Sunday, September 30, 2012

Whew. Bad food wrecked my body in a week. Let's put that behind us, shall we?

When I got out of my last exam this Friday, I just crashed. And this is the last exam related frenzy I want to work myself into. Not that it'll never happen again. It will. But Good GOD, self. Let's let this never happen again.

It all started with not buying groceries for last week. You see, it just occurred to me that I had reviewed the same lecture 3 times, and the whole thing was going over my head. Not because medical school is particularly hard. The majority of the learning process is no more difficult than learning a new word in the dictionary. The very reason is that medical school is hard is the fact that there is SO MUCH.

Usually I do ok. If I can make a big picture, everything will be fine. But starting this block of exams, we are officially entering the disease parade. Raw memorization is not my forte. I was falling behind and my brain tried to rescue me via a week long panic. 

I will spare you most of the details. I did not each much that wasn't shelf stable. I slept restless.The last three days I was walking around with a permanent head ache. And by Friday, I was so bloated, I fit back into my dress pants that fit me 10 pounds prior--sans droopy drop crotch. Hadn't gained any extra weight. Things were just that messed up.

And the first thing that came to my mind was...hell yes. A whole new world of clean laundry just opened up.


The grand finale of this of course was a fine bout of IBS that bordered on gastroenteritis. At least I was drinking enough water. Heh.

I'm full aware that I did this to myself. And it took a very dedicated boy friend and kind roommate to snap me out of it when it was over. I'm a lucky person to have them.

Suffice it to say, I got a good lesson on how important food and sleep are. A real good lesson. Without my steady steam of wonderful perishable green things....I am. so. screwed up. And for the people who are forced to eat like this on a regular GOD. I feel you so bad right now. How are you surviving the misery of your body constantly barking at you? I want to give you a hug and title you master of survival. You deserve it. Not the pain of course. You deserve the hug. The hug.

I'm not the only medical student who lives this way. I can't be. We are groomed in undergrad in the dream of being harvested for this behavior. Getting into medical school is a very long term, calculated effort on the part of the student. It is ridiculously competitive but confusing and enigmatic at the same time.  I can't tell you how many conversations I've had in my pre med years that started with "What do you think they want? I mean really, really want?" Schools have tried to select against this tunnel vision by looking for applications with "diversity" or proof of some outside life in the form of non medical related extra curriculars, but you've still have got students who just respond right back with calculating that "unique angle"/sense of whimsy into their to-do list with the rest of the requirements.

The application process is just an obsessive free for all with everyone scrambling to cover all of their bases regardless of the source of information. That kind of attitude is hard to shake when you finally do get in. And we've all gotten really good at fostering either our competitive sides along with our tunnel vision.

Luckily, I am at a pass fail school. So there isn't really a breeding ground for the nasty stuff. But you'd be surprised what peer pressure can do otherwise. It is really normal to throw away the body for the sake of learning a bit more. No one bats an eye at that any more than the students who seem to be going to the gym every night or running 5Ks. This is like weather talk for us. We bond over how little sleep we're getting.

Yeah, we're a funny breed. There's a lot of swinging between excellent health practices and then saying fuck it all, being a doctor is more important than this. But once you define "this", it turns out it's human needs. It's screwed up, I know.

While writing this, I thought of an ally request I got on the Superbetter forums. The statement was that I seemed like a happy and extroverted person, and that they hoped this would be an opportunity to get to know a type A person better. And I was so confused, because 1. I never associated type A with extroversion alone. 2. I always assumed that type A = organized bordering on OCD, and 3. I actually covet the organizational skills of my peers, and their ability to make it look so dang easy. I spend a lot of time combating the feelings that I am the bumbling screw up of the class, even though I know that a lot of this is in my head. I even wrote them back asking to clarify what they considered type A. Cause hey, we must be running on different definitions right?

Believe it or not, I consider myself to be way below on the competitive, power student scale within my class. Probably because the "ROAD to happiness" specialties don't interest me in the slightest. Besides a bit of work for an overseas clinic, my extra circulars involve froofy things. Like painting sets for a play. Or writing a blog.

But then I wrote this post and geeze. Yeah. Whatever the definition you use for type A, the beast lies within.

