Goodbye “Science and the Scleroderma Girl”… I’m Heading Back to the Garden

Today is World Scleroderma Day. Gosh, there should be a huge post today that pulls together my whole monthly effort… nope. That sounds just exhausting, doesn’t it. How about we just head out to my garden to see what’s up. After that I can show you the big picture on what I’ve been doing all month in “Science and the Scleroderma Girl”.

Getting into the garden has been difficult for me since the sun and I are not friends. Last week I went out for a couple of hours to weed in the morning in the shade, and yep… I developed a rash on my arms and then the flare arrived. I was holed up for days getting over that little misadventure. After I  recovered I tried out weeding after dark. Gosh, I’ve had more fun moping floors. It just isn’t the same if you can’t actual see what you are doing. I wonder why that is?

Arm
But look at what I scored today while I was out shopping!! Do you see that the pattern is teal colored butterfly wings? How more appropriate for World Scleroderma Day can you get?
Sun protection!
Do you see what is written on this arm? This is a outfit designed to provide full sun protection for people playing in the surf. It is cool, wicks moisture, and will protect me from the sun. This is exactly what I need!
Jacket
Check out the whole top. This plus a hat should set me up for morning gardening, don’t you think?

There are leggings too to provide complete sunblock for the surf enthusiast, but that probably is more than I need to tend to the roses. I usually get wet while I’m watering in the evenings, and once again this baby should handle it fine. I am so set up for the rest of the summer!

Let’s see what is still alive in the garden after a week of amazing, blistering heat. Yesterday it was 105°F; these plants are no longer happy.

Purple flowers
The flowers in the tub on the back porch made it…
Veronica flowers
So did this Veronica. I’ve been transplanting this into several flower beds since it does so well.
Strawberries
Even the strawberry plants are producing well. Look at the berries that I had Tuesday afternoon. I decided to wait until Wed morning to pick them…
Bare strawberry plant
Unfortunately a squirrel beat me to them. This is all that was left, and I’m sure that he left this half eaten berry just to taunt me!

This weekend will be cooler, and I gave all the plants a good watering this evening so that they will recover over the next few days. Poor plants. Life has been tough for the last couple of weeks: heavy rain for a week followed by triple digit temperatures and blazing sunlight.

Now that we are leaving the garden here is my Scleroderma Month of June:

What I didn’t put into this was a lot of actual information about what scleroderma is. Oops. This post that I wrote for Rare Disease Day should cover that glaring omission.

So, this is World Scleroderma Day. All over the world people have posted the pictures of their smiles in an effort to make an invisible, but pretty darn serious, disease have a face. My smiling face is above: a little crooked these days, my lips have gotten too thick to smile right, and my hair is falling out, but I am doing well. Every day brings a new challenge, but still, with good luck, humor and a touch of science, I rise.

Have a good weekend everyone!

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Science and the Scleroderma Girl: The Patient Scientist

It is really annoying to have an illness that just keeps going on and on and on… think of the energizer bunny here. A really annoying scleroderma energizer bunny. I am so over it already. I love my doctors, but they are really focused on slowing down the progression of my bad boy illness, systemic sclerosis, and are kind of dismissive of the pain and dizziness that is coming my way courtesy of the fibromyalgia and Sjogren’s Syndrome.

It isn’t that they don’t care. They just have clearly defined priorities in mind as they treat me. It is kind of like when my mom was going through chemo for her cancer. The doctors were very sympathetic about her struggles with nausea and fatigue, and helped her the best they could, but they did not let up on the chemo schedule. My doctors are also sympathetic, but they still took my immunosuppressant dose up as high as they could when I got into trouble with my lungs two years ago. Oh, you are having trouble sleeping? So sorry. Hang in there. It will get better…

Cat and computer.
Do you see how much help MacKenzie is giving me while writing this? He too is sympathetic. Oh, your legs are hurting today? Here, I’ll sleep on top of them for you…

I had a surge of rebellion about the same time that this was going on and decided that I would consider myself a walking experiment of one and would try to get a better handle of my symptoms; surely there must be correlations between what I was doing in my day and how I felt. If I understood my test results better perhaps I could have better conversations with my doctors. Stop being a victim, I told myself, and become a patient scientist!

