I’ve bike commuted to work the past three days this week (Mon/Tues were rainy/icy). By far the biggest impact this has had on the rest of my work day is that I’ve been insanely hungry. I’ve wanted to eat my lunch immediately upon arrival (which is generally a recipe for a bad afternoon). Today I actually made a post-commute-worthy snack: avocado/turkey panini. It hit the spot. Anyone have suggestions for post-commute second-breakfasts?
The weather has been in the mid-30s during my morning ride so I’ve been bundling up in my warmest cycling gear. (I realize this is “warm spring weather” for my readers who live further north.) I’ve felt a little slow/unconfident on my bike handling and reactions and can’t decide if it’s due to 1) decreased range of motion in hands/torso/neck from warm clothes, 2) brain fog from antihistamines (pollen is already insane in Texas!), 3) my lack of focus/enthusiasm about riding in the cold and wind, or 4) less-observant drivers.
I skinned the side of my shoe/cleat side-swiping a curb crossing through a crosswalk that turned sharply (seemed safer to cross there because drivers were clogging the main lane). I sheared off the side of my cleat’s set-screw (Speedplays), which thankfully I never use or need to adjust because from here out that will be impossible. I’ve been almost hit by unyielding university buses 3 times this week either not yielding to oncoming (bike) traffic when turning left, or rapidly pulling into the bike lane in front of me to make a stop. I also nearly rear-ended a car who zipped in the bike lane to turn right on red and then slammed on their brakes in front of me, and felt my life flash before my eyes at a 4-way stop as someone almost T-boned me while they turned (I was wearing a neon yellow jacket, which might have been the only reason the car saw me). I kind of feel like mostly I’m not at fault for any of these incidents, but have felt an urge to be on high alert to make super-extra-cautious choices as a cyclist because close calls make me question my reactions/handling.
Hopefully the warmer weather coming next week will set my mind right and eliminate my bike handling confidence as an issue and my commutes will feel more fun and less perilous. It will be spring break, and while university staff still have to work 3 days next week, hopefully there will be considerably fewer distracted drivers on the road.
The Emperor of All Maldies: A Biography of Cancer by Siddhartha Mukherjee: Excellent book about the history of cancer. I especially liked the section about the development of chemotherapy. It offered a good scientific perspective about why/how doctors developed chemotherapy as well as took the idea of fighting cancer from a nebulous, shot-in-the-dark sort of task to something tangible and logical. (Although the how/why of cancer and how to treat it is still somewhat nebulous in comparison to other diseases.)
The Doll: A Novel by Taylor Stevens: This is the third in the Vanessa Michael Munroe series, which is about a contract “operative” who good at finding missing people. The protagonist is likened to Lisbeth Salander of Steig Larsson’s Millennium trilogy, though the setting and her skill set are quite different. I enjoy this series because it’s sort of a spy-thriller and the “home base” of the series is set in Dallas, where I went to college.
The Sixth Extinction: An Unnatural History by Elizabeth Kolbert: NPR never fails me. I heard Elizabeth Kolbert doing an interview on NPR and immediately knew Matt would like this book so we both read it. The premise of the book is that we are amidst the sixth great mass extinction of our planet, as evidenced by the gradual disappearance of small indicator species (like frogs) and large animals (like rhinos), due to human activity on our planet.
Field Notes from a Catastrophe: Man, Nature, and Climate Change by Elizabeth Kolbert: This is an earlier book by Kolbert, which I liked even more. It’s a little more cohesive with it’s message—the evidence and urgency of human-caused global climate change. It discusses melting permafrost, shrinking glaciers, green house warming, droughts, floods, changes in migratory patterns and habitats of animals, scientific evidence of global warming and future predictions, (lack of) political response, and the social responsibility to halt our environmental impact for the sake of generations to come. I’m not going to sugar coat it: this book makes me frustrated at the lack of importance and priority my country has placed on combating/responding to climate change and preserving our planet for future generations.
Nemesis by Jo Nesbø: This is the fourth (2nd in English) in the Norwegian crime novel series I am reading. Same as before—I enjoyed it a lot because it kept me on my toes, it was a good mystery, and there were no plot holes.
