how we can't eat anything

Exponential decay

2012-01-28T12:11:00.000-08:00

We are learning about neuron equivalent circuits in school. In honor of said topic, I present my own example of exponential decay.

Last week was the most idyllic example of an exponential decay in condition that I have ever experienced. Laughably so. And thus, I share.

Monday (100 enthusiasms): Treated to a fancy dinner with a group of excellent people. Up all night with epically bloody Throughput despite only eating beets and salmon.

Tuesday (10 ens): Receive denial of insurance coverage for the Remicade that I have been getting under new student insurance since October. They just now decided it was "not medically necessary". Morning spent on the phone with the GI, the infusion center and the insurance broker instead of doing science. Experiment set back by two full days because I am a noob blundering about a new lab with no one to tell me to parafilm my culture dishes so they don't dehydrate. Still losing irregular amounts of blood.

Wednesday (1 ens): Journal club blitz presentation for a particularly terrifying professor*. Afternoon spent haggling pharmacy over whether or not my prescription renewals have been translated instead of doing science. Fell, despite my greatest efforts, into behind-the-scenes mediation of a high school drama-esque conflict between two classmates. Still losing irregular amounts of blood.

Thursday (0.1 ens): H.K.'s birthday, for which I could muster only a card. Intense nausea all day long. Managed to do some science. Still trying to encourage adult resolution of a childish conflict. TA'd a lab. By late afternoon, running only on the fumes of media broth and some desperate hope of still being able to impress my PI this rotation. Continuing to lose irregular amounts of blood.

Friday (0.01 ens): Wake up with an un-concealable budding stress-induced cold sore. Recruitment day! After an extra-painful extra-long 4 hours of class (instead of the normal 3), the afternoon was spent escorting/interviewing/socializing with fresh meat instead of doing science. By the evening, cold sore noticeable, muscles aching from lack of oxygen, I couldn't even bike home. H.K. had to pick me up. I was in bed by 8pm, falling asleep on my study materials. Dreamed of my two midterms coming up on Monday and Wednesday.

*Of my classmates, I was the only presenter that she said "good job" to, which provided a fleeting blip of positivity in my week.

Perspective

2012-01-04T17:09:00.000-08:00

I just watched the documentary "Under Our Skin", which is about Lyme disease and the disgusting politics surrounding the insurance companies and medical boards (surprise) that prevent it from being properly treated. One of my most favorite people in the universe has Lyme, and her perseverance has always been inspirational to me. It's an important message about how biomedical research is just as susceptible to being stunted by corruption as any other major enterprise.

Consequently, watching these types of documentaries is incredibly depressing to me. Though there is always a ray of hope at the end, I can't help but sink into guilt. I am not earning my health, there are people so much worse off than I am that I must be faking it, I should be in toxicology or immunology or infectious disease instead of neuroscience, etc, etc...

H.K. is kind enough to remind me of what pitiful condition I am in without the right medication -- how dysfunctional I was before Remicade started to work a year and a half ago, the concern for what will happen when I can't take Remicade anymore, and that even though the pain is now benign and infrequent I have acquired all kinds of side effects. One of them is being in grad school. For which, though I complain (because that's where camaraderie comes from), I am so incredibly grateful...

Bring it on, 2012.

Latency in Stress-Induced Crohn's Attacks

2011-12-18T09:36:00.000-08:00

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.

Crohn's v. Grad School Free Lunch

2011-12-15T23:50:00.000-08:00

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.

Remicade... I've lost count.

2011-12-10T14:43:00.001-08:00

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.

Rotation 1 closes; cue Rotation 2

2011-12-08T17:28:00.001-08:00

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.

the post-SfN sickness

2011-11-19T14:06:00.001-08:00

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.

Things I've learned in graduate school

2011-11-04T14:58:00.000-07:00

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!

How to Suvrive in a Disorganized Lab

2011-11-01T14:31:00.000-07:00

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.

Hamilcar!

2011-10-18T17:07:00.000-07:00

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.

Crohn's versus Grad School: Episode I

2011-10-14T13:26:00.000-07:00

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.

the conundrum: rotation saga part III

2011-10-06T16:16:00.000-07:00

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.

things that keep me up at night

2011-09-28T22:51:00.000-07:00

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?

Neurobeer: an orientation week finale

2011-09-24T20:34:00.000-07:00

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.

Remicade and identity theft

2011-09-05T10:36:00.000-07:00

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?

first lab mtg: part II in the lab rotation saga

2011-08-29T15:47:00.000-07:00

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.

cold feet: a lab rotation saga

2011-08-25T00:05:00.000-07:00

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.

the traveling Crohn: displacement

2011-08-16T18:52:00.000-07:00

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.

the traveling Crohn

2011-07-31T22:51:00.000-07:00

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.

rollin' in the deep

2011-07-26T08:14:00.000-07:00

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...

unkempt

2011-07-17T09:20:00.000-07:00

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.

the year of plenty

2011-07-09T09:16:00.000-07:00

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.

Crohn's Wins and Technician Survival

2011-07-07T17:59:00.000-07:00

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 night lights

2011-07-01T23:30:00.000-07:00

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.

the weight of inadvertent flakery

2011-06-28T08:57:00.000-07:00

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.

basic skillz

2011-06-24T15:13:00.000-07:00

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"?

3am dirge

2011-06-16T04:19:00.000-07:00

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.

stress management fail, Buffy and RagaDetox

2011-06-14T11:50:00.000-07:00

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.

of Crohn's and food cravings

2011-06-06T17:08:00.000-07:00

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?

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

2011-06-01T15:18:00.000-07:00

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...

don't worry, be happy now

2011-05-23T16:01:00.000-07:00

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... ...

Food of the Day: i drink coffee for my liver

2011-05-19T11:33:00.000-07:00

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 2005; Bichler 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.

* 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

Food of the Day: seaweed

2011-05-18T09:20:00.000-07:00

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-κB in 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).

Mozuka (from http://www.e-expo.net/materials/016131/0004/index.html)

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.

fiber and loose ends

2011-05-15T21:48:00.000-07:00

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.

why I blog

2011-05-08T19:08:00.000-07:00

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!

re-calibration

2011-05-04T14:12:00.000-07:00

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.

pleasant surprises

2011-05-03T18:04:00.000-07:00

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.

how Crohn's made me a better scientist

2011-04-27T11:44:00.000-07:00

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.

defeat

2011-04-26T18:50:00.000-07:00

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?..

Just another serenader

2011-04-23T17:53:00.000-07:00

What am I going to do in three months when I can't cure my ails with days like this? I do love to be in the ocean, truly, but nothing revives like a PNW river.

We had a heart to heart last night, H.K. and I. He's scared, which puts the situation in a startling new light for me. The process of decay is not easy to hide, nor do I consistently give it my best effort in front of H.K., poor thing. It was necessary for him to express his worry, I think, for me to remove myself from brooding and take initiative (read: wait more optimistically for my GI appt. at the end of May). This is not an unbeatable foe; it requires only the cooperation of my physicians and a plan of attack that can be undertaken successfully within three months, because hell if I'm going to be thrown back into the darkness of 2009 before the move south... and hell if it's going to make me put off school for another year. It's hard to keep in mind that I'm not a unique scenario, just another serenader... on lots of antibiotics.

Perspiration stains and varicose veins...

2011-04-22T23:05:00.000-07:00

Manuscript accepted. Data collected; results surprisingly awesome. Small miracles.

But at the end of the day, no matter how it sparkles, I wind up in front of the bathroom mirror for twenty minutes massaging and inspecting brittle bones and applying every kind of imaginable medication to my various districts of rotting flesh. Throughput is a background distraction.

New developments this evening: yet another cavity creeping up from below my gums on that one tooth that is barely standing and cost me a fortune to keep and cap (whom I have dubbed FitzMolar, as he has proven wholly illegitimate), and "pretty severely" Staph-infected scalp psoriasis. Thank you Universe for that call just prior to supper -- although, it probably saved me from my deep immersion in #scimom blogs and the depressing daydream of what a magnificent father H.K. would be and what a terrible idea it is for me to consider engendering spawn.

Funny how quickly all the glory washes away and I crawl into bed seriously contemplating dentures and the removal of my uterus.

My eyes look shot, my belly's got a pot and there's a pimple on my nose...

I am the Entertainer

2011-04-22T09:13:00.000-07:00

I luvs nausea-free mornings. I luvs them.

Today is Behavior Day, which marks the highly anticipated culmination of five weeks of therapy for my most venerable participants. It also means that for the next ten hours, I will sit down perhaps once, juggle a protein assay whilst crunching data between behavioral tests, and probably not eat until supper. I might even present said data to my boss before attempting to toss together an abstract to submit to SfN 2011 before the deadline in two weeks. Maybe.

And I will most definitely be checking in on Wiley to see if my most recent manuscript re-submission has been accepted.

One must take advantage of days like this.

Crohn's, Parkinson's and hypochondriasis

2011-04-18T09:53:00.000-07:00

Typically, I post research reviews in HWAH, but today's report involves a degree of hypochondriasis which I deem too personal for the "professional" demeanor of HWAH.

The first article that I read this morning was a report on two case studies of young women who developed Parkinsonism (PD) after adalimumab (Humira) treatments (there was, of course, mention of a similar case associated with Infliximab (Remicade)). Wouldn't it be funny, I thought, if my Crohn's treatments lead me to develop the disease whose study launched my research career? I decided that it would be ironic, but not funny.

Naturally, only MRI scans and Unified Parkinson's Disease Rating Scale (UPDRS) scores were reported. No biomarkers, no longitudinal coverage. I do appreciate case studies and understand their valuable contribution to biomedical science, but it always bothers me that they feel so incomplete.

