wherein the anti-inflammatory diet bites me back

On September 27th, I woke up with stomach cramps.  They weren't strong enough to prevent me from biking to work and I expected that they would wear off by mid-morning as they and nausea typically do.  On this occasion, however, the opposite occurred and the cramps not only got stronger but began cycling through the wave, with which all Crohns are familiar.

For those unfamiliar, the wave is a cycle of pain in which the sensation begins modestly and proceeds to grow like a swell before hitting a peak around which it dawdles for a time and then swells back down.  Each cycle can last anywhere from 1-10 min depending on how violent is your episode.

The day before, I was very proud to have gone my first complete day without eating any "illegal" foods on my self-imposed anti-inflammatory diet.  Like a veteran, I weened myself away from refined sugars and carbs very slowly:

Breakfast:  banana and blueberry smoothie (with coconut oil) 

Lunch: leftover steamed veggies and roasted fennel

Supper: coconut flour biscuit with lox and raisin cashew carrot salad (with lemon juice)

Apart from the food -- none of which was new to my system nor should have done any harm -- the day was not without a very significant amount of stress, which no doubt contributed to the episode the following day.

Since I had a masters and undergraduate student arriving on the 27th to be under my supervision, and the 4th day of 12 straight days of behavior to conquer, there was to be no standing down.  By 10am, however, the waves had picked up their ardor and I found myself clutching my stomach while giving a microscope tutorial and a brief anatomy lesson.

At 1130am it was time to traipse from the medical to the main campus (~10 min walk) to do behavior.  By this time, the waves were such that when I walked I could feel every reverberation from the placement of my feet -- a shock spiraled up my spine each time my heel hit, the ball of my foot, my big toe, the rest of my toes, and as weight shifted back to the ball of my foot, to the side, and as my heel lifted and weight transfered to my ball and toes again.  It took me almost 20 min to make that trip, slowing down in attempt to increased the fluidity of my steps in vain effort to avoid the reverberations.

Just 2 hrs, I told myself, and H.K. will pick me up and bring me home to drug myself into oblivion and hopefully avoid a visit to the ER.  To briefly elaborate, the wave is almost never a sign of a rupture or abscess.  Four times in my Crohn history a day like this has been as debilitating: the first, when I was maybe 14 and no visit to the ER was made, and I was fine; the second, third and fourth when I was in my early 20s and made visits to the ER during which I was given morphine and a CT scan after which time I was sent home with a bottle of percocet and told that nothing was wrong.  The all-too-familiar gab of a physician who doesn't give a shit.  As a scientist, I can tell you via very basic logic, that if the body allows nociception to deliver enough consistent pain to knock a person off their feet, there is something wrong.  There just is.

I have no idea how I survived those 2 hrs of behavior.  Honestly.  I'm fairly certain that I took the opportunity to black the fuck out during my 20 min break.  As to my subjects?  I have tremendous and impressive control over the projection of my chakras.  If they knew anything was amiss, I would be flabbergasted.

In any case, I did not go to the useless and unhelpful ER.  I did, however, take 20 mg oxycodone over the course of the evening, and a hit from my vaporizer each time I awoke in pain throughout the wee hours (1, 3, 4 and 5am).  Yes, my friends, it was in fact that bad.  On this day, I was only able to stomach a few spoonfuls of broth and 2 saltines, and that only to give the oxy something to mingle with.

On Sept 28th, I did not move from my bed until 11am, at which time I needed to return to the lab to do more behavior.  This was a most assured FML event.  H.K. was wonderful enough to put off his own work for a few hours to stuff a Boost down my throat, drive me to my destination and run an errand for me while I did my thang.

Upon returning home, I again relieved the still miserable but notably less excruciating pain with more drugs and slept until the evening.  Not a BM to be found through this whole saga, mind you, nor was this gas related.  So the remaining culprits are stress and food intolerance.

Today, the 29th, I am sore, weak, bloated and nauseous, but the wave is gone.  I performed my behavioral tests today in significantly less agony.  And I am slowly adding back solid -- although not remotely anti-inflammatory -- foods back into my system.  Saltines?  Noodle soup?  Jello?  This is a documented instance in which anti-inflammatory food brought me to my knees and carbs and sugar revived me.

hi's and lo's

What is provoking this sudden flurry of posts??

