Archive for the 'Uncategorized' category

My Crowded Nightstand: A Cry for Help

May 25 2017 Published by under Uncategorized

My bedside table is getting too crowded, and I need to get something off of it. This could be best accomplished by eliminating my clock radio. After all, I have an iPhone that has to be there when I'm on call. It has an alarm. It has access to my favorite radio station. In short, it can do everything my clock radio does.

Except wake me to a radio stream.

The system's built-in alarm can access music and playlists, but not radio streams that are present in the Music App. This seems to be the case for the third-party clock radio apps in the store.

If anyone out there knows how to make this happen, I would love to hear about it.

4 responses so far

My Mantra

Mar 24 2017 Published by under Uncategorized

Today I will be repeating the following:

  1. I am a bitch
  2. Bitches get stuff done
  3. I can handle this because I have resources, I can find help, and I am a bitch.

No responses yet

Medical Stress

Feb 24 2017 Published by under Uncategorized

Yesterday I received a medical bill for my husband, hardly an unusual occurrence given his brain tumor. Unlike the usual bills, this one included almost $4,000 in charges when his out-of-pocket expenses were satisfied last March.

Going through line-by-line, I discovered that no one filed claims for three procedures in November and December, including a surgical procedure that resulted in most of the amount due.

All of this should be covered.

I called the billing office, and they told me to tear up the bill and await a corrected one.

Yesterday was a stressful day anyway. We found out that the tumor was progressing again, and we are now waiting to hear what other trials my spouse can try.

Getting that bill was unnecessary stress. Part of me wanted to curl up and pretend it didn't exist. Part of me thought about just paying the damn thing so it went away. Luckily, the part that won said, "WTF? How can that be?" and went through the charges to find the problem.

Brain tumors suck.

 

 

3 responses so far

Wanted: Pediatric Nephrologists

Sep 15 2016 Published by under Uncategorized

Are you a pediatric nephrologist? Or one in training?

childrens-logoAs the soon-to-be section chief at Oklahoma University Health Sciences Center, I am ready to start recruiting a junior faculty member!

We have a nice children's hospital  with an amazing group of 3 current nephrologists. We have a transplant program and a hospital-based pediatric dialysis unit. We are working to officially post the job, but it's coming soon.

Contact me via email or social media - hell, you can even write via snail-mail if you want. If you see me at Kidney Week, give me a yell.

A four-person group makes for a livable call schedule. Besides, you get to work with me; what's not to love about that?

No responses yet

Toilet Police

Aug 23 2016 Published by under Uncategorized

ToiletLoveFor many years I have ridiculed self-flushing toilets. What problem do they solve? They seem to go off at random, at least on some occasions becoming a bidet in the process. What a waste of water.

Then I overheard this conversation in a public restroom:

Mother: All done?

Child:  Yes

Mother:  No, do not flush. That handle is dirty.

They then left the waste floating while they left. They did wash their hands.

I just wanted to scream at them! How many people will now avoid that stall because it might be out of order? Do you think public establishments have someone who just runs around flushing the toilets periodically? You need to wash your hands anyway after wiping your naughty bits, so touching the flush handle is not going to harm you. If you're that skittish, wrap some toilet paper around your hand and then throw it in the trash before you wash your hands.

This behavior is why we need toilet police, not stalking!

2 responses so far

Damage Control in the Cortical Collecting Duct #expbio

Apr 04 2016 Published by under EB2016, Uncategorized

Vasopressin-Escape Does Not Involve marked Changes in the Ratio of Intercalated-to-Principal Cells in the Cortical Collecting Duct

Chou C-L, et al.

Vasopressin, also known as anti-diuretic hormone (ADH), promotes absorption of water from the kidney’s cortical collecting duct. Under certain conditions, ADH can be inappropriately secreted, resulting in excess water retention and lowering of the body’s osmolality. Changes in osmolality can be quite dangerous, especially for the brain, so it is not surprising that the collecting duct can “escape” the effect of ADH to limit low plasma sodium and osmolality. This group previously showed that such vasopressin-escape occurs in association with lowered levels of expression for aquaporin 2 (AQP2), a water channel that allows ADH to do its job.

Autocrine and paracrine regulation of collecting duct principal cell ENaC and AQP2. Much commonality exists in regulation of ENaC (left) and AQP2 (right). Flow stimulates ATP, PGE2, and ET-1, which act on their cognate receptors to inhibit Na and water reabsorption. Similarly, bradykinin, adenosine, and NE act on their receptors to inhibit ENaC and AQP2. Flow-stimulated EET uniquely inhibits Na, but not water, transport. Compared with the wide variety of inhibitors, relatively few autocrine or paracrine factors stimulate ENaC and/or AQP2 activity. Renin, ultimately via AngII, as well as PGE2 binding to EP4 receptors, are potentially capable of augmenting principal cell Na and water transport. TZDs (via PPARγ) and kallikrein (via cleavage of an autoinhibitory domain in ENaC) may increase Na reabsorption. See the text for more detailed descriptions of each regulatory factor. ACE, angiotensin-converting enzyme; AGT, angiotensinogen; Ang, angiotensin; AQP, aquaporin; EET, eicosataetranoic acid; EP, PGE receptor; ET, endothelin; NE, norepinephrine; NO, nitric oxide; PPARγ, peroxisome proliferator–activated receptor-γ; TZD, thiazolidinedione.

