Date: 2007-11-09 23:41 Subject: More cool patients! Security: Public Mood: Fascinated

Thursday was awesome...

How often is it that you get to see a kid with a rare genetic disorder that arises primarily from her ancestry??
We saw a little girl whose parents are Norwegian and Irish, and she presented with multiple fevers over the course of her short 15mth life.

We had to send off 2 different genetic tests to test for HIDS (Hyper IgD Syndrome) and TRAPS (TNF Receptor Associated Periodic Syndrome) both of which are seen only in those of Scandinavian descent. Very very neat diagnosis :)

There are other disorders in that family of syndromes, but no one really knows why they occur preferentially in certain races. Although, the course of the diseases have been studied extensively and they've been pretty well characterized.

http://en.wikipedia.org/wiki/Periodic_fever_syndrome

I'll re-iterate : very C-O-O-L!

I also went to a talk given by a guy from Italy and he was taking about Tunneling Nanotubules (TNT) in the immune system. Some pretty amazing mechanisms are present in the body, and with the technology we have now, we're able to see these TNTs as they form!

Every day, I learn how little I actually know about my field, and its FASCINATING!

Date: 2007-09-18 22:47 Subject: Holy Crap. Security: Public Mood: boggled

Wow, I absolutely didn't realize how much effort went into completing the applications for the MD/PhD.
And I'm still working on my primary apps (which apparently, I'm already late for...even though the deadlines are mid-October - it seems schools look favorably on early applicants. ugh)

Not only has this primary process made me go through my entire college career in minute detail, its also forced me to re-examine every reason behind why I want to be a doctor and why I want to do research. And its HARD work to put your life and goals in perspective.

Well, in a "perspective" that makes you seem like the ideal candidate to the admissions committee without tooting your own horn too much.

I had forgotten how difficult it was to write an essay that extolled your virtues without making you seem pompous...until today.

I have 3 essays to write to complete my Primaries - and I plan on spending every spare moment on them to make sure they're amazing...because the only way I'll be accepted into such a competitive program is to completely blow them away.

You girls willing to read them, and tell me what you think???

Date: 2007-09-11 20:53 Subject: The state of the healthcare system Security: Public Mood: contemplative

As adept as the healthcare professionals are in the United States, the actual healthcare system leaves a lot to be desired. I am all for the average person being able to support their medical needs with their "average" salary instead of having to pay an insurance provider to subsidize ridiculously inflated prices of treatments.

I understand that most of the cost incurred during the actual production of drugs, the manufacture of the machines and the salary of all the healthcare providers is astronomical - I mean, every experiment I run costs in the thousands of dollars, and putting a drug on the market is many, many, many steps down the road from the research I am doing. But there has got to be a better way for a country to support its citizens' well being.

For instance - the non-subsidized cost of my daily medications, combined with my monthly checkups, annual doctor's appointments and tests run an average of $13,000 - about $600 a month in medications ($7200 p.a.), monthly lab tests at about $400 ($4800 p.a.) and annual specialist visits ($200 p.a.) with imaging studies ($500 p.a.). This is on a good year for me, where all the above are only to maintain my health. With insurance coverage, I pay approximately $500 annually. If I have a couple months where I flare, the cost jumps exponentially. The discrepancy is unbelievable. I don't know how someone without insurance could cope with any sort of chronic ailment.

Because the cost is so great, insurance providers usually spend as much time as they can to ascertain that the treatment is vitally necessary for the patient before approving it. Over the last couple of months, I have seen this issue be brought into sharp relief because we've had to prescribe less effective (but cheaper) meds to patients whose insurance will not cover the newer treatments. They usually insist that we prescribe the tried-and-true meds first before coming to the conclusion that they are not working - then they finally give in to covering the necessary medication. Knowing what I know about the efficacy of these drugs, it makes no sense to me as to why cutting edge treatments aren't covered (not at first, anyway). The insurance ends up spending more money in the long run through the course of the treatment with the old drug because of all the potential health problems and side effects. Undoubtedly, there are risks associated with giving meds that are relatively new to the market, but physicians don't make the decision to prescribe them lightly. In the end, their priority is the health of the patient, and every step they take is hopefully moving toward that goal as efficiently and safely as possible.

