Monday, December 29, 2008

take back the city for yourself tonight
i'll take back the city for me...

god knows you've put your life into its hands
and it's both cradled you and crushed
but now it's time to make your own demands

all these years later and it's killing me
your broken records and words
ten thousand craters where it all should be

no need to put your words into my mouth
don't need convincing at all
i love this place enough to have no doubt

it's a mess
it's a start
it's a flawed work of art
your city, your call
every crack, every wall
pick a side, pick a fight
get your epitaph right
you can sing till you drop
'cause the fun just never stops

i love this city tonight
i love this city always
it bares its teeth like a light
and spits me out after days
but we're all gluttons for it
we know it's wrong and it's right
for every time it's been hit
take back the city tonight

tell me you never wanted more than this
and I will stop talking now
one perfect partner, one eternal kiss

take back the city for yourself tonight
i'll take back the city for me
take back the city for yourself tonight

i love this city tonight
i love this city always 

( some end-of-the-year music thoughts are here if anyone's interested )

Monday, December 22, 2008

the verdict is in...

... and I have narcolepsy.

The nurse at the Sleep Center called me this morning to let me know my results.  Out of the five naps I took, the average time it took me to fall asleep was 5.2 minutes.  Apparently anything less than eight minutes is abnormal.  (Who knew?)  Also, I entered dream sleep in four out of five naps.  Which means that I definitely have narcolepsy.  The doctor is prescribing me the drug Provigil, which is a stimulant I will take every morning to help me remain alert throughout the day.  It should not stop me from being able to fall asleep at night, which is good.  I have a packet of scientific information about the neurochemistry of the drug, which I have been meaning to read.  I should probably get around to doing that sometime.  I am going in tomorrow to pick up a one-week sample of the drug and hopefully I will get to talk to the doctor, because I would like to ask him some questions.  For example:  will the condition get worse throughout life?  (I sincerely hope not.)  Anyways, that's all I know for now.  I am pretty bummed out that I have to start taking medicine because I have never had to take it before.  I will probably forget a lot... 

Thursday, December 18, 2008

sleep study... DUNZO.

At around 8:30 Wednesday night, I arrived once again at the Sleep Center to begin my study.  I sat in a waiting area for a few minutes with three or four others, all of whom were much older than me.  I was then shown to Room #3, which according to the technologist Dustin, was "not quite the Hilton, but not too bad either."  He asked what time I normally went to sleep and I told him 11 (kind of a lie, considering I haven't gone to bed before midnight for weeks).  So he left and I read my book for the next hour and a half or so.  At 10, Dustin returned to begin the laborious process of hooking up all the necessary wires and electrodes.  Guys, this process is not for the faint of heart.  The first step involved a lot of measurement of my head and marking it with a marker in various points.  He then put some kind of jelly-like paste on the many spots where the electrodes had to go, cheerfully informing me that five years ago, they had to use Super-Glue for this.  (I shudder at the thought of washing globs of Super-Glue out of my hair.)

Once the glue was in place, it was time for the wires.  I would say there were approximately ten different electrodes and wires on my head alone.  In addition, there were also two EKG wires on my chest to monitor heart rate and two wires on each ankle to test for Restless Leg Syndrome.  Once I laid down, he fastened one strap around my torso and one around my abdomen that had respiratory sensors in them to keep track of when I was breathing.  Then he inserted a "nasal cannula" which is one of those clear tubes that has two sprouts that go into each nostril, as well as something underneath called a thermal coupler consisting of two wires that somehow tracked if I breathed through my mouth.  I might add that many of these tubes and wires were hooked behind my ears.   My ears are quite tiny, and this became quite painful when trying to fall asleep and lay on the side of my head.   As a final touch, almost an afterthought, he placed my right pointer finger in some sort of large plastic contraption that was connected to yet another wire.  It was strange and I can't figure out what the purpose of that one was.  