Food log.
Today’s entry into my little symptom journal. I started out tracking my daily food intake, and then added in entries about other symptoms.

The food log was perhaps the most important thing that I did. I began to figure out lots of things by focusing on what I was eating and what my symptoms were. I ignored the “universal truths” that I was being told to me by other people and focused on what was happening with me. Bam! Some of the things that I figured out actually changed the diagnosis list on my chart, and I certainly improved the quality of my life. Here is the short list of what I discovered about myself: absolutely NO SALT or other forms of sodium, gluten is fine, fiber is a problem, lactose free dairy with live cultures is a daily must, bananas are boss, and I should eat foods with a low glycemic index. Oh yeah: vitamin D and krill oil supplements are good, but tart cherry supplements will damage my kidneys. Good to know.

What happened when I changed my diet? Muscles pain went way down, I got more energy, my gastritis and other GI symptoms improved greatly, I slept better, and the quality of my life improved. For each of those food choices I used myself as an experimental animal. Just one change was made in my diet, and then I tracked symptoms for a week or two to see what happened. My latest experiment has involved bananas; a banana a day keeps my muscle pain way down. Who knew? Have a headache? Eat raisins!

I began to gather other types of data. I took my blood pressure during times when I was feeling poorly to see what it was doing. That’s how I figured out that my inhaler was making my blood pressure drop. Now that I’m off my blood pressure medicine, my pressure is back up, and I’m using my inhaler safely every day. Today I noticed that I was a little short of breath while doing laundry…

Oxygen monitor
Oh. That blood oxygen level is a little two low. It was in the high 80s when I first checked, and was up to 91% by the time I snapped the picture.
Oxygen monitor
Well look at that! This is what happened a couple of minutes later after using the inhaler. My oxygen level is up to 95% and my heart rate has dropped back down. I really need to use this inhaler every day as it is helping keep my small airway disease under control.

Now that I’m using the inhaler daily my energy level is up in my little notebook. Hmm… I’m not sure if this is completely due to the inhaler as I also added bananas to my diet, but as I keep logging observations I may figure it out.

I also have started collecting all the data that I can get from my routine heart and lung testing. I usually get a phone call from the doctor that tells me how I’m doing, but with the data in hand I can have more meaningful conversations with my doctors.

PFT results.
This is some data from pulmonary function tests that were done 2 years apart.

The data that I have circled in the upper table of data shows that my lung volume didn’t change very much when administered a dose of albuterol during my first pulmonary function test, which was done right after I was diagnosed. Two years later, when I was really struggling with shortness of breath, the data in the lower table showed that I improved 16% in my lung volume after that same drug. The technician told me that this was a big response and that he was sure I would be prescribed a drug to help me; that didn’t happen until I made an appointment with my internist weeks later, told her about my response on the drug, and showed her the specific data that I had picked up from the hospital where the test was done. Bam!! I got the inhaler that day.

By collecting data at home and paying attention to my symptoms I’ve been able to give better information to my doctors who have responded with changes in my drug protocol and treatment focus. Today all of my doctors shoot me a full copy of all of my testing data as soon as they get it. I also can access data through the patient portal at Kaiser. I follow changes in data over time, and then I can have a meaningful discussion with my physicians when I see them.

I’m just one data point out of all of the patients that my doctors treat, but by using myself as a walking experiment of one I’ve been able to figure out management strategies to help myself and how to better communicate with my medical team to work with them as a collaborative partner.

This is good. I will never be in control of my illnesses, but I sure am poking them with the pitchfork.

Err… knitting needles. They have definitely been poked.