Also, next goal to work on. Getting 8 hours of sleep a night. Let's do it.

Tuesday, September 25, 2012

Quest Water Works: How I finally drank my daily water requirements.

I'm going to make this post quick. I'm in the thick of studying for exams.

A whole week went by and every morning I found myself too rushed to go out of my way to find a bottle. Eventually, I got bored of the whole quest all together, and was ready to call it a wash.

Honestly, the only difference in today was that I had to go to my car to retrieve a belt before walking to class. And behold! There was a tumbler. (That's a plastic, reusable, cup and straw combination. I never knew of such things until I got into medical school where people buy them from starbucks and apparently hand them out at events.)

And oh yeah. I might as well drink water today. I took it.

So despite that I was running late and the morning was looking grim, the rest of the day I was well hydrated thanks to my adult sippy cup. Just like going to a restaurant where you drink out of boredom.

When I went home, I measured my cup and it held 24 ounces, or 3 cups. I made it through 6 cups of water during the day, and lost count after 9. Mission accomplished.

Apparently, I need to make things ridiculously easy for me in order to follow through with them. SUPER ridiculous easy. Better tuck that thought in my back pocket and save it for a rainy day.

So Reflection Time:

1. I wont do anything without it being easier than not doing anything. That's like...extreme ease or something.

2. I have to make my goals measurable. And even if they seem to be measurable, it isn't enough unless I take the time to figure out what those measurements are.

3. I get bored very easily. I probably have a 3 day window before I'm mentally off the wagon. Best to make my moves before the motivation fizzles out. And by making my moves, I mean making it extremely easy to do whatever I want to do.

4. Sometimes you've gotta appreciate random opportunities. Take 'em.

5. Some unhealthy practices of mine are road blocking others. While I only want to focus on one thing at a time, the process makes you realize all these other issues. For example: I'd skip drinking because poor sleep would cause me to rush in the morning. I'd didn't drink enough water because I hadn't packed my lunch and went to a free lunch provided by an interest group meeting instead...but they only had cola. I'd skip drinking because I wasn't eating regular meals. Lots of reasons that ultimately make you realize that you're treating your body like a forgotten house plant.

6. Even the simplest things are not so simple. My quest was just to drink more water. But to do this regularly, I have to take care of other health issues, reorganize aspects of my life, and then do it under a time crunch before my motivation wanes.

7. Finally, yeah you've got to pee more when you drink more. But! Urinating really dilute urine is actually a good, comfortable feeling. When you compare it to peeing concentrated urine that has been stagnating in your bladder all day, it makes pissing the dark stuff feel down right brutal in comparison. Peeing stale urine is mildly uncomfortable. It's like spidy sense for UTI's. Body awareness superpowers, Baby.

8. Ok, finally again. Being used to coping without food, or water, or sleep, or any other basic need isn't something special to be proud about. It just means that you've lost your ability to tease out what your body wants and needs to function at it's fullest.

Once I started realizing what it was like to be fully hydrated, the special kind of drain that comes with being dehydrated became more obvious. I had been confusing that recently with being tired, but they layer on top of each other. Being tired alone is definitely much better than being dehydrated and sleep deprived...and maybe hungry.

And I think once we lose that power to tell what our bodies want, we lose the power to give them what they need before its too late. Then you're just getting mysterious headaches and the like.


Ok. Back to the grind. I'm not picking any new quests yet, though I'll probably tackle my sleeping issues next. For now I'm going to bask in my small victory of craving out a new routine. Become friends with my sippy cup and stuff. :D

Thursday, September 20, 2012

Quest Water Works: Days 2 and 3. Setting up a micro environment.

I have this belief. Sometimes I just carry it around in the back of my pocket and forget that it's there. Other times I'm reminded to pull it out, reflect, and smack myself on the forehead.

The belief is that will power is little more than a happy collection of habits. Especially the will power we perceive in others.

Take myself for example. When I was in my late teens-early twenties, I had a friend who was struggling with weight issues. This was a friend who had a particularly harsh temper and was very defensive. For some time, our conversations went like this. She would bring up how much she hated her weight and her body, that she didn't know what to do about it. I would then flounder about how to respond. I had learned over time that bringing up suggestions to swap foods or adjust portion sizes was going to bring down a defensive wrath of "you think I'm fat", "you don't get it", etc. If I tried to tell her she was beautiful as is, that size need not define beauty, I would be labeled a liar or that "it's easy for you to say because you're skinny".