After all this was hooked up, it was almost eleven.  Dustin turned out my lights so it was pitch black in the room and left.  He then proceeded to talk to me through the speaker next to my bed and guide me through the "Patient Calibration Exercises."  This consisted of commands:  Lay there with your eyes open.  Lay there with your eyes closed.  Move your eyes to the right.  Left.  Straight ahead.  Up.  Down.  Flex your right ankle.  Flex your left ankle.  Grit your teeth.  (et cetera.)  After the calibration exercises were finished, I was instructed to get comfortable.  It took me a good five minutes to figure out even a remotely comfortable position.   And then it took me forever to fall asleep.  The next morning, they told me that it took twenty minutes, but I am used to being out as soon as I hit the pillow so it felt like AGES to me.  I didn't sleep all that well.  (I think the box on my finger was the clincher.  I like to sleep with my hand under the pillow and that made things difficult.)

At 6 a.m., I was awakened by Dustin's voice over my speaker.  He came in and removed the breathing straps, nose tubes, and the finger box (thank goodness.)  A few minutes later, Dr. LeGrand, the doctor I had seen the day before, came in to discuss the results of the overnight test with me.  I do not have sleep apnea, I do not snore, and I do not have Restless Leg Syndrome.  (No surprises here.)  Basically all this told them was that I needed to stay for the daytime Multiple Sleep Latency Test, affectionately known as MSLT.  I knew I was going to have to do this anyway.  After receiving a breakfast of a cold bagel and strawberry cream cheese, I was instructed to stay awake for two hours so that I could begin the next test.  I watched the Today Show for awhile and read a couple magazines I had brought with me.  At around 8:30, however, when my first test was scheduled to begin, the power went out in the hospital.  It was kind of a bummer because it stayed out for about 20 or 30 minutes and there wasn't much I could do.  The emergency generator powered the hall light and my bathroom light, but there was still not enough light in the room to read and obviously the TV would not work.  I remembered about halfway through the power outage that I had my iPod with me, and I listened to some Fleet Foxes until the lights came back on.  It took awhile for the computers to boot  back up after that, so the first test didn't start until about 9:15.

The tests consisted of five naps at various times throughout the day.  Basically, I would perform the patient calibration exercises, the nurse would tell me to take a nap, and then about 30 minutes later she would wake me up.  Then I would wait for an hour or two.  In between I watched a lot of TV even though the hospital does not have a very good selection of TV channels.  I also read some of Enduring Love, but I kind of had a headache and reading was making me want to fall back asleep again, an activity from which I was strictly prohibited between authorized naps (for obvious reasons).  

I didn't finish until about 5:15 pm.  The nurse told me to be expecting a phone call either Monday afternoon or Tuesday after Dr. LeGrand had a chance to look at my results.  However, she did say that from what she could tell my tests did exhibit symptoms of narcolepsy.  With a very concerned tone, she advised me to be careful driving home.  And that is the (not very exciting) story of my sleep study.  It was, in all truthfulness, pretty boring.  A DVD player would have made it a little better.  Or perhaps a bunch of friends all completing the study with me.  Actually... that might be fun.  It would be like a slumber party.  And it would provide for some good photo ops.  Next birthday, anyone?

some appropriate music:

Wednesday, December 17, 2008

wish me luck...

I have just returned from the Huntsville Hospital Sleep Disorders Center where I had a consultant with a sleep specialist.  For some time now I have suspected that I may have a sleep disorder, possibly narcolepsy.  The doctor confirmed my suspicions, but to be sure I have to return to the Sleep Center TONIGHT to have a sleep study done.  Maybe I am a nerdy medical student, but I am kind of excited about this.  