Back on the anti-inflam diet today.  Feeling good.  Even rejected the primal urge to partake in free baked goods and coffee at a seminar.

[leftover] coconut flour biscuits courtesy of Comfy Tummy, cashew raisin carrot salad.  Dried ginger and cherries for dessert.

Eaten away by the hour, however, upon discovering this morning that I had made a mistake several months ago now that has been causing the problems in an experiment a colleague and I have been working on [on and off].  With each hour, it becomes more difficult to tolerate the mistake.  Minimally my fault as I was a complete noob thrown into a DIY cloning situation with almost no direction other than an end goal.  But months wasted nonetheless, and my own integrity disintegrating in the eyes of my colleague.

Funsies.  Evening deprecation.  Romanticizing about what a good night's sleep once felt like.  Feeling thrice my age.  Losing patience with my GI (elaboration to follow).

is it fall yet?

I'm effing tired.

Everyone seems to think that I'm effing tired because I work 60-70 hrs a week.  We've been through this, folks.  I work 60-70 hrs a week because I'm obsessed, not because scienceownsmysoulomgfml.  I gave my soul to Science freely.

I'm effing tired because it's effing hot outside and I bike every day.  I'm effing tired because I have Crohn's disease.  I'm effing tired because the most horrifying and consuming tragedy I have ever experienced has been looming over me for the last 6 months and threatens indefiniteness.  And I'm effing tired because my entire lab seems to think that I don't contribute beyond my own projects (even though I do most of the lab-wide organization and cleaning up after people), and that I have no idea what I'm talking about (even though I have more experience with most techniques than anyone else and am actually quite good at what I do, despite the Jack Sparrow facade).  Perhaps I need to be more outspoken about my menial daily achievements?..

So before you tell me that I look exhausted and need to take time off of work, please consider that my work is one of 2 things (the second being H.K.) that is keeping me from a serious mental and physical breakdown.  Plz.  Thx.  Much love.

On a less snarky note, I got a SfN sponsored travel award to go to the conference in October.  Yay!

why i am a workaholic/anti-social

I have been having more frequent bouts of depression recently.  It hits me at night, after a 11-hour work day when my eyes are inflamed (see "blepharitis" posts) and all I want to do is be with H.K. and sink into the couch/bed.  It is then that my mind slows down and I realize how many people I've blown off lately and what a shitty friend I have been and how in the world I thought I could meet all the social demands I had set for myself.

When this happened two nights ago, I unloaded in "drunk-dial" fashion on my dearest friend, Liz.  Master and Ninja of all things Life -- particularly mindfulness and self-acceptance in terms of chronic illness -- Liz helped me to find some perspective.

For more perspective, see this article.  Only after reading it have I been able to piece together my position on the social bailing that has made me so upset lately.

I have had a very difficult time explaining, not only to other people but to myself, why I have the energy to work 60-70 hours a week but not to socialize.  It comes down to two things: 1) I am a troglodyte, and 2) I absolutely love my work and am bewildered that I am actually healthy enough right now to do it.  The latter of these, as you may have guessed, is the more pertinent.

Having had Crohn's disease for ~14 years now, I have experienced many lows and highs.  During the lowest lows, I am bed-ridden, emaciated, and in consistent immense pain.  But during the highs... there is freedom.  There are windows of time when I can do whatever I want to with the energy that I do have.  And I chose to do science, because I love it almost as much as I love H.K., and I am compulsively -- sometimes obsessively -- driven by it.  It is much harder to find windows of health that allow me to embrace research than it is to find the stamina for being with people I love.  It may seem backwards, and/or fucked up, but I take advantage of my rare working windows at the expense of socializing.  It has nothing to do with my love for people.  It is simply a reflection of my passion taking precedence where/when it can.

The above article explains this conflict well.  You do what you can, when you can.  Sometimes your body bails on you and plans change.  Sometimes you overestimate what you will be able to accomplish and things further down on the list get put off or dropped.

Just because I am working does not mean I am healthy.  It means that I am healthy enough to do some things, but not everything.

year one recovery

Around the time that my last final exam was submitted for Core, I slept until 3pm.  I got out of bed at 3pm for the sole purpose of seeing Prometheus.  I went back to sleep immediately afterward.