Eventually I realized that I regardless of what I had to offer on the subject, I wasn't in a position to say anything helpful. But she was a great friend. It was just this one sticking point.

So over time, I just listened more. Of course this resulted in some awkward conversations as well, the pinnacle being her stating that she was going to figure out how I got thin by examining what I ate. And then she proceeded to do so somewhat angrily, while making play by play comments. Long term, she did not adopt anything permanent from her "discoveries". However, she did continue to berate herself, and I continued to flounder with trying to figure out exactly what kind of support wasn't insulting.

But the point of this odd little story is, she beat herself up needlessly. My friend would swing between extremes of motivational highs and depressive lows regarding her weight. When things failed, she would self flagellate, blaming her will power. Calling herself pathetic and worthless. And each time it would happen, she would get angrier at herself, while simultaneously putting my "will power" on a pedestal. At the time, I really didn't get what was happening. Because...I really didn't see my self as particularly stubborn or powerful regarding my health choices.

I was born lucky enough to have good mentors to ingrain some naturally healthy habits in myself. And that's it. I don't stop eating something because I'm particularly willful. It's because I'm full, or I'm bored with the flavor. I don't choose water over juices because I'm willful. Its because I started too cheap to be above tap water, and now I'm used to it. I prefer the water. Other drinks effect my stomach somewhat like food. They don't quench my thirst and I find them irritating.

Or am I a better, more willful person now that lost my extra 10 pounds and got back to my undergrad weight? No. I moved closer to campus. I'm the same damn person I was over the last three years in grad school when I had to take the bus. But now it's faster to walk than wait.

Yet with the way society treats weight and image, it's not too far of a stretch for someone or some article to describe me as a "better self" or a better version of whatever.

I'm not. And you're not. There is not "better" version of who you are right now. Not your past self, and for hell not your future self. Your worth is the same as it was before and will always be the same. The only difference for the "better" person is that they are in a better environment, that makes healthy habits either easier, or more fun than the conventional choice. And once you do something long enough, that habit becomes the norm.

We would never admit to judging a human life on these things, but we do it to ourselves all the time. Funny right? I myself, have spent a huge amount of time trying to achieve "better versions" of myself. Oh, I had my own visualization techniques, guilt motivationals, and everything. Mostly it's been a waste of time. Nothing new has ever come from all that. No profound personal growth.

What of the times when I have grown profoundly? Really now. That's always been when I was outside of my comfort zone for some random reason or another. They've always come from having to wrap my brain around a new challenge or environment and discovering something from that. It's never by force of personal will. So I've come to learn something I never expected, that the vast majority of my personal growth came from the outside in. I stick by that.

If you want to change yourself, then don't touch yourself. Work on making micro changes to your environment.

So. Back to water. Today and yesterday went like this. With the new found information of how much my cups at home contain, I have been able to drink my totals in a day. But I only drink properly when I am at home, where the cups are. So the part of the day where I need my mental status most...I'm not drinking much. But I'm not going to beat myself up for this. Just taking the time to measure the volume in my cups was a change in my environment because it brought new knowledge to it. Writing in this blog was a change in my environment because it holds me accountable. Together, I've made much more progress than I would have otherwise. I may not be steadily hydrated, but I am at least flushing my system out at night.

My next step may be the game changer. Bring a bottle. Dramatic, I know. I'll need to figure out where to store that one extra thing in my already stuffed purse. But I've got this. Environmental micro changes. That's how I get healthier. Because hey, I'm not getting any "better".

Take care,
Kick Kick

Tuesday, September 18, 2012

Quest Water Works: Day 1, Errr...winging it?

I should state that almost as soon as I wrote my last post, I realized that 2+ liters of water isn't really that much. It just looks like a lot when you imagine it in all one bottle. It's because I picked up a bottle of water that I could easily drink, looked at it, and realized it was already 700 ml, very close to 3 cups.

