inner peace

I left work early today.  It was one of several instances lately when I have thrown up my hands before the ten-hour mark.  And I began to feel that inner grumble that mobilizes behind a shield of guilt in preparation for the battle against your will to take care of yourself amid the insanity.

Not only did I leave "early", I bailed on a last minute evening venture to see family up north.  Instead, I made myself some soup (oh yeah, also have been working through a cold lately in prolonged immuno-compromised fashion) and watched a stupid movie.

Right when the army of inner grumble set to charge, my phone rang.  It was a call from a most dear of loved ones, with whom I had not spoken for the long long end of several months.  A medical student herself, she had called to ask for my neurobiological expertise [read: expertise is her word].  The conversation extended, as long-craved ones do, far beyond the initial subject culminating in "so I'll get you from the airport and we'll grab dinner before you give your lecture!"  But further, it ended in our both being reminded of who we are and how we once functioned when we were college roommates.  I don't think it unfair to say that I was far more in need of that reminder than she, and far more in debt to her presence in my life than she to mine.

Of late, I have underestimated myself to a greater degree than is standard.  I have fallen into the stereotypy of academia: feeling like I have to do everything in my power [and out of my power] to impress people at all times, and making absurd excuses to myself for why I cannot always be impressive, and do everything, and be excellent at everything, and be a brilliant scientist at every moment.  It's a very hard thing for me to admit that that is an unrealistic and unachievable expectation.  For I have somewhat of a Sherlock Homes complex [read: not the genius, the obsession], or what Francis Crick calls an inclination toward mad pursuit.  An obsession with making the puzzle fit and finding the right pieces and doing it all in a timely fashion [often inhuman] with minimal mishap and maximum impact.  And I get upset when I cannot accomplish this while also being a marathon runner and party thrower and regular soup kitchen volunteer.

This is because it seems, to me, that everyone around me is accomplishing all these things with perfect grace and professionalism.  In reality, I have very flawed vision and graciously give all these accomplishments to all people, when in reality they are divided among many.  My brain knows this, but my mind does not.  And mind wins over brain every single time.

My dearest, most remarkable and admirable friend who called this evening reminded me that I need to suppress the incessant need to impress people all the time in every aspect.  That I have already impressed them, and need to take care of myself now.  Advice that keeps her alive and  in balance these days.  And so I have quelled the inner grumble, and am at peace with my decision to bail on work and on social call to take care of myself.

SfN 2012

I love the Society for Neuroscience meeting.  I am beyond excited to explore new research and people and see New Orleans -- well, the French Quarter at least.

People act like traveling to this event is no big deal.  And to most, it isn't.  But organizing how I get to and from work each day and accomplish tasks and errands is as involved for me as traveling to this conference is for most people.  I am now what can be considered a seasoned veteran of the SfN extravaganza.  The meeting itself is dangling in front of me like an unimaginable treasure chest.  So on the eve of flight, I am Zening like a mofo [read: zoning on too many episodes of The Walking Dead with H.K. beside me].  Checking off the packing of forms, drugs, ER addresses and food supplements like a master, and doing everything in my power to avoid those panic attacks that have been cascading me into Crohn's episodes for the last 4 months.

This year I have 2 poster sessions, the first a requirement in light of my travel award.  And real, purposeful shmoozing.  I cannot wait.

This is the least healthy that I have ever been prior to travel like this.  And I'm so looking forward.  And so anxious.

in which i meet my Crohn mate

Y'all: today, the most exciting news surfaced.

Turns out, one of my most favoritest colleagues is a Crohn.

!!!!

I have never had an IRL friend who also has Crohn's!  With the exception of the most outstanding Kara, who I had the privilege to meet but once [thus far]!  But, y'all.  A new Crohn in my life?  In my lab??  Who I see on a daily basis?!

This is so epic, in fact, that when said colleague approached me today to have that serious and confident conversation, my first reaction was "no shit!" after which I proceeded to smile with glowing eyes as she explained her current condition.

Incidentally, I had just had that same serious and confident conversation with my BossMan after the episode from September 27th which knocked me out for 5 days.  He could not have been more concerned and considerate about the whole thing, by the way.  That's 2 BossMans in a row that have regarded me with respect and kindness even after learning my [additional] shortcoming.  Can I pick 'em, or can I pick 'em?!

grad school priorities #12

What I should have accomplished today:

Recovering from last week's trifecta of PCR, cloning and transfection failure.

What I did accomplish today:

Two free exquisite gourmet meals provided by my amazing building in honor of symposium day, and the purchase of ubernerd embroidered patches for my lab coat.  Met a fellow Crohn right in my own backyard!

