Engaging through Twitter

I’ve been using Twitter to engage in academia more, and I love it. It can be overwhelming, so I use TweetDeck to help me stay organized, and I try not to sweat the small stuff. If I miss things I miss things.

But there is something about being limited to 140 characters that feels less intimidating than approaching a journal article or book, or paper. I can approach 140 characters at a time. And if I need to vent or tweet about something else, I can. It isn’t purely academic. I can tweet about health stuff, or medical stuff, or things I’m a fan of. And I can engage with others. I’m really enjoying it as a stepping stone to becoming involved in academia and scholarship again.

I spent today home, trying not to vomit every time I moved (what is wrong with you body?!) and besides napping, I managed to engage in two academic chats on Twitter. Which actually turned it into a pretty decent day, besides me feeling like crap.

Yearly Doctoral Progress Report

Two posts in one day, what? My brain must be working today… or I’m tired enough that I just don’t care how this reads later.

Every year the graduate school requires its graduate students to complete a progress report summarizing how far you’ve gotten in the program. The report asks about credit hours completed towards your degree, research and dissertation hours completed, dates major exams (quals, plan of study, prelim, prospectus, dissertation defense) have been completed or are intended to be completed, current G.P.A., goals for the next year, and any awards/presentations/publications and/or service to the program you’ve done over the past year.

For most students, and even for me in my early graduate student career, the form wasn’t too difficult to fill out. Look a few things up, fill in a few blanks with reasonable guesses, and that’s it. But now I look at those questions and I don’t know how to proceed.

Honestly, I have no idea when I’ll do my prelim, let alone my prospectus and dissertation defense.  And goals for the future… if I write “figure out whats wrong with me, and how to manage it so I can get back to working on what I want to” will that be taken the wrong way? Will the graduate school see that and tsk-tsk me for continuing to be a full time graduate student, taking research and dissertation hours, and not really making and progress on my degree? But what other goal can I reasonably say? I really, really, do want to make progress on my degree but going is difficult and slow. It’s gonna take time, and I haven’t the foggiest idea of how much. Are you going to be okay with that graduate school? While I struggle on with my health (mental & physical) and try to wrestle even the tiniest of thoughts about scholarship, I still haven’t finished any measurable milestones. There isn’t anything concrete I can share with the graduate school to imply I’m not just taking up space. And even though my counselor says I’ve made fantastic progress since she first started seeing me, that isn’t anything I can turn into them. Not really. And certainly not on this form.

How do you evaluate your year, from an academic perspective, when every day you wake up happy you’ve made it this far at all? That you’ve gotten up again. That you put one foot in front of the other, and move through the world at all?

Mental Health & Grad School

Depression has been my biggest enemy lately. While we still can’t figure out what is going on with the occasional limb jerks, pins and needles, ocular flashes, GI trouble, and mental slowness and difficulty, it was clear my depression wasn’t making anything better – and likely making things worse.

As I alluded to last post, I’ve taken to seeing a counselor and psychiatrist, which has been a great help. We’ve slowly upped my prozac to 40mg, and it’s like I can breathe again. I hadn’t realized how much my depression was weighing on me the past few years. Even in moments where I thought I was doing better pale in comparison to the interest and motivation I’ve felt in life again the past few weeks.

And its with all of this experience, the reaching a point of breaking down and not making any progress on my degree–in a resolve that my health had to come first–and finally coming up for air again that I realize how unhealthy graduate school can be.

Graduate school is a constant state of pushing. You are always pushing to be working, to be generating, to be doing better. Now, don’t get me wrong, there isn’t inherently anything wrong with pushing, it is good to be driven. But there needs to be reprieve.

But that doesn’t really come in graduate school. As any graduate student if they’ve ever felt “grad school guilt” and they will unanimously answer yes. It’s the guilt of not working on something academic or scholarly at every moment; the guilt of not working on your personal thesis/dissertation research even when you’re working on something scholarly.

It’s fed by some warped notion that you should be doing more. That even though you’ve spent all day working on your assistanceship, in classes, doing homework, working on your personal research, that you aren’t doing enough. And it’s perpetuated by a culture of “we’ve all been there, we’ve all done that.” You rarely get reprieve from advisers, committee members, or even peers. Everyone is feeling the push for more.

When you add this level of guilt to a high level of stress you build a recipe for poor mental health. Now, I’m not saying it’s terrible, but it is something we should be aware of and strive to make better.