This was a science-heavy month. Looks like next month might be, too, since there is a big, long, and important science book I’m not finished with that will carry over to March.
-Route: West Campus
-Distance: 14.6 miles
-Average speed: 13.4 mph
-Weather: overcast, 69 deg, south wind
-Number of other cyclists: 3
-Number of construction sites: 4
Today’s ride was one of those where my energy level was zero. I think my blood sugar was too low when I started because I had to eat a snack about 20 minutes in and never really got my energy level back up. I can’t really describe the issue accurately. Afterwards I don’t feel fatigued or like I worked out hard, but I feel like I want to flop down and melt into my bed. But a blah ride is better than no ride. And no part of my body hurts so I call that win.
This picture is of the construction site for a new building my department will move into. It’s been in the planning phase since September with the original groundbreaking planned for October. As with many things at universities, there were many delays, including a few redesigns, and a location change. It will not be a large building and is designed to mainly house materials science core facilities (multiuser facilities housing analytical instrumentation and fabrication equipment). I work at the analytical facility and it was an exciting, once-in-a-career opportunity to be included in the lab design. They broke ground this week and today there were tons of trucks driving in and out of the site and a backhoe digging a giant hole.
I’m currently watching a CF research update webcast from the Cystic Fibrosis Foundation. This image is a beautiful presentation of what is wrong with each and every cell in my body. This is a cross-section of a lung cell. What is green in the right image is a protein (CFTR) residing in its rightful place in the cell membrane. See the green on the left image? That’s what my lung cells look like. The CFTR protein is floating around all over the place and is everywhere EXCEPT in the cell membrane. The most exciting part about the image on the right is that the CFTR migration to the cell membrane is MEDICATION-INDUCED!
Moreover, from a scientific perspective, this is a powerful image. It depicts the cellular defect in the most common mutation of cystic fibrosis. And it proves that science can help fix it.
I love science so much it gives me chills!
P.S. I’m pretty sure this image is from a mouse cell from this paper, though I can’t find the image itself.
It turns out all the blood tests my rheumatologist did last week are negative (good news). One of the tests, ANCA, was positive when my CF doctor tested it last August, but this time they did a different testing method. The first one (imunofluorescence) can apparently give some false-positives.
In light of all of my negative tests, she thinks I have CF-associated arthritis/palindromic rheumatism. And then she clarified something that reminded me that having access to knowledge (google, pubmed) and scientific literacy are not equivalent to medical training.
Palidromic rheumatism and CF-associated arthritis are essentially different names to describe joint pain that comes and goes spontaneously, and does not cause any permanent joint damage. Tow names for the same thing. The part that confused me last week is that none of the CF joint pain-related medical research articles call it “palindromic rheumatism” and it’s probably because there is not a lot of research done about CF-associated arthritis. Or whenever the symptoms are severe enough to warrant a rheumatologist’s consult, there might ALSO be other rheumatic diseases in play as well (like rheumatoid arthritis). I guess it’s just two different medical fields speaking different languages that they probably each understand, but didn’t translate for me, the patient.
The good news is that the rheumatologist doesn’t think I need any medication at this point for the joint pain (besides NSAIDs). I’m glad of that. My main reason for wanting to hear a rheumatologist’s opinion was to make sure I’m not causing any permanent joint damage because I need to be able to use my joints and exercise, since it’s so important for my respiratory health. And it seems that’s the case so I am just going to pretend my joint pain never existed because the flareup just sort of went away on Saturday and I feel like a new and totally able-bodied woman this week.
I went to see a rheumatologist two days ago about the intermittent joint pain I’ve been having for the past year. My CF doctor referred me to the rheumatology clinic at the same hospital SIX MONTHS ago and the soonest I could get an appointment was just this week. When I was referred, I was experiencing frequent joint pain and things came up inconclusive/normal on the blood tests my CF doctor ordered. Then I went for many months symptom-free and was planning to cancel the appointment, but then about a month after my last course of antibiotics the joint pain returned. Might as well go and get a different and possibly important medical perspective.