It is good to be a science geek.

Science and the Scleroderma Girl: The Nature of Science

Logic clearly dictates…

Spock, Star Trek II: The Wrath of Kahn

Science. Everyone knows what science is, right? I mean, we have all been exposed to courses in science that involved learning lots of stuff about rocks, atoms, moving objects, plants, furry animals and stars. There are all of those books and all those facts, equations, and laws to learn. The vocabulary is ridiculous!

Science is also a way of thinking that allows us to learn new information about the world around us. It is a system of reason and logic that helps us understand what we know, and why we know it. Every year I started the biology course with a little unit called “The Nature of Science”, and this is what it covered:

  • Science is used to explore the natural, physical world around us. The magical and supernatural spheres are definitely off limits. The reason why is…
  • Science requires that we be able to collect data about a phenomenon we are studying: it must be observable with our senses or instruments. Something may be real, but if we can’t observe it we can’t study it using the rules of science.
  •  In science you cannot whip out a miracle to make your model work…
  • The data that is collected should be consistent over time. Think about ghost research; instruments that show the presence of ghosts work on some occasions and not on others. That data isn’t reliable because it isn’t consistent. If I drop a glass it will fall to the floor every time, and it will accelerate towards the floor at the same rate every time I drop it. That data is reliable.
  • It should be possible to make predictions based on observations and prior understandings. We generally call these predictions hypothesis, and they get tested all the time in…
  • Experiments! The way we expand our understanding of the natural world is through experimentation that tests these predictive hypotheses. Observable data is collected during the experiment that allows us to draw some conclusions about whether the hypothesis was correct or false. Either way is fine. The point here is, we should be able to test the hypothesis to see if the prediction was accurate.
  • Here is the best part of science: based on what new understandings are generated our predictive models should be able to be adjusted. NOTHING is forever in science when you are dealing with the big predictive models that we call theories. For example, when I was a child I was told that mountains were formed as the earth cooled and wrinkles formed on the planet “like a raisin”. Ugh! Can you believe I was taught that?! Our current understanding of mountain formation involves the movement of large plates in the earth’s crust (plate tectonics), which actually makes more sense as it also explains earthquakes and volcanoes. Is my heart set on plate tectonics? Nope. If some new information emerges that supports an expanded or new model of mountain formation, I have to follow the data. That’s why theories are said to be “supported” by evidence, but never proven.

Science is about using logic and reason to learn new things about the world. Logical safeguards are in place to help make sure conclusions are valid (you know about some of these… I’m talking about controlled experiments, reproducible results, and peer review of published experimental results). Science is actually a form of applied philosophy; early scientists were called “natural philosophers” and today the degree is still called a Doctor of Philosophy. Yep. That’s what Ph.D. stands for.

Why is this stuff important to me and anyone else with an autoimmune disease? Unhappily, we are out there on the edge of the envelope, falling off the map, and beyond solid scientific understandings. We have diseases that developed via unknown pathways and causes, and they are not completely understood. There is no definitive treatment that will “cure” the disease. We are part of a continuing effort to expand scientific and medical knowledge as we progress through our illnesses using drugs and interventions that are the best predictions for good outcomes. We are all walking hypotheses, and what happens to us helps build the body of evidence on how effective our treatments were. As knowledge expands in labs about the biological pathways and the disease mechanisms, new treatments will be developed, they will also be subjected to this scientific process, and the total body of scientific understandings will grow. Someday it will all be “old stuff” and written in a dusty book.

But today, I’m rocking the edge of the envelope as a walking experiment of one.

I even keep a science notebook on myself.

That’s tomorrow’s post.

It’s June! Introducing Science and the Scleroderma Girl.

