Cyclothymia

Take a class, learn something.

I just handed in my term paper on the developmental sexual dimorphism of the preoptic area of the hypothalmus. Really sounds like a page turner, I know. However, despite the rather dry vocab, sexual differentiation is a truly fascinating process, due in no small part to the voyeuristic, comical, and sometimes sad behavioral testing methods used to measure the effects of various physiological manipulations.

What did you do last night? Oh, watched rats hump each other under a red lamp.

Some of the testing is done under "sub-optimal" conditions, which either means a scary new environment, a less than receptive female (if you feed them a few drinks they stop resisting so much), or, and this is my favorite, restricting access to the receptive female by tethering the male to limit his movement. One tiny little rat harness + one lusty but coy female = some aggravated rats around the water dropper in the morning.

Dude! I was SO ready to go but there was something holding me back. I don't know what it was. Maybe we've just grown apart.

I ended up writing the damn thing in one solid 8 hour stretch because I procrastinated for so fucking long. I had a thorough outline done, but still. Half of me is rather proud of what I managed to pull off, but the other half is kicking myself senseless BECAUSE IT WON'T ALWAYS WORK OUT THAT WAY.

What? You want to fail out of medical school? You want to know only 3/4 of the operation you are doing? You are proud that you have no self-discipline or work ethic? Sit up straight, and eat your breakfast.

Yeah, that part of me is really loud and really annoying.

Oh, one other thing. You might want to read up on the role of COX-II as far as masculinization of the brain during the perinatal period goes. Exposing a perinatal male rat to the potent COX-II inhibitor indomethacina "markedly" impairs adult sexual arousal mechanisms...the poor things just aren't interested when they get older. Latency to mounting? Long. Latency to intromission? Long. Note that's "inTROmission" not "inTERmission". Sadly, there is no half-time show or popcorn in the little tiny rat cages. Honestly, though, there should be SOMETHING to help alleviate the awkward mood. Ejaculation? Never. No word on cuddling.

Why is this relevant, you ask? Well two other (mild) COX inhibitors are asprin and acetaminophen. Yep, rats exposed perinatally to asprin show similar, although reduced, impairment of function as adults. Humans have very similar mechanisms, so the next time you or the guy you're with can't get it up, you can blame it on your/his mother and her filthy asprin addiction (as if you/he hadn't already). And if you're pregnant? How bad is that headache, REALLY? You horrible, horrible mother. See, it always comes down to mothers sucking.

ps. Just in case some fundy out there stumbles across this, mangles the science in their own special way, and starts having urges to go burn down a drugstore - asprin fucks with arousal mechanisms, which are not related to sexual preference. Asprin might make you flaccid and prone to buying sports cars, but it doesn't make Teh Gay.

Things I've Learned Recently

• Given my shockingly paltry alcohol intake lately, it is somewhat imprudent to go on a wine-tasting date. Two drinks in a month?! Oh, my poor neglected vodka. I have a loud mouth to begin with, but getting hammered in the first 45 minutes of a date seems to knock out whatever ragged bit of propriety I had managed to scrounge up for the occasion.

"You, sir, need to learn all about hyenas and their bizarre PENISES! No, really, they're fascinating! Sure, I'll take more wine. Anyway, the females have PENISES! Well, to be precise, they have PENIFORM CLITORI, but they're basically PENISES. Seriously! Isn't that, like, TOTALLY AWESOME?! But wait, it gets better, or worse, depending on whether you're a hyena or not - the females GIVE BIRTH through the aforementioned PENIFORM CLITORI. Max tip stretch? 2.5cm. Average cub head diameter? 7.5cm. You do the math. Let's just say a lot of dead puppies are born to first time hyena moms. Thankfully it (by which I mean the GIRL PENIS) rips during that first birth, so the others are fine. Isn't that soooooo weird?"

Cute, smart, funny, athletic, and apparently completely inhibition-free...dating me is a dream.

