You Don't Have to Know You're on a Diet...

So far Dean has been doing very well on his diet. I haven’t changed too many of my cooking habits to accommodate his low fat needs since I tend to only cook with olive oil, lean meats, low fat dairy products and lots of fresh produce. The biggest area where he needed to make adjustments was eating out, where he doesn’t make the wisest decisions. So the rules are (1) I continue to cook delicious, health conscious meals (2) meals he eats that I don’t cook must be “wife-approved” and (3) Saturday nights are freebies.

Why, you ask, must I approve meals I don’t personally cook? Because Dean says things like, “Broccoli cheese soup is healthy, right? I mean, it’s soup.”

We decided Saturday nights were a good free meal because the doctor said the main culprit was fast food. (“Did you ever see Supersize Me?” the doctor asked. “I have. Obviously he has not.”) We are not as likely to eat fast food on Saturday nights since they are typically reserved for something like Carrabba’s. Fast food was usually for a week night or lunch. He is currently getting used to Wendy’s grilled chicken sandwich with a side of chili. Fries are only approved occasionally from Chik-fil-A since they fry in peanut oil.

Dean’s been lurking more in the kitchen to see what substitutions I’ve made for dinners, which as I mentioned have been few. Last night I was making tacos when he came up behind me to check things out.

“Um, what is that?”

“What?”

“That. It doesn’t look like beef.” He said pointing at the skillet.

“Ground turkey…”

“Ugh. Gross.”

“You won’t be able to tell the difference.” I said, grinning.

“Of course I will!”

“Well, you didn’t notice when I first swapped all the ground beef for turkey three years ago.”

Silence.

What I wanted to write about yesterday

but I just couldn't.

runnergirl did a much better job than I would have anyway.

My Response

Thank you, readers, for all of your deeply thought-provoking comments to my last post. As much as I would like to address each one of you individually, I’m afraid I just don’t have intelligent responses to all of the questions posed.

I have heard of several people having similar experiences where an illness whether mysterious or not was misdiagnosed, undiagnosed or diagnosed in such a tardy fashion as to no longer be applicable. One clucks and shakes their heads at these stories until it happens to them. I hadn’t experienced first hand the frustration of seeing a loved one in pain while doctors twiddle their thumbs and leisurely plod through bureaucratic bullshit.

Ultimately, it all comes down though to trying to save a buck. While diagnostics may be a dying art form that is shifting irreversibly to pure technology, there is a way to use it to our advantage. If CT scans were even somewhat routine in general medicine, of course Dean’s condition wouldn’t have taken as long to be diagnosed. But think of how many tumors could be detected before symptoms are presented. There is a way to use CT scans to assess artery plaque build up before you even have a heart attack! Of course health insurance companies won’t pay for it because they don’t believe in early detection; just treatment after the shit hits the fan.

For health care to improve in this country, health insurance companies need to look beyond their noses and see value in catching diseases early, before the long hospital stays and surgeries. The government must also value preventative medicine and get off their asses to make sure everyone has health care. And no, simply giving a tax break so that people can optionally use that money for private health insurance isn’t going to cut it. Don’t tell me that people need to be responsible for their own health because when it comes down to choosing between using that money to get a seemingly trivial annual pap smear and feeding your family, which one will win? And it’s not an education thing. I can’t count how many fellow physics grad students don’t have health insurance. Funny how it is illegal in Florida to drive without car insurance, but perfectly legal to live without health insurance. When will people learn that women will stop dying from breast and cervical cancer when every single woman gets examined on a yearly basis?

Okay, now I’m way off topic. But really, these are the sorts of things I know other Americans will be thinking about when they go to the polls next year. We are sick of special interests, Big Pharma and the paralysis of trying to get fixed simply because our insurance would rather shell out later than sooner. I might not have thought about it as seriously had I not had a front row seat to the circus that is our health care system.

Thank you especially to the three nurses and one pharmacist who weighed in and gave some of their insight into this (as well as the biologist, the two physicists, the ever articulate barista and the two kickass tech guys). Damn we have some good conversations!

Diagnostic Rant

I want to preface the following rant by saying that I have no idea how to fix the health care system. As a rule, I truly admire those of you who spend countless hours caring for patients who may or may not appreciate it. I realize that medicine is not an exact science, you have to do the best with what you know. And since no two people are the same, inherently no two afflictions will be the same despite an overall “diagnosis” that may be present in a text book.

Now, all that being said, I am going to tell you about a several-month long ordeal Dean has been going through. I didn’t want to bring this up any earlier because we had no idea what was wrong with him. There is no point worrying everyone I know when there is no information I can give people one way or another. After today it looks like he is going to be fine so now I feel like it’s appropriate to give an overall assessment of his experience.