Okay, this is it. I’ve been fussing for over a year about writing a series about science, biology, medical decisions, and navigating safely through a world of alternative medicine and treatments. I’ve come close to launching into a block of mini-rants before, but never went there because it would just take too much energy…

June is Scleroderma Awareness Month. As luck would have it, June has also arrived as I sail back into calm waters following a 6 week storm set off by worsening symptoms, medical testing, and finally a collaborative consensus between my doctors and myself based on data that informs a new course of treatment. In other words, science, biology, and data-driven medical decisions have saved the day. I have lived a life of science in my educational and professional life and this training and way of thinking continues to save the day for me. I do have other skills, of course, but the foundation is always based in science.

I guess I think that it is time for me to share in case it helps anyone else.

Hot Cocoa Rose.
June has brought me the first rose of summer, too. Look at this cutie!

This month I am better. This month my energy is coming back, ideas for topics are swirling in my head, and I think that the time has come. I’ve started a planning grid with all of my topics and resources, and things are starting to come together. Since June is Scleroderma Awareness Month, this is the month that I should do this. If I can put this all together, there will be a post each day this month. With Star Trek quotes, of course!

I did tell you I was a science geek, didn’t I?

So Long, Farewell, Auf Weidersehen, Good-bye… to My Support Group

Okay, this is a rant. This rant is so long and complicated, with so many connections to other topics, that I have considered that I should perhaps launch another blog just to deal with it. Or maybe create an online course for people with complex autoimmune diseases. Something. Because I finally have snapped for sure.

It happened while I was attending my monthly Scleroderma Support group in July. I go to these meetings because I need to talk to people about my illness, become educated about treatments and coping strategies, and to get, you know, support! I want to flock with my peeps!! Usually in these meetings there are introductions, a little sharing, nice snacks, and a presentation by a guest speaker.

This is the problem. The speakers who have been coming are often involved in alternative treatment strategies. As in alternative medicine. As in flat out pseudoscience masquerading as legitimate methods of treatment for our complex health conditions.  These speakers have been trained in their “method” and faithfully parrot back what they were told in their training. They have little actual knowledge of human physiology, biology, disease, or science. They are connected to a product or system that they want to sell to us to help us “stay healthy”. They especially tell us that they can help us have “healthy” immune systems and/or take away our pain. Since I am in pain because my immune system is misbehaving it’s hard to not find their messages appealing.

Except… I was a biology teacher. I used to work in a research lab. I know science as a logical process with rules, and this information is so outrageous it causes me to wiggle around in my chair, bite my tongue, and often whip out my cell phone to fact check.

Me: Google, please tell me if Leaky Gut is a real thing?

Google: Are you crazy? Of course not.

Me: That’s what I thought…

But evidently I absolutely, positively need to take this essential oil to protect me from leaky gut. Or the toxins will leak out though the holes in my intestines. This is the cause of many complex illnesses. Research? We don’t need no stinking research. We have testimonials!!

Compression Points on Foot
This pressure point chart was so outrageous I needed to put down the knitting to take a picture!

How about the day I learned that I need to massage my hands and feet at specific pressure points to clean the toxins out of my liver, pancreas and other parts of my body? Really. I was informed that the problem is that the cells of my body get dehydrated, will form tough protective barriers, and the fascia then can’t move fluids throughout the body. This was such a garbled version of reality it was practically science salad.

Me: Google, please tell me exactly what fascia is.

Google: Sure. Fascia is the thin, tough barrier around muscles and organs. It is part of your connective system and made of collagen.

Me: Google, just to be sure, it doesn’t have anything to do with fluid transport?

Google. No, dumb ass. That would be the lymph system.

Me: Google, that’s what I thought. No need to cop an attitude with me, you wouldn’t believe what I’m dealing with here.

As if all this fact checking wasn’t exhausting enough, there is also a hint of “anti-science” in the room. Several other patients have become convinced that we need to stop taking our meds as they have unacceptable side effects. It is better, they argue, to control our disease with diet, essential oils and supplements. OMG! It isn’t possible to google fast enough to keep up with this stuff!

Me: Google, what is this alkaline diet all about?

