Home again home again jiggidy jig

I made it back to the States in one piece.  Spent the first week with my mum and people I love.  Had a wonderful thanksgiving, and soon will have another (which will make 3 in 2 days).

I still have a cold, and transferred my southern hemisphere germs around all week.  Hopefully everyone else has an immune system that works.  The only person I’m worried about is Grandpa, but we will keep an eye on him and get him to the doctor if it looks like he’s coming down with it.

Today is “black Friday” and I managed to leave my wallet at home, so definitely no shopping for me. 

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Through the Haze

Made it through exams and to the other side.  I am applying for Impaired Performance tomorrow when I go to see the shrink.  With that, I should have passed them all.  I’m generally pretty good at exams and they asked questions that I knew answers to, so I should be set.  Now I am counting down the days until I get to go home to the States to see my family and friends.  This week I will be packing up my room into various boxes (TV and Xbox are totally going last, but bookshelves and other bricabrack will be boxed up as much as possible).

I visited a couple of friends down in Lower Hutt over the weekend. We putzed around town for a bit on Saturday and I bought a much needed new bra for $20 (its a nice one too).  We had a lovely lunch at Burger Fuel and then drove along the coast and had some white wine in the sunshine.  The wine we had was very interesting, a white Pino Noir (yeah I was sceptical at first too, don’t worry).  Essentially they took the skins off of the Pino Noir grapes so that the wine was white instead of red.  It was quite fruity with some of the tannins still detectable making it almost dry as well.  It had a smooth finish (and now I feel like a total wine noob) and I really enjoyed it.  Enough that if I could find a bottle I would probably actually drink it.  For dinner we had roast chicken and chips (potatoes totally count as a vegetable), and then went to a gay bar called S&M’s (Scotty and Mal’s).  There wasn’t a lot going on, but I met a number of new people who were very nice.  On Sunday, my one of my friends and I got a massage at the East Day Spa in Wellington.  We got the Monsoon package (which you can look at if you follow that link) and it was amazing.  I felt so relaxed that I almost fell asleep several times.  The giant knots in my shoulders are considerably smaller than they were, and my skin is nice and soft and not angry at me all the time.  After our rubdown we met another friend for lunch.  I had delicious stuffed mushrooms on toast and good conversation.  Then we went back to my friend’s house and napped.  She made a delicious lamb roast for dinner and then I drove back home.  Apparently the Beast gets pretty good gas milage (kilometerage?) as it only took half a tank to get there and back (much better than I was expecting).  Its still an expensive trip, but not as bad as I had initially estimated.

Today (and last Friday) I tutored a friend in Cell Biology.  She has her final exam tomorrow and needs to pass it so that she can move on to other classes.  This is her third time through the class and even though she knows the material, she stresses out with exams and then psychs herself out.  I have been going over some of the things that she has confused herself on and untangled the knots.  She should be able to pass with a pretty good mark if she can remember to relax and breathe.

Now to head to bed because I am very tired from my vacation.

Feline Allergic Bronchitis

Today is the Physiology test, and one of the questions is going to be about Feline Allergic Bronchitis (the professor said so and if he lied there will be killing).  Because of this, I have decided to write my model answer here, for all of you to read.  That’s right, all three of you get to read the answer that I am going to be writing again in a few short hours, that is how much I love you.

This is a subject near and dear to my heart, as my darling cat back home in the states has this condition.  My sweet Littl’un has been suffering from it for years, and is the main reason that I am so very good at administering pills to reluctant cats.  Littl’un was diagnosed using a history and chest x-ray, I don’t remember if blood work was done but it is highly likely.  She gets long acting shots once or twice a year when she gets really bad, and is managed with a steroid inhaler and steroid pills throughout the rest of the year.  The poor thing blew up like a balloon thanks to the side effects, but can breathe and we like her breathing.

Feline Allergic Bronchitis is a narrowing of the small passageways of the lungs due to increased sensitivity to an allergen.  The starting process for hypersensitivity begins with a particle encountered in the lungs.  This stimulates a normal immune response, eliminating the threat and setting up specific memory cells to guard against future attacks by that type of particle.  When that same particle is encountered again, the immune response is rapid and decisive.  In affected cats, it is also overblown.  The release of histamine leads to bronchoconstriction, an increase in mucus secretion, and an increase in capillary permeability (allowing more fluid to cross if not limited).  The immune response also increases the amount of prostaglandins, which leads to inflammation.  Esinophils (a type of white blood cell) act to prolong the airway injury by slowing recovery, they are jerks, and affected cats tend to have higher numbers of them hanging around.  The increased mucus secretion (accompanied by decreased cilia movement) causes mucus plugs to form, increasing resistance along the airways.

This immune response also contributes to an imbalance of sympathetic and parasympathetic signalling.  In a healthy animal, the two (which are in direct opposition) are in balance and the airway is open.  When the sympathetic side is stronger than the parasympathetic, the airways are even more open – this is the fight or flight response system.  When the parasympathetic side is stronger, the airways become constricted.  Parasympathetic stimulation causes smooth muscle in the small airways to contract which narrows the radius of the tubes.  Flow is inversely proportional to the radius to the fourth power, so even a very slight change in radius has drastic effects on flow rate.  This decreased radius also increases the velocity of the air passing through, which causes turbulence.  Turbulent air is less efficiently removed and causes problems with ventilation.

Overall, each of these things causes an increase in resistance across the airways which decreases flow of air.  In normal breathing, the diaphragm contracts to increase thoracic (chest) volume, and then relaxes to decrease thoracic volume.  When the chest volume increases it decreases the pressure surrounding the lungs, which causes air to rush in from outside (where the pressure is now higher).  When the chest volume decreases, the pressure inside the lungs increases (until it is higher than outside) and pushes the air back out.  When resistance is too high in the small airways, the passive action of the diaphragm moving is not enough to increase the pressure in the alveoli to overcome the pressure difference.  This triggers the cough reflex and air is forcibly removed by contraction of abdominal and thoracic muscles.

Treatment of this condition is based around opening airways.  Inhalers with steroids and bronchodilators are used for acute attacks, and maintenance steroid pills for longer term.  Steroids work by decreasing inflammation caused by prostaglandins during the immune response.  These are not the anabolic steroids used by athletes and body builders, they are corticosteroids that bind to receptors in cells to reduce inflammation.