And I held this thing in my hand and felt quite silly. I could easily drink one of those with each meal and take a few gulps from a fountain. That would hit me right around my 2.2L mark and this would be no challenge at all. Or at least one that no longer seemed unreasonable. I might drink that much in a SITTING if I'm at a restaurant and there's some endless glass in front of me. And I know I've easily drank half a gallon while working out in the sun in the past. Which led me to looking up the numbers and that's 1.89 Liters alone.

Silly and sheepish. This wasn't going to be a challenge at all, and I had already hyped myself up for a challenge, with full on dramatics. I do that to half motivate myself, and half just because it amuses me. Oh well. Gotta move forward. I did make a promise to myself and posted that promise on the internet so I would follow through right?

But this soon grew to overconfidence. And before you knew it, drinking was the last thing on my mind. I'd like to say that I didn't set myself up to succeed yesterday because I was testing my will power. A lot of people rely on will power alone to throw themselves out there, and there's a preconceived notion that you should be able to accomplish any health goal just by "going out and doing it". I never agreed with that sentiment, and would have more than enough motivation to make an example of myself using the vague "go and do it" method. But that was never intended, which maybe makes it more appropriate.

I got crap sleep the night before. So I opted for the <7 minute version of my morning routine, which is sadly becoming the "usual routine".* The <7 minute routine consists of putting on clothes that pass the sniff test, brushing my teeth, and swiping deodorant before I start walking to school. That's it. I skipped breakfast and zombied my way into class.

But zombies, fictional or real, only really do a few things. They groan, don't drink any water, and live unnaturally with their body's cry for rest. Of course movie zombies eat brains, and med student zombies just eat sugar...but the brain is mainly fueled by glucose, so it makes sense. Regardless, I wasn't drinking water. And crap...I remembered I needed to, but I hadn't brought a bottle. I was stuck with fountains and no means of measuring my progress.

Later in the day, I attempted to catch up, but also I realized I didn't know how much my glasses could contain. I was back to square one with the whole, I have really bad judgments of volume.

Sooo. I've already learned quite a bit. Keeping your self hydrated is a little paradox with seeming deceptively challenging or deceptively simple depending on where you're coming from. And if you just tell yourself that you're going to "just do it" without setting up a new micro-environment to make that happen will probably set your self up for less than success. I retroactively measured my cups today. My glasses hold 16 oz if you fill them up to the brim. I think I drank a total of about 6 cups, 2/3 of my goal yesterday. All of that was after 12 when I walked home for lunch.

The most important lectures of the day fall from 8-12. Yep. Zombie. Now I'm playing catch up and juggling "Do I catch up on the extra lectures I need to review tonight or do I go out and buy a bottle, and mark it with measurements? Or do I spend the rest of that time catching up on sleep and cooking the meat in the fridge before it goes bad? What about the laundry and the patient video review for tomorrow?" There's a lot I can get done, but as usual, something will give.**

Today is going better, but there's still room for improvement for tomorrow. Oh yet till I reach the coveted accomplishment of clear pee! without trying too hard. That's weird.

Till next time,
Kick Kick.

*Remind me to tackle sleeping issues for a future quest.
**And that's why the fish tank wasn't cleaned last week.

Saturday, September 15, 2012

New Quest! Hydration!

Drink eight glasses of water a day. Drink eight glass of water a day.

This is one I hear all the time.

However, that's not actually what is recommended. I'm going to use the Mayo Clinic for this one because they're very well respected. Go to the link and you'll read:

How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.
So how much fluid does the average, healthy adult living in a temperate climate need? The Institute of Medicine determined that an adequate intake (AI) for men is roughly 3 liters (about 13 cups) of total beverages a day. The AI for women is 2.2 liters (about 9 cups) of total beverages a day.
 9 cups!'ve got to click on the next page.

