again] indulge in foods which encourage peristalsis, and [again] spend the evening with the Thunder Pot in more excruciating pain than I have been in over two years.

Had we not planned on leaving at 330am the next morning, I would have woken H.K. and fled to the ER for morphine salvation.  Instead, and without any form of painkiller, I endured.  Because I am an idiot.  And then got up at 330am.  Because I am an idiot.  You betcha.

H.K. was kind enough to do the majority of the driving to the Bay Area (a 12 hr trek).  We arrived with ample time to greet and have dinner with his family, after which we made for the ER where I was plugged into saline and chugged a gallon of CT scan contrast (in apple juice, which I have never had but was surprisingly effective).  Four hours later, I had peed I'm pretty sure at least 20 times, was given a "negative" CT scan and prescribed oxycodone and a very acute steroid dose.  Come again?  Acute steroids and no inflammation?  Sorry bud, not going there.  The oxycodone will do me just fine until I get down to New Home Base and find a new Dr. GI with whom to discuss an actual treatment plan.

The weekend has been lovely so far, with morning swims in the heated outdoor pool directly on the Bay, breezy walks on the Bayside promenade, coffee to encourage the Throughput and relaxing games, all less than 10 min from the nearest Thunder Dome.  I'm starting to return to functional status.  H.K. is loving this mini-vacay.  Neither one of us are yet dreading next weekend when we drive down to L.A. to meet our moving POD.

** lest I have over-sold my impotency, please know that in reality I did a ton of work for this move.  just... the heavy lifting paled in comparison to H.K. and Minister Man.

Tuesday, July 26, 2011

rollin' in the deep

Is there ever a better time for your whole world to come crashing around you than three days before a move to a new life?  Nope.  The universe knows this and plans accordingly, I'm pretty sure.

In recent events, we have the following:
a) rotting sewage pipes and the stank from hell rising from the depths of our kitchen foundation for three months and the current stank-free-but-Frankensteinian state of my unusable kitchen,
b) coworker fiascos and consequences of arrogance in abundance,
c) three days left to pack a three-bdrm apt. to travel 1009 miles,
d) credit card fraud,
d) officially failed performance of Remicade and inability to make a treatment adjustment until after the move,
e) exponentially increased anxiety over the grad school decision and heavy sadness surrounding leaving Boss Man,
d) and a loved one's confession of narcotics addiction at t minus three days to departure.

Really?  Srsly?

The Crohn's is having a field day with this.  Nightly attacks, almost constant nausea, diet of primarily saltines, not much sleeping to speak of.

Almost on the beach... almost on the beach... almost on the beach...

Sunday, July 17, 2011

unkempt

Yesterday was a day of unkemptitude in the Ragamuffin abode.  The first 4.5 hours were spent in Remicade infusion, steeping in unwashedness with greasy psoriasis treatment-stained hair thrown up in a bun with loose strands draping over the letters "MINI" which stretched across my anythingbutmini rack.  I think it weirds my nurse friends out to see such a creature reading books on the Carnegie Steel Company and Russian politics of the WWI era.  Although this is typically how I roll in the infusion center, it's not how I run errands... typically. 

Upon returning home, having added the odors of saline and ethanol to my aspect, there were errands to be run.  Thus, the Lego store and two groceries witnessed the essence of Ragamuffin.  Apparently, even after two years of Remi, I run myself into the ground after infusions as if it were nothing.  Heat flashes and vertigo abound and I nearly pass out in the car ride home.  Brilliant.

Home again, I am so excited at having bought real food after two weeks of not being able to use my kitchen that I spend 20 minutes arranging things.  Here would be a good place to note that the stank in my house is gone (after only 3 months! hazzah?); pipes replaced, hole in kitchen covered in cement and 1/3 of my cabinets and counter space ripped out.  The ant situation has resolved itself, and I have decided that what drove them to our kitchen was their own home being overrun with rotting sewage-soaked soil.  Neither the missing vinyl floor nor the counter will be replaced before we move.  The fridge resides in the middle of the room blocking both the stove and dishwasher, as it cannot be placed over the new cement yet.  And yet, I am resolved to use my kitchen in these last two weeks of residency.
 This is what it looked like before the cement.  
Now, imagine rock debris and the fridge front and center by the dishwasher.

Still un-showered, the rest of the afternoon was devoted to unclogging the bathroom sink and shower drains for about the 6th time in the 2 years that we've lived here.  I am willing to admit after the experiences of the last 3 months that this place -- aside from new carpet, white walls and a lot of space -- is an absolute dump.