Since that day -- roughly 2 weeks ago now -- unless I am in lab or otherwise actively doing something, I am constantly exhausted.  The kind of exhausted where I opt to remain where I am sitting/laying instead of obtaining food.  Since almost nothing (sans incredible pain or nausea) has the power to make me abstain from food, this state strikes me as noteworthy.

In the same period, I have now had 2 bouts of extraordinarily painful attacks.  The kind where the pain can't be contained by the gut alone and invites the spine to orchestrate the party in nearly paralyzing waves.

It occurs to me that this is yet another one of those instances where stress has suppressed my immune system (the other part of the immune system that Remicade does not touch) so intensely for so long that immediately upon release from said stress, the body goes wild exercising all the things it could not do during suppression. Namely, sleep and flare.

Thank you, Core.  Damn you, and may we never meet again.

tremendous pain and throughput reunited

Last night, I was paid a visit from my dear old friend, Tremendous Pain.  TP -- stoked to see me -- insisted on re-hashing everything we had ever done together (ALL the old times).

As luck would have it, my oxy had not expired.   Neither had the Promethazine I was out like a light by 8pm.  Until 3am, when the roaring from my tummeh all but woke H.K. from his own deep slumber.  The next two hours were spent crumpled intermittently on the floor of the bathroom.  TP had revitalized his old buddy Throughput, and together they had a splendid time bringing me to my knees.  Fortunately, as soon as the battle quelled I had an hour left to rehabilitate in bed.

Somewhat less fortunately, I had a 3 hr class to teach this morning.  Yeah.   TP was ready to call it a night, but Throughput was still eager to party.  And Promethazine?  That bitch just does not metabolize.  So this morning, I lectured and taught a 3 hr lab to a group of unsuspecting undergrads as a Throughput Zombie.

What is the point to all this complaining, you ask?  To prove that I am a bad ass mother, and that TP, Throughput and Promethazine be damned, my students will learn neuropharmacology today.  In all honesty, I have no idea how I made it through without a vasovagal event.  The only thing I want in the entire world right now is to sleep it off.  But Raga has a presentation tomorrow morning...

Adventures in the Cancer Infusion Center: Real Live Support Group

Many of us are fortunate enough to have loved ones of all types who recognize our limitations and support our ventures in overcoming them.  H.K. is one such phenomenal human being.  But in the end, there is nothing like talking to the MS patient in the infusion chair beside you for two hours; he with his Tysabri and you with your Remicade.

Mr. Jones was a happily married father of two kids in college.  He was, without question, the most talkative person I have ever met in the infusion center -- and although creepily Michael Keaton-looking, the youngest besides myself.

He was diagnosed with MS when his children were 9 and 11 years old, and took advantage of every feasible route to being able to keep his job and contribute to supporting his young family.  Last year, with his kids finally moved out of the house, Mr. Jones had to retire (there is no way the guy was over 45) due to the cognitive irregularities and physical strain he suffered from MS-induced lesions.  He started Tysabri treatment, and I met him today during his 14th infusion.

Interestingly, Mr. Jones brought me into a conversation with his nurse about recent numbness in his limbs (a side effect of Tysabri).  He was elated to inform me that he has never fallen, because when he notices he is walking funny, wherever he is, he sits.

I was regaled with stories of other MS patients in his support group who are confined to wheel chairs and whose spouses left them because they could not take the demand.  Who fell out of their wheel chairs trying to get out of their houses because their adult sons (yes, plural) could not build them a plywood ramp... or help them cross the threshold, evidently.  I was brought to the verge of tears several times.

He was visibly perplexed at my being in graduate school.  "Dude, aren't you totally exhausted all the time?" he entreated, "how to you think clearly enough?"  We addressed each other as "dude", which I thoroughly enjoyed.

"Well -- hah -- I am, and I don't really.  Especially during exams," was my reply.  And it could not be more true.

Being surrounded by other graduate students is amazing in many ways, one of which is that I feel completely normal in their company.  The caveat, of course, is that I begin to wonder why I am not acting so normal.  Why am I not up for a study group until 2am?  Why am I not up for going out to dinner on a Wednesday night?  I tell them that I need to spend time with H.K., which could not be more true.  But I don't tell them that I am impossibly wiped out from the day and I can't think of anything but eating and sleeping.  Omitting the latter excuse from my responses makes me forget that I'm not just being the troglodyte homebody out of lack of interest... I'm being a troglodyte homebody because I'm not healthy.