Factors that influence water needs

You may need to modify your total fluid intake depending on how active you are, the climate you live in, your health status, and if you're pregnant or breast-feeding.
  • Exercise. If you exercise or engage in any activity that makes you sweat, you need to drink extra water to compensate for the fluid loss. An extra 400 to 600 milliliters (about 1.5 to 2.5 cups) of water should suffice for short bouts of exercise, but intense exercise lasting more than an hour (for example, running a marathon) requires more fluid intake. How much additional fluid you need depends on how much you sweat during exercise, and the duration and type of exercise. During long bouts of intense exercise, it's best to use a sports drink that contains sodium, as this will help replace sodium lost in sweat and reduce the chances of developing hyponatremia, which can be life-threatening. Also, continue to replace fluids after you're finished exercising.
  • Environment. Hot or humid weather can make you sweat and requires additional intake of fluid. Heated indoor air also can cause your skin to lose moisture during wintertime. Further, altitudes greater than 8,200 feet (2,500 meters) may trigger increased urination and more rapid breathing, which use up more of your fluid reserves.
  • Illnesses or health conditions. When you have fever, vomiting or diarrhea, your body loses additional fluids. In these cases, you should drink more water. In some cases, your doctor may recommend oral rehydration solutions, such as Gatorade, Powerade or CeraLyte. Also, you may need increased fluid intake if you develop certain conditions, including bladder infections or urinary tract stones. On the other hand, some conditions such as heart failure and some types of kidney, liver and adrenal diseases may impair excretion of water and even require that you limit your fluid intake.
  • Pregnancy or breast-feeding. Women who are expecting or breast-feeding need additional fluids to stay hydrated. Large amounts of fluid are used especially when nursing. The Institute of Medicine recommends that pregnant women drink 2.3 liters (about 10 cups) of fluids daily and women who breast-feed consume 3.1 liters (about 13 cups) of fluids a day.

Well I'm not pregnant, or currently ill. But I do live in a very hot, southern climate, and I do sweat. Med school has a dress code so you typically wear pants no matter what the temperature you're walking in outside. Regardless, It is recommended that I drink more than 9 cups of water a day. How much more I didn't find. But the rest of the article is a good read and basically has asked to monitor oneself by making sure your pee comes out clear.

So why have I chosen this quest?

Today I watched a friend get very dehydrated and was close fainted. She was holding the ropes for me while we were rock climbing, and deftly passed them to another person. Everyone was A OK. Still, it got me thinking.

I set myself up for similar situations all the time because I have particularly low blood pressure. Always have. 90/60. So I get dehydrated easy. If I have to stand for a long time, let's say talking to a patient, I get whoosy and I have to sit down. I've taken to either making sure there is a place to sit just in case, or I have to go out of my way to warn everyone that I may need to sit down. Because trying to tough it out never cuts it. Can't fight a blackout with will power.

Alright: Let's lay out the rules for my quest. 

Starting next week, Monday, the goal is to drink 9+ cups of water a day. Water. Not sugary crap, or anything else. Water. 9+ cups is 72+ ounces. That's 0.5625+ gallons.

Why the plus? Well...I live in a hot climate. The plus is...+1-2 cups if I'm exercising. Or +1 cup if  I pee and that pee ain't clear.*

How long am I going to keep this up? Let's start with a week.
*"Ain't" ain't a word! I live in the south, and I am sorry to inform you that any time that you see or hear a repeatable string of phonics with an attached meaning that a collective whole indeed have stumbled upon a....a word. Culture, y'all.

Wednesday, September 12, 2012

Reflection time: What's going on + The Stuff I do Right.

So here is what is going on in my posting lull.

1. I'm studying for an exam. Which...yes, I know that official "doctors orders" would be to study more regularly, not procrastinate, and then have my diet and exercise programs kept up on. They call that "staying whole" and it's advice they give to us over and over again.

The student response to this is...screw you, that doesn't help me in the middle of a panic, I'm gonna pass. Then after the test, every one does one of 3 things: crash, drink themselves into a stupor, or runs off to the gym out of desperation to regain normality. Truthfully, it's all some effort to regain normality, it's just that we define it in different ways. I personally prefer crashing, and have been known to clock in a good 14+ hours of sleep the day after a test.

2. I pulled my shoulder moving a book shelf. And, since it seems to be healing, I'm not going into the doctor. YET. If it gets bad...I promise. I'll stick to my word and do it. Even though I'm pretty sure they'll just tell me to rest, or ask for things that I can't afford.

3. I am thinking of what my next project is going to be. In the mean time, I should probably tell you the couple of things that I do right so I can cut out what my project is not going to be. Or we can call this as "Yay, I'm not really THAT bad. Let me pat myself on the back without staying in denial about the other stuff I clearly need to get going on."