I.  cannot.  wait.  to move.

Saturday, July 9, 2011

the year of plenty

In the last year, I have been exceptionally fortunate.  Acceptance to graduate school, publication of 5 manuscripts, the receding of Crohn's to a point where social activity and (dare I say) sleep could be resumed.  But above all, I have been a wife this last year.

My Heroic Knight is, without a doubt, the best decision I ever made, a better partner than I had previously ever imagined could exist, an extraordinary individual who makes my life equally extraordinary, my hero, my knight.  The amount of love in this house can be nauseating.

The man I married a year ago made this for me to celebrate our first anniversary.  I'm pretty sure I win epically on all fronts here.

Thursday, July 7, 2011

Crohn's Wins and Technician Survival

In the absurdity that has been my final month in my current lab, I have neglected several announcements.  But this afternoon, I finished collecting data for and writing the first draft of my last Home Lab manuscript, and now I have a few moments to breathe.

1.  My first CCFA Take Steps for Crohn's and Colitis walk was, for me, a big success.  We raised some big monies with the generous contributions of many friends and family, including some fellow Crohn bloggers!

2.  Operation Raga Detox has gone swimmingly, and I managed within 2 weeks to bury the Throughput deluge in its own audacity (too visual?).  This, my friends, means that I will be trying to work things out with Remicade for a while longer before throwing in the towel, ripping the shirt, or what have you.  I'm pretty much on the BRAT diet for now, and between that and neglecting all coffee and alcohol (I dare you to try this in PDX where happy hour is like breathing) things are churning at a tolerable pace in there.

3.  Also, until today I hadn't been on Facebook or read anything from my extensive blogroll in 2 weeks.  While that was its own version of nice, I'm ready for a break from the 10-12 hour days (weekends included) and the monotonous and yet never-dulling misery that has been waking up and going to work lately to bust my ass and attempt to ignore my chastising and mocking coworkers (again, thank goodness for my summer student slash REAL replacement).

4.  In news that I still can't seem to grasp, my boss wants to continue paying for my health insurance until the student coverage kicks in, instead of having me dry up my funds paying for COBRA continuation and then being without coverage for the month following, which was my ingenious plan.  This is why I break my butt for Home Lab.  My boss/mentor/surrogate uncle/guru/guide gives me fancy tea and healthcare.  The conversation went something like this.

Boss Man: So, when you talk to Payroll today, see what it would take to allow me to pay for your continued health coverage until your student plan kicks in.
Raga:  Haha... no.
Boss Man: Why not?
Raga: Well... because you're not firing me, and you're already paying for my Big Conference expenses even though I wont be here.
Boss Man: Oh nonsense.  You're going to be working on the manuscript revision and poster after you're gone anyway.  Think of it as salary.
Raga:  I don't think I can do that, even if Payroll will let you.
Boss Man:  Look, I wouldn't offer if I didn't have the money.  And frankly, I wouldn't have the money without the work you've done this year alone.  What you've helped to develop in your tenure here will carry several future grants.  Covering your health benefits for two months is but a small token of appreciation.
 Raga: *sob*... Alright, I will try to think of it that way.

Why am I leaving this lab again?

Oh yeah...

Friday, July 1, 2011

friday night lights

Who has two thumbs and spends their Friday night learning how to use EndNote and finishing off the last speculations of a manuscript in hope of avoiding a nervous 4th of July breakdown?  This guy.  ..er.. whatever.

I've finished up most of this beast of a paper.  My grand finale, so to speak.  My legacy, my investments, my several clumsy self-stabbings with syringes carrying various types of toxins, tea times with my boss, my first real collaboration, and four years of developing a disease model and a successful intervention are all wrapped up in these pages.

Did I mention that I'm still waiting on 1/5 of the data?

Not that there is any build up of pressure, what with less than three weeks to go before this baby is submitted and my butt is out the door headed for warmer climates.

Final projects are straggling along, throwing tantrums left and right as if I don't have an urgent need to get their boots and jackets on.

Coworkers are combative at every step, as if everything I attempt to teach is an attack on their person (I cannot emphasize enough what a drag this makes everything).

The only things that save me from unleashing a smackdown are tea times with my boss (when he is in town, which is not often these days).  Mornings of discussing data, the general state of the lab, the future of science and fine loose leaves.  These are why I work late on Friday nights.  These are why I do not dread going back to the lab Monday mornings*.  And they make it very, very hard to leave.


*only with the most recent stresses (see... most posts from June) has this ever been an issue.  In the four years prior, I have only ever loved to be at work.  It is amazing what negative attitudes do to their surroundings.