• One person's "rolling hills" are another person's "death march". It's just lovely that we have our own individual experiences isn't it? That is such a special part of the special gift of life. I went for my first outside ride of the season; 20 miles on what was described as "rolling hills." The funny thing about "rolling hills" is that what they really are are "endless hills." Before you have time to say "thank jeebus, a downhill," you look up and, shocker of shocks, oh yes, it's ANOTHER fucking uphill.

This experience has convinced me to buy proper bike shoes. My regular pedals with runners ain't cuttin' it anymore. I refuse to get my ass kicked by my riding partner every week for the foreseeable future. I WORK OUT DAMMIT, IT'S NOT FAIR. But you know what, it was a spectacularly pretty day,  and we managed an acceptable pace for my first outside workout, especially w/out the clip in pedals, so I should probably retract the whole "death march" bit.

• I have discovered the source of childhood obesity in America. It's Kimball Farms ice cream. Their kiddie size is...a pint. I'm not kidding. You would have to see their banana split to believe it. We both got kiddies and couldn't finish them. We, brace yourselves, THREW OUT ICE CREAM. It's a sad, sad day. Next time we resolved to get one and split it...but when I've got low blood sugar and ice cream within view I'm not necessarily at my most cooperative, or patient, so we'll see how that goes.

Shooting For Average

Trivia was a disaster last night. We ain't just ignorant, we're also stupid. It's been long time since we've been shellacked like that.

Here are two that I'm ashamed to say we got wrong:

What is the name for the interaction of light with the surface of materials such as minerals (eg. quartz) and metals that comes from the greek word for light?

What is the common name for the common medical condition known as epistaxis? It does not usually require medical treatment. However, the condition can occur either anteriorly or posteriorly, and the posterior version sometimes requires medical treatment.

Personhood, In All Its Forms

I was reading an excellent new book last night: Drawing The Line - Science And The Case For Animal Rights. I've never thought the line between the human animal and the rest of the kingdom was all that black and white, so he's preaching to the choir a bit with me, but even so the examples are fascinating.

It strikes me as so bizarre that "anthropomorphizing" became such a dirty word in animal behavior circles. Eliminating our own experiences and processes from our observations of animals is like willfully choosing not to observe the apple falling from the tree with our eyes, instead relying solely on our ears, and then maintaining the apple doesn't move because we didn't see it moving.

In any case, as we gather more and more data we are discovering that every new line we try to draw eventually begins to waver. Tools, theory of mind, even language (yes, including grammar) are no longer the sole domain of humans. Animals grieve, plot revenge, get depressed, lie, and form deep attachments which can only be described as love. We could say that we'll protect the animals we know to be capable of grammar, or the animals we see expressing what we consider to be complex emotions, in an attempt to hold some semblance of the line between ourselves and them, so that we can continue justifying cruelty to the rest of them for selfish reasons, but what I wonder is where does that line get drawn?

As I was thinking about this last night, however, something occurred to me. There might be one behavior that is still exclusively human: recreational drug-taking. It's so evolutionarily backwards that I'm guessing no other animals do it, but I'm not sure. Something to research. Because, people? If bush babies are secretly shooting up some otolemur version of heroin, or holding little tiny raves, there really IS no line.

Crispr Is Currently In Private Alpha

The comments on this photo are hilarious:

What? Why are you looking at me like that?

What Goes Around Comes Around

Dear Mr. Bush,

I am writing to you because the people have spoken, and apparently they seem to be a little pissed off at your buddies in office. There's even talk of a very clear "mandate". Puhlease, when you had a "mandate" you had a much larger margin of victory. Wait, you didn't? Oh, pish, the popular vote doesn't mean anything, those people are probably just a bunch of pansy-assed, pro-terrorism, anti-family, atheist homos. I hear most of them don't even hunt. You had it where it matters, the electoral college baby! And in 2004 you had both - by a full 2.4% no less! You're the MAN. Man in charge with a big ole' MANDATE, that is.