SO. Here's the list of stuff that is impractical for me to work on, because I have it under wraps.

1. I don't smoke. Never have.

2. I don't use recreational drugs. Never have.

3. My alcohol consumption is lower than the standard recomendations for women "No more than 1 drink per day and no more than 5 days a week". At least I think that's what it is, I could be wrong. Please correct me if I am. Any way, it's a lot lower. Because I'm cheap like that. Also alcohol tends to make me really boring at parties because I get really sleepy and sort of shut down. I'm not an angry or sad drunk, just a damn boring one.  I drink about once a month, maybe twice.

4. I technically do 30 minutes of light cardio five times a week by walking 15 minutes to class and walking back. But my exercise is clearly a product of transportation and the fact I set myself up to live close to where I need to go. Most people don't have that luxury for one reason or another, so I'm going to revisit the exercise issue to make things conveniently inconvenient. But not right now. Not yet.

5. I eat my veggies. A lot really. I pick whole grains and I don't generally turn to fast food because of money issues/it makes me feel sluggish as hell. The major problem with my diet is that I have a tendency to become overwhelmed with work, skip meals, and crash into blood sugar zombie mode. I'm a semi functioning blood sugar zombie right now, as we speak.

6. My cholesterol is the bomb. I recently got the results from my blood test back. HDL is 74. Over 60 is considered very beneficial. Everything else is in the right ranges. I don't see myself trying to change that.

7. My BMI is just fine, 20.2. Although I hate that measurement because it doesn't measure how much muscle you have, I know I don't have an overweight problem. I don't know what my body composition is, but before I lost weight this summer, it was about 21% which is nice and healthy for a woman. I'm curious to see what it is now.

That's about it. This is where I'm starting from. Truthfully, that seems like the pinnacle of health to many of the people I know, especially my parents. Most people are willing to call it a day as long as their body type is thin enough. But I think that's entirely missing the point.

Monday, September 10, 2012

Quest Stool Sample: Part 7. Le Fin!

I got my results back today over the phone and everything is A OK. I don't need to take any anti parasite medication. So hooray. Needless meds can be happily avoided. I asked my doctor and I don't need to do anymore follow ups for anything else at the moment.

That gets the obvious stuff out of the way. Now what new quest next?

Friday, September 7, 2012

Tuberculosis Check: Part 2

Nothing much to report here. I came back to get it checked and all is well. Zero reaction. I guess everything just soaked right into my skin.

Did get my flu shot though. Cause I'm supposed to.

Conversation went like this, in perfect rehearsal:

"Do you normally get your flu shot?"
"Nope. I just get sick?"
"So why have you come in today?"
"Tired of getting sick."

Flu...please stay away this year. I just had you in June.

Wednesday, September 5, 2012

Quest Stool Sample: Part 6

Not much to report here. Super Nurse said I could drop my samples off when I came back for my PPD read, but I felt so guilty. So I dropped them off today. Office is so clogged with patients that you have to wait 30 minutes just to drop something off. I was kinda having a silent freak out that I wasn't going to make it to class on time, but everything worked out.

It's gotta suck for them in there. Busy days are hard.

Quest Tuberculosis Check; Part 1

Today was a day of much joy. No I didn't turn my samples in. I actually forgot them at home and my nurse was a bit disappointed in me. He is a very good nurse: takes the time to explain everything in his scope of practice, is really good with a needle, and has a calm demeanor. I don't want to disappoint him.

No today I came in for my PPD, it's a skin test for tuberculosis. I've been exposed pretty heavily over the summer while being in direct contact with patients with yes, tuberculosis. Respiratory and otherwise. At the time we didn't actually know this clinic dealt with so many tuberculosis cases, although we should have guessed. So because of that we were never bought the proper masks that are tightly woven enough to protect us from the pathogens. We still used masks. But only the ones we could purchase in the local pharmacy. And we did try to get masks sent in, but they were on the restricted list; they never made it through customs. 