My prevailing theory (shared by my CF doctor I saw two weeks ago) is that it’s related to fluoroquinolone antibiotics (cipro and levaquin), which are known to cause inflammation and spontaneous rupture of tendons. The pattern and description of my joint pain seems an awful lot like it’s related to tendons in my opinion (tendons are what connect muscle to bones at joints) because I have more of what you’d call fatigue at the joint and not stiffness, and occasionally even bruising at the muscle insertion point. Both times I’ve had more intense joint pain flare-ups have been about a month after a course of fluoroquinolones. When I have pain, the best way to describe it is unusual burning muscle soreness (right where the muscles connect to my joints) like when you work out really hard but are out of shape. However, it happens after I do things that should not cause me excessive muscle soreness, like my 5 minute walk to my car after work. And then out of the blue I’m back to normal for weeks at a time.
I think it was good to see a rheumatologist, but basically there’s no reason you might be in a rheumatology clinic that is some random, spontaneous issue that will resolve itself and never return. You’re there because the simple, typical causes don’t match the symptoms or the problem persists. The ideas and diagnoses a rheumatologist will come up with are serious, lifelong medical problems whose cause cannot really be pinpointed and treatment and/or cure are never fully understood or certain. Therefore, when discussing what to me seems like a minor, annoying inconvenience of occasional (but intense) joint pain which a CF doctor might chalk up to either the not-uncommon CF-associated arthropathy (no long-term joint damage or necessary treatment besides NSAIDs) or a medication side effect, a rheumatologist considers it a possible symptom of a serious inflammatory or auto-immune disease.
When the rheumatologist mentions the possibilities, being fairly google-adept, I have already read about what the disorders are and know the grim prognosis. Therefore I feel discouraged, sad, disappointed, angry, wonder why the universe hates me. Why is that it seems like the best of life and my health has already passed me by?! I’ll probably have have eroded joints, become disabled, and be dependent on serious immune system altering drugs with undesirable side-effects for the rest of my life! Not an encouraging potential prognosis, especially when a life-altering, essential “cure” for CF is within a year or two’s reach. Beat one disease, but karma has it out for me, so I get another? These were all the thoughts running through my head after my rheumatology appointment where I had blood drawn for even more tests.
Sometimes my outlook has to swing from one wildly unlikely extreme (I’m perfectly healthy!) to the other (my body will crumble apart right before my eyes!) before I land back at a rational, moderate perspective on my health. The fact of the matter is I have occasional joint pain with an unexplainable cause. From a CF perspective, a doctor might call it “cystic fibrosis associated arthropathy,” but a rheumatologist might call it “palindromic rheumatisim.” The symptoms look pretty similar on paper, but one comes with a shrug (CFAA) and the other comes with OMG-immune-altering-drugs-my-hair-will-fall-out. Is choosing one and not the other simply a difference in paradigm in these two fields of medicine? ALSO, the fact of the matter is my symptoms don’t exactly fit either exactly.
I don’t have the results back from my blood tests so I’m trying not to dwell on the potential worst case scenario of my-body-is-crumbling-before-my-eyes. I’m going to choose to think of this through CF doctor eyes: I’ve got joint pain? Eh. It doesn’t make me unable to work/live life. It just makes me a little whiny and sometimes it doesn’t feel very good to exercise. But today I have already ridden my bicycle to work, and in the end, regardless of the cause, isn’t conquering it what’s important? Maybe I have [horrible autoimmune disorder]? But I BIKED TO WORK so I win today.
-Route: West Campus out & back
-Location: College Station, TX
-Distance: 14.5 miles
-Average speed: 13.5 mph
-Average heart rate: 162 bpm
-Weather: 68 & sunny, slight wind
-Number of other cyclists: 3
-Number of roller skaters: 8
-Number of babies in strollers on the disc golf course: 1
-Number of ostriches: 5
-Number of herds of cattle: 3
What a lovely day to ride! Since I haven’t been riding much in the past few months, I did not want to be too ambitious and pick a longer loop that would leave too sore to move tomorrow (this happens too often to me; my goal for 2014 is to have realistic expectations for my body). I rode to campus and intended to meander around, but ended up having a great workout and going farther than intended.