Autocrine and paracrine regulation of collecting duct principal cell ENaC and AQP2. Much commonality exists in regulation of ENaC (left) and AQP2 (right). Flow stimulates ATP, PGE2, and ET-1, which act on their cognate receptors to inhibit Na and water reabsorption. Similarly, bradykinin, adenosine, and NE act on their receptors to inhibit ENaC and AQP2. Flow-stimulated EET uniquely inhibits Na, but not water, transport. Compared with the wide variety of inhibitors, relatively few autocrine or paracrine factors stimulate ENaC and/or AQP2 activity. Renin, ultimately via AngII, as well as PGE2 binding to EP4 receptors, are potentially capable of augmenting principal cell Na and water transport. TZDs (via PPARγ) and kallikrein (via cleavage of an autoinhibitory domain in ENaC) may increase Na reabsorption. See the text for more detailed descriptions of each regulatory factor. ACE, angiotensin-converting enzyme; AGT, angiotensinogen; Ang, angiotensin; AQP, aquaporin; EET, eicosataetranoic acid; EP, PGE receptor; ET, endothelin; NE, norepinephrine; NO, nitric oxide; PPARγ, peroxisome proliferator–activated receptor-γ; TZD, thiazolidinedione. Click image to access full review article.

Their current question centers on how AQP2 gets down regulated. It could be an intracellular mechanism or remodeling of the collecting duct, with a change in the ratio of principal and intercalated cells in that structure. Principal cells regulate sodium, potassium, and water reabsorption in the collecting duct, while intercalated cells influence acid-base balance. Decreasing the number of principal cells could decrease the effect of ADH. A full review of principal function can be found here; the image above comes from this paper.

After micro dissecting cortical collecting duct segments from animals in the early phases of vasopressin escape, the investigators probed them with a marker for all cells; an antibody to H+-ATPase, a marker of alpha intercalated cells; and an antibody to pendrin, found in in beta intercalated cells. They could then calculate the number of principal cells and intercalated cells to see if the principal cells decreased to explain the diminished AQP2 expression.

The cellular ratios did not differ between normal and vasopressin-escape animals.

So what intracellular process could be involved? Further exploration suggests a shift in cell cycle from G0 (resting) to mitosis. How this reduces AQP2 expression is not yet clear.

No responses yet

It's All About the K

Apr 04 2016 Published by under Uncategorized

Despite the title of this year's Gottschalk lecture, it really was all about the potassium...

No responses yet

Welcome to #ExpBio 2016

Apr 03 2016 Published by under EB2016, Uncategorized

San Diego once again proves itself to be an absolutely lovely city. The sun is out, it is 70 degrees, and a light breeze tickles us as we stroll from hotel to convention center. I feel refreshed, both by the locale and a gathering of friends.  The science starts in ernest tonight with the Cannon Lecture when Amira Klip of the Hospital for Sick Children in Toronto presents her work on muscle-immune cell crosstalk in the genesis of insulin resistance. 

I will be live tweeting her talk using the hashtag #Cannon16 if you want to follow along. If not, I will present my notes/tweets here at a later time. Also be on the lookout for my take on today’s APS Communication Workshop, Setting the Record Straight for Science: How to Write to Local and National News Outlets.

Now I have to put some juice in my phone and get ready for the address. 

No responses yet

Ups and Downs

Mar 25 2016 Published by under Uncategorized

Chronic disease includes periods of relative “health” and intervals of exacerbation. The health problems my spouse and I suffered, until recently, meant taking some medications and monitoring parameters. We always had to remember our limits, like a tickle in the back of our minds, but otherwise life felt normal.

This brain tumor has other ideas. Since March 1, my spouse has spent 7 nights at home. Today I fetched him home again, following a procedure that I hope will keep him out of the hospital for a nice long while.

As hopeful as I am, I know that we are highly likely to achieve inpatient status again in the near future. It’s the nature of the beast for now. I do have new empathy for my patients and their families, especially when an acute illness means ruining a vacation or birthday or other event. 

Good luck to everyone dealing with chronic disease. Even if you are in the relatively healthy, silent phase, you still have to be wary.

One response so far

Before and After

Jan 27 2016 Published by under Uncategorized

Life contains a number of events that define turning points. "Before graduation", "after I had kids", and "once I got promoted", for example.

Last week now stands as one of those events. My husband developed a major mental status change. Within 24 hours we diagnosed his brain tumor and had it out the next day. He is much better now mentally, but we have a long road ahead of us.

In those first days, adrenaline kept me going. I had to notify family and get through the immediate issues. (By the way, 140 character twitter updates are the perfect length for anyone in a surgery waiting room. Cute animal photos also make a nice break in the tension.) Post-op, he was sitting up in the ICU talking to us again. Every time I saw him over the next 5 days he was more fluent and seemed more like himself.

Now the relatives have gone and the bouquets are fading. He manages his own medications again. He does not yet feel like he should drive (and he is grounded till his neurosurgery follow-up in 2 weeks), but he wants to use our OKC Thunder tickets this Friday. His progress is not as fast, but we both hope it will continue.

We no longer have any idea what our future holds. For now, we are dealing with stuff as it happens. Be warned - this blog will likely feature some intense introspective naval-gazing in the coming weeks and months.

Welcome to After.

7 responses so far

Older posts »