Me: Google, is dairy inflammatory?

Me: Google, do I need to take massive doses of probiotics every day, or can I just eat yogurt? This speaker is telling me I have to buy their product since I can’t eat dairy anymore…

Me: Google, how quickly do bacteria divide? Every 20 minutes? So I don’t need a massive dose?

Me: Google, is there any research showing a positive benefit of essential oils in systemic sclerosis?

Google: Stop! I have smoke coming out of my ears! Let me direct you to this nice List of Topics Characterized as Pseudoscience. There. You’re welcome.

Lunch
Yep. This is my lunch. See the dairy? That yogurt has 8 live cultures in it and I am not giving it up!!

While loading up on gluten free snacks at the break I finally snapped and asked the group facilitator if she thought it would be appropriate to let people advocate going off their meds and using essential oils to treat their conditions if this was a cancer support group?

“Well, no…”, she replied. “But that’s cancer.”

I just looked back at her until I saw something click in her brain, and then I left. I’m done.

Since then I have been fussing around about why this is happening. I understand that this is a tough disease (in more than one way), but how awful it is that there is so much misinformation out there that people don’t know what is accurate, and what isn’t. Desperate people will clutch at anything that gives them hope. Sometimes these things are based in sound logic, reason and science (stem cell transplants), and sometimes they are not (amber beads for pain relief). Obviously people need to know more about the nature of science, basic physiology, immunology, cell biology, and how the medications prescribed by their doctors work. They need to know their Star Trek!!

Star Trek Meme
A no-win scenario, the Kobayashi Maru test was designed to be a test of character. 

That’s right. Star Trek II: The Wrath of Kahn is what I needed to put this into perspective.  So many movie quotes, so many posts.

So, I feel a lot better after finishing up my rant, but I still think that I may need to launch a mini-series of posts relating to this. I mean, there are all those pseudoscience cures to debunk. All that biology to share. All those Star Trek quotes.

Stay tuned. If I start the new blog, I’ll let you all know where it is. Otherwise, a lot of my knitting friends are going to be exposed to some biology.  Feel free to let me know how you feel about that.J

Biology Brain

When I taught high school biology I had a sign over the door of my classroom that said “Biology is Life”. (I also had a poster with a picture of Charles Darwin and a caption that said “AP Biology: Adapt, Migrate or Die”, but that is another story…) Anyway, I thought my sign over the door was cute. And true.

This week I finally took on the task of weeding out my flower beds and getting them ready for the new year. Really, a simple and somewhat rewarding task, but for me an afternoon of rich classroom memories and an endless rush of biological trivia. It was so much fun, in fact, I thought I’d take all of you on a short trip through my garden. Ready? Here we go!