Tuesday, June 28, 2011

the weight of inadvertent flakery

For the record, this Ragamuffin has not been at her best lately -- physically or mentally.  There has been too much for a healthy me to handle, and I am not a healthy me.

The pressure at work has been astounding for several weeks now, accompanied by feelings of not wanting to be there (which are horrid, because I love my research with all my being).  Coincidentally, dearest Remicade seems to have stopped working its magic, becoming a premature delinquent and leaving me with a very big decision to make.  Therefore, there seems to be some competition between my mind and my gut for who is currently the most put out by Life, and who deserves the most coddling.  I've been closing the door on both of them and left them to tire of their own tantrums.  This has not been as effective as I had hoped.

The not being well has come at a very bad time -- it's a brilliant creature, Timing.  With a month left before the big move, I have been making an honest effort to gather with my friends (among many, many other things which are not the subjects of this post).  This has recently required one, and sometimes even two, after-work outings each week.  Such outings, while they can be so soulfully rewarding, are not accommodating to pain or heavy Throughput.  Therefore, I have been making plans freely with the best intentions, and inevitably canceling or rescheduling them with great embarrassment.

I am not a flake.  But my insides are.  Therefore, my most sincere apologies to those of you who I have slighted of late (none of whom read this blog, incidentally), and to those of you who I have yet to slight (some of whom do read, incidentally), be forewarned.

I have thirteen years of this practice under my belt, and yet I am still bothered when my flaking is not well-received.  Don't they understand by now -- my friends of ten years or more, especially -- that as type-A as I am, sometimes (often, lately) I just can't make it happen?  It comes as a surprise to me that many of them do not.  Love me as they might, they still do not understand the chronic nature of chronic illness.  And so despite my greatest efforts, I become a flake.

Friday, June 24, 2011

basic skillz

Insanely busy work days are days when you do not want to flaunt your laziness, allow me to take care of your sloppiness, undermine my mentorship or otherwise provoke me to break your face with my heel.

And yet, I am having to remind the same two people to refill a solution which they share with me when they use it up, or at least give me enough warning that I can make more myself before anything time-sensitive gets destroyed.  Here I am taking out the recycling because it's overflowing onto the floor and neither of my coworkers has thought to walk it down the hall so no one trips on it and dies.  Here I am doing these things because I have already mentioned at least two other reminder today, and if I mention any more they will instantaneously forget those previous.  Here I am doing these things because even though I am barely able to handle my own work load today, my coworkers cannot find a moment to get off of Facebook to earn their salaries.

Perhaps it's the coffee talking, but I feel like these are very basic skillz that I should not have to continuously remind people to improve... or develop.  If it were my place to give a verbal whooping, I'd be all over it; alas, I am mentoring/supervising my peers and so I must refrain.  

They tell me that in California, scientists are driven, enthusiastic and competitive in a supportive way.  I cannot express how much I yearn for this.

Can I get a "Rawr"?

Thursday, June 16, 2011

3am dirge

hello 3am Throughput deluge, you jerk.  i thought i made it clear that things were not going to work out between us.  back off.

see this coming much?  indeed.

Tuesday, June 14, 2011

stress management fail, Buffy and RagaDetox

A lot has gone down in the past 8 days.  Serious things like H.K. and Optimus Prius getting t-boned by a girl on her cell phone (H.K. is unharmed, O.P... not so much), bringing my young brother and his musician's gear home from college for the summer, sewage leaking underneath our kitchen which requires that H.K. and I live on the streets for several days this week, and family BBQ.  In addition, my boss has been away at a meeting and I have been left with Incompetence, Arrogance, a wonderful summer student, and the installation of and training on two new apparatus in the lab.

Smaller things that have gone down include an eye doc demanding that I expand the repertoire of my reading glasses to include computer-staring and T.V.-watching because my eyes have been blood red for a month now.  Never fear -- we ruled out iritis/uveitis, who were suspected based on prevalence in immunodeficient and Crohn's types.  Also on the list of less significant gripes is that while all of this was going on around me, I was also working on a manuscript, collecting data and taking care of my boss' mice, and cleaning up after Incompetence who continues to thoroughly live up to her name.

Needless to say, I died of tired on Sunday and have not yet recovered.  I need several days of incubating in my robe and watching Buffy the Vampire Slayer marathons... through closed burning eyeballs.

Either from the pain in my gut or eyes, or from the agonizing ordeal that is going to work every day lately, I have not been managing my stress smartly (enter the 5 cups of coffee and ~2 bottles of wine I consumed last week).  I have decided, therefore, to eliminate coffee and alcohol from my diet this week.  To some people, detox means flushing one's body with 8 cups a day of sunflower and stinging nettle teas and eating nothing but flax seed and green vegetables; RagaDetox just means no coffee or alcohol.