As graduate students, we need to be kind to ourselves. We need to accept and respect our limitations and find a healthy way to balance our expectations with what we can do. And when we can’t do something, we need to accept that that’s okay.

Right now I am working doing that myself. I’m working on engaging more with academia and scholarly work. I’m focusing on baby-steps, reading a little here and there when I can, following educational news and other instructional designers on twitter. And when I can’t get something done I’m not beating myself up about it; I’m thinking positive about what I can do and what I did get accomplished. And I am so thankful I am learning the skills to do so, because honestly being easy and kind to yourself is one of the hardest things you can do.

Dr. C

I’m incredibly exhausted after this long day, but wanted to give y’all some brief updates.

I met Dr. C, the neurologist, this morning. Her office is slow, but she is wonderful. She listened to my health saga, then did a neurology test – testing reflexes, my eyes following her finger, if I could hear her rustling her fingers at different distances from my ears, having me squeeze her hands and push against resistance, asking me some basic recall questions, and walking across the room in various ways- normally, on tip-toe, one heels with toes up, and heel-to-toe like on a tight rope. She also took a peak at my optic nerve.
She wants me to see an opthomologist again, and gave me a few names of doctors she’d prefer I see, so I went by the student health center after my appointment to get a referral. I’ll give Dr. F’s office a call tomorrow.

She also gave me an order for lab work – quite a lot of it, including ANA, metabolic panel, thyroid panel, various vitamin Bs, vitamin D, a lyme test, and a few other tests I had never heard of. The student health center will be doing the blood work tomorrow, since I need to be fasted.

Dr. C is also working on an order for an MRI of my brain and neck, with contrast. A spinal tap. An a consult with a neuropsychologist for cognitive function testing. I’ll have to pick up the orders and take them to the student health center for referrals from them, so that the insurance will cover the highest rate on those tests.

And, I have two appointments for EMG, nerve conduction tests, at Dr. C’s office already scheduled. One day to do my arms, and another day to do my legs.
Plus, she’s having me wean off the amitriptyline, and start the prozac.

I’m both excited and terrified about the tests. Excited, of course because I have a Dr. giving me her full attention and actually ordering tests to try to figure out what is going on; all of you spoonies know how relieving that is. But the spinal tap and EMG have me a bit nervous.

Any one have tips for getting through these pokey-needle tests? Or just dealing with medical anxiety? I’d love to hear them.

Cognitive Dysfunction?

How do you know if you’re experiencing cognitive dysfunction?
Analyzing the two words you have “cognitive” – of or relating to cognition, with cognition being the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses; and “dysfunction” – abnormality or impairment in the function of a specified bodily organ or system. Therefore, cognitive dysfunction would be an abnormality or impairment in mental action and the process of acquiring knowledge and understanding through thought, experience, and the senses.

Theoretically, I’m there.

But what is cognitive dysfunction really? What does it look like? Feel like? What qualifies and what doesn’t?

I’m struggling with this.

As a living creature cognitive function is obviously essential, but the degree of what is considered impaired can vary greatly. As a PhD student, my life and my livelihood revolve around my cognitive function. What may only seem like a subtle slip up or may be entirely unnoticeable to others is a huge impairment for me.

Like this summer, I should have written my preliminary exam. I should have devoured literature and produced at least a solid thirty pages of concise and well written argument that grounds my research ideas in the literature and points out what questions are still unanswered.

What have I actually done? Struggled my way through reading one book. I haven’t even finished it yet.

And I can’t help but question if I haven’t gotten as far as a should because I’m being lazy, or just a poor student. Even though I really want to be doing my research; I find it incredibly interesting and was quite excited to have the time to focus on my prelims at the beginning of the summer.
But if I’m not being lazy, why am I struggling so hard to get anything done?

Is it the depression? … it could be a contributing factor, but my depression is made so much worse as a result of my lack of productivity.
Is it the lack of estrogen? Menopause has been known to cause brain fog.

Or is it something else? Is it avoiding doing my reading and writing because of a cognitive dysfunction that makes it so difficult for my to comprehend what I’m reading, critically think about the materials, and generate new ideas? And if so, am I avoiding working because I simply can’t do it to a level I expect my self to be able to.

How do you know? And what can I do about it?

I haven’t made any significant progress on my preliminary exam- which I was supposed to defend in September. I don’t know if I can even make it through classes this upcoming semester- can I engage with the materials like I should be able to?

