Latency in Stress-Induced Crohn's Attacks

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

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

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

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

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

Crohn's v. Grad School Free Lunch

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

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

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

Remicade... I've lost count.

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

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

 

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

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

Rotation 1 closes; cue Rotation 2

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

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

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

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

That was Monday.  I started Rotation 2 on Tuesday.

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

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

the post-SfN sickness

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

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

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

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

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

Things I've learned in graduate school

1.  forgetting to eat is a bad habit

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

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

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

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

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

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

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

Are you fucking kidding me?  I just spent two hours clearing this up.  You have the information in your system now.  Go ahead and turn your computer on.  Do it now while I'm on the phone so I can guide you through the process.  She's been checking that detail for the last 45 min... apparently their computers are made of bark.  Meanwhile...

"Oh hai there! Btw: your insurance wont be covering your Remicade appt because you were referred by your GI's office and not be the university health center!"

.................. is a referral by the doctor to whom I was referred by the university health center not by proxy a fucking referral?   I'm looking into it.  Because apparently their phones to other offices are also made of bark.  I'm sure I'll find out right after I get the bill.

6.  your PI and lab manager being in disagreement on the critical details of your new rotation project and failing to let you in on their decision 2hrs before your scheduled surgeries to use your mice for some other thing that came up... is just not cool.  serious demerits, y'all.

7.  TGI-take-home-midterm-F!

How to Suvrive in a Disorganized Lab

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

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

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

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

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

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

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




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