None of this sounds very remission-y.  But.  My boss is back in town, and things are beginning to look up... sort of.

Monday, June 6, 2011

of Crohn's and food cravings

When I was small -- and even during gymnastics when I had to carbo-load and be careful about protein and sugar balance -- I never had issues with food cravings.  That was an adult-onset thing.  Alternatively, it could have been a Prednisone-induced phenomenon.  Although it's well known that part of Prednisone Mania can include enhanced sweet tooth and weird food cravings during regimen, there seems to be no accessible record of either long term effects of these sort.  Then again, I haven't looked very scrupulously...

That I [and my medical journal of poo's and drugs] can recall, I started to have food cravings beginning after my first encounter with Prednisone when I was 16 (notice that I categorize 16 as "adult-onset").  Since then, I've only ever not had some degree of craving when I was nauseous.  Usually this is just a sweet tooth, but in my later years it has become refined to sushi, curries and Teriyaki chicken burgers*.  I have also expatiated on my inability to ignore food after a run to the grocery store, when the fridge and cupboards are replenished with veritable goodness.

In the past month, however, my cravings have subsided -- even in the [natural or coffee-induced] absence of nausea!  This is very uncharacteristic and, so far as I can surmise, unprovoked.  Am I just getting old?  Am I evolving from a stress-eater to a stress-starver?


*as an aside, why doesn't Google know how to spell Teriyaki?

Wednesday, June 1, 2011

in which Remicade is a Mercedes Convertible, and I decipher Russo-English science

It has finally happened.  I -- organizational and scheduling fanatic -- have missed an infusion.  By two weeks.  How did this happen?, you may ask.  I'll tell you.

I rescheduled my infusion to be two days after I met with Dr. GI, so that if we decided to scrap the Remicade and move on to "sexier cars" (his words), I would have drug-free buffer room to start immediately.  In fact, what happened was that when the nurse rescheduled me, she in fact neglected to reschedule me.  So my appointment came and went, as did my alleged infusion date, and I called the clinic to see why they had no appointment for me.  "You were a no-show on the 14th," is what I was told.  "But I rescheduled for the 27th of May, I just did not receive a reminder from Epic as I typically do and so I have not yet been infused -- I must not have been rescheduled" I retorted.  "Oops," the nurse replied, not at all withdrawing the reprimand from her previous remark, mind you.

Not all that exciting a story, really, but I wanted to get your hopes up.  The recent increase in Throughput over the past two weeks may be in part because I am overdue for my drugging.  Dr. GI was firm in his conclusion that it is not because I've increased my veggie intake.  My miniature experiment wherein I ate only crackers/rice/broth for a day and produced a 50% decrease in Throughput the following 24 hr period was noted.  The 50% reduction did not convince him.  And since I've been buffering all my veggies with fluffy carby foods over the last week with no Throughput let-up, I am beginning to side with him.  It is possible that my notably increased nausea and dependence on Percocet to survive the evenings are weighing in.

So... I'm taking my Remi from the 8- to the 6-week interval -- perhaps the 4 -- and if in the coming two months I do not see improvement, I will concede to move on to "sexier cars".  For now, I will deliberate between Humira (the Benz), Imuran (the Lexus) or LDN (the Prius).  I refrained from challenging Dr. GI as to whether Imuran was a Lexus or, in fact, an Astin Martin.

Meanwhile, in my small corner of the world of science, I am reviewing my first manuscript as a Peer.  It has been translated from Russian, and while the findings are very exciting, the syntax, run-on sentences and hugely neglected Methodology section have been problematic for my novice brain.  I spent 6 hours on Sunday trying to get through this thing (during this same period, my boss pummeled through a 140 pg dissertation... pwned).

Something I am gleaning from my meager experience in reviewing and being reviewed is that reviewers tend to hope that you cite them in your work.  Often, when we (my lab) produce(s) manuscripts, we request reviewers whose work we cite in the present work.  The Russian paper from this weekend didn't cite any of our work anywhere, which was not really offensive so much as remarkable because their findings were so intertwined with ours, and supported by some of our previous publications.  They did not defend discrepancies between their data and that of other studies which they did cite (which was a weird door to leave open), nor did they speculate on the correlations within their own data set (also odd).  It is a very different experience to read a submitted manuscript than a published article.  I think I like it...

Monday, May 23, 2011

don't worry, be happy now

Oh Bobby McFerrin, how mesmerizingly you sing my counsel...