I don’t know what to do anymore. I can deal with using the wrong words occasionally, and even burning myself on hot pans when I forget to put the oven mitt back on. But I’ve already had to change fields once as a result of my health. I don’t want to do it again. I absolutely want to be a PhD. I’d love to do research and teach. I’d love to work in industry as a consultant. Using my brain means so much to me.

I can’t even fathom what I would do if I can’t continue on my current path. The weight of this is crushing me, and I don’t know what to do about it.

…On the bright side, I finally have a neurologist appointment. I’ll be meeting with Dr. C on Sept. 14th.


I was going to write a post about my worsening depression. How being unable to feel productive and capable of doing the things I need to be able to do, and once could do so easily, was driving me into a deeper pit of melancholy and despair. But I didn’t. Because the depression robs me of my ability to get things done just as much as my other ailments.

And then I had a [mildly] productive week. I called Dr. S’ office to check on the neurology referral… which I am still waiting on. They were apparently playing fax-tag with my medical records when I called early last week, and I haven’t heard anything since.

I even worked on submitting an abstract and summary for a poster at an academic conference, with a co-worker. I hadn’t felt that academically capable in a long time. Unfortunately, it didn’t last, and as soon as I tried to read the literature for my own scholarly interests again, my brain went back to sluggish understanding and struggling to make critical connections. I did manage to get three chapters read last week. That’s nothing really; I should be reading more at least 5 or 6 chapters or articles a day, and doing a lot of writing. But I’m trying to stay positive, and take some joy and accomplishment from what I am currently capable of doing.

And I crocheted up a couple of drink cozies as part of an ongoing project I’m working on. They’re for a fundraiser the greyhound adoption group I volunteer with has been invited to participate in, in October. I’m getting a head-start now, before classes start again. I’m making drink cozies, some clutches, and a houndstooth scarf. I’m hoping they will go over well and bring in some nice donations.

Unfortunately, over the past few days I’ve also had a worsening of, what I assume is, gallbladder symptoms. Mainly right sided pain- under my ribs, but some upper left sided pain too. And an increasing feeling of heart burn… but not really heart burn. Plus some right shoulder pain. It’s not just after I eat though. Its starting to be pretty prevalent throughout the entire day.

I’m also having more pelvic pain. That lower right side pain that never went away after surgery is still there. It isn’t nearly as bad as it was before, but it likes to pop in and remind me it’s still there.

I’m exhausted, and I don’t know what to do next. Do I try to go back and see Dr. S and have the gallbladder out? Can I even afford to do that this summer? Will I ever get an appointment with the neurologist? Will it even tell me something? Will I be able to make it through the next semester? Through my PhD program in a timely manner? What do I do if I can’t?

I don’t have the answer to any of these questions. I feel like I’m stuck in a holding-pattern when I desperately want to make some progress and move forwards. But I’m just waiting. waiting. waiting.

What now?

I called Dr. S’office today. Apparently the hospital had my bloodwork in their system, but it never transferred over to Dr.S’ office system. The looked up the results and apparently everything looks “really good.” Since the ultrasound came back with absolutely zero indication of anything wrong with my gallbladder, Dr.S recommends that I hold of on the surgery.

So the gallbladder is hanging around for a while.

But that means we still have absolutely no idea of what is causing my problems. According to the nurse I talked to today, Dr. S thinks I should try the low FODMAP diet… which I’m guessing she forgot we already did. And it didn’t make a difference. So I guess Dr. S is out of ideas. I didn’t even get a new appointment. Tests came back negative, and I guess were at her limit. Which is a shitty feeling. I don’t know what to advocate for here…

But, in brighter news, we did get the neurologist referral all worked out. It was incredibly complicated, requiring an administrative referral from my student health center on top of a referral from Dr. S’ office. I’m going to swing by Dr. S office this afternoon and see if they will call a neurologist and do the official “referring” instead of me calling some neurologist’s office and saying Dr. S wants to refer me, and I have an administrative referral from the health center. I’ve had bad luck getting into neurologists before- and by that I mean, I wasn’t able to see one when my chronic migraines started even though I thought I should, wanted to, and had someone refer me (though he was a chiropractor and a family friend, but the insurance covered the MRI he ordered just fine. I don’t know why the neurologist wouldn’t see me). I’m hoping having Dr. S’ office set up the appointment helps things along this time.

And hopefully we’ll get an appointment in before the end of the month. Because on July 31st, I have to get all my referrals renewed or my insurance bumps them all down to the lowest payment tier and will only cover 65%. Which is no good.