Over the last 2 weeks, I've been fighting with my insurance company for them to cover one of my meds - something I've been taking for the last 5 years...which they decided (out of the blue) that I was only going to get 7 days worth, non-refillable. Being that I can't really function without it, I've been on a mission to get them to say yes. After many, many frustrated conversations with everyone that could have a say in whether I get the meds, I finally picked them up today. These orders to fill my prescription stand for a year, at which time I am going to have to renew all the authorizations. I am extremely thankful that it all worked out this time, but I can only imagine what someone else would have to go through if they were in a similar situation. I was lucky in the sense that I knew the people that could make the insurance company change their minds, but without that extra advantage, it would probably take twice as long to achieve the same result.

It just makes me upset that a patient (who is trying their hardest to stay healthy) has to go through haggling with the insurance companies when their prescriptions are denied. They have to flip back and forth between talking to their physicians and the insurers, then back to their physician to to have them call the provider and back again...and a week or two later (if they're lucky), they finally get to reap the benefits of all their efforts.

I wish there was a way to make it easier for both the patient and the provider to benefit from this insurance system. There is an uneasy balance at this point when it comes to day-to-day prescriptions and procedures. However, when the situation calls for more complex treatments, more often than not, it is the patient that suffers.

There needs to be a situation where the most important part of the equation, i.e., the patient's needs, are met to the fullest degree.

How is this going to be possible?

Date: 2007-09-09 22:41 Subject: (no subject) Security: Public Mood: tired

I'm done with the test!

Now, on to the phase of keeping my fingers crossed and hoping for the best...

Had a great weekend, though :) Hung out with the girls on Friday and celebrated being done and then hung out at Jon's all Saturday night!

Date: 2007-09-04 10:09 Subject: (no subject) Security: Public

I should've have studied more over the course of the summer...

Date: 2007-08-29 23:17 Subject: (no subject) Security: Public

4 new patients in clinic tomorrow!

Date: 2007-08-28 00:59 Subject: Dear diary... Security: Public Mood: numb

Today was intense, and disheartening and long.

With surgery on the horizon, the constant pain and the MCAT in 10 days, I hardly have enough emotion left to deal with daily circumstances.
However, if all goes well, my applications should be ready within the next month, and be on their way soon after.

Also talked to Bryce at length today, and he gave me a suggestion - to keep an extensive diary of what it feels like
a. to be a person suffering from the disease and its complications
b. to be working in a clinic and seeing seeing similar patients and their treatments
c. and doing molecular research on the same condition.

In jest, he mentioned how it could be publishable when I end up being a successful doctor.

All joking aside, I think it'll be interesting for me to take on such a project. With all the ups and downs of being a recent college graduate applying for a graduate degree, dealing with a bad breakup and having to cope with the effects of the disease and the meds I take, I think it'll be therapeutic for me to put down all the feelings of frustration and conflict on paper, and perhaps the process will help me sort through them better.

Plus, it might keep things in perspective when everything feels like its spiraling out of control (like now, for instance).

As another aspect of this log, it would be nice for me to keep track of the things I am blessed with and am undoubtedly extremely grateful for. It never hurts to count your blessings, and it'll go along with my renewed faith in keeping a positive attitude.

Things like my job and the absolutely wonderful people I work with, my loving family, supportive friends, no other complications of the disease process so far, advancements in treatments, my determination to accomplish my goals etc...The diary will include details in these categories - things I see everyday that make me thankful to be able to experience them.

With everything that is going to happen over the next several months, keeping my chin up is going to be my hardest challenge.
- Surgery itself is scary (and I will need 2 - a couple months apart)
- Then there is the physical therapy associated with each surgery and having to learn how to walk again.
- Finishing up applications for programs that only accept between 9-12 students every YEAR and waiting with bated breath for a secondary app or an interview.