I've been abnormally exhausted the last few weeks.  As proof, I slept like a rock until 10am this Sunday.  It's stress, I'm sure, which shows glaringly in my consistently burning and bloodshot eyeballs.  It's stress, I'm sure, from work.

The day of my departure creeps ever closer (yes, with two months to go I'm already panicking), and my colleagues slash successors are not easing my nerves with their competence.  Ever aware of my capacity for excessive worry, I am trying to be the patient observer and not accuse anyone of , well, amateurishness.  This is increasingly difficult for me to do.  The urge to approach my boss and request the authority to tell my protégés that they are doing things totally wrong and that I refuse to pass on my legacy to them unless they change things is throbbing in my brain.

Halp.

My internal monologue to my inveterate coworker goes something like this:
It is one thing to consistently force the colleagues with whom you share equipment to clean up after you.  That's just disrespectful on a peer level, like the time (last week) I mentioned your error, and witnessed its repeat no less than four hours later.  But when your neglect of expensive and sensitive apparatus results in its corrosion or other damage, you're disrespecting your boss and unnecessarily costing him many monies.  These monies should be on reserve for actual screw-ups.  The equipment is plenty capable of doing this on its own, thanks.   
When I leave, there will not be anyone to clean up after you before IACUC or the VMU folks drop by (or to forget to do so, for which mistake my ass has been burned several times).  Frankly, I've enjoyed that you are prompt with coffees and homemade treats to share in apology, but I urge you to bribe yourself with these things, for I will no longer be around to play the forgiving role, and you will have to take the heat from the higher-ups for your own mistakes.
In addition, I'm sorry to say, consistency of timing does indeed play a crucial role in behavioral data collection.  Specifically, if you begin testing a subject at 9am one day, you cannot then begin testing others in his cohort at 3pm the next round.  Hormones, circadian rhythms and neurotransmitter levels alike are in play here.  It is clear from your conduct that you may have forgotten this, despite your ten years of experience and self-touted expertise in animal research.  So I remind you and beg your to be cognizant of these variables in future.  
Please, please take to heart the things I am teaching you.  This research cannot afford for you to defy my every word to satisfy your ego.  I know you've been in the business much longer than I have, but I have been mastering these things which are new to you, and I will humbly argue that my experience with them gives me seniority.
To my new colleague/trainee:
If I may be so bold, it has come to the point where I can no longer tolerate your arguing with my methodology and telling me that every explanation I give you is wrong.  Lookit, bud; I have spent four years developing my techniques, optimizing and expanding them.  I am no idiot, and as much as it pains me to be arrogant, I do take ownership of this.  Having published five manuscripts based on my research and my techniques, written by my own hand, I'm pretty sure that the scientific world has at least begrudgingly accepted my analyses and interpretations.  I have been respectful of your questions, praising of your intelligence and encouraging of your perspective.  I had hoped that my example would be enough to convince you that it is ideal to respect your mentors and peers and their experience, but it seems that subtlety eludes you and I must take measures to be verbal... but not too verbal. 
Chill.  It'll make you a better scientist.  There are reasons that I do things a certain way, and, similarly, there are reasons that I do not do things certain other ways.  I am open to suggestions -- part of science is constantly optimizing and when I leave you will certainly improve upon what I have developed.  You may contest or challenge my rationale, but you may not blatantly tell me that I am wrong and you refuse to do it my way but that you have no idea why.  Sorry, bud.
Please, please take to heart the things I am teaching you.  This research cannot afford for you to defy my every word to satisfy your ego.  I know that you are fresh out of undergrad and think you know everything and the world is your oyster, but I have been mastering these things which are new to you, and I will humbly argue that my experience with them gives me seniority.
I stress because I worry (perhaps selfishly and egotistically) about my legacy collapsing when I leave --I hope that this is an exaggeration of the circumstances.  Mostly though, I stress about the amount of my work that is being passed on to my boss -- yes, my PI -- because my colleagues are not capable of learning the skillz.  Seriously.  I do not want to leave my boss in a situation where he is too overwhelmed to function.  The man is the reason I have any shot of being a good scientist.  He provided me with every opportunity under the academic sun, and I do not intend to leave his research teetering on a cliff.

Deo volente, I will refine these thoughts and project them in the upcoming weeks... ...

Thursday, May 19, 2011

Food of the Day: i drink coffee for my liver

I have trouble justifying my typical 2-4 cups of coffee a week.  No matter how diluted with rice milk, whether regular or decaf, there is no denying the less-than-ideal effect of the acids on my tummeh.

However, my average 36 oz of coffee a week has other benefits.