The causal relationship was primarily based on motor symptoms developing after 7 mos. (Case 1) or 11 mos. (Case 2) of Humira therapy. The cited Remicade case showed symptoms only 1 week following a first treatment. And though Parkinson's cannot be ruled out in the first two cases, many studies of early-onset PD are associated with the Parkin gene mutation, good response to levodopa therapy, and slower progression compared to late-onset PD. This suggests to me that since no biomarkers were reported in the current study, it is equally possible that early-onset PD was already en route to phenotype and possibly exacerbated by the TNFalpha blockers. In defense of this hypothesis, both case studies responded well to Carbidopa/levodopa.

Who says that only medical students get Medical Student Disease? With all the allergy symptoms that I've developed over the last six months, why not add potential PD to the list? Granted, I've been on Remicade for 18 mos. now with no perceivable motor impairments, but what's to say that it wont manifest later on? After all, my allergy symptoms were comparatively delayed. If I weren't moving and beginning graduate school in the next few months, I would drop Remicade and experiment with supplement and diet maintenance. The reason that this is a bad idea is that I will likely relapse as I have so often done on supplement and diet plans, make miserable the 22 hr. drive down to Southern Cal, and cause me to fail out of school within my first term. So plz, PD, stay away until I'm at least 60. Thx.

Ha AD, & Jankovic J (2011). Parkinsonism and dystonia associated with adalimumab. Movement disorders : official journal of the Movement Disorder Society PMID: 21495070

Spring

2011-04-17T15:49:00.000-07:00

Spring has sprung. It is still mostly gray, rainy and often sleety. It is still invariably no more than 55 degrees at the warmest parts of the day. But... the ants are out. A sure sign of Spring.

I am grateful that our bug infestations in the PNW exclude scorpions, bed bugs and brown recluses. However, I can't bring myself to be at peace with waking up on the couch to a horde of ants crawling up my afghan and in my hair.

Neither can I abide waking up in the morning and coming downstairs to a kitchen that seems to be alive with an entire anthill. Not a crumb of food or dirty dish to be seen, mind you. The entire counter space, stove top and empty sink were crawling. (and it is of note that the fruitbowl on said counter space that held two ripe bananas was devoid of any Hymenoptera).

Thank goodness that Sunday is Adventure Day. We wiped out the horde, hopped in the car and headed north. Lego store, bit of hiking, and Phở. Standard. Phở is always good for H.K.'s sinuses and my nausea. The exercise is not so much, although as I think I've mentioned, that will hardly stop me. The nausea is settling into its Springtime routine; it swells after I've eaten [anything], when I have forgotten to eat [anything] for more than five hours, and is exacerbated when my sinuses flare. Bring it on -- I'm armed with Phở, Netti Pot, five kinds of nasal spray and even more variations of antihistamine.

We arrived home to find that the counter tops had been resurfaced with a fledgling ant colony 1/3 the size of what we encountered this morning.

in which ambition is met with not so positive reinforcement

2011-04-13T17:45:00.000-07:00

The PNW continues to sweep the skies with both effulgent blue and hail. And it makes me think I have special powers or some such chimerical baloney. This afternoon, feeling especially accomplished after a long day, I came home and ran. And felt great about it. And lasted for a whole 2 miles. And then collapsed on the couch like a dead tree. A repulsive dead tree untouched even by organisms of decay, and with a coelom full of turbulent sea water that has no business being there. Nausea, heartburn, colon spasm; the whole gang came to partay. I can't even keep tea down right now, but at least my fatigue feels warranted. I may not eat for a day or so after this one.

Why is it that I am most motivated to exercise, or run errands or do chores when I feel [physically] most miserable? It's almost as if when comfort sets in I'm perfectly happy to just sit back and enjoy it. Then, when the rotten feelings come I feel an extra push to run myself into the ground in order to beat them at their own game. Except most of the time I don't feel better for it afterward. Or maybe the ambition is just a side effect of the sunshine... In any case, despite this [not so] positive reinforcement that now has me desperately pinned to the hard, flat, motionless couch cushions, somehow I don't think I'll be deterred from running again tomorrow afternoon unless an icy storm hits.

publishing misnomers

2011-04-12T14:12:00.000-07:00

Some may recall that last year when I got married I put an excruciating amount of thought into changing my name, both legally and professionally. I ended up deciding to publish as Name Initial Maiden-Initial Last. It has since become apparent that I made the wrong decision.

With this new outpour of publications and grants, my family has realized that they are substantially upset that since my maiden name is represented only as an initial, I am not recognizable as their kin. I have that distinctive maiden name where I'm related to everyone else in the world who has it, and my family is very upset that it is not represented. They didn't care nine months ago before I had published or been awarded anything, but feelings change with press coverage...

The obvious solution to this is to scrap Name Initial Maiden-Initial Last and use Name Maiden Last from now on.

A brief refresher on why I did not do this in the first place:

1) Publishing with two last names (and no, Maiden does not pass for an obvious middle name) confuses potential "referencers" who would proceed to cite me incorrectly. This leads to a dual body problem: one "Last, NameInitial.MaidenInitial." and one "Maiden-Last, NameInitial."... and being two people is not ideal;
2) Publishing with two last names confuses potential bosses who would proceed to not figure out how to administer my paychecks and W2s correctly;
3) I can't hyphenate because I don't legally have two last names, and hell if I'm going to go through that legal name-change bullshit again to do something that I didn't want to do in the first place.

Although all these points remain totally valid, I may have to throw all caution to the wind and change my publishing name. Indeed, the very thing I thought I had avoided with my previous reasoning. When I first changed my name, I had no publications yet and it didn't matter. But now, I'm wrapping up revisions on my fifth manuscript, and I have two (publicized) fellowships. Good thing that in five years no one will remember my first five manuscripts and two fellowship awards anyway?...

blue skies, hail, nausea and wine

2011-04-11T13:21:00.000-07:00

Monday mornings never sink me like they do many people in my midst. Usually, I'm excited to begin whatever needs beginning on Mondays. This morning has not been my average Monday.

It's beautiful outside, with a classically PNW combination of blue skies and hail. It's very fitting with my acid jazz and manuscript-writing ambiance. What doesn't fit is this biting maelstrom of nausea and acid reflux that I've had since last week (boosted, indubitably, by Boardgame Night's over-the-top partaking of 4 glasses of wine Saturday evening.. oops).

The manuscript is in the "accepted pending revisions" phase, as I choose to interpret it. So in a mish-mosh of protein analysis, scoping and drug administration, I'm finalizing my fourth first author paper. It's not that I don't enjoy this kind of day, sans the physical irritations, but I want nothing more than to sit at home in my calmly lit reading chair with a huge pot of tea and my book about George, Nicholas and Wilhelm and the events leading up to WWI, pop a promethazine and wait for sleep to catch me before emesis does.

But I will resubmit this manuscript first.

It's a Moondog kind of day.

fellowships and grants -- pre-graduate

2011-04-05T09:51:00.000-07:00

You know that feeling you get when people give you money? Like, real money? The kind of money that supports three years of research (read: three years of stipend) and makes your resume look really pretty? Well, I do now. Two months ago I was awarded a Fellowship from the graduate program at which I will be starting in the fall...

This morning, along with monstrous cramps and nausea, I received an email from NSF congratulating me on receiving a prized NSF GRFP grant.

...say what?

Please understand: I wrote this grant before being admitted to a graduate program. I did NOT expect to receive it. I was hoping with all of my might that I would get onto the "honorable mention" list. I am totally blown away.

Though I was not yet in a graduate program during the application process, I was very fortunate to have my boss' input as well as guidance from a former NSF GRFP applicant and awardee. Below are the primary points which guided my application:

Research Proposal
1. Format:

Introduction
Two to three Specific Aims described with experimental approach
Brief conclusion describing implications
References

2. Specific Aims #2-3 cannot depend on the outcome of Specific Aim #1

3. Do NOT emphasize clinical translation; NSF is not interested in funding biomedical work. For example, if you are proposing to study a model of Parkinson's disease, write about "neurodegeneration" or "stimulating neuroplasticity".

4. Give brief, clear descriptions of things specific to your project very early on. Your reviewers will be familiar with your field (e.g, Neuroscience), but do not assume that they will be familiar with specifics (e.g., substantia nigra, tyrosine hydroxylase).

5. If you are an undergraduate, or an RA, write about a project that you would like to do. In my case, I proposed a project based out of my boss' lab on the off chance that I would stay here for graduate school. Because I ended up entering a program at a different institution (and have yet to even begin rotations), the project will change. The GRFP understands this and is more interested in funding the scientist than the project. As long as you submit your updates to them, and acknowledge NSF funding in abstracts and publications, you are set.

Research History
1. Don't try to be too creative. NSF is interested in anything you have ever done in scientific research, and how those things have brought science to the broader community.

2. That's... that's really about the gist of it. Find further suggestions at Philip Guo's blog.

Personal Statement
1. Two thirds of this essay was paraphrased from my graduate school statement of purpose. Communicate who you are as a budding scientist.

2. The final third of my essay talked about my leadership experiences and how they had impacted the greater community (e.g., climate change activism, national affiliations and how they have influenced my scientific collaborations thus far).

* Happy to email out pdfs of my essays to anyone interested in a sample.

Remicade, and other stories

2011-04-04T09:56:00.000-07:00

In a striking turn of events, I feel like a bag of bones today. A very nauseous, very tired, ever so slightly irritable bag of bones.

My umpteenth Remicade infusion was Saturday, and I left the hospital feeling ill, which typically does not happen. Full disclosure; I did enter the infusion clinic preemptively concerned about having developed Remicadibodies and having an allergic reaction. This manifestation stemmed from my sort-of-recent hyper-allergenic condition (read: psoriasis, dermatitis, new mouse allergies, hives). While there was no immediate reaction to be seen -- bummer -- I did not feel well for hours afterward. In fact, I did not feel well for any part of Sunday either. And, in case reiteration is necessary, I do not feel well today.