Back in October, Dean went to the clinic because he had a bad cough. He was coughing every morning, sometimes so hard he was vomiting. They gave him a chest x-ray, didn’t see anything and they diagnosed him with pertussis, or whooping cough. They gave him hard core antibiotics (which came with the usual side effects such as nausea and an order not to drink while taking them), which didn’t do anything. In the meantime he kept coughing and vomiting and after afew weeks he said there was “blood in it.” Now I’m still not sure if he was coughing up blood or vomiting up blood. I asked him several times if he could tell if the blood was from his lungs or his stomach. He said it felt like his lungs. He went back to a different clinic and that doctor (Dr. P) ordered (1) blood tests (2) stool sample (3) new chest x-rays (4) pulmonary examination and (5) tuberculosis test. All but the chest x-ray and the TB test had to be done outside of the clinic.

(1) was done at a special lab where they drained him of several vials of blood (after fasting, of course). He was sent home with instructions and a kit for doing (2). (3) was done on the same day as the initial visit with the new doctor. They said they would call him to schedule (4). They never did. When he went to get his TB test read (negative) he finally called the people that were supposed to call him about (4) and got in that same day. Meanwhile a week later he went back to Dr. P to discuss (1), (2), (3) and (4). Oh yeah, and he’s still been vomiting up blood every day. Not to mention, he’s had to take several hours and half days from work at this point just to get the tests done. (1): normal. (2): normal. (3): normal. (4): normal. The blood work said normal cholesterol, normal white blood count. The stool sample ruled out a stomach ulcer. Dr. P had recommended some Pepcid in case it was an ulcer that somehow got past the stool sample. (My understanding is that if the ulcer is in the smaller intestine, the blood doesn’t always make it into the lower intestine and into the stool. Correct me if I’m wrong, Nurses). Don’t get me wrong, I was thanking God she had ruled out cancer or any serious respiratory diseases.

She poked around his tummy for awhile and was surprised when he found it very painful for her to touch up near the ribcage and on his right side (Why didn’t she do that earlier?!). So, she ordered (6) more blood work to check for the organ functions (which apparently weren’t checked in the first gallon of blood he gave) including gall bladder, liver, kidneys and pancreas. She also ordered (7) an ultrasound to check for gall stones and/or a stomach ulcer (again). By this time it was mid-December and he was still vomiting everyday. It was clear he wasn’t coughing up blood, it was coming from the digestive tract. His next round of blood work and the ultrasound had to be done while I was in Minneapolis. We joked that neither of us would have guessed he would be the first one between the two of us to get an ultrasound!

He did the blood work and ultrasound while I was out of town and went back to Dr. P a couple days after I returned from Minneapolis. I wasn’t with him for his consult, but apparently Dr. P said she didn’t know how to read an ultrasound. Lovely. She needed help interpreting it and told him it was all clear. No gall stones. Definitely no ulcer. She had also gotten the blood work back which revealed a high count of liver enzymes but nothing else out of the ordinary. She gave him samples of a new acid reflux medication. Next stop, (8) CT scan of the abdomen.

He scheduled the CT scan for last Tuesday. Saturday he had to go pick up the barium sulphate contrast agent. Monday he fasted except for drinking the barium sulphate which tasted like total crap (I know because I was dying to try some). In the meantime, the acid reflux medication seemed to have helped. As of today he hasn’t vomited in two weeks. He was almost ready to just let it drop if it weren’t for the pesky liver enzyme levels.

So this morning we went to see Dr. P again, who was 45 minutes late for the appointment. Dean was tense because every minute he spent at this appointment he was going to have to tack onto the end of his day. He taken so many half days, long lunches or late starts that he really didn’t want to use up any more sick time. She was late to the appointment not because she was behind schedule taking extra care to explain things to a patient or calm down an anxious family member. She simply showed up for work 45 minutes past her first scheduled appointment. The CT scan gave us the answer we had been looking for for two months: steatorrhoeic hepatosis or fatty liver. It is reversible with diet and Dr. P said that anytime there is something wrong with the liver, the whole digestive tract can get cranky, sometimes causing acid reflux. Not that I believe a whole lot of what she has to say at this point. But colon, kidneys, pancreas, spleen and gall bladder all look healthy. He should keep taking the acid reflux medicine, lower the fat in his diet (read: NO MORE FAST FOOD!) and get his blood tested again in a few months.