This picture is a herd of calves that I’m sure will become one of the study herds for the ag department wherein they are fitted with “fistulas,” which are openings on the outside of their bodies so their digestion can be studied. Terribly gross and fascinating at the same time. There’s a herd on the other side of the back fence in the picture of adult cows of this sort working hard for science.
I decided this year that I am going to write a post each month recapping the books I’ve read. Over the last few years I have started to really enjoy reading, mostly because I no longer am required to do so for school and actually have time for it. January will be a little book-heavy because I started some of these books in December during winter break.
Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital by Sheri Fink: Chronicle of what happened in one hospital in New Orleans in the immediate aftermath of hurricane Katrina. It’s brutal and graphic, but I liked it. It made me very sad though.
Final Theory: A Novel by Mark Alpert: Scientific thriller with centering on the hypothetical existence of Einstein’s unified field theory. I liked it because the main characters are physics professors. It’s a little far-fetched and cheesy, but the science felt believable to me. (I am not a string theorist so I can’t ACTUALLY speak to the credibility of the physics.)
No Country for Old Men by Cormac McCarthy: I love Cormac McCarthy. I listened to this as an audiobook and the reader in my opinion makes his books even better. I’ve seen the movie before and it’s pretty true to the book.
The Redbreast by Jo Nesbø: I’ve been on a Scandinavian crime novel kick and this is the first in a pretty popular (or so the kindle store keeps telling me) Norwegian series. I liked it a lot. I like murder mystery/crime novels because they keep my brain working trying to guess how the mystery will unfold. So far, no holes or predictable plots with this series and I’m mostly through the next book. A maybe-important comment: these books were published in English out of order. I started with the first one in English, but it’s apparently halfway into the original chronology of the series, but it wasn’t hard to quickly get into the book.
The Ruins by Scott Smith: This is a sort of archeological thriller and it was kind of just ok.
The Fault in Our Stars by John Green: I listened to this as an audio book and I really, really enjoy John Green’s conversational style of writing. (I also really like John Green’s Mental Floss videos and wish he was my real-life friend.) Many people with cystic fibrosis have liked this book because they felt they could relate to the main character, who has lung cancer (they are both lung diseases). I really didn’t relate to the character in that way—mostly because the nature of cancer and the mindset are very different in my opinion than CF (my disease). In one (cancer) you never know if this day could be your last, where in the other (CF) the disease slowly progresses so you are aware of how quickly you are approaching end-stage—it’s not as sudden and your prognosis is not unknown. But regardless, John Green’s writing is such that anyone can understand and sympathize with the feelings of uncertainty, love, and loss which his characters experience. You should read this book.
Will Grayson, Will Grayson by John Green and David Levithan: This is a team-written book that I also listened to as an audio book. This was nicely performed as audio and I think it enhanced the story greatly. Will Grayson, Will Grayson was very entertaining and I was laughing out loud a lot. I am far removed in age from the teenage characters and this book reminded me of how much I have forgotten what it’s like to be in high school. The overarching theme of loving and appreciating those around you is affirming and I will probably read it again.
The Disappearing Spoon: And Other True Tales of Madness, Love, and the History of the World from the Periodic Table of Elements by Sam Kean: This is about the periodic table. I am a chemist, so I loved it. I find the history of science sometimes more interesting than science itself. I enjoyed learning the background of how each element was discovered and how scientists figured out how they are related to each other in order to construct the periodic table. If you like science, you should read this book. (You don’t have to be an expert to understand or appreciate the book.) I’ve also read another book by Sam Kean, called The Violinist’s Thumb, which was equally intriguing.
-Route: Barron loop
-Distance: 8.25 miles
-Average speed: 14.2 mph
-Weather: 61, clear, south wind
I rode my bike today. It’s actually for the second day in a row. The weather in Texas is cycling from raining to freezing to sunny/70s every 7 days. The polar vortex is nuts. Today the nicer weather actually coincided with a day that my joints haven’t felt terrible. Hopefully tomorrow will, too. The bursts of pleasant weather really accentuate how much I really want winter to end. By the way, I am on a sidewalk but did not ride on it. I merely pulled over to order take out Mexican food.