It is highly unlikely that this is more attributable to Remicade than to the gluttonous amounts of [cooked] leafy greens I've been eating of late. I would even stretch to suggest it might be a result of the increased carb-heavy (read: salty, sugary, processed) foods whose ingestion I have defended on the basis of not being able to chew anything with much of a texture (potentially making the leafy greens an even more obvious culprit). Thanks to Remicade, I'm not in very much pain, but those manifold side effects are aggregating.

And yet, this bag of bones was here at work promptly at 7am processing tissue samples and simultaneously probing nitrocellulose membranes. This means I have what it takes to survive six years of this work load ten fold in graduate school, yes?..

in the throes of pre-graduate school anxiety

2011-03-31T14:40:00.000-07:00

There are some types of uncertainty with which I do well (lab project outcomes). Other types of uncertainty (did I choose the right graduate program) highlight the fomentation of anxiety at which I excel.

I have read that this is a common after-effect of deciding on a program, or a post doctoral or even faculty position. The additional consideration that I am entering this with a much more specialized background than most students (read: 4 years in a lab where I introduced, managed and wrote manuscripts for my own projects) puts the anxiety into perspective.

I have chosen an excellent program, with a handful of outstanding mentors and a supportive student populous; and in it, I will thrive.

My particular mental block comes from peering (possibly, too) far into my future. Research, for me, will always be most exciting in the world of repairing neurodegenerative pathologies that lead to motor dysfunction. Ideally, Parkinson's and Huntington's diseases. But there are also technical skills hovering in my dreams that I can only learn (in my chosen program) in spinal cord injury research.

This is perfectly adequate in terms of developing interventions for motor impairments. However, it presents a confound to the seamless progression of my academic career. Namely, if I transition from the basal ganglia (PD and HD, where I have spent the last four years) to the spinal cord, I risk limiting my future post doc positions to spinal cord labs.

Had I the resources, I would present the stats on graduate students who obtained post doc/ faculty positions in a different sub-field of neuroscience than their graduate studies... For the time being, I will attempt to resolve my inner conflict with the hope that it will all settle itself when I get there.

graduate school by the numbers

2011-03-23T14:41:00.000-07:00

I can hide it no longer. My recent guest post series is up at Benchfly.com:

Interviews

The Decision

The Aftermath

scientists with disabilities: part deux

2011-03-21T22:16:00.000-07:00

The first part of this discussion can be found here.

It's time for some pro-activity.

There is an opportunity through the Society for Neuroscience called the Neuroscience Scholars Program. It is a small three-year stipend for aspiring neuroscientists to fund enrichment opportunities such as conference attendance, workshops, travel for methodology training, etc. It is aimed at those students of underrepresented race or ethnicity, from a disadvantaged background or with a disability.

Although I hate to refer to Crohn's as a disability, it can be very much an impairment to normal activity. Therefore, I have decided to apply for the scholarship in the hope that the support from the program will ease my pursuit of opportunities beyond the laboratory. One of these is to begin giving a voice to scientists with health impairments. When I first decided to work toward my PhD, I scoured the internet and other resources for evidence that a chronic health condition such as Crohn's did not condemn one to mediocre science. Instead, such a condition forces a researcher to be more innovative about approaching and negotiating obstacles, both in and outside of the lab. I found several historical (e.g., Edison's diabetes, Einstein's dyslexia, Galileo's chronic rheumatic seizures) but almost no modern accounts of success.

In my case, although I have had intermittent years which took a horrible toll on my soul, I found solace in my ability to continue with scientific inquiry. When I could not conduct experiments, I read and wrote. When I could not think clearly, I did extraordinary amounts of smaller tasks which involved more muscle memory than mind. When I had to go slowly, I gave up reading or movie-watching time to relieve myself of the stress of time constraints on my lab projects. There are always avenues that could be modified to accommodate the changes in my body. There are always new strategies.

It warms my heart whenever celebrities out themselves in the media as maintaining a modified rockstar or celebrity athlete lifestyle with Crohns. It gives hope to those of us who only see the seemingly flawless outcome, otherwise. I decided that someone needed to be that celebrity for the world of science. It is certainly not me, but I am taking steps to reach out to the physically and mentally disabled communities of scientific researchers (if you know of any, please send them my way). With the support of the Neuroscience Scholars Program, I would hope to enhance this outreach in the way that CDSN and Benchfly.com have provided a support and resource hub for Crohnies and scientists.

Wish me luck.

cry of the neglected tummeh

2011-03-18T14:44:00.000-07:00

Alright, I can take a hint.

I've been far too stressed, eating too many salts and sugars, indulged in a little more wine than I should. Or, I have a stomach virus. The fatigue, nausea and pain are indicative of either.

For the second day in a row, my gut is calling out for attention. "Drug me! Heat me! Love me!" I'm not a thrilled. But I totally deserve it. Perhaps its also calling, "Slow down!"...

I'll give it another day or two before I implement Prednisone or Promethazine.

a role for pattern-recognition receptors in gut flora dysbiosis in Crohn's

2011-03-17T06:57:00.000-07:00

It's not been a spectacular last few days, and I've not been feeling particularly well. The stress of my rotting teeth/jaw, decaying scalp, deteriorating wallet, work transitioning and the realization that in three months I will be leaving all the people I love is, indeed, catching up with me.

So I decided to make all efforts to allow today to be as awesome as possible... excluding exercising. I'm at work at 6am, which is early for me these days, in order to finish a project before 1pm... so that I can make it to my fourth dental appointment in the last three weeks... so that I can receive some more bad news... so that I can be sucked down into the gutter and then be plucked out again by a dinner with two of my favorite human beings tonight.

I've been reading a lot of literature on the imbalance of helpful and harmful gut flora lately, a condition called dysbiosis. There have been several microbiota implicated in Crohn's disease (klebsiella, E. coli, paratuberculosis, Campylobacter jejuni, enterohepatic Helicobacter species). However, a recent review in Nature suggests that no single bacterium has been definitively associated with Crohn's. Instead, Si Ming Man and colleagues argue that defective sensing, killing off and generally balancing of gut microbiota is largely due to defective pattern-recognition receptors.

Pattern-recognition receptors are just what they sound like. They allow the host [read: intestine] to identify molecular fluctuations in gut microbiota that might indicate harm, and activate an immune response. These pattern-recognition receptors (mostly toll-like receptors) in membranes of the epithelial cells that line the gut activate nuclear factor kB (NFkB), which leads to productions of interleukins and the infamous TNFalpha.

Man SM, Kaakoush NO, & Mitchell HM (2011). The role of bacteria and pattern-recognition receptors in Crohn's disease. Nature reviews. Gastroenterology & hepatology, 8 (3), 152-68 PMID: 21304476

some more great research into the role of gut flora in digestive disease

2011-03-16T09:39:00.000-07:00

A recent article in Scientific American left me surprisingly impressed with its coverage of some very well done research presented by post doctoral fellow Michelle Smith at the International Human Microbiome Congress in Vancouver, Canada. Kwashiorkor is the condition that causes the abdominal swelling due to malnutrition that is so common in poverty- and famine-stricken regions. Smith concluded that differences in gut flora can determine individual susceptibility to malnutrition and other illnesses.

This kind of research bodes well for the acceptance of balancing gut flora as an approach to treating many gastrointestinal disorders.

resources for the neurosciences graduate student

2011-03-11T14:43:00.000-08:00

I can't stress enough the importance of networking in the scientific community. Be it for collaboration on a study, tips on a technique, developing your career or just commiserating, your peers in the world of research are often your greatest resource.

Some of the links in my Procrastination Station are some networking resources which I have found to be outstanding. Benchfly and Society for Neuroscience's Menthorship Program.

What is terrific about Benchfly is that it transcends individual scientific fields and highlights what we share between specializations. This is a hub for video protocol sharing and career jump-starting, survival and development.

The relatively new Mentorship Program through SfN is specific to SfN members. It is a way for fledgling scientists to connect with the masters of the trade through whom to find guidance and tips.

If you have a favorite networking and development site, please share it with me!

on not so terrific starts to the day

2011-03-09T04:12:00.000-08:00

Dear 3am,
Back off. It's not going to happen for us.
Not without Prednisone, anyway.
- R

I keep waking up in cold sweats with anxieties about my jaw falling off and my lab falling apart when I leave in July. Perhaps it's my overzealous ego rearing its ugly head, but I like my teeth and no one can deny that the pace in my lab will slow when I leave. In my defense, my boss is stressed about it, too. Half of my stress comes from wanting to assure him that everything will be fine when I'm worried that it wont.

It's really not so terrific to dread going in to work each morning because your guilt pangs are so intense and your confrontational skills are so lacking that you spend the wee hours of the morning anticipating incidents and practicing being stern with hard-headed and cocksure trainees who are convinced that they don't actually need to be trained.

Were I feeling better, I'd just go for a run and start the morning, but I'm not. Everyone around me is flaunting their cold, and my defective immune system is trying to convince me that I haven't caught it. Well played, I-Sys, but not well enough.

Three cheers for no nausea though, eh?

wherein Crohn's disease meets dental work

2011-03-05T22:19:00.000-08:00

I do have good news forthcoming. It is being delayed by my promise to withhold such commentary here until my guest post is published on the esteemed BenchFly blog.

In the meantime, I have been to the dentist. Admittedly, it has been two years since my last visit. Part of the reason for this is because I've been so overwhelmed with directly Crohn's-related medical appointments/maintenance. I emphasize directly, here, because my new dentist was kind enough to give me the gritty details (te he) of how the current condition of my teeth and jaw is indebted to my Crohn's treatments.

Just to brag, I have six new cavities, one previously filled cavity that has deepened and threatens to warrant a root canal, and jaw misalignment which threatens to evolve into a serious TMJ problem. My wallet is thrilled.

For a brief history, I had no dental problems until the age of 20. No cavities, no alignment problem, no braces. Then, after my second Prednisone stint, I suddenly had three cavities. Two years later, one of those cavities became root canal-worthy -- over the Atlantic on a flight to Israel, no less. Now, at 25 and following my third and longest acute Prednisone treatment and my first year of Remicade, I am blessed with an onslaught of six new cavities, a potential second root canal and likely TMJ.