Hence, I think this diary will be great. All I need is that and a subscription to Nature - Immunology and Netflix, and I should be able to pass the time just fine :)

More details on when the surgery will be happening and what it actually entails will follow as soon as I know them.

Keep your fingers crossed for me...

Date: 2007-06-19 23:50 Subject: Long overdue... Security: Public Mood: tired

Much has transpired since my last entry -

1. Started a new job, which I absolutely LOVE everything about on 05/14
2. Saw my first patients as a professional :)
3. Hung out with co-workers (as a colleague, not just a student) at the boss-man's amazing house in Stillwater
4. Dates with boys :)
5. 21st Birthday!!! Great dinner, fun after-food bar hopping, followed by some unpleasantness
6. Awesome wedding and dancing for 3 days straight
7. Spiderman 3, Ocean's 13, Fantastic 4 - The Silver Surfer, Shrek 3
8. Studying for MCATs have begun in full force
9. First real attempt to work out on a regular basis, although a potentially major setback has already been encountered :(
10. Plans are in full swing for graduation party on 6/23
11. Grandparents arrived end of May, to stay till October - excited about that!

The pace of this past month has been unbelievable...work is keeping my nose pretty much glued to the grindstone!

The future looks promising, though. WIth all the clinical and research experience I'm getting, I'm excited that the prospect of getting accepted into an MD/PhD program is becoming more and more of a reality :)

Date: 2007-05-13 22:11 Subject: One small step for man... Security: Public Mood: excited

It will be my first day of work tomorrow :)
My first step into the rat race...to being called a professional!
A college graduate with a career!
HA! Thats pretty effing awesome.

Date: 2007-05-07 20:29 Subject: So its somewhere I can access it Security: Public

From JH's LJ:

"I think the life cycle is all backwards. You should die first, get it out of the way. Then you live in an old home. you get kicked out when you're too young, you get a gold watch and you go to work. you work forty years until you're young enough to party, you get ready for high school. you go to grade school, you become a kid, you play, you have no responsibilities. you become a little baby, you go back into the womb, spend your last nine months floating...and you finish off as a orgasm."





It takes courage to recognize the real from the convienient.

Date: 2007-05-01 00:20 Subject: (no subject) Security: Public Mood: blah

Bought a new watch that I'm in l-o-v-e with!! (after retiring my old Skin watch which lasted my almost 8 years!) Its even got a name...Luluida, by Swatch.

Witnessed an accident on 394E near the 100 exit...hoping no one died, but the victim in the sedan did seem like he needed an AWFUL lot of medical attention. I'm trying not to think about it. Second accident witnessed in the past year. Not a good morale booster.

Date: 2007-04-17 08:31 Subject: Can I be emo again? Security: Public Mood: blah

Virginia Tech shooting yesterday - death toll so far is more than 30. This includes my friend (whose name I won't reveal). I got an email announcing his demise...I guess everyone in his addressbook received the same notification. I'm crushed. Even though I didn't know him well, we still shared a laughs and a love for immunology.

RIP, good friend. You will be missed. And my prayers go out to the families of all the victims.

Another death close to home yesterday - close family friend's dad passed away today. He tried to kick a soccer ball a couple days ago, fell and then died in the hospital yesterday.
He was 87 years old, so at least he did live a full and happy life.

My brother went to the ER yesterday because he took a tennis ball to...um...his balls. He is ok, but is in pain, poor kid.

I think everyone needs a break from pain every once in a while.

Weekend was busy - Friday night was the GK induction, and it went pretty well. Am really glad to be done with all that planning. Then went and celebrated at a Drag/Masquerade party :)

Saturday was the ASU banquet - where I was at the same table and Kevin and girl. To say it was a strained couple of hours would be a huge understatement. Then went over to Tom's and hung out for a little bit.

Went to Josh/Bryan/Eman's place for dinner and drinks and The Devil Wears Prada. Hanging out with Greg and Bryan definitely constitutes a good evening!

Date: 2007-04-15 02:07 Subject: (no subject) Security: Public

Totally emotionally tiring night.

