Tuesday, September 16, 2014

ojo rojo

My last morning in Mexico I woke up with tears in my eye. After wiping them away, they quickly returned. I ran to the bathroom to see what I knew was inevitable; an eye infection. Was my eye going to be red, pink, or white? It was white. Phew, I thought, at least I won't stop traffic with my clearly infected eye. Plus, there was still time to wait before officially declaring myself with pink eye, since it wasn't puffy or pink.

I have had conjunctivitis (pink eye) in more countries than I care to count. If you are not prone to eye infections, they can be scary entities. Many people don't like touching their eyes. And an eye infection scares the sh#* out of them.

I am no such person. I've been getting eye infections my whole life. I've also worn contacts (on and off) since middle school. Sticking my fingers in my eyes is common practice for me. I have been known to put a contact back in during the most precarious of situations. Because, believe it or not, the most dangerous place for me to be in is the one where I have no way of seeing. Without prescriptive lenses, I can't see. I'm not exaggerating. My prescription is in the negative double digits and I have never met a person with worse eyesight than mine. I can't even read the clock on my nightstand without lenses.


What the world looks like to me without corrective lenses.

So what does one do when she finds herself with an eye infection in a foreign land? Oh yeah, to make matters more complicated, I was on a small island off the Caribbean coast of Mexico.

I casually went down to my hotel lobby and told the lovely desk agent, "Umm... fijense que estan infectados algunos ojos." (Translation: Umm, I think some eyes might be infected). She quickly told me about a doctor with morning hours, whose office could be found above a pharmacy three blocks away. She gave me good directions (rare in Mexico), and I headed out.

I found the pharmacy, but I was too early. Doctor hours didn't begin until 10am. I had two hours to kill. No problem, I'd be back. But just out of curiosity, I asked the pharmacist how much the doctor visