Jul 16, 20224 min read

Trust yourself, but try not to get your bike stolen.

Programming note: My plan for these posts is to include life updates, a reflection and a “disease of the day”. Read whatever parts of it that interest you. And of course, scroll down for pictures!

The updates:

The Good bits

I moved into a new apartment in downtown Morgantown. It’s a darling studio close to The Blue Moose Cafe, one of my favorite spots in Morgantown. And even though the buses only come once an hour, there are several stops within a block of my place.

Some classmates and I went to D.C. for the weekend at the beginning of June for Pride! Two of us stayed in a “capsule hostel” on a Friday night, which provides small but sturdy nooks to sleep in with a charging station for $75/night. We spent that Saturday eating, exploring DC and of course, going to the parade! D.C. is three hours away by car, but totally worth it.

I know others in the cohort have also been getting up to some fun stuff on the weekends, like going to a Bigfoot Festival elsewhere in West Virginia.

The Not-So-Good bits

I did end up getting that car delivered but it’s been in-and-out of the mechanic’s shop for the whole time that I’ve had it. Thankfully, it’s under warranty so I’m paying nothing (except for transportation costs during the times that I don’t have it).

Continuing with transportation woes, my bike was stolen. My lovely e-bike that's carried me many a commute. The silver lining there was that I did get some insurance money from it. My renter’s insurance came in CLUTCH. For anyone who is interested, I used the renter’s insurance offered by GradGuard, who also offers tuition insurance through the university.

We’ve had a couple of COVID scares, but they’ve been isolated and anyone who has tested positive or been exposed seems to be doing well.

The School bits

I had my second gross room rotation this past week. I spent an hour on Wednesday and then four hours on Thursday grossing some real specimens and I think it went okay! Doing anything for the first time is always daunting, but I felt pretty prepared from having taken Anatomical Techniques last semester and being able to refer back to those notes. On Wednesday I grossed my first placenta and Thursday I grossed a segment of ischemic bowel, a LEEP biopsy, a cervical cone biopsy, and 1st trimester products of conception. Everyone was very helpful and I didn’t feel at all rushed. I’m sure that someday soon I WILL be in a situation where I feel rushed and maybe people aren’t so helpful but that’s life.

Reflection

I won’t lie, I can feel the grind everyday now. I’m tired, and it’s hard to be interested in studying when I feel like Sisyphus. Only every boulder is another exam. The past 6 months have felt like approximately one million years and also 2 weeks.

Whenever I start to question why I made the decision to do this, I remember two things:

I’ve always known my own mind, and I’ve always been bold enough to go out and try to get what I want out of life. I think this has to be true of anyone who decides to go to graduate school.
Rizzo from one year ago wanted to do this badly enough to fill out applications, take the GRE, and move across the country.

I trust myself enough to follow through on my decision from one year ago. Not because of any pros or cons list I could make in my head today, but because no one knows what’s better for me than I do, and I had the same inner wisdom then that I do now. You have to choose to trust yourself, just like you have to choose to trust anyone else. But the best part is that when you trust yourself, not only can you be confident in choices you’ve already made, but you can have confidence that you will be able to handle anything that is yet to happen.

The Disease of the Day!

What is Myasthenia Gravis?

Myasthenia Gravis is an autoimmune condition, whose primary feature is the presence of auto-antibodies against acetylcholine receptors in the neuromuscular junction and 15% of the time against a sarcolemmal protein, muscle-specific tyrosine kinase.

How does it happen?: Our muscles move because our nervous system tells them to, right? The place where the nervous system communicates with the muscle is called the neuromuscular junction. The main signal that the nervous system uses to communicate with muscles is acetylcholine (ACh), and in order to communicate effectively, the muscle has to have a receptor to receive the ACh. Well, in Myasthenia Gravis, there is a protein created by our immune system that interferes and destroys these receptors! So the nervous system can be sending out signals, but the muscle can’t receive them.

What does it look like?: The first symptom is muscular weakness that worsens the more the muscle is used. Patients may also have drooping eyelid(s) (ptosis) and double vision (diplopia). In severe cases the condition may start to affect respiratory muscles and the patient may need help breathing.

It is also associated with tumors of the thymus (called thymoma), and thymic hyperplasia. Since the thymus is involved in adaptive immunity in infancy it kinda makes sense that it could be connected to an autoimmune condition.

How is it diagnosed?: Diagnosis is based on the clinical history and current presentation of the patient, identification of autoantibodies and what’s called electrophysiologic studies. Electrophysiologic studies stimulate the muscles and measure the strength of the muscle’s response. In Myasthenia Gravis the muscles will show a progressive decrease in response as it is repeatedly stimulated.

Be well everyone, and trust yourself.