The Virginia Senate seat was declared for the democrat Jim Webb by a downright pitiful 0.33%, and Montana by a barely better 1.75% for Jon Tester (D). Unfortunately, as you know, this means that the control of the house, senate, and majority of governorships are now in democratic hands. I am as appalled as you are. Following your decisive victories in 2000 and 2004, you tried only to implement the will of the people, and those ungrateful bastards don't seem to appreciate it.

You know what I think it might be? I'm sure some of your advisors may have brought this up already, but just in case; I think it might be the war on Iraq. Er. I mean terror, war on TERROR. I really don't understand why people don't realize that the democrats are going to feed our babies to Osama bin Laden, you made it as clear as is humanly possible. Osama bin Laden = 9/11 = Saddam Hussein = Weapons of Mass Destruction = Evolution.

Just between you and me, you probably shouldn't have declared victory before, you know, the civil war had even gotten properly started over there. Hehe, that's a bit of egg on your face, huh? But, I can understand your excitement; it's that heady smell of oil, it's intoxicating for me too. The last time I stole billions of dollars of natural resources I ended up doing 6 tequila shots, stripped naked, and gave Rumsfeld a blow job. Don't worry, I'm female. At least I didn't invite CNN. I did hang a banner saying "Nyah, Nyah Condi!" Nobody's perfect.

Well, anyway, I'm sure you're in a little bit of shock. But you have to understand, the populous is really, really self-absorbed. They don't have your vision, plus they're really fucking whiny. "I have no joooooooooob" they say. "I have no healthcare!" "I don't want religion taking over my country..." Blah, blah, blah. Cry me a river. They don't understand that jobs have to be lost at the bottom to save money for the top! I mean Jesus H. Christ, it's so basic, no wonder they're unemployed!

And helloooooooooo, securing the Iraqi safety comes at a price, and that price just happens to be tens of thousands of Iraqis. Sure, those ones aren't safe, and our soldiers aren't safe, but the oil....well, the oil isn't safe either. Minor details. Their ridiculous zeal for the facts almost makes you think evolution might be true...clearly some of these "people" have the IQ of a monkey. KIDDING! That's crazy talk; no matter how retarded they are, we know God made them in his image. His retarded image.

So, I guess that's that. You are going to have a tough time implementing the rest of your mandate and the people's vision without the senate or house. But, on the upside, if you aren't going to be able to get anything done, no one will fault you for giving up and spending the rest of your term at the ranch. Just keep in mind, you do have the supreme court on your side, so maybe you can get those nasty results reversed. Fingers crossed. Better yet, I'll pray for you!

Your loyal fan,
Bree

Medicine Needs Me

I had my endocrinology appointment this afternoon. I've basically been a wreck while waiting for it, because, you know, only my sanity and life rested on it. My body and I have reached our breaking point. I can't live with it for one more second. Freezing cold limbs, socks everywhere, toothpaste squeezed from the middle; I'm looking into legal emancipation from the damn thing.

The doc started off by asking why I was there. In a nutshell, don't feel like I've ever gotten respite from hypothyroid symptoms, even when labs are "normal", sez I. She responds by saying that if the labs were normal, then my symptoms were not due to hypothyroidism. Just exactly what I dreaded hearing. Hmm. So you are saying that the symptoms which were the basis of my initial hypothyroidism diagnosis, a diagnosis backed up by abnormal labs...you are saying these same symptoms in the same body are NOT due to hypothyroidism if the labs aren't abnormal? She said, "yes, that's what I'm saying, but your labs WERE abnormal, so this is a moot discussion."

No, no it's not, because for years I've been a good little patient, eating up the party line that my labs are normal, it can't be hypothyroidism causing my problems. For years I let them tell me the labs were normal, when what they called normal was just barely over the lip of normal. A stiff breeze would have blown my normal results back into wackyland. Except that getting the symptoms treated one by one didn't work AT ALL.