This is not to say that I'm not doing incredibly well.  Sans the blepharitis, nausea and exhaustion I am healthier than I have been since I was 10 years old.  Mr. Jones reminded me that I am legit.  He also reminded me how fortunate I am to be doing so well on Remicade.  And he reminded me how phenomenal is my spouse.  I couldn't feel more honored to have met him.  Thank you, Mr. Jones.

Exponential decay

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.

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!

stress management fail, Buffy and RagaDetox

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

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

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

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

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

don't worry, be happy now

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

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

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

Halp.

My internal monologue to my inveterate coworker goes something like this:

It is one thing to consistently force the colleagues with whom you share equipment to clean up after you.  That's just disrespectful on a peer level, like the time (last week) I mentioned your error, and witnessed its repeat no less than four hours later.  But when your neglect of expensive and sensitive apparatus results in its corrosion or other damage, you're disrespecting your boss and unnecessarily costing him many monies.  These monies should be on reserve for actual screw-ups.  The equipment is plenty capable of doing this on its own, thanks.   

When I leave, there will not be anyone to clean up after you before IACUC or the VMU folks drop by (or to forget to do so, for which mistake my ass has been burned several times).  Frankly, I've enjoyed that you are prompt with coffees and homemade treats to share in apology, but I urge you to bribe yourself with these things, for I will no longer be around to play the forgiving role, and you will have to take the heat from the higher-ups for your own mistakes.

In addition, I'm sorry to say, consistency of timing does indeed play a crucial role in behavioral data collection.  Specifically, if you begin testing a subject at 9am one day, you cannot then begin testing others in his cohort at 3pm the next round.  Hormones, circadian rhythms and neurotransmitter levels alike are in play here.  It is clear from your conduct that you may have forgotten this, despite your ten years of experience and self-touted expertise in animal research.  So I remind you and beg your to be cognizant of these variables in future.  

Please, please take to heart the things I am teaching you.  This research cannot afford for you to defy my every word to satisfy your ego.  I know you've been in the business much longer than I have, but I have been mastering these things which are new to you, and I will humbly argue that my experience with them gives me seniority.

To my new colleague/trainee:

If I may be so bold, it has come to the point where I can no longer tolerate your arguing with my methodology and telling me that every explanation I give you is wrong.  Lookit, bud; I have spent four years developing my techniques, optimizing and expanding them.  I am no idiot, and as much as it pains me to be arrogant, I do take ownership of this.  Having published five manuscripts based on my research and my techniques, written by my own hand, I'm pretty sure that the scientific world has at least begrudgingly accepted my analyses and interpretations.  I have been respectful of your questions, praising of your intelligence and encouraging of your perspective.  I had hoped that my example would be enough to convince you that it is ideal to respect your mentors and peers and their experience, but it seems that subtlety eludes you and I must take measures to be verbal... but not too verbal. 

Chill.  It'll make you a better scientist.  There are reasons that I do things a certain way, and, similarly, there are reasons that I do not do things certain other ways.  I am open to suggestions -- part of science is constantly optimizing and when I leave you will certainly improve upon what I have developed.  You may contest or challenge my rationale, but you may not blatantly tell me that I am wrong and you refuse to do it my way but that you have no idea why.  Sorry, bud.

Please, please take to heart the things I am teaching you.  This research cannot afford for you to defy my every word to satisfy your ego.  I know that you are fresh out of undergrad and think you know everything and the world is your oyster, but I have been mastering these things which are new to you, and I will humbly argue that my experience with them gives me seniority.

I stress because I worry (perhaps selfishly and egotistically) about my legacy collapsing when I leave --I hope that this is an exaggeration of the circumstances.  Mostly though, I stress about the amount of my work that is being passed on to my boss -- yes, my PI -- because my colleagues are not capable of learning the skillz.  Seriously.  I do not want to leave my boss in a situation where he is too overwhelmed to function.  The man is the reason I have any shot of being a good scientist.  He provided me with every opportunity under the academic sun, and I do not intend to leave his research teetering on a cliff.

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

defeat

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

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

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

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

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

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

Perspiration stains and varicose veins...

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...

in which ambition is met with not so positive reinforcement

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.

Remicade, and other stories

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?..

on not so terrific starts to the day

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?

on exercise and health

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

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.

the Fall and the full

 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.

Of nasal exoskeletons and forcible exhaustion

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?