So I've been exposed. But this isn't the first time this has happened. The summer before med school I roomed with a bunch of foreign grad students. None of the guys had cars, and it's safe to say as a grad student you live as cheaply as possible. Food, health, everything. So when one of them told me his friend had some kind of growth on his neck that had broken open multiple times, oozing puss, but now he was worried because his skin had turned black...I pretty much dropped everything and demanded that I take the guy to the hospital. Later we found out he had TB too. He had it as a child and it resurfaced because the guy was trying to save money by eating nothing. No food. Nothing. He became completely immunocompromised and residual TB took over that lymph nodes, turning it into a baseball sized abscess. He got the treatment he needed in the end and went back home if you're wondering. Then in the same week, my boyfriend was working on an ambulance and was exposed to a different case. It was a fun time for everyone.

I'm not unfamiliar with the test. 

They put a small bubble of fluid under your skin that contains an antigen. If your body is good at fighting tuberculosis because it has been exposed to something before, it will mount a measurable immune response. Your skin will get raised around where the needle came in, and it will turn red. It's kinda does that anyway though, but there's no reason to get freaked out because you should expect your immune system to do something. It's best not to over think it, or try to interpret things yourself. Let the nurse do what they do best. Provide you care. 

The needle is small. So small, you could probably practice some kind of exposure therapy with it for people who hate needles. The procedure was virtually painless. I've had nastier mosquito bites. Like a 1 on a scale of 10. 

Now I'm waiting for the 2-3 days to check the response. If it grows to be big, and raised, that still doesn't mean I have TB. Just that I've been exposed and my body has this kind of figured out. They'll send me to get a chest X Ray to confirm the case. If I have healthy clear lungs, I'm good to go. 

If there is too little response to be considered positive, I come back in another 8 weeks and get the test again. Things take time to incubate.

That's it. It's easy to be a good patient with TB tests. Even I can't screw this up. 

Monday, September 3, 2012

Quest Stool Sample: Part 5. Pooped my last poop!

Yaaaaay. I can eat red meat again! I'm done pooping in little trash cans.

Pooped my last poop. 

I wish I could say I learned a super valuable lesson and that I've grown as a person. But I'm not sure how much growing I can do in a matter of a week. 

Really, I've only taken one small step away from being the hypocrite who refuses to go to the doctor. But even a small step can be the right step.

I can say a few things are confirmed an additional time for me. It is confirmed that being a patient sucks. It is confirmed that I don't want to do that again. And it is confirmed that I will still do it if needed. For my health. Makes it worth it. 

Alright! What are we tackling next? Let's go simple. It's time to get another PPD. 

Sunday, September 2, 2012

Saturday, September 1, 2012

Quest Stool Sample: Part 3. How do you take a stool sample? Well it sucks.

So for various reasons, this got put off. Some unavoidable, others not. However with the three day weekend coming up, I have a straight shot to getting this done. Of course my body is still going to fight me a little, but she can only hold out so long. So at 2:30 in the morning, I get the urge.

Really GI? now? When you know I really want to go to bed and not figure out the logistics of doing things I don't want to do into things I don't want to do them in? Now is the time?

But I must steady myself. Hell yes, now is the time. Because I know, that if I don't do this now, I'm going to have to push this back another day and then I'll be in school, and I'll be living last week all over again just to get that last sample. Besides, my roommates are asleep. Best figure this out now. Maybe this is a blessing. 

Luckily, I had already decided what I was going to "go" in, and it was NOT a take out box. For the mental image, it's a hot pink bucket that was meant to be used as a trash can or a shower caddy for a dorm. Hot pink, lime green, and chocolate brown was the rage when I was 18. So I had that, a bunch of plastic grocery bags, and of course my brown paper bag of supplies for...sampling. And I ever so quietly ninja'ed these provisions into the bathroom, while praying to a god I've never known to not make my roommate get any sudden urges for the bathroom at this time. 

Cause this takes TIME. 

Now sarcasm aside, I'm going to write out how to take a stool sample to the nitty gritty detail. My hope is that sometime in the future, someone who needs to take their own stool sample will see this. And they'll laugh, feel better prepared, and tackle their business. Cause even though it sucks, taking the samples are worth it for your health. I don't waste my time on useless shit. Rarely does anyone.