When I was younger, my dentist gave me the same spiel every six months: "Your gums are bleeding so clearly you're not flossing. You need to floss more." As an avid every-other-day flosser up until college, I was prompted to give up the habit when my dental health declined despite my scrupulous efforts and I decided the flossing mantra was bullshit.

My new dentist told me that it was very apparent that I was taking care of my teeth (the flossing habit returned when my husband entered the picture), and that my medications were sure doing a number on my bones. Say, what?

My renowned gastro was very convinced each time I asked (before each of my three Prednisone treatments to date), that my treatments were so short-lived that my bones were not a concern [repeat: not a concern]. So I wasn't adamant about calcium supplements [read: there were no calcium supplements involved during the first ten years of my treatments]. Nor fluoride treatments. Oops. Your gastro hardly ever cautions you to take care of your teeth on Prednisone or Remicade, but the above developments in decay are not specific to me. Google it.

My new dentist's explanations included citing the bone density loss associated with prolonged Prednisone, or multiple short acute treatments. Remicade's role seems to be more subtle, in terms of causing dry mouth which, by decreasing salivary flow, decreases the washing-over of gums and teeth with salivary disinfectants such as lysozymes and peroxidases which help fight cavity-forming bacteria. This example is in addition to Remicade's suppression of the immune response, in itself making the mouth more susceptible to bacterial invasion.

As a scientist, I am embarrassed at not having assumed these conditions of my own accord and treated them despite a lack of concern on my physician's part. As a human being, I feel bummed and duped.

I am currently brushing twice a day, flossing once a day, using anti-cavity fluoride rinse twice a day, having each cavity filled over several appointments, chewing xylitol gum daily, fitting a mouth guard in attempt to ward off TMJ, and taking calcium supplements religiously.

Wouldn't it have been nice if a gastroenterologist could have helped me prepare to fight these potential side-effects at any of the three times that I've been put on Prednisone, or when I started Remicade treatments? In fairness, they're not dentists. But also in fairness, "bone density loss" implies inclusion of teeth as components of one's physiology. In yet even more fairness, I have not been to the dentist in two years, and perhaps a good dentists like my new one would have mentioned something earlier on that would have helped me to prevent this mess. Live and learn, eh? Now we know what my fellowship money will be spent on.

milestone: I have officially lost count of Remicade treatments

2011-02-21T17:22:00.000-08:00

Yesterday, I realized that I have now lost track of how many Remicade infusions I've had. In celebration of this milestone, and just to spice up the morning since I needed the next four hours to write, I opted to place the I.V. in a very new spot. On a recommendation from Sempre, I had my last I.V. on the back of my wrist -- ideal for motility and/or mobility. This time, my nurse honed in on the tiny vein halfway up my medial forearm. Yeah, it's sensitive there. Though my nurse is a ninja with a needle, this particular vein had not yet been broken in, and elicited a breath-holding type of pain. It did do the trick, for I was fully awakened, and with a heating pack the spasms died down in half an hour. Three essays later, it was time to head home with not even the smallest bruise. Needle Ninja.

I will probably not use this vessel next infusion because I like to give each vein a fair chance to show off its docking capacity, but I will use it again. Certainly on days when I need to get work done...

it's all happening

2011-02-16T21:16:00.000-08:00

I haven't posted. In eons. This seems to be fashionable among everyone in my little corner of the blogosphere lately. I haven't posted because I have been unable to transcribe laconically everything that bears reporting (yeah, I know how your anticipation has been eating at your soul).

For those faithful readers who can still recall, this is a blog about a research scientist with Crohn's disease on the path to a PhD. In the fall of 2009, I applied to four of the most super fancy PhD programs in Neuroscience in the nation. I was denied by all. In the fall of 2010, I fine-tuned my program choices and applied to four new schools more fitting to my interests and goals. This year, I was accepted by all.

Last week, following twelve days of intense interviewing [read: 27 interviews, three states, six plane flights] I was in the throes of a dark mental struggle between the two programs to which I had narrowed down. It came down to Semi-Prestigious Program with a terrific reputation, a guaranteed research agenda with multiple publications on the horizon, and a comfortably affordable lifestyle; and Second-Most-Prestigious Program in the Nation, with totally uncertain but potentially amazing opportunities (pending funding), and guaranteed forcing my husband to live in a box for the next six years.

How opportune that during the weekend before Valentine's day my poor husband was in another state attending the memorial of a late family friend and I was forced to stay home to finish my interviews and dwell, in my emotional weakness, on my very first life-changing decision: which of these two lives will be the most beneficial for us both? I wont lie, it was pretty depressing, and there was a substantial amount of American Dad and Tetris involved.

Fortunately, Valentine's day brought my husband's return, yummy hole-in-the-wall (-slash-victorian-house) Indian food, IBM's Watson on Jeopardy, and the joint-settling of that internal debate. We decided to accept the invitation of Second-Most Prestigious Program in the Nation. Don't misunderstand me -- one of the best things about this school is that for its amazing reputation, the environment is so laid back and the community of students and faculty is so collaborative that it is nigh familial. But I also can't deny that I was swooning at some of the legendary minds with whom I was privileged to interview.

2011 has been a surreal year for me. Following 2009-10's Crohn's saga and rejection from all of my programs of choice, I am in a very very different place. I am healthy-ish, married to a man who can only be described as ineffable, on my way to an amazing adventure (in dirt-poor student-land) and welcomed into the next step of developing my career. I have published three manuscripts in the last few months with two more in the works, and I have been awarded a fellowship from Second-Most Prestigious Program in the Nation just for being one of their "top recruits". Surreal. And I'm too excited to feel guilty about it. It's all happening.

More on the logistics of being a Crohn in a graduate science program to follow.

from the sleep saga

2011-01-21T17:05:00.000-08:00

Funny thing about waking up 7 times a night: the dreams don't necessarily end just because I wake up. There's a confused agony in trying to realize that the dream is separate from reality while simultaneously trying to void my mind of thoughts so that I can fall back again. It doesn't help that the dreams themselves are stressful and depressing.

I feel like Ray Fiske from Damages, who had recurring dreams of his teeth falling out in a bloody mess because he was holding back a secret... except that I have no secret. There is no Prednisone involved here, just my body's not remembering how to get through a night's sleep without the interruptions of pain or incontinence. It's finding other outlets...

increasing women in neuroscience

2011-01-12T14:44:00.000-08:00

The Department Chair Training to Increase Women in Neuroscience (IWiN) is scheduled to meetin in Tucson, at the University of Arizona this April. The workshop, funded by the National Science Foundation's ADVANCE program, is a three-year program aiming to increase the number of women on neurosciences faculty. The participants of these workshops expect to leave them with tools to implement recruitment and advancement plans for women within their universities, and to disseminate the information they have gained in "echo" workshops at their institutions.

The IWiN workshops will be hosted in 2011 and 2012 at two of the graduate schools at which I may be a [woman] student at the time... depending on how interviews go at the end of this month. Three of my four choice graduate schools are already participants of the ADVANCE program, which is not too shabby except that the missing institution has a ratio of approximately 1:3 women to men and does not facilitate an equity program in research.

I mention the IWiN workshops in response to a recent article in the New York Times discussing a nice array of statistics about the paucity of tenured female faculty, and women in the upper administrative echelons of science in general. This was summarizing a study based out of UC Berkley. The statistic that I thought was deserving of further attention in the New York Times report was this one:

"Tenured male scientists are considerably more likely to be married with children than tenured female scientists — 73 percent for men versus 53 percent for women. The report noted that among tenured science professors, women are nearly three times more likely to be single without children than men — 25 percent to 9 percent."

The Berkeley article itself furthers this discussion beautifully, and as a woman weighing the possibilities of children and eventual faculty tenure (albeit, we're talking about ten years down the line), I highly recommend a read and consideration of the original research article:

Mary Ann Mason, Marc Goulden, Karie Frasch (2010). Keeping Women in the Science Pipeline Focus on Workplace Flexibility

of Crohn's and graduate school interviews

2011-01-08T20:32:00.000-08:00

Most folks think of hotels and cabs and hosted, socializing dinners as The Way to Travel. A Crohn, more like, would be comfortable camping in the remote woods where if Throughput or any other less pleasant behavior rears its ugly head, it is easier for one to withdraw from The Scene to relieve one's misery.

During a particular two-week stint at the end of the month, I will be embarking on the former journey -- an all expenses paid (or reimbursed) jaunt between four interview sessions through three states and four graduate programs. That is right, your humble narrator has finally achieved the nigh unachievable: graduate school interviews.

Do any of my current readers remember how I began this blog in the first place in order to catalogue the adventures of a Crohn in pursuit of a sciences PhD?... well, it appears as though that promised content may not be lost to the wind after all.

January 27th-30th, I will be in Irvine, California interviewing with the program at the Medical School. January 30th- February 3rd, I will be in Tucson, Arizona where my interviews have been specially scheduled by yours truly so that they do not directly overlap with the next series. February 3rd-6th, it's back to Irvine to interview with a different department, and one of the most prestigious Neuroscience programs in the nation.

Notice the distinct less-than-one-day gap between interview periods. Imagine how carting one's myriad pharmaceuticals around to interviews, on tours and at social dinners because one must have any and all back-up plans available in lieu of interrupting such a trip with an emergency room excursion, would look (not that I don't need to know where the hospital facilities are in these cities anyway, but there has got to be a better time).

Lest it be denied, I can assure that just because only three of these twelve days will be comprised of formal interviewing sessions with potential mentors, graduate program candidates will be under scrutiny the entire time. Putting on one's best face and being on best behavior is essential. Missing an interview because the stress of the previous day's delayed flight transition, which made you late for the courtesy ground transportation has rendered you unable to move the following morning, is not an option. Looking trashed for an interview because you are high on oxycodone which is the only reason you made it to the interview at all is also not an option.