First of all, it magically suppresses nausea.  Secondly, it helps me to stave off hepatic cancer and chronic liver disease (Johnson et al 2011*).  And as anyone who has ever taken steroids or 6MP or been on chemo/biologic therapy knows, this is a handy dandy organ.  Specifically, Dr. Johnson and colleagues report that of their coffee-drinking cohort participants, those who drank 3+ cups of coffee per day on average had a 44% reduced risk of develpping hepatocellular carcinoma compared to those who never drank coffee.  As clinical studies go, 44% is a pretty big deal.

There are other reasons to drink coffee, such as its recent implication in protecting against prostate cancer, and the age-old [read: 6-year old] claim that coffee can protect lymphocytes from toxin-induced DNA damage (Steinkellner et al 2005Bichler et al 2007).  Suffice to say, there is ample support for moderate coffee consumption.

Folks, I needed an excuse to get my French roast fix.  Or Brazillian roast, or fair trade Guatemalan... really, it's whatever is being served at Journal Club.

ResearchBlogging.org
* Johnson S, Koh WP, Wang R, Govindarajan S, Yu MC, & Yuan JM (2011). Coffee consumption and reduced risk of hepatocellular carcinoma: findings from the Singapore Chinese Health Study. Cancer causes & control : CCC, 22 (3), 503-10 PMID: 21258859

Wednesday, May 18, 2011

Food of the Day: seaweed

ResearchBlogging.org
It may or may not be apparent to most of my readers that it has been quite some time since I've blogged on a Food of the Day.  The reason is that, well, there are only so many foods a Crohn can eat [read: admit to eating].  Since I'm diving most enthusiastically into this fiber fest, it is time to give some hard-won and well deserved attention to seaweed.

Seaweed, to me, has always seemed a benign and healthy food for two reasons: 1) it is an algae, and algae is generally purported to have excellent mineral benefits, and 2) because seaweed makes Sushi more chopstick-friendly -- nigiri is very complicated because it is a 2-3 bite endeavor, and sashimi is too expensive to eat as often as I eat sushi.

I was, therefore, thrilled to learn that types of seaweed have direct benefits in both in vitro and in vivo models of IBD.  Fucoidan (brown seaweed extract), specifically the Cladosiphon okamuranus Tokida kind (collegially, Mozuka), has been shown to protect against the development of intestinal tumors in rats (Yamamoto and Maruyama 1985).  Even more exciting was that Mozuka inhibited interleukin-6 (IL-6) activity and down-regulated  NF-κin a model of colitis (Matsumoto et al 2004).  IL-6 and NF-κB are two of the primary triggers of intestinal inflammation.


Yet another study suggests that Mozuka inhibits the adhesion of Helicobacter pylori to an in vitro human gastric cell line (Shibata et al 1999).  Reports on the effects of Mozuka against H. pylori are, in fact, numerous: Shibata et al 2003, 2000; Nagaoka et al 2000).

オキナワモズクフコイダン


But as you might imagine, Mozuka, being brown seaweed, is not sushi seaweed Nori.
                                

Nori (stolen from http://gluttonforlife.com/2010/11/09/the-nori-story/ -- read her awesome post!)

Nori saeaweed is rich in minerals such as calcium, zinc and iron (Shaw and Liu 2000) which are typically lacking in Crohns or persons with any digestive dysfunction.  Shaw and Liu also suggest that Nori helps the intestine to absorb minerals from other sources such as the Crohn-coveted magnesium.  It is also an excellent source of soluble fiber.

There are many other benefits of various seaweeds, but as you can see, this post is already quite orange.  I will continue to ingest my moderate portions of sushi, roasted nori and Wakame (in soups = nom!) without fear.

Sunday, May 15, 2011

fiber and loose ends

This post being about fiber, I thought it fitting to tie up -- or at lease re-lace -- a few loose ends (tehe...).

The ants have been Terminixed into oblivion (or scared away for the moment).  The rotting flesh has relented just enough to inspire the hope that it will one day be gone (I now have a sexy little bald spot -- fortunately hidden -- which I dare to dream will be refilled in the happy future).  And finally, my zest for experimental cooking has been reborn and outrageously fiber-themed.

In truth -- there was a day where I ate an egg, a kale and apple salad (uncooked... wtf?) and grilled asparagus.  It's like wishing for death by intestinal rupture.  But I've been on a good streek...

 That's not my beer.

The fear that I might have to resign from Remicade in the near future sparked a desire to reintroduce as much fiber into my diet as possible while I still can, and perhaps get to a point where I can rely on it for maintenance.  I have long been jealous of the folks who are able to maintain a level of comfort through the Simple Carbohydrate Diet, which I have never been able to do without catapulting into a flare or exciting a collective of food allergies.