This was all a great relief. But my question is why did it take a total of three months and 8 tests to correctly diagnose this? Why did my husband vomit up blood every day for several weeks before he something worked? Why doesn’t a general practitioner know how to interpret an ultrasound? I know that our insurance has been billed several thousand dollars (I know this because our co-pay on it is 10%). It seems like such a waste of money and our time when a CT scan could have been done much sooner had thorough blood work been done immediately. I am aware that there are hoops one has to jump through regarding health insurance so that not everyone is getting CT scans, but what if there was something seriously wrong that the CT scan could have revealed much much earlier? Dr. P said if she hadn’t found anything today she would have referred Dean to a GI specialist. Ummm, ya think?! That could have been done sooner as well. Thousands of dollars have been billed to our insurance for pretty much no reason, and we wonder why health care is so expensive. Dean had to miss several hours of work not to mention working while being ill which probably decreased his productivity. I can’t help but think that if the very day he went saying “I’m puking/coughing up blood” and they would have bit the bullet and admitted him to a hospital he could have gone home that same day knowing what was wrong. I know it’s idealistic and that the system doesn’t work like that. But why not?!

Easy Like Sunday Morning

Typical Sunday at our house. Excuse the messiness- that's pretty typical as well. And as Dean points out, it's mostly mine. Let me also point out the universal law: the colorful kitty making love to the black sweater.

Ummm....yeah.

I have a friend in the lab who I can never get a good read from. For now I'll call her Mo, since she hasn't told me I could use her real name. She has the appearance of being very prim and proper. She's sort of quiet and reserved, yet will come out and do the funniest things. For instance, one day James and I were sitting around the lab making weird noises. You know, like cracking unusual body parts, whistling through our teeth, pretty much par for the course. Then Mo busted out with the classic spit on your hand, clasp your hands together and make fart noises. That was when we knew she was one of us.

For the holidays she visited her family in the Philippines. She very thoughtfully brought me back a gift that was prefaced with, "We're friends, right?"

"Sure, Mo," I said puzzled. She handed me the gift:

I couldn't figure out what the heck it was. Why was a wooden man hiding in what appeared to be a barrel? Was this some sort of local deity? I tried to pick it up by placing my fingers around the barrel and lifting. Much to my surprise, the barrel was unattached and slid off while I was trying to lift up the figurine.

So it was a prank. A shocking (coming from Mo) and pretty funny one. Wrigley was impressed by the spring action arms and peener.

For No Other Reason Than He Loves Me

Even MIT Girls Get the Blues

I wanted so badly to hate her. An MIT student defending her dissertation in May, she has tenured professors lining up to interview her for a postdoc. She is gorgeous- tall, thin and exotic looking. She is outgoing, excellent at networking with a big welcoming smile. She makes good eye contact. I was positive she wouldn’t remember that day when Dr. Hari made James and me go to lunch with her and her advisor for the simple reason that someone from MIT wanted to have lunch with us.

I was ready for the awkward moment when I pretended not to remember her either so as not to make her embarrassed and somehow we’d have to start all over. But she walked up to me with an unassuming smile, hand outstretched and said, “Hi! I don’t know if you remember but we ate lunch together in this same fair city in March…”

“Of course,” I replied graciously taking her hand, shocked that someone so used to having her butt kissed would remember a forced meal with two students from a university she had probably never heard of.

Our advisors were catching up. A third party walked up to her advisor and asked if he was still at MIT. He looked surprised. “Where else am I going to go when I already work at the best school there is?” Despite the disdain I felt at this scientific brand of royalty, I had to admire his honesty.

That evening, Dr. Hari had already made plans for us to go to dinner with an old friend of his from Italy. It was the friend’s idea to ask the MIT professor and his student along. I had mixed feelings. I wanted to get to know Dr. Hari’s friend better. I wanted to relax a little without the sour (read: jealous) feeling one gets in the presence of someone so obviously better than yourself at the one thing that matters. I wanted at times to be the point of discussion, humbly smiling and shaking my head while Dr. Hari tells the Italian how promising I am. That’s difficult when Ms. Perfect is sitting next to you about to graduate from the best institution in the country.

In the end I decided to make the most of it and engage her in conversation as best I could. “So, what are your plans after graduating? Academia? National lab?” Typical discussion for which every grad student has a typical 10 second response. Since we were a conversation away from our bosses, her response was surprisingly candid. She told me about her skepticism towards academia. She didn’t think she was a good fit. She wanted job security, immediate stability. She didn’t want to move several more times. She wanted to settle down, start a family. She didn’t want to work 12 hours a day, 7 days a week and be dead on her feet with no time of her own. She didn’t need the prestige that would come after spending the best years of her life not enjoying them and instead toiling over tenure, writing proposals while not getting to know her kids. That is, if she were lucky enough to have time to reproduce while she was still able. She was practically in tears. Her advisor didn’t listen; he felt that she could do these things so she should, no matter what her heart was telling her.