Here's what is going to happen:  I show up at 8:30 this evening, with an overnight bag packed "as I would for an overnight stay at a hotel or a friend's house."  Beforehand, my hair has to be washed with just shampoo, not conditioner (EEK) and I am not allowed to wear any type of makeup or lotion.  (In other words, I will look like a raving frizzy-haired dry-skinned lunatic.)  Once I arrive, I will get settled into my comfortable hotel-style accomodations.  They will then hook up about a thousand wires to me.  According to the helpful pamphlet:

"Next, approximately two dozen sensors which are generally small metal discs (called electrodes) are applied to the skin of your head and body using an adhesive.  These sensors monitor... brain waves, muscle movements, eye movements, breathing through your mouth and nose, snoring, heart rate, and leg movements.  Flexible elastic belts around your chest and abdomen measure your breathing.  A clip on your finger or earlobe monitors the level of oxygen in your blood and your heart rate."

When I wake up in the morning, it is not over.  I will be sticking around for the MSLT (Multiple Sleep Latency Test), which consists of a series of naps throughout the day using the same monitoring equipment.  A staff of trained technicians in the next room will be monitoring everything about me while I sleep.  Hopefully everything will turn out all right!    Expect an update tomorrow evening after I return from my adventures in the Sleep Center!

P.S. I am not allowed to drink caffeine before my study begins.  Of course, I am having caffeine withdrawal symptoms right now.  If I had known, I would have loaded up this morning.  

Friday, December 12, 2008

pomegranates & other things

I happen to absolutely love pomegranates.  They might be the most fun thing to eat ever.  What other fruit allows you to eat a spoonful of SEEDS?  I mean, hello.  However, although pomegranates are delicious, they come with their fair share of problems.  If you research the correct way to extract the seeds from the fruit, it goes something like this:

1. Slice pomegranate in half.
2. Score each half into several sections.
3. Hold sections in a bowl of water, releasing the seeds.  The seeds will sink, and all the white stuff will magically float up to the top.  
4. Scoop out the white stuff, drain the water.
5. Enjoy.

Sounds pretty simple, right? Wrong.  When I prepare it, the steps usually go something like this:
1. Slice pomegranate in half.
2. Look down, realize that I am wearing a white shirt which is now covered with many miniature purple splotches.  Lament for approximately five seconds.  Change shirt into something dark red or purple, soaking aforementioned shirt with Oxi-Clean (TM) or similar product to try to remove stains as quickly as possible.  Return to kitchen.
3. Score each half into several sections.
4. Hold sections in a bowl of water, painstakingly pulling out every little cluster of seeds.  Most of the seeds sink, except for the ones that still have tiny bits of white stuff clinging to them.  These can't decide whether to float or sink so they hover in a kind of halfway limbo.  Try to remove white bits from seeds, but they never seem to go away.  Give up and realize that eating a little bit of white stuff is not going to hurt me (right?)
5. Wish that I had some sort of small strainer to scoop out the white stuff floating on top, but I don't.  So I use my hands and it takes about ten minutes.  Meanwhile, all this unrest in the water is making the seeds rather uneasy.  Some more seeds with clinging white particles float into the limbo position.  
6. Give up completely on removing white matter.  It's probably loaded with fiber, anyway.
7. Strain seeds. 
8. Enjoy.

Also, I am now officially finished with my first semester of medical school.   Hooray!  I am planning a very full Christmas break.  Tomorrow I am headed home to Huntsville for the holidays.  Here are the books I am taking home with me:

Obviously I will probably not get through all of these books.  If anyone has any suggestions as to which ones I should go for first, please let me know!  The only one I have read before is Enduring Love by Ian McEwan, but the other ones are all new.   

*NOTE: Tricia, if you are reading this, that is your copy of The Kite Runner.  I am sorry for keeping it this long but I really, truly am going to read it over break and I will bring it back to you ASAP.  

Sunday, December 7, 2008

just in case...

In case the gifts on my previous "Holiday Gift Guide" entry were STILL too much for your budget, may I suggest this affordable alternative:

Note that it is shipped DIRECTLY from China.  Yippee!