Date: 2007-04-11 22:29 Subject: Drained. Security: Public Mood: emo

This week has been a little (a lot) tough to get through.

First with the cold and now snow...my hips and knees are taking a beating. Also figures that this is the week that I started seriously working out again. So, after the first 2 days, I'm back to sitting on my ass because I can't move. Its very motivating.

Not really.

Second - my uncle's brother (mother's sister's husband's brother) just died - he had a brain tumor removed 5 years ago and was fine till this past month. He passed away really suddenly because the tumor returned, and was much more aggressive than before. Its not like I was close to him or anything, but still having something like that happen to a family member is more painful than expected.

Then, I got a message on Monday on FB that my best friend in S'pore for 4 years committed suicide. Needless to say, it was not the easiest way to receive that information, considering we'd lost contact apart from the occasional email. The feeling of guilt was terrible! That day was filled with calls to and from people I'd known in S'pore hoping to find out more information. Turns out that someone else from my school with the same first name was the unfortunate soul. I still knew the girl, but was definitely relieved that my friend was ok.

In the spirit of bad news - my cousin was planning on coming here for a month in June and we (i.e., my brother, him and me) were going to visit the different univeristies across the country that he was planning on applying to. BUT, his visa application was denied since he is an 19 year old male studying engineering who is very likely to find something he likes in the US (apparently) and move away from India. Bastards. So, now he can't come and he is crushed :(

Also, my honor society's induction ceremony is coming up on Friday (the 13th...which is always nice!). I have to figure out my speech etc. since I'm the president, and the planning and confirming/re-confirming is driving me up the wall.

But once Friday rolls around, things will start to look up. Andy is driving up from Chicago :) and I get to go to a party with the theme "Desserts, Drag and a Masquerade" with Josh, Eman and Bethany...Beth being my date, of course! It should be exciting! I have dinner plans at Josh's on Sunday, which should be exciting also. Plus, Aaron and I are finally getting down to going for salsa lessons!!

Let see, the past couple of weeks have been eventful:
- went to the Acme comedy club (with Kristina, Ankur, Roma, Falgun, Mayuri, Nandini and Vipul)
- watched TMNT with brother (and was disappointed)
- went down to Winona (with Kyle and Jackie) and had a good ol' time with Mr. Tequila!
- got sketched to be a kickass leather-wearing, blade-toting assasin in Sam's comic book...rock on!
- had dinner with Robert at CPK
- grabbed coffee with Vicki and Grace (whom I haven't seen since almost 3 years ago)
- went to Taste of Asia with Jane where we got henna done (amongst other fun run-ins)
- bought my first Twins T-shirt
- got interviewed by Haley for almost 2 hours at Starbucks for her medical paper thingy
- had an amazing time with the Thanksgiving crowd at a party for Surbhi/John, Shuba/Chuck. Sunayana/Raj and Shilesh/Noopur
- played a joke on Jamie over AIM telling her that I was getting engaged to a boy I'd been dating in secret!
- had Kristina come over and teach mom and me some traditional Garba/Dandiya moves
- got my hair cut and colored...so I am now almost a redhead :)
- have plans to meet Michael for lunch next week
- oh, and went on a couple dates! (which I will refrain from describing here...but they were FUN!)

On my list of really really important things to get done:
- clean my room! (such a disaster area...very very uncharacteristic of me!)
- ***** finish the DAMN thesis and send to readers by next week *****

Apart from above mentioned, nothing new going on in my world.

Date: 2007-03-26 00:54 Subject: Result of watching TV at 11pm Security: Public Mood: thankful

http://img.photobucket.com/albums/v112/iiacslaterii/kenadie.jpg

Primordial Dwarfism.

I just watched a documentary about this condition - only about 100 kids exist in the world and 40 of them are in the United States.

Average height : 2 - 3 feet
Average weight : 15 - 40 lbs (for a 16 year old)

Its unbelievable...all their organs are miniature, proportionate to their physical size. When they speak, it sounds like what you'd expect a diminished voice would sound like (think back to Honey I Shrunk the Kids).