…This whole thing is exhausting.

If its not one thing, its another

I was finally feeling a smidge better; just clear enough that I could read some of the literature I need for my prelim and feel confident that I could cognitively process and make connections on a level that I needed to. Something I’ve been having the hardest time with lately. Why, oh why, has my thinking gotten so slow and difficult? I misuse words- often saying something entirely different than what I mean, even if I recognize it immediately. I feel as if my brain is swimming in cloudy jello. Its so much effort that I’m not used to putting into thinking, and not high level, innovating, working on ill-structured thinking–I’m accustom to working really hard at that– just basic thinking.

So I finally feel a bit of a break in the cloudy jello, and I get one chapter down and eagerly start on a second when all of a sudden I notice I’m not breathing. The same kind of thing that happened on the percocet. I doubt I don’t breathe for long, but it’s long enough to notice and feel short on air and my brain to go “OH SHIT BREATHE IN DAMN IT.” And then I can barely get air in. I tried counting my breaths in and out, with a longer exhale. I tried changing position. Nope, nada. So I break out my inhaler.

I don’t know I’ve said this before. I hate my inhaler. It makes me all jittery, and my brain has a hard time focusing, and it really only barely helps my breathing. Thankfully I hadn’t needed it all winter. I hadn’t taken a puff since August. But tonight I had to. Two puffs at 9:00pm.

And I still have to consciously think about breathing. If I don’t concentrate I’ll catch myself not inhaling again. At least my lungs feel like they can get air when I inhale, but I guess I’m done with work for the night. I certainly can’t focus on my reading, and meaning building, and conceptualizing while every second I have to pay attention to breathing. It’s been hard enough to write this damn post. And thank goodness for the easy ability to edit on via computers, or else this would have been an illegible mess, I’ve misspelled about every other damn word, hit the wrong button for delete over half the time, and had to take many breaks to string my thoughts together while thinking about getting air.

What a lovely way to end my day. As if all this health stuff wasn’t getting to me lately anyway. And I wasn’t already feeling awful about the amount of attention and work my academic career has been getting.

Like yesterday, I’ll be doing my best not to breakdown and cry myself to sleep. At least the amitriptyline helps me fall asleep, even if I have been getting flashes in my vision again by the end of the day.

Gallbladder, oh gallbladder

I just got back from Dr. S’s office.

She thinks the left sided pain may be referred pain from my gallbladder, and that surgery is our best option at this point, but understands my reluctance, especially since the change of resolved problems with atypical symptoms is 41%.

So she’s agreed to do the ultrasound and run the blood work for pancreas function (amylase and lipase) when I asked her to. The ultrasound and blood work is scheduled for the 2nd. It’s pretty much the last test we can do to give us any indication if its the gallbladder, short of removing it.

So, if those results of the ultrasound and blood work don’t give us any new information that contradicts surgery, then I agreed surgery would be the best next move.

Every time I go to her office, I bring a report of everything that’s been going on since my last appointment. My reports have included information about my bladder being reluctant to empty completely, the pins and needles I get in my limbs, and the random muscle contractions that occasionally occur in my right leg– most often before bed (which she said is normal) but also have occurred when I am awake (she said that is not normal). She thinks I should see a neurologist. So I’m going to look into if I can go to the student health center over the summer, and get the student health center to refer me to a neurologist, since the insurance will pay more of the bill (90% instead of 80%) that way. If I can’t go to the student health center over the summer, Dr. S said she can refer me to the neurologist.

I really like Dr. S, and am so glad she listens to me and validates my effort, thoughts, and research into my own health. In my experience, it is rare that a doctor does that. She’s one of the good ones, which makes up for the incredibly slow speed of her office, and why I will continue to see her as long as I need to.

Now I just need to think about the financials. It’s stressful enough that my health causes “speed-bumps” in my academic work and mental functioning (I have had some cognitive dysfunction lately, often switching a wrong word for what I mean to say, and making mental connections is slower than I’d like… Which is NOT conducive to working on my preliminary exam this summer.) But the financials are getting pretty tight. Graduate students don’t make much money.

I have an annual $3000 out of pocket max on my insurance. I need to find out if the “year” is the calendar year or the school year. It’ll make a big difference if my out-of-pocket max rolls over on July 1st, or January 1st. If I’m going to have that surgery this summer, and see a neurologist- with more tests I’m sure, I really want to know if I’m looking at a new $3000 bill, or if it will be less since I’ve had, and paid for, procedures so far this calendar year.