So here's what you gotta do.*

First, screw any doctor who suggests you poop in a "left over take out box". That's going right up there in the list of top medical gaffs for me. You're going to poop in something that will support you. It can be a waste basket, or a 5 gallon painter's bucket, whatever. Just make sure it can hold your weight. Or, if you're a parent and have a toilet trainer for a toddler, poop in that. That would be luxurious. 

BUT first! LINE that fucker with a bag. And push it against the tub so you can hold onto the sides for dear life while you crane in the grand piano. Test your stability for good measure.

You're still not ready to poop yet. Remember, we're assuming that you haven't eaten anything in the last 3 days that was on a no no list provided in your kit. No red meat, no liver, no crazy vitamin C suppliments. And no whatever else they put on there. I'm assuming you've already got that down. I'm also assuming you've been eating almonds and roughage by the handful to help you go. But no, you're not ready to poop yet, because no one can poop without peeing first. It's like a law or something. Number two does not come before number one. So you have to pee. 

Pee what ever you can into the toilet. Don't poop in the toilet. Your bucket is lonely. Also, you will ruin your sample by getting it wet. How? I don't know. The directions said not to do that. But the directions also said no urine on the sample, so to prevent extra tricklage, You're going to need a wad of toilet paper to cover your urethra when you're having your bowel movement. Of course that leaves you with only one arm for stability. This is risky business. You're kinda damned if you do, and damned if you don't. For the young bucks, probably not a problem. I guess people with disabilities get bed pans to make this easier. I can't imagine this any other way.

Might as well save yourself the flush by the way. You're just going to have to flush later. Oh yeah, label all of your tubes and cards at this point. You're going to hate yourself if you have to look at what you did to them while you're putting on the labels later. TRUST ME. Not for the queasy. 

Poop in your bucket! Use yoga breathing if you must relax yourself. But Yeah, be prepared for the smell. I'm not trying to insult your intelligence. I know, that you know, that poop smells bad. Everybody knows that. We're not talking about roses. But what you don't know, is why we poop in fresh, clean water. That layer of water does such a good job holding in the smell, that you know what? My past self could be convinced that maybe my shit really does smell like roses. But my present self knows better. Smells bad. So prepare yourself. Because you're going in closer. 

Now, you get to stick your face in it like a bad puppy while you unhappily dissect your turd. Depending on what you are collecting for, your poop house will either be a tube filled with formaldehyde, or a paper card. The tubes come with minature sporks attached to the tops. For the paper cards, you will need to provide your own popsicle sticks. Armed with your miniature spork/popsicle stick you will carve out a chunk of poop from one end. When you flip open the card, they have two little spots to put smear some doo on. Pick one. For the tubes, just get it in there the best you can. Then you get to carve a chunk from the opposite end. Use the second spot of the card. For the tubes, again, just get it in there the best you can. In your disgust, you'll probably not put enough sample in. Tubes should have a marker on them of how much you've got to put in. Check and make sure the formaldehyde level is up there. Oh, and the tubes want sample from the middle too. So spork out a little extra from mid poop to go in there too. 

Your sample is done. Screw on the cap tightly or close the card back up. If you haven't filled out the labels, I am very sorry. You're going to have to look at your success and smell it a little longer while you write that out. 

Dispose of the poop! I just turned the bag inside out into the toilet and then flushed. But of course there is still a very gross bag to take care of. Put it in another bag and tie that up. This isn't clean business. If poop has dropped on the floor...I am so sorry. But don't be ashamed or feel you can't do anything right. Because I'm pretty sure we're all beginners here. Just clean up with a little bleach. Wash up your hands with soap and all that stuff.

Final step is to ninja everything back out of the bathroom, hide your samples at room temperature, and take a proud stroll through your apartment complex to the dumpster to dispose of your personal poop bag. 

Then we do the heebee jeebee dance and call it a day. Maybe even write a blog about it. And you deserve a pat on the back, and something that tastes really good like raspberries. 

Because this is sample 1 out of 3. And tomorrow, you're going to have to do it again. 


* But please, don't take this as medical advice. At most, consider it a supplement to you doctors advice from that crazy friend who talks too much and DOES NOT DISPENSE medical advice. BECAUSE THEY DON'T HAVE A MEDICAL LICENCE. and if they did...they would never give you medical advice over the internet.