No knowledge as to why they are the way they are. Hence no treatment and no cure.

Couldn't even fathom what kind of emotional stress these kids are under from their friends in elementary school and middle school.

Date: 2007-03-20 10:56 Subject: (no subject) Security: Public Mood: hungry

I forget why I love my job at times (like the last couple of days), but each time I have a meeting or talk with my colleagues, I am reminded why I've stuck with the same lab for the last 3 years. Kathy is amazing in the way she motivates people - she is one of those nurturing bosses, who 'suggests' what she would like to have done, but ends up making you feel like you came up with the idea all by yourself :)

This is just to say that my meeting with the heads went really well. Looks like my thesis will be done in 3 weeks max (as long as I stay on the ball and get drafts out according to plan) - then I'm done. The lab here is winding down pretty smoothly - people have found new places of employment and them some others are getting hitched! Now, if I get the job I am hoping for, I'd say that the lab has brought pretty good luck to all involved!

Plans are underway for a Winona trip this coming weekend and Jane has already started sending emails out about the summer cabin trip. Hopefully I'll be able to make it, but if its too much trouble to have everyone's schedules coincide with mine, I would say to go ahead and do whats best for the majority (although, I'll miss being a part of it this year if that happens!)

Hoping to also see Bethany, Alexa, Jessica, Ranju and Tarun sometime this week. Hopefully I can work that out.

Oh, and I have also come to the conclusion that I am done feeling bad about the whole Kevin situation. It is going to be a conscious process, but I figure I only have time to move forward. Wish me luck.

P.S. I plan on typing and posting the journal I kept while in Paris. Expect a long entry soon!

Date: 2007-03-16 23:51 Subject: I know I am a little late in catching this one, but... Security: Public

"If I were an enzyme, I'd be DNA helicase, so I could unzip your genes!"

Date: 2007-03-14 23:00 Subject: I have a dream... Security: Public Mood: determined

...that someday, I will be able to set my mind to a task and accomplish it well before deadline.

But:
I have a serious procrastination problem.

Example : First draft of thesis to be presented to boss(es) on 03/20 = 6 days left.

However, since I usually crank out papers 24hrs or less prior to deadlines, I am not compelled to do it now. BUT I know I will be in serious trouble if I don't at least finish this one and revise it twice before I show it to the powers that be. All this work definitely requires more than 6 days.

Still, all I do is hang out with people, watch TV and squeeze in maybe an hour or two of work somewhere in the middle.

NOT acceptable.

Beginning tomorrow - I am cutting myself away from TV (except for the hour at night when Grey's is on) and spending every waking moment either working on the paper or resting to get over this wretched flu!

Good luck to me.

Date: 2007-02-28 21:54 Subject: uggggggghhhhh! Security: Public Mood: awful!

You know that awful feeling you get in the pit of your stomach when you realize that something you did could end up resulting in something awful? I have that feeling now...and I feel terrible!

My cousin wanted an Ipod from here (they live in India). So, she asked us to buy it and insisted on mailing it out to NJ where my uncle (i.e., her dad) was visiting. So I bought a $260 piece of equipment and sent it via priority mail with delivery confirmation. Here's the thing - I've been checking the tracking number online and it says it was delivered this afternoon, but my uncle hasn't received it yet. Which, by itself is freaking me out.

SO - now, all I can think about is the fact that I should have sent it by extra priority mail, and perhaps gotten the insurance or something...I don't know. Its killing me. I don't know how I would deal if it (heaven forbid) has been stolen/gotten lost.

And with all the snow, and the fact that our flight might be delayed etc...my spirits before my vacation are very down in the dumps.

I am keeping my fingers, toes and eyes crossed in hopes that everything works out well, and I can enjoy the next week.

------------EDIT-------------

So I got the call this morning that the Ipod reached safe and sound. The website might have been a little off, but everything is good again :)
yay!

Date: 2007-02-27 23:36 Subject: (no subject) Security: Public

OMG PARIS!