Unweeded Garden
What a disaster! This garden has several little tea roses, a beautiful English rose, and some nice perennials. Ugh. Mostly I see dandelions
Flower and Bee
Clever camera: it focused on the grass instead of the flower. (and my biology brain reminds me that the grass is a monocot and the dandelion is a dicot. Thanks bio buddy…) Oh, well. You can still make out the bee in the flower, can’t you? We think of dandelions as pests in our gardens (well, I do!), but they are actually early blooming plants and an important source of food for bees and 
Ladybug
my personal favorite (after bumblebees) the ladybug. Later on the youngsters from this beetle will help keep my aphid population on the roses under control, so that makes dandelions a good thing,
Dandelion Puff
I know that they are good for the wildlife, but I still have to get rid of these darn plants so my roses can shine. Look at this puffball of seeds (dandelions use wind as a dispersal strategy chants my brain… The seeds can survive up to 5 years and help the plant population survive fires…)
Dandelion root
and the root! I’ve been told that the root as also an adaptation to help the plant survive prairie fires. Don’t know about that one, but we all know we need to get the root out or the plant will come back. (That root is a tap root . Thanks biology brain…)
Pill Bug
Oh, wow. A pill bug! I love these guys. I would teach my AP Biology class how to make potato traps and assigned them the homework of catching 10 bugs over a weekend so they could design experiments using them in little choice chambers. The students learned how to design controlled experiments, drew conclusions about animal behavior, and the bugs had a fun outing and all the potato they could eat. It was fun, really. (Arthropods, crustaceans really, says the ever intrusive biology brain.) Over the years so many bugs were released in the flower beds at the front of the high school a robust population could be counted on to bail out any student team that forgot to do their homework.
Earthworms
Exactly the same type of thing happened at my house where yearly infusions of classroom earthworms established many happy garden occupants. (Annelids, says the brain. If you accidentally cut them with the shovel they will probably make it, but not as two new worms. ) My students loved to name and race their worms. If you put them in your hand you can feel the little bristles on their tummies (Setae! Thanks, brain.) The bristles anchor the worm as it pushes forward in the soil. Kind of like wax on cross country skies…
Rose Seeds
The English rose has a mature rose-hip with seeds in it. Look at these guys. I wonder if I can get them to sprout and grow. (…the seed is really a baby plant and the food it needs to grow. The food part of the seed is double fertilized so it has more copies of the roses’s chromosomes than the rose plant does. Roses, unlike humans, can have different chromosome numbers… shut up biology brain. Enough!!)
Finished Rose Garden
The weeding is done. You can actually see the rose plants OK now. They all came through the winter in good shape and are putting out new growth.  The largest rose is my Princess Alexandra of Kent rose, and it has started growing the first buds. All is looking good. Time to mulch, feed (plants need the elements in fertilizer to make more proteins and to copy the DNA in their cells so they can divide… yep, the brain is still going…) and get to work on the other jungles gardens.

Rich with life, details and memories, my gardens are once again growing.

Biology is life!!

The Art of Serendipitous Phenomenology

When I used to work in a medical research lab one of my co-workers described what we did as mastering the art of serendipitous phenomenology.  I think that he meant that we (hoped to be) alert, observant, curious and reflective about events around us. Big discoveries can occur from chance observations if one pays attention; one of the famous ones is Alexander Fleming’s discovery of penicillin. Another of my coworkers discovered an important immune system inhibitor (which led to a patent and eventually a drug. How cool is that?) Of course, there aren’t any big scientific discoveries in my life right now, but I have had a run of fun occurrences lately. It’s been making me think about serendipity, and that perhaps one of the secrets of finding joy in every day living is in mastering the art of serendipitous phenomenology.

So, here is my run of fun;

Starbuck's Card
I went into a strange Starbucks Sunday on an impulse while picking up Chinese takeout. I needed a new Starbuck’s card as I had just lost mine. Look at what I found!! The hard-to-read text on the left says, “Year of the Sheep”.
Book.
I was in a slump this weekend because I had just finished a good book. I forced myself to start reading the next book on my list, and it’s a science fiction with the title of WOOL!!  It’s a really good book, too. How much fun is that?
Yarn
Serenity 20 sock yarn by Zen Yarn Garden. The colorway is Jewel.

I was already contemplating serendipity when I arrived at my favorite local yarn store yesterday. I had a hazy notion that I wanted to get a cashmere blend yarn that would look nice with grey to make another Hitchhiker (by Martina Behm). Going through the sock yarns with a friend a skein suddenly fell out of its cubby and landed on the floor at my feet. “Well, there’s your yarn”, said my friend. There it was indeed! This yarn is 20% cashmere. The color is perfect for me and my new grey sweater. After going through all the yarn we could not find one that was a better fit.

Hey, who am I to argue with the universe? This yarn is clearly destined to  become a Hitchhiker. The answer to Life, the Universe and Everything. Obviously I needed to buy this yarn.

See what I did there? Even though this yarn was expensive I was able to absolutely justify buying it with my smoking post-Christmas credit card.

And that is the Art of Serendipitous Phenomenology, my friends.