Since the insane kale asparagus day, I have backed off somewhat, eating raw veggies only occasionally and always buffered by starch of some sort (yeah, the gluten-free thing didn't last too long either thanks to dear and shamefully neglected GERD), or Tofu.  Grilled julienned zucchini and seaweed is my new favorite lunch kit -- small, fast prep and consumption, filling enough.  The Lab forces me to eat healthier lunches anyway because I have this compulsion about not eating finger food between bench runs, and sometimes have to neglect my meal midway through to make time-sensitive sample transfers or solution adjustments.

Unfortunately, fiber -- particularly insoluble fiber, which is the star of this new dietary whim -- also leads to very unpleasant bus rides to and from work.  The kind of bus rides that I have mentioned before (so many times, in fact, that it should really be its own tag term).  The kind of bus rides that elevate anxiety and provoke daydreams of flowing off of public transit in a deluge of... well, let's keep this PG-rated, shall we?  Fiber alters [read: lengthens] my schedule in order to accommodate new time slots between meals in which it is safe to travel.  The starch buffer helps to a degree.

Yes, that is an ice Lego minifig in my BenchFly mug of diet soda (allow a woman some indulgences...).

Is it worth it?  Are the long-term benefits of eating healthier foods during this pain-free window going to have efficacy?  I like to think of the inconvenience as analogous to a woman who wears anti-ergonomic heals despite the arch aches and blisters, and to hope that I wont later appear to myself as ridiculous as she does to me.

Sunday, May 8, 2011

why I blog

It appears that this blog, which I have always thought to have pretty low readership given the specialization of its topics, has received some recognition.  The Nursing School Blog has recently listed How We Cant Eat Anything in their "Top 40 Blogs for Crohn's Support".  How cool, and how humbling to receive such recognition!  It inspired me to expatiate a bit about why it is that I blog.

When I first began How We Cant Eat, it was intended to be a source of support and humor (amidst myriad complaints and woe-is-me's, of course) for other Crohns.  In particular, I had hoped to reach out to other Crohns and anyone with AI  Sidekicks (autoimmunity, not to be confused with artificial intelligence) who were pursuing a similar career path to myself; that is, Science.

During my period of darkness which began in August of 2009 (see archives), I had scoured any and all resources for proof that it could be done, this juggling of chronic health tempestuousness with the scientific research and graduate student lifestyle.  I found (at the time) no such accounts, and decided to create my own in the hope of attracting protagonists of a similar vein.  The accounts I did find, however, have been -- and remain -- extraordinary comforts and testimonies of empowerment (see "Crohnies and Foodies" and "Science Coterie" blogrolls, and here).

Today, my reasons for blogging have evolved slightly.  First of all, I'm actually about to enter into that mysterious land of pre-doctoral scientific research, and will be equipped to comment on the maintaining of balance.  Twoly, I hope to continue to contribute to the discussion of tips, successes and failures, keeping hold of a proactive state of mind and body, and obstacle negotiation methodology.  It has been hugely beneficial to me thus far, and I can only hope that readership and discussion will continue to grow.  Perhaps this recent link love from The Nursing School Blog will not only buffer readership of  How We Can't Eat, but through doing so connect its humble narrator to many more such catalogs of the journey of balancing AI Sidekicks with successfully (at least sometimes) chasing one's passions.

I love to write, I love science, and I love trouble-shooting.  The latter is a large part of my ruminations on Crohn's disease as well as research, and wh'ver the twain shall meet.  How We Can't Eat is also a juxtaposition of my entirely science/media oriented blog, How We Are Hungry.  I write in that blog purely for the pleasure of deliberation, to develop my scientific voice, and (pardon the blatant allusion) out of hunger for any extraction from the intricate puzzles of universe through the scientific lens.

Afternote: Please plug your blog if it does not already appear on either of my blogrolls!

Wednesday, May 4, 2011

re-calibration


See those 2.2 red lines in the left hand document?  That is what I've accomplished today.  Somebody shoot me in the foot.  Do it quick so I can have an excuse to go outside and recalibrate.

Tuesday, May 3, 2011

pleasant surprises

It doesn't surprise people that I was a gymnast and dancer for most of my life.  I have a gymnast's short, thick build.  You can tell that I had muscle definition once.  My thumbs by default fold in slightly when I walk, and I do that thing walking downhill where my toes point outward and the ball of my foot hits pavement first, which weirds people out.

The person it does catch off guard is me.  Every so often I remember that I once was a ball of energetic artistry.  I chose to remember today.