I am extremely nervous for these interviews, not because of the intimidation of the formal mentor interviews, but because the Crohn's has never traveled under such stressful circumstances and I am uncertain of how it will behave or how I will control it. Not to mention the containment of the nasal exoskeleton and the as-yet-unabated ear colony.

Army Strong, folks. This adventure calls for a little bit of Army Strong.

The fourth interview session begins on February 10th, so I have a four-day sojourn to sleep in my own bed, cleanse in my own shower, and eat things like Boost and rice and fiber crackers.

Wish me luck, Dear Readers.

the placebo effect and IBS

2010-12-24T09:07:00.000-08:00

A recent study from Harvard Medical on the placebo effect in IBS patients. My thoughts can be found here.

Dear Remicade, and other stories

2010-12-18T13:22:00.000-08:00

This morning's Remicade excursion began like any other, with a cold, dark and barely-awake drive to visit my second home. Michelle and Wish, my regular infusion center nurses, perked me up with chatter of new serum biomarkers, holidays and my veins. Feeling extraordinarily adventurous today, I opted to give my poor inner elbows a breather in favor of a more fancy-pants IV site: the wrist. Though I have what is probably an unhealthy comfort with needles, IVs in the back of the hand and wrist have always weirded me out. It was, to my great amusement, very classy. Michelle even put a bit of gauze between the needle and the tape so as not to rip out the tube too harshly and invite the typical mess due to the allergic reaction I have to the tape itself.

Wish inevitably asked about my ear, and I refrained from extrapolating my theory of an organism from an alternate universe in favor of the more benign, "this is seemingly a consequence of a suppressed (oppressed?) immune system." Though it has been a noble fighter in the past, my line of defense is whithering to a sad benched quality -- thank you, Dear Remicade. In no uncertain terms, this drug has saved me from regular excruciating pain and replaced it with an irritating inability to fight off much of anything that assaults me. The Colony has by now expanded into my hairline, around the lobe of my ear and is creeping down my neck and onto my face in an inglorious manifest destiny. (Because I have been bragging about this for three months now, I feel that I owe you:)

Gnarly, eh? Conscious of keeping this blog PG-13 rated,

I sopped up the leaking blood and serum for you.

If it gets to the point where my eyesight is threatened or I fear it will otherwise interfere with graduate school interviews (one acquired, four to go), I may invoke a short-term Prednisone stint in effort to fight the inflammation that not antibiotics, hydrocortizone, athlete's foot cream nor hydrogen peroxide have been able to defeat. The Derm appointment is only ten days away (my birthday present to myself!), and I count the days (sometimes broken into 8 hour segments... no joke). We shall see if he supports my Steroid Hypothesis.

Meanwhile; bladder is fully functional, intestines are in agreement with the current diet (even with a few holiday indulgences), night sweats are somewhat controllable or at least don't wake me up as often, and the nasal exoskeleton with its tremendous stores of green mucous continues to subside with the help of Nasal Crom. Progress, though painstakingly slow, is finally observable.

of frump and holidays

2010-12-05T14:27:00.000-08:00

What I love about starting a business is that it is organization intensive. I don't get to coordinate the lobbying or event logistics or portfolio presentations since I stopped working with the CCN, so I thoroughly enjoy my obligatory role in helping H.K. in his new entrepreneurship.

Most peoples' living room floors are peppered with holiday gifts in various stages of wrapping. Mine, for the last month, has been drowning in bags, and bags, and bags and bags of Legos. Today, H.K. and I made a two-trip purchase of no less than 28 Sterilite drawer bins into which all the Legos in my living/dining room are currently being transferred.

For the occasion, your humble narrator appeared in public in unwashed 80's hair, tweed coat and scarf, and sweatpants which, being new and tightly cuffed, showed off the fashionable white Puma socks whose tops were exposed above my Dansko clogs. Stylin'.

During our second trip, a gust of wind caught both our over-filled carts rounding a corner of the store and blew three of our drawer bins out of the carts, sending one flying into the street in front of a car who was, to our great fortune, actually going 5 mph around the corner and stopped before annihilating our merchandise. I was then obligated to surrender my coat to weigh down the bins as we proceeded onward to the car. Now decadent in a near-fluorescent orange T -- which matched my sweats but was quite Hobo-esque with my scarf and flying frazzled hair -- and coat-covered shopping cart, I booked it to the waiting vehicle. Let it be known that H.K.'s sweatshirt-adorned cart looked less Hobo than mine, and he, being in jeans, suffered no humiliation. Also let it be known that I am quite proud of my performance in 30 degree sunshine.

We attended a dear friend's birthday last night, at which I indulged in fruit salad made with coconut milk, gluten-free tirimisu sans the marscapone icing, and chips. And now, here I sit in my much-more-fashionable matching regal blue robe and slippers sipping Earl Grey and waiting for my fiber cookies to kick in. For the last two nights I've been woken up (unsurprisingly) due to abdominal pain (shockingly). Could it have been the latkes? Could it have been the vinegar in the pumpkin chutney (a scrumptious gift from my wonderful coworker)? Could it have been the halibut (gasp)? Who knows.

Fortunately, Chanukah is not a bust. On the third night we finally pulled our (read: my) act together to feast in the warmth of our new robes, lit candles and obsessively decorated home, while watching Beauty and the Beast on blu ray. Fairly epic, but now H.K. is feeling the pressure to get me a giant library for my birthday. To clarify, that is external pressure from yours truly, not internal pressure.

Chanukah sameach!

on exercise and health

2010-12-02T11:23:00.000-08:00

I am not well. The adrenaline from the conference has worn off, and in the bombardment of the holiday season I find myself sinking.

The CT scan of my sinuses revealed an osteoma, which is evidently of no concern because it is not causing obstruction. Therefore, I continue to mollycoddle my nasal pathways and oblige the constant flow of green mucous. My ear colony, which is either fungal or an exiled celestial community, has responded to its daily chemical assaults by growing over the last two months. Touché, Ear; I will be taking you to the Derm in a few weeks.

I think that it has been so long since I slept through a night that it doesn't bother me as much anymore. And by doesn't bother, I mean it doesn't keep me from going to work every day, or shopping or cleaning or getting other things done. What it does do is keep me from getting to work on time, being any degree of efficient, and enjoying anything that I am doing. In brief, I pretty much feel like I'm hanging on for dear life until around noon. For the rest of the time, I am a confused drone.

"Are you exercising?" my doctors ask. By the way, I've also been to no less than 13 medical appointments over the last 2 months. In a pleasant twist, none of these appointments were related to abdominal misery. Hooray?

"Yes," I answer, mentally rolling my eyes, crossing my legs and preparing to explain to whichever physician I am seeing that day what exercise actually does for your health.

The endorphins! Physicians pedal endorphins like they are the Western version of harmonizing one's Chakra. Endorphins and metabolism-boosting are the more direct effects of exercise, and why it is the physician's favorite shout-out. And while I have no arguments with the widespread benefits of physical activity -- it is 50% of my own research, after all -- it is certainly not a therapy without caveats.

In Parkinson's disease (PD) research, in which I am most fluent, it has been the general finding, although uncommonly published, that voluntary exercise has more positive effects on gait and neuropathology than does forced exercise. Observations lead by Dr. Carl Cotman at UC Irvine have shown that PD patients guided in treadmill exercise received minimal improvement. In other studies, aging canines taken for walks and given the opportunity to explore and run displayed great improvement in gait, cognitive ability and initiation of neural growth factors (2, 3).

A study was recently published in the British Journal of Psychiatry surveying the effects of "leisure" or "work" exercise (i.e., voluntary versus forced exercise) by Harvey et al. The implications of the study are very aptly presented by one of my favorite neuroscience bloggers, Neuroskeptic. What the conclusions amount to is that forced exercise does not have the beneficial effect on depression that voluntary exercise does. People who got exercise through their labor-intensive jobs did not experience the positive changes seen in people who chose their own exercise on their own time.

Therefore, the study suggests that it is not just the physical activity that is important to the therapy, but the interest in engaging in it, and the feelings of accomplishment, etc., that help a person achieve positive results. This has been the case for me my entire adult life: when I enjoy physical activity, it helps me get through the day, it helps my mental state, it makes me feel better about myself; but when I do it out of sheer guilt and obligation I get absolutely nothing out of it. As a woman who spent the majority of her life in competitive gymnastics and dance, this is not a new subject for me.

So yes, Dearest Physicians, I do exercise. But I do not do so when I feel like I am dying.

My physician looks at me, puzzled. "You know, if you make sure that you exercise consistently you will have better results. I want you to try to exercise more often, even if you're tired in the morning."

...<headdesk>

SfN 2010

2010-11-21T12:22:00.000-08:00

As I sit recovering from a week of travel, rich food and constant bombardment with science and brilliant minds, I can't help but feel proud of my restraint.

I paced myself well, got a bit of sunshine, and suffered from not a single Crohn's attack. There was a great deal of rich food at my fingertips. Several days begged for lunches out in downtown San Diego, as >31,000 neuroscientists poured out of the convention center and into the streets to acquire sustenance for the afternoon's activities. Our lab was also cocktailed, wined and dined by a very lovely medical liaison -- just a wonderful woman -- which called for rich Italian food.

Fortunately for the intestines of yours truly, San Diego is brimming with fresh seafood. I even ventured to eat three stunningly delicious prawns and had no backlash. Nausea was minimal, throughput disconcertingly normal, and energy manageable. I ate scallops with mushrooms, kale, pomegranate seeds and pumpkin puree (butterless). I ate mahi tuna sliders with ginger (creamless, and oddly low in oil). I ate mussel and clam capellini and, randomly, amaretto and cherry liquor coffee with biscotti. I survived, I suspect, because rich meals were limited to one a day; other meals being oatmeal or Odwalla protein bars.