I was stunned. She might as well have been reading my mind. We spent the evening pouring out our hearts over sangria. Whispering our thoughts on our advisors pressuring us to break the mold and be female faculty. We agreed on why there are so few female faculty- even MIT students have biological clocks which will win out over clawing our way up the academic ladder. It’s not worth it and we can see that from miles away. I was so relieved that I wasn’t the only one to feel this way. That the smartest women in the world gave up the best opportunities in the world for the same reasons I was contemplating. And that other people’s advisors were similarly unwilling to accept this prospect.

That was the night I had the most fun at the conference. I blushed as thoroughly as a junior high boy when I asked for her contact information. I nonchalantly said something about us women sticking together, especially those of us secure in our decisions not to pursue a tenure track. She seemed truly touched at my thinly veiled attempt to be friends with her. And she accepted.

2006

From the time we are little we learn that growth happens in spurts. I remember wearing the same shoes for a year and then needing new ones, two sizes bigger. Sure, we grow a little each day, but largely physical and mental growth is not a linear function. We never stop growing, and this growth never stops happening in fits and starts.

2006, unlike any other year I can remember, was a growth spurt of a year for me. The changes I have felt within myself have been nothing short of immense. I feel as if an inner eye finally opened widely with clear vision so that I could see what is important, what isn’t worth sweating over, what it means to live, to give, to hurt and to be loved wholly for (or in spite of) who you are.

Losing Randy was the most difficult thing I have ever experienced. It showed me how unfair life is, how cruel nature can be. It forced me to face mortality and taught me how to keep people alive through the memories they leave behind. I lost dear friend on January 29^th, 2006. But I also made friends by getting to know his family and the people in his other circles. And I’ll never listen to a tuba the same way again.

On the other hand, getting married was one of the most amazing things I have ever experienced. Even though no one was there to see it, the flood of emotions I felt when Dean stood up before me, the non-denominational minister and possibly God (whoever He or She may be) and swore to love me and honor me no matter what was the best high I have had. On September 9, 2006, we vowed to live our lives together, to love each other come hell or high water, in times of financial distress, emotional distress, in any city we wind up in, no matter how many kitties, bobbleheads, or books. He vowed to accept me and love me despite the volcano of crazies that is constantly threatening to erupt. And I him, even when his team loses and he’s hurtling insults at the TV and the kitties are hiding. It isn’t going to be easy, but something about taking this step makes it more concrete.

Though I joke about being a crazy cat lady and write way too much about my adventures with the dumpster kitties, those mangy fleabags changed me for the better this year as well. What I am about to write to so cliché, but I don’t really care. It feels so good to do something that makes a difference. I realize in the grand scheme of things fixing 13 stray cats isn’t going to change the world. But it has changed their world and my world. It isn’t easy and it isn’t always fun but damn it can be rewarding. And even that puts things in perspective. I love caring for them and I’ve reached a point where I would rather spend my hard earned money feeding and caring for them than buying myself another book I won’t read or a trendy shirt I’ll wear for a couple months. I’m not finally going off the deep end, I’m still relatively presentable and keep Dean well fed. I guess what I’m trying to say is doing good is addictive. It’s a drug I’m glad I discovered this year.

All these things and others have combined to make me grow up this year. I feel a maturity I didn’t possess before. An understanding (not necessarily an acceptance) of the world in a broader sense, and a taste to do more. To live for those who are no longer with us, to help those that cannot help themselves and to know that no matter what all this entails I won’t have to do it alone.

Checking In

Every time I see that it's been a week since I last posted, I think to myself "if I don't write something soon, people are going to stop reading!" Frankly, I've been too busy and then too sick to write much of anything. I had a very busy holiday break in Minneapolis. By the time I arrived back home on Monday I had come down with a stomach virus/food poisoning that is just today starting to subside. Besides causing all the normal discomfort associated with stomach issues (I'll spare you the details) it has completely kicked my ass. I've been sleeping an absurd amount, and even today when I made the leap to solid foods I can think of nothing but closing my eyes and drifting off for just a couple more hours...

This means that today probably won't be the day I finally punch out the deeply reflective post about 2006 and how my life is much different after it. That post has been swimming in my mind but hasn't wholly taken form. By the way, what's the statute of limitations on New Year's posts?

I am taking my time recovering from the holidays (mentally and physically) mostly because I have to be mentally sharp as a tack next week. On Sunday I am off to Baltimore for the 2007 Magnetism and Magnetic Materials conference. I present both Monday and Tuesday. And I'm going by myself to be joined on Tuesday by Dr. Hari. Yep, that's it. Him and me. No one else from the lab. The good part of that is that I'll have my own room at the swanky Marriott Harborside. And I can go to bed at whatever time I want, not to mention plenty of Indian food as long as Dr. Hari has no plans. And if he does? Room service.