So we have a major pink elephant in the room, hypothyroidism, and the doctor is like "Don't look at the elephant, you have normal labs." Well, frankly, doctor, that's just bad science. It seems more likely to me that there is something you and your labs don't understand about treating hypothyroidism, than that I have just randomly developed seven ailments that happen to match the symptoms of hypothyroidism, but, oh yes, aren't hypothyroidism. But where are my manners - you just said my labs are currently abnormal, so lets get back to that. Please, don't mind the tears running down my face, carry on.

So you are willing to agree that my current symptoms are probably hypothyroid related. My weight gain, fatigue, muscle pain, tendinitis, depression, headaches, low blood pressure, low body temp, low sex drive, currently these are all acceptable hypothyroidism symptoms because my labs agree that I'm actively hypothyroid. And yet, I had all of these symptoms last year too when my labs were normal. They were all moderately better then, but still there. So back then they weren't hypothyroidism, but now they are. And now that my hypothyroidism is actually registering as worse in the labs, the symptoms are all worse too. But that must be a coincidence...perfect symptom overlap.

She asks if can tell her why I'm so upset (apparently the unabated tears were unnerving her). I asked if she wouldn't be upset if she felt like her symptoms were slowly ruining her life,  but she wasn't able to get them treated because they were tricky or fell outside of some arbitrary parameters for being taken seriously. I said I didn't understand how she could look at someone with all the symptoms of hypothyroidism clinically, and ethically/morally refuse treatment based on the labs. She said, "Well, how do you know I'm not hypothyroid?" And I said, "I know because you would have so much more sympathy and be willing to look outside the box, to do anything really, to try and solve an awful problem." She sighed, and said "I'm not hypothyroid, but I've treated thousands of cases". Mentally I put air quotes around treated, and thought, well, you asked.

We talked some more during the exam. She zeroed right in on the fact that I'd been treated for depression and see a therapist, it was obvious she thought depression was my main problem, hypothyroidism secondary, and I can see how a patient weeping in your office might be construed that way. But on the other hand, the more compassionate hand, it could also be construed for what it was - the sadness of a drowning patient who is having her hope and lifeline ripped away from her.

I defended myself by pointing out that psychiatrists are now treating refractory depression with thyroid medications, and seeing major success, even though the patients show normal thyroid function. Is it not possible that some functions are particularly sensitive to thyroid levels, and given that "normal" TSH values range from .3 to 3, a full order of magnitude difference across the range, that one person might do better at some point in the normal range, and another person do better at another point etc.

If a person has the symptoms, why not explain the risks in going with a higher dose of T4, or going with T3 supplementation, and give it a shot? If it doesn't help, it doesn't help. The risks of the treatment are not that high, but the risks of remaining untreated are getting pretty close to unbearable to me. It strikes me as so callous and cowardly to huddle behind the lab results and say go elsewhere, rather than accepting that perhaps there are things they don't understand about the system, and working to treat the patient. But like I told her, that's how I know she doesn't have the disease, anyone with the disease would feel differently.

She did eventually agree to give me a minuscule dose of cytomel, a T3 replacement, under the conditions that I come back every month for blood tests and every 6 weeks for appointments. I just don't know if I can consider her a partner in my care when her philosophy is so obviously not patient care based. I don't think trying a new therapy will work if I have an antagonistic relationship with the doctor, so I might be better off going with the other doctor I found who sounds very open and who I talked to in person. He didn't have appts till late Dec. though.

One good thing though, Justin has been helping me keep my spirits up and think about the options positively. I just wish he didn't have to go to work in the morning, it's not the same snuggling his pillow.

Corposum Delictum

I put photos of some of the medical artifacts here in my building up on flickr. I particularly like the skeleton of conjoined twins. It makes me feel all single-headed and fully-grown. I may have my flaws, but at least I have that.