Unsurprisingly, I arrived home fatigued and drowning in adrenaline. We flew in Thursday evening, and work the following day was driven by excitement and seemingly uninhibited by exhaustion. Thank goodness for a weekend empty but for catching up on crap tv, football, laundry and blogging. I am not -- I repeat not -- ready for the onslaught of Thanksgiving-Hanukah-Christmas-New Year-Interviews. Chuck Norris, help me.

A beautiful and enriching trip. Feel free to see my science blog for details.

dilemma

2010-11-02T19:02:00.000-07:00

It comes to my attention, vis à vis a comment from my primary and an observation of H.K.'s, that I have somewhat of a medical dilemma on my hands.

This is an interactive post: Crohns and scientists alike, please weigh in. The Drug In Question will remain anonymous to eliminate biased interpretation.

Second to purinethol's 11-year reign, one of my co-treatments has been daily for 5+ years. It happened that on one of my myriad October appointments, my PCP mentioned that she would like to experiment with taking me off of the medication since I have been symptom free for over a year, and since it is never good to be on such drugs for too long (why this is the first time any doctor has brought up the matter, I cold not say). We decided that when my current battery of ailments is dealt with and I return to a more homeostatic condition, we will try this experiment. Naturally, I make a mental note that this will occur following my conference so as to avoid provoking any symptoms during this exciting and stressful week.

Upon complaining incessantly to H.K. over the following several days about my nausea, which has crippled my mornings lately, an idea was proposed. H.K. inquired as to the likelihood of the Drug In Question's being the cause and/or amplifier of my nausea. Of course, it was possible -- all medications have side-effects of nausea. I used my handy-dandy scientific journal access to research the long-term side-effects, and lo' and behold, there was nausea. What I found interesting was that among the other side-effects listed were every single health problem I've been having for the last six months: renal dysfunction, random hives/itchiness/andotherdermatologicalproblems, changes in mental state, fatigue, sinusitis.

Of course, these could all just as easily be evolutionary stages of Crohn's and a slowly Remicade-induced decay of the immune system. However, my PCP, when presented with this idea, recommended that we experiment immediately with removing the drug in question from the equation to see if the above conditions are indeed all side-effects. Ay, there's the rub.

Although I would so deeply love to be in good health for SfN in ten days, it is uncertain whether staying the course on the current antibiotic/antifungal/antidepressant battery or dropping the Drug In Question would be more or less harmful. On one hand, I have been on said battery for two weeks with little to no results (although these things do take between 1-3 months to do their thing, typically), and I may be able to wipe them all out in a week by dropping the Drug In Question. Alternatively, the Drug In Question may not be at fault, and dropping it could cause me to flare during the conference. In concert with the physical strain of the as yet ineffective antibiotic/antifungal/antidepressant battery, I do not favor the latter scenario.

To remain feeling like shit and looking twice as bad at the conference, or to attempt to annihilate feeling like shit and looking twice as bad but risk failure and flaring at the conference?

in which i grow tired

2010-10-28T13:08:00.000-07:00

Well, I am broke. Thus far in October, I have had eight separate doctors appointments spanning five doctors. I have three more -- count 'em, three -- this coming Wednesday before I head south to Willamette U. to be on a career panel for up-and-commer scientists and then get infused with Remicade before flying to San Diego for my first major conference. With all due gratitude to my government bosses for providing excellent coverage for their employees, never underestimate the paycheck-dissolving power of copays and prescription fees. I can no longer afford to eat sushi twice a week. Woe is me! My bedside table is officially over flowing with all my vials of drug, and I'm not entirely sure that my body is tolerating them either.

However, our home is thoroughly draped in Halloween splendor and this Saturday's party -- whether or not my guests decide to appear in costume, ahem -- will be well-worth the cooking frenzy (let's not kid ourselves -- I am not above a last-minute run to Costco to make sure the meal is edible). And Sunday... Sunday is reserved for horror flicks and football. Hell. Yes.

The cycle has snowballed, and I am, as yet, uncertain whether it is calming down. Despite all the more tangible symptoms, the fatigue is what is most getting in my way. Because of the fatigue, I don't run in the mornings. When I don't run in the mornings, the depression comes on all the more easily. When the depression sets in, I don't sleep because I spend the evening terrorizing and bloating my sinuses. When my sinuses are bloated, not all the sinus irrigation/flonase/sudaffed/fexofenadine or promethazine in the world can help me sleep. And when I don't fall asleep, it doesn't matter how many times my bladder forces me to get up through the night.

Where is my colon in all this, you ask? It's fidgeting on the sidelines trying so valliantly to get onto the field. "Lookit me! I'm giving you car sickness every morning and every afternoon!" it wails, "I'm giving you the most delightful smorgasbord of Throughput and you're not even paying attention to me!" Alas, my loyal companion, you have taken a back seat to other -- dare I say, more pressing -- issues. Never fear; your time in the lime light will come again soon.

the Fall and the full

2010-10-17T16:44:00.000-07:00

Halloween approaches, and so I begin my ritual of orange-food gorging, pie making and home-spookifying. This year, I have inherited a few decorations from my mother; among them, a porcelain child in ghost costume holding a glowing Jack-o-lantern which so encompasses all of my warm childhood memories of this very important holiday.

In honor of this conferment, and of all the new drugs I am on, I have decided to throw a small Halloween party this year. To hone (read: stumble embarrassingly through) my hostessing skills? To give my apartment some personality and to fill it with warm and spooky company? Because I am feeling well enough to truly enjoy the season? Perhaps all of these are their own motivation. However, it's mostly because I want to make edible eyeballs out of lychees and grapes and hide them in peoples' soup.

In the spirit of the winter season, the beautiful rain, and my venture back to a balanced state of mind, I have visited enough doctors and filled enough new prescriptions lately to account for well over half of my paycheck. The elusive urinary tract syndrome, which has been addressed by GI, primary, OBGYN and urologist is being treated with yet another antibiotic which seems to be at least participating in warding off the next episode. The outer ear infections are being treated with antibiotic as well, and the crusted plasma-oozing sore behind my right ear is being treated with a clever combination of cortisol and athlete's foot creams. The dermatologist assigned to me The Next Big Thing in acne antibiotics and tried to convince me to try Accutane (yes, on Remicade. yes, I rolled my eyes at him and explained what Accutane is, what Remicade is and what a liver is). My nasal exoskeleton is on its third (or fourth?) week of the Allegra-Flonase-Sinus Irrigation trifecta and is being admirably defeated (read: the reasons I don't sleep at night are no longer because of my inability to breathe). And lastly, I have been put on sleeping medication as a first serious approach to overcoming this ghastly depression which has been pwning me since July. Promethazine finally procured although it took a month to convince my GI that the vomiting actually is impeding my ability to work (that's a lie, because work is going exceedingly well, but what's a girl to do?). Now I just need to go to the dentist. When I get my next paycheck. And if I don't first spend that paycheck on Halloweeny Essentials.

This body is currently full with drugs. Damn antibiotics for working far better than any Astragalus, Ashwaganda or l-theanine supplements I've ever taken. H.K. remains, of course, my most effective medication.

This weekend, we acquired several very large and very face-friendly pumpkins. Hamicar and Toby remain faithful guardians of our domain, although only when the sun is out. Next weekend, H.K. has nobly volunteered to help me experiment with the Halloween menu items so that I don't kill any of my guests. Successful recipes will be posted. Unsuccessful recipes will probably also be posted.

This is Hamilcar

2010-10-06T14:35:00.000-07:00

For all who enjoyed meeting my pet spider, Toby: this is Hamilcar. He is a hybrid Carthaginian Amazon spider who has made a home catty-corner to Toby in our doorway.

Hamilcar dwarfs Toby by roughly 2.5x; he is brown and orange and hairy and he scares the shit out of me, but he is the size of my eyeball so I have no intention of messing with him.

the besting of Hell Month

2010-09-27T20:39:00.000-07:00

August was wretched. Full of deadlines and uncertainties, and brimming with uncontrollable outcomes -- many of them broken or bad. August was Hell Month. And what's worse: Hell Month so viciously consuming the soul of your humble narrator, there was no relief to be had (not that there were not opportunities; there were plenty begging for attention, but despair would not yield). Poor H.K. knowing not what to do with the sack of melancholic potato that had replaced his wife, did his very utmost to provide rejuvenating intervention. How he survived, I will never know. 'Patient' doesn't begin to do him justice.

September. We both held out for September. That beautiful transitional month where all students withdrew to their various institutions of edification. When all manuscripts would be submitted, new projects begun and peaceful nights at home would ensue. September failed me, and with manuscript rejections compounding the anxiety over That Test and the extemporaneous decision to apply for a massively competitive grant, I wobbled, and then collapsed.

But as September closes, Hell Month Part II is daring to show only its last fading embers. There are still projects, manuscripts, grant writing and applications, but these are what I live for. Well, I mostly live for H.K., but secondarily I live for science. With That Test out of the way, 99% of my burden is alleviated, and the rest is more than manageable. In fact, there is even time for Experimental Cooking and playing outside. And so it would seem that Hell Month has finally been bested.

This is Toby. Toby resides above the shrub adjacent to our front door, and has greeted us every morning and evening with his magnificently large web, which is consistently inhabited by some poor large insect about to be devoured by this disconcertingly large spider.

This is Toby snacking on a giant grasshopper.

Currently, there is only the growing nausea and this four-month drawn out allergy disaster to hold me back -- and they are weak contenders if ever there were any. Remicade has given my immune system a startle, and it did not remember how to handle allergens when they came about this season. Since June, I have had a nasal exoskeleton and a nasal cavity effervescent with green mucous. For two weeks, I even developed an aversion to mice (a career-ending obstacle if permanent; please appreciate the potential gravity). The most recent diagnosis last week was "you clearly do not have an infection, so take everything together, and if it still doesn't work we'll give you an allergy shot!" Brilliant. To clarify, three weeks of Allegra, Sudafed, Flonase and sinus irrigation (otherwise known as drowning without involving the lungs) should do the trick. In theory, I should be sleeping again, not nauseous and not having post-void residual problems like a man who just underwent prostate surgery. We're a third of the way there, folks (because I am now sleeping from 11pm-5am!)! (!)

