grad school priorities #1

What I should have done before class this morning:

Read papers for discussion so as not to look a fool.

What I did this morning instead:

Realigned my bike wheel, Sharpied over the spots on my sweater that got bleached in lab, sewed up a hole in my sock.

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.

Second term wraps up

I have officially passed my second term of graduate school.  "Unscathed" and "successfully" are not the right adjectives, but I feel like a more evolved scientist no matter what the politics of graduate school think of me.  To celebrate, H.K. and I went on a small hike this weekend.

Yes, that thar is the ocean.

That is not to say that I haven't done well.  I have.

Yours truly is -- as of several weeks ago, actually -- part of a new lab home.  Where did I end up, you ask out of unbearable curiosity?  Why, in the bustling and exciting new lab of Dr. StemCell!  I have a tremendous project manipulating cell therapy in several PD models and cannot wait to imbue myself full-time this summer.

The Crohn's baby has been oddly tolerant of the inordinate levels of stress that this term has induced.  Only three minor flares the whole term.  The rest of my body, I'm afraid, has not been so tolerant.  It seems that I have developed anemia again, and consequently have been demonstrating vasovagal responses all too frequently for anyone's liking.

Apparently I have joined the ranks of the chronically anxious (although one would think that anxiety would be accompanied by more frequent flares, hence, "oddly tolerant").  My awesome university physician has a philosophy that there are two kinds of graduate students: the kind that are on SSRI's and the kind that should be.  She also recommends the greens, which I can't say that I'm opposed to.

In other fascinating news, my constitutively dry eyes which were "diagnosed" roughly a year ago have advanced into a new stage of dysfunction.  Welcome, Blepharitis, to my platoon of Misfit Side-Effects!  Since the psoriasis, exoskeleton nose and bladder infections calmed down I've been aching for a new challenge.  Srsly though, thank god for polyquaternium eye drops.

And -- AND -- my new anti-nausea drug (Zofran) does not knock me out cold.  Which means that I can actually take it when needed.  Score.

Things I learned in graduate school, Part II

1.  Do not forget to eat food.

2.  Do not forget to eat food and then half a cup of coffee and a handful of Pringles for lunch.

3.  Do not forget to eat food, have coffee for lunch, and then take a full dose of antispasmotic.

4.  Do not forget to eat food, have coffee for lunch, take a full dose of anti-spasmotic and then nearly fall out of your chair from being high while your PI is explaining a complicated procedure to you which you will be expected to perform for the first time on your own the following day.

Raga Conductance

Remember the graphic projection from last week, folks?  This most recent set of 24 hr bins has not been good times all around either.

My most recent week.  Plotted as the slope of Raga current over Raga driving force.

The week began with residual driving force (V) from the one before -- roughly less than 0 enthusiasms.  As the week continued and midterms were confronted one after the other, driving force increased steadily as was demanded by scheduled events through the continued failure of lab projects, the continued battle with insurance for coverage, the increasingly aching body and cognitive blips (which are new) and the return of a particular midterm grade.  Driving force, still not in positive range, saw Raga current (I) approach 0 and Raga channels all but give up.

Then, on Friday evening, a peep of hope.  I learned that my particular midterm grade was actually quite reasonable when weighted through the class as a whole.  My trouble-shooting efforts in lab were rewarded with a high-yield experimental result.  And my insurance broker called to say that the appropriate paperwork was being transferred and that it should all resolve in the next few weeks.

And with that, Raga reversal potential (ERaga) was met, and current slowly began to creep upward into functional levels.  With Raga driving force now increasing due to internal and not external factors, it's off to mini-golf and amazing food that is bad for me in honor of H.K.'s birthday, which was so cruelly ignored last week due to recruitment and midterm prep.

I could survive this, yet.

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.

Perspective

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.