The last several days I have felt myself plummeting into a frequency of sporadic depression.  The PWD kind (previous posts on which I have not tagged --denial--).  Somewhere between half-watching that masterpiece of theater and screenplay, Vertical Limit, while reading yet more horribly depressing articles about the aftermath of Osama, I decided that enough was enough.

So today, I dove whole-heartedly into protein assays and the first sections of my next manuscript, came home and paid homage to my Once Self.

I pumped the Reggae and broke out one of the hip hop warm-up routines that I used to teach to intermediates.  On the treadmill.  Win.

Wednesday, April 27, 2011

how Crohn's made me a better scientist

Many people are able to recognize their type-A personalities early on in young adulthood.  Type-A folks always make better scientists, we all thought.  Not so with yours truly.  I spent much of my responsible years thinking that I couldn't possibly be type-A because my memory was not terrific and I habitually make small-to-moderate sized mistakes.  Not long ago, I realized how type-A that thought was.

There were other signs: I always wanted to be the group leader because I didn't trust anyone else to get 'er done, but I was very conscientious of bossiness; I needed to have an organized schedule, but it didn't need to be the same day in and day out; I am only ever early or on time, but never late.  Ultimately, the driving force of these tendencies is actually Crohn's.

needing to know where the nearest restroom is...

scheduling things perfectly so that there is always room for a five minute Throughput break... or an hour long retreat to a hidden spot to wait for the pain to go away... or doctor appointments...

scheduling time for food prep... bringing food to places where I know I wont be able to find edible things...

These things necessitate the very efficient scheduling of experiments and juggling of multiple procedures, and allow me to transition "easily" between technical mode (bench) and theory mode (grants and manuscripts).

However, I try to remain flexible.  Science is anything but predictable, so when things go wrong or results are totally unexpected, I thrive because my particular type-A-ness is most enthusiastically channeled through trouble-shooting.  Or, H.K. and I often plan trips that turn into spontaneous (mis)adventures, which I love.

Interestingly, this does not cross over into the more irritating "things that go wrong": for instance, my gripe today is that Dr. Derm "jumped the gun" in diagnosing my Staph-infected psoriasis last week, and found out this morning that "the rest of the culture" showed that what I have is in fact resistant to the antibiotics he prescribed me.  I'm soo glad to have already taken 5 days of unnecessary antibiotics that make my gut hurt on top of everything else.  So glad.  And extra happy about not getting refunded for my doctor's eff-up.

Someday, I hope to trouble-shoot these most irritating instances of being screwed over more efficiently. (although I must say, my little cry over the ant horde last night helped my ceaselessly-bloodshot eyes immensely!)

Grumble.  Rediscover the terrible music I listened to in high school.  Move on.

Tuesday, April 26, 2011

defeat

I effing hate ants.  This afternoon marks a peak incident in the rising number of the pests who have over-ridden my bathroom, living room and kitchen each morning and afternoon for the last several weeks.  Maybe it's because I worked a very long and labor-intense day.  Maybe it's because I had coffee this morning and am still on-edge.  Maybe it's because I'm tired of planting spiders in various corners of my home and willing them to gorge themselves (yes, I actually do this and spiders have become so my friends through Spring that I do so with my bare fingers).

Maybe it's just because I came home and walked into my kitchen and stepped on a two-inch thick trail of ants leading from behind the fridge to the [sealed] garbage and recycling bins (it is of note that the traps that I set in the crevice between the fridge and wall were totally desolate).  Perhaps it has something to do with my being startled into jumping for safety to an ant-free zone and looking down to see that I had skipped onto yet another trail of ants -- headed, seemingly, to my dishwasher.

I would even go so far as to speculate that it has something to do with my spending 25 minutes (yes, I clocked this shit) vacuuming up ant trails, taking out the garbage and recycling and Lysoling every inch of linoleum.  This was precious energy that I so carefully preserved throughout the day, and which I had hoped to use to run this evening after a long day of standing at the bench and staring into hours worth of statistical manipulation.  It could, however, also be because when I re-entered the kitchen with emptied/Lysoled bins, the two-inch thick trail of ants had entirely replenished itself...

It could be because of any of the above reasons that I am now feeling totally defeated, exhausted and not chillaxed.  However, I think it was walking out of my kitchen feeling that I had finally won the battle, plopping heavily onto my couch and seeing that my living room carpet was alive with tiny black beasts that ultimately did me in.  I just gave up and cried into the couch pillow.

In a history of 9 houses/apartments, I have never seen anything like this.  I cannot wait to move out of this miserably maintained crap hole.

Nothing like a little H.K. humor and some garlic broccoli to  lighten a girl's heart.  Isn't it something that I am more likely to be undone by ants than by Crohn's?..