This evening: my attempt at Falafel Waffles. Though a half-failure, my chickpea-lima-chive concoction was also half delicious. It was very dry and crumbly, but would have been oh-so delicious with the appropriate sauce. Inevitably, no matter how crucial to the recipe, I forget about the sauce.

You can already tell how dry...

Falafel were meant to be deep-fried balls of internal soft moistness, and had I tossed them in a vat of boiling oil, they may have been just that. Although I followed Lisa's recipe to the last detail (excepting the cilantro and parsley... and the sauce), I could not make them puff in the soft way that Black Bean Cakes or Polenta do. I'll get you next time, Fawaffle... NEXT TIME!

on reclaimng life

2010-09-26T11:47:00.000-07:00

Having gotten through the most terrifying aspect of this season (the GRE), and having experienced the worst case scenario (not only unimproved, but slightly lower scores than last year... when I was high, nauseous and in pain), I am successfully emerged on the other side of doom.

Oddly, I am less bothered by average scores than I expected to be. The relief of its being over with is much more potent than the disappointment with my performance on this particular exam. Frankly -- and I'm not alone here -- I regard that test as far more highly referred to by graduate school admissions committees than is wise. That said, I am acutely aware of how biased, political and funding-based the admissions process is in general and, therefore, am aware that average test scores will not be my undoing.

That is, of course, unless my average scores prevent me from being invited to interviews. The thing is that highly prestigious schools will triage applications to the discard pile if they are not at a particular level. Here is why I think that is a complete bullshit filter for applications:

This summer, I had the privilege of teaching several intern students. Two of them were at he high school level, and were very fun to teach because they were fledgling scientists with lots of interesting questions and a flare for the work. At least by the end of the summer, when the results of their month-long project started trickling in, their enthusiasm was wonderful. This is why I love teaching.

In another vein, however, I had the privilege of teaching some biochemical techniques to one of our veteran students who has been doing analysis in another part of our lab for three years, and whom we had come to regard as a genius. This student happened to be entering his senior year as a Biochemistry major, was applying to graduate programs, and was using his last summer month with us to buffer his resume by learning some new techniques. He was, for all intents and purposes, my peer.

He was also a complete dolt in the lab -- more clumsy, less interested and with the worst memory I had ever seen in a person, scientist or otherwise. I was completely taken aback by his lack of apt for deduction (read: common sense). Please understand that this is not an exaggeration; I was shocked and befuddled that teaching my peer was like teaching a kindergartner. I had to cut in half what I had planned on teaching him in that month because he could barely handle what he was initially tasked with.

How this boy could possibly be an academic genius became more and more puzzling. Yet, his GRE scores trumped mine. And he will be invited to interview at Stanford (yes, he is applying to the exact same programs that I am), and I will not, because his scores are higher than mine. He will bomb his interview, because he knows almost nothing about what he's been doing for the last three years, and has very poor social skills (for which I do feel bad for him), but he will get them, and a small part of me dies whenever I think about that. Despite this, he may actually be admitted to programs that I am rejected from because the more prestigious the school, the more weight is put on his exam scores. I have effectively buffered the resume of a boy who, for all his pompous yet oblivious innocence, will never be a decent research scientist much less a Stanford-grade one. What's more, he has no idea why he wants a PhD; it's just another step in the academic achievement track. And this, as I studied for my own second-go at the GRE, was infuriating.

However!, having faced my worst fear and come out the other side, I am happy with whatever school I am accepted to because I know what I want and what I'm doing, and will be a huge asset wherever I end up. Whatever I want to make happen with what I'm given will happen, because that is something I've consistently been good at. Getting into an amazing school instead of an average one, however, would be much welcomed reassurance that I belong in this field.

I could write volumes on how to best approach finding a graduate school, preparing yourself, exploring options, what the GRE actually says about your scientific potential, and negotiating the politics of science, but this data dump is dry enough as it is.

To end on a pleasant note -- and I must, because I feel better now than I have felt in two months -- this weekend was beautiful! I worked on my grant while being infused for four hours on Saturday, stopped at New Seasons to pick up special sandwiches on the way home, and took the bikes and Frisbee out for some exercise at the park for the afternoon. It was freeing, and wonderful to be able to throw myself back into real life.

Today, I will finish my next manuscript and make some progress on applications having filled my tummeh with my new favorite Lisa-inspired breakfast: waffled eggs with chive Tofutti and onion bagel.

I feel good.

on waffling

2010-09-21T16:30:00.000-07:00

One of my most favorite wedding gifts was from Lovely Lisa. Leave it to the Waffle Wizard to bestow upon me a waffle maker of my very own.

Not only does my fancy new culinary instrument occupy perfectly that-one-shelf-space-in-the-kitchen-into-which-nothing-else-fits; there is just no topping the ultimate design of the waffle in terms of entree base.

This is one of my favorites.

Last night, I conducted my first experiment: waffled polenta. It was simple, speedy and surprisingly delicious -- delicious in a reliable way, as if I could make this thing well more than one fluke time in my life.

Next up, "Fawafles".

yes, this is, indeed, Tapatio sauce.

Protest all you like about how terrible corn is for the Crohn tract. While cornbread, polenta, grits, hominy and cornmeal soup are all reproved in the common Crohn's or IBS diet, these are also gluten free foods, so if your reactions tend to be more volatile with wheats, polenta can be a benign substitute. Cornmeal is also higher in fiber than wheat, and can be very helpful with Obdurate Throughput. With Crohn's the clinical studies never cease to reveal that what is beneficial to one case is likely to be harmful to another, and there is no universally harmful food in Crohn's disease (Triggs et al 2010).

Of nasal exoskeletons and forcible exhaustion

2010-09-17T03:15:00.000-07:00

It may be surprising to my viewers that I am awake at 3am. The typing kind of awake. Shed your marvel, my friends, for this has been my habit for a month, now.

In June, when the allergy bug settled in my sinuses, this was just a regular infection, and I treated it as such with saline, my trusted Nasal Crom, and even hopped on the Neti Pot wagon. By mid-July, when none of these therapies worked, I threw up my hands and called it in. By this time, I have developed inner nasal scabs which made mucous expulsion quite the bother. A prescription of Flonase was bestowed without even an appointment. Beautiful.

Fifteen dollars and three glorious weeks of regular breathing later, it was time to abandon the steroids and hope that their effect would be sustainable. Fat chance. So I called it in again, asking my doctor what the next step might be. "Try saline washes and using the Neti Pot," says my doctor's replacement.

"Are... are you serious?" I wanted to respond, but refrained in the interest of actually getting some help on the stagnant-green-pool-harboring nasal exoskeleton front. So I actually tried these saline treatments again, hoping that with the steroids having brought me back to stage one, they might work. Negative. A month later, the scabbing and green mucous flow are worse than ever, so I call it in again.

"Hi, I've been having some problems with my nose and may need antibotics."

"Well, why don't you give me an idea of what's been going on, sweetheart," says the Southern Bell on the other end of the line, who I must trust to translate my story to my doctor.

"Well, three months ago I just had what appeared to be a regular sinus infection. I treated with all the different saline washes for a month, was prescribed Flonase for a month, and the infection got worse when the steroid treatment ended. So now I'm concerned that I might have a more serious infection and be in need of antibiotics. This is my first allergy season being on Remicade, so I'm susceptible to infection. This is the first time in my life I've had a sinus problem nearly this severe and that may have something to do with it."

"Well bless your heart, you poor thing. Let me send this message to the doctor and call you right back!" I've spoken to this woman many a time. She is, if not effective, very sweet.

[Time lapse of three hours, Southern Bell calls me back]

"The doctor says she'd like you to continue using saline washes and wait until the peak season is over in October."

"Excuse me?"

"Yes, she said continue with the saline. You're doing the right thing."

"Alright, look. I know this isn't your fault, and I apologize for getting upset, but I'm at my wit's end, here. Saline has not been anything resembling helpful during this whole situation. I have gotten progressively worse with the exception of the fast-acting and fast-disappearing effects of Flonase. I have been expelling green mucous out of my mouth at least ten times a day because my nasal passage has developed an exoskeleton so strong that I can't blow my nose because the mucous has no way to push through. I bleed every time I sneeze, I now have scabs on the outside of my nostrils, I wake up at 3am every night, and frankly, I can't breathe at all unless I flush my nose with hot water every morning and try to peel away some of the blockage, and to exacerbate this I am in the crux of the most stressful time of my entire life. Saline nor steroids have been helpful in this matter and have, in fact, allowed things to get much worse, and the doctor doesn't think that I might have an infection that my immune-suppressed body just can't fight on its own?"

"Well honey, I'm sorry. Let me send a more explicit message to the doctor and get back to you soon."

That was a week ago. I think I may have scared off poor Bell.

My exoskeleton needs a hot shower. I'm effing tired. I'm effing stressed. Please give me some effing antibiotics. I am working 50-hour weeks, writing grants, writing graduate school applications and studying for the GRE (something which I can't quite support logically). I haven't run in two weeks because, well, it makes my sinuses swell.

Anyone have thoughts on just chopping the thing off, going Tycho Brahe style?

L'shana tova, u'metuka!

2010-09-08T15:04:00.000-07:00

If I can't hold to a marriage resolution, perhaps I can cling to a new year's resolution. My favorite holiday -- at one time, for no other reason than the unassuming joy of casting away my sinful bread crumbs into a flowing body of water -- comes to the rescue.

L'shana tova u-metuka, everyone! May the new year 5771 be the one during which I finally set sail for graduate school and begin actually working toward my and my husband's future. And may Gaia accept this Jewish celebration, absorb my bread crumb sins into her bosom and recycle them back to me as renewed opportunity. May there be abundant apples and honey, and may the Pedant Neuroscientists of the world not get in my way again this year.

Or some such gibberish.

Squatter Evangelism

2010-08-31T11:27:00.000-07:00

I want a squatter toilet. With a Bidet.

http://www.slate.com/id/2264657/

Hell Month

2010-08-30T11:06:00.000-07:00

As Hell Month comes to a dragging close, I feel inclined to explain my "prolonged" absence and attempt to begin September anew. August is typically difficult for me no matter what; it's the month where summer student projects realize their failure to culminate properly, when grant money comes in, when last years money must be spent or be lost to the government, when deadlines abound, and when I realize that I have been dawdling all summer and must reclaim some kind of focus. This August, however, has been particularly acerbic.

I have not written much since July because my emotional mind has been inhabiting a very dark place. It appears that I did not actually recover from my PWD phase until very recently. Since I have not cried for a mind-boggling four-day continuum -- with the exception of M&L's wedding yesterday, which does not count -- I think it's time for a celebratory return to the real world.

This August, everything came crashing down. My baby brother alone and unhappy in his new college surroundings; summer student projects failing to culminate; the complete revamping of my journal papers, which would be fine except for that the longer it takes my boss to edit them, the less likely it is that I will have their publication on my graduate school C.V.; weddings of those dear friends who decided last-minutely not to attend my own or send a gift, or a card, or even acknowledge an intent to do so, but who expect my attendance at showers, bachelorette parties and their special days (and, yes, I know exactly how that sounds); the sickening regrets about my own wedding that I seem to hunt down, which is its own special kind of painful and stupid act; the desperate need to get H.K. on my health insurance, which has been delayed by the marriage certificate fiasco, the name-changing social security card fiasco and the title and registration DMV fiasco that is guaranteed to occur; the realization that I am, Crohn's wise, exactly where I was last year at this time and somewhat terrified that it will all begin to replay at any moment, and the major anxiety that last year will fully repeat itself and I will not get into school again, even though I'm more qualified than 90% of applicants in the country (yes, I know exactly how that sounds, too). This is do-or-die year. If it doesn't happen now, it's not going to.

There have been several instances of tummeh turbulence that put my Crohn's panic into play. Namely, a weekend out in Seattle with dear friends where eating out twice a day, despite my greatest efforts -- and I was very careful... excepting the alcohol -- sent me into a painful reenactment Monday evening. Secondarily, the immense stress I've felt deep into the dorsal horn of my spine makes even butter a dangerous contender. 'You're doing so well,' I tell myself, 'don't throw it all away in the name of gustatory freedom.' And it's so much more easily said than done.

Sleep? None to be had. Exercise? Fluctuating with the consistency of supermarket produce quality. Meditation? Intimidatingly unsuccessful unless there is alcohol involved.

I need something good to happen here. In the mean time, I am at least escaping from the grasp of beastly depression.

how we are hungry

2010-08-10T15:03:00.000-07:00

No one in my line of work ever says, "It's so beautiful - so meaningful - what you're doing." People don't look at graphs and n's and alpha values and feel the shell harboring their emotions crack.

I have to. Every so often, I have to hunt for a study that is so powerful, and so beautiful that my jaw clenches and my eyes swell. If I don't, I break under the politics of science. I rarely find one.

So many years spent choreographing souls, extending life in my arms and dancing disease out of existence. Science is not like dance. No one ever reaches through the laminate of graphs and methodology to find the empathetic compassion of a fellow scientist.

I need to know that it can be so powerful - so beautiful - what I'm doing.

Apparently, it can be, and I lose sight of it:

What you do makes my jaw clench and my eyes water, though.

You see the day to day, deadlines to keep grants, shooting mice in the stomach with needles, and training new med school idiots who are clearly beneath you.

My second host mother, E, had the most warm, loving, wonderful parents. Her tall, strapping, powerful father slowly began to shake more and more each day until he was diagnosed with Parkinson's. All of a sudden this strong man was made to feel like an incapable child in his own body, leaving his tiny, frail wife to treat him like an infant. He felt emasculated and helpless. He went on the most top-notch medication known at the time in order to control his uncontrollable shaking and ended up having psychedelic nightmares every waking and sleeping moment of the day. Waking up, shitting himself from fear, literally seeing a wrecking ball smashing through the room, muscling his weak body over his wife to protect her from his delusions.

I've seen another man, not much older than your parents, with a teenage child. But instead of looking his age, the stress from Parkinsons leaves him looking in his 70's, barely capable of continuing his accounting practice because it takes him over 5 minutes to write his name. He can't keep a conversation because the shakes take over and he can no longer concentrate. "It's a bad day," he says to me, when he can't even complete a sentence, asking me about his [business transaction].

My heart breaks. But you are doing something about it. Your blood, sweat, tears, frustration, stress, training...your life will contribute to the future. So other people won't go through life like this.
When I found out this is what your focus was, I heard my host mother in my head. "I don't wish this disease on anyone." She was on the verge of tears as she watched her father try to simply walk through a doorway with so much difficulty. I was so proud of you, and to even know you, right then and there.

Thank you, K, for reminding me that what I am doing can be so beautiful, and so meaningful.

marital resolutions

2010-07-21T07:36:00.000-07:00

On July 10th, I got married. On July 11th, I made a marriage resolution to never again cry over small things like having to buy a second marriage license because of a single ink slight or having to swim through endless legal bologna to change my name in all of the necessary systems, or the haunting mistakes surrounding the beginning of H.K. and me that have resurfaced in my conscience. July 14th through the 19th, I failed my resolution.

Post wedding depression, I discovered, is actually a thing, like postpartem depression. My business-week long PWD, however, had nothing to do with realizing I was trapped with this man, or with adrenaline withdrawal, or with no longer being the center of attention, as the classic syndrome characterizes. My emotional imbalance came from recognizing that this man actually married me; he is the one who is stuck -- I successfully conned him into thinking I was the greatest thing on earth -- and I don't know what to do with that amount of happiness and fortune except worry that he will someday regain whatever rationale I've temporarily numbed, and want out. And that is way, way too much paperwork to even think about...

I would like to think that I've come to my senses, and found a way to cope with being the most fortunate and undeserving twenty-something in the galaxy.

The wedding was beautiful, the guests were amazing, the "minister" could not have been better chosen and the adventure afterward was phenomenal. There are no adequate descriptions. It was all far too sweet and far too short. I demand a replay.

As an aside, the top of the cake was devoured with no reservation over the course of the honeymoon. Being covered in dark blue final frontier-like fondant, it died the Throughput a rich green color for the remainder of the trip. Vegan cake was a brilliant decision, because other than the odd color I suffered no nausea/hot flashes/constipation or stabbing pain until the evening we returned home. Success, almost.

romantic ruminations and rhubarb

2010-07-01T15:33:00.000-07:00

H.K. and I answering a questionnaire and trying to figure how we're going to personalize our wedding ceremony:

HK: 'What do you most look forward to about life with this person?' The summers. If you have seen Raga in a bikini you know what I'm talking about.
Raga: I said, "everything we haven't experienced yet." I look forward to everything because I get to share or experience it with you. ... and that is the lamest thing I've ever said.
HK: the question says, "most"
Raga: I know. It's all the most.
HK: the summers aren't better? I think the summers are better.
Raga: I think I'm so painfully love-struck that it's all just a wash.

I know it sounds like we're having our own personal conversations here, but we're really on the same page. Truly.

It appears that I have eaten one-too-many salads of late, and my supposedly non-existent ileal stricture has beaten me down. Therefore, I have taken a personal day today in order to mollycoddle my belleh in the interest of surviving (dare I say, enjoying) my wedding day. My beloved cake chef is making the chocolate kahlua tier a vegan one . In his honor, I will be dining on rice, chicken and the goodies featured below for the next eight days.

Here's what happened to that rhubarb I mentioned:

I may or may not but almost certainly did over-bake the crust, add sugar to the egg whites too quickly whilst beating the meringue, give up the meringue-beating too early and then forget that I had left it all in the oven after adding the meringue to crisp; but these rhubarb custard meringues were nonetheless delectable.

Grocery Days

2010-06-27T21:43:00.000-07:00

I have a terrible habit. Sundays are typically grocery days (interrupted by the occasional Tuesday when I find exceptional goodies at the farmer's market at work), and they are accompanied by excessive eating.

It has to do with having so many "new and exciting" foods in the kitchen. These can either be items we have not seen for a year (rhubarb), or things we have been missing for 3 days -- their presence in my kitchen is exhilarating either way. The bad habit is that I, in this recent Quasi-comfortable Tummeh Era, consistently oblige my urge to consume everything new.

The only reason this does not send me into a state of catatonic bloating and pillow-burrowing is because I munch. Like a squirrel. Micro-portions of each of the newest and most exciting items from the grocery store are consumed over the course of Sunday, between Sunday-esque tasks such as laundry, vacuuming, cooking, and most recently, poolside bronzing and running.

Although the Squirreling technique is helpful in confusing my tummeh into thinking I am treating it respectfully, it is ultimately poor eating etiquette in that I eat so many different kinds of micro-portions. I have found over the last decade, not surprisingly, that the wider array of foods I eat in a single day, the more uncomfortable (or nauseous, or in pain) I feel by the end (or over the next few days).

For the last three months or so, I have been running 3-6 days a week (note: this has lowered my weight even below what the last six months starvation did, and allowed a maintenance in that range -- I have not been this happy with my body since high school). Over the last three, I began to notice an ache in my lower left abdomen during my run. I disregarded this as side ache and was simply careful about drinking water beforehand. Today, however, the pain was deeper and more distinguished, and I realized I had probably aggravated the Crohn's Baby.

Today, therefore, I held back on the pressing urge to consume the newandexcitingitemsinmykitchen, and opted for an afternoon of cooking and a summer meal. Cold cucumber soup with baguette, fresh pesto and tomato. I am definitely not sitting here munching on leftover baguette and tomato...

Notice the new color in my diet!!