OMGSUCCESS!

grad school priorities #11

What I should be doing:

Relaxing and feeling good about my convalescent accomplishment of ascending a flight of stairs and going on a light walk today.

What I am doing instead:

Organizing and reorganizing tomorrow's calendar, freaking about about the lack of breathing room between obligations from 6am-5pm, and mourning over the preparations that I should have made during Saturday and Sunday instead of healing. 

concerning the ineffectual techniques and person of my GI doctor

Last week -- strangely, just a few days before the big episode -- I had an appointment with my GI doc.  This was not a regular check-up, nor did he care to see how I was doing.  I made this appointment because for the last 6 months, he has not been able to find my medical records.  Yes, truly.

He says "they're here in the office somewhere, I know I didn't throw them out," Yes, I know I didn't throw them out.  This is an actual thing that he said to me.  For the moment, I withheld the threat of a HIPAA lawsuit.

The medically related subjects we touched on were these:

1) "So when was the last time you got a CBC/liver panel done?"

"Well, that was something I wanted to request since during the first 2 years that I was on Remicade, I had panels done once every 3 months and I haven't had one for over a year now [since I have been your patient]"

"Oh sure, yes let's have those done then." 

2) "My 3-part-sagas have been infrequent and I finally found an antispasmotic that works, after 10 years of trying things that did nothing"

"Oh that's great, what is it?"

"Marijuana."

"Oh..." He huffs a little and looks at the floor, disappointed. "Well have you tried everything else?   Bentyl?"

"Yes, you prescribed me Bentyl last year, it didn't do anything"

"Clidinium?"

"Yes."

"Hm."  With that, he was out of ideas and proceeded to ask me about pot.  A series of idiotic questions that made it abundantly clear that he had no idea how it is used medicinally.  "So how did you get it?  It had to be prescribed, right?  So you go to a doctor who examines you and gives you a card?  Do you smoke it?"

"Yes, it was prescribed.  I use a vaporizer, which only releases the medicinals of the leaves.  There is no burning, and no smoke."

"Can you... I mean, are you able to do things afterward?"

"If you mean, do I get stoned, no I do not.  I take one hit and that is sufficient to relieve my abdominal pain within 10 minutes."

"Huh.  Because you know I have a patient who uses marijuana and smokes every day, and does nothing with his life and lives in his mom's basement.  So..."  

"That is unfortunate, if only your patient had access to a psychotherapist who could help him work through Crohn's related depression and dependence.  But not to worry, I do not have an addictive personality and I have the motivation to avoid drug dependence.  I use it once or twice a week."

"Well, I guess whatever works." Let me emphasize, at this point, that this is an OD, not an MD.  An osteopathic physician whose schooling is specific to harmonizing the body, not just about which prescription drugs do what.  This is a man who should at least know what marijuana is and how it is used medicinally.  This is a man who should be open to non-pharmaceutical therapy, not excessively closed minded toward and ignorant about it.

3)  "So I'm trying this new anti-inflammatory diet and it seems to be going pretty smoothly.  I've been weening into it for a month now.  But still, I eat a banana and I'm constipated for 2 days."

At this, he laughs.  "Yeah, I have another Crohn's patient that that happens to."  That was the end of his response.  No commentary about how often I should be eating bananas, or other ways by which I might acquire potassium -- not that I need direction.  "So you're not eating any grains then?  No wheat, no rice -- well, except brown rice -- no oatmeal?"

"Well, oatmeal actually has anti-inflammatory properties," I corrected as nonchalantly as I possibly could.  How does this guy have a gastroenterology practice and not know anything about marijuana or diets?  How, I ask you.

"Well alright, let me order those tests and I'll give you a call when the results come in."  Really?  You have nothing to say about my dietary choices?  No recommendations based on my medication?

"What should I do about not feeling that great lately?  Lots of constipation, nausea and the big D?" I asked desperately trying to get any kind of medical advice out of him before he shuffled me out the door.

"Well, it's up to you.  Do you feel like you want to increase the dose?"

"Is that something you recommend based on my symptoms, or do you think they are just IBS and not related to inflammation?"

"Well, it's really your call on the Remicade.  You can increase or decrease it at your discretion."  Again, not remotely answering my question or giving any kind of medical advice.

This is the kind of medical treatment that student insurance covers.  God help me survive the next 4 years, or until H.K. gets rich enough that he can help me acquire real health coverage once Obamacare finally kicks in and I can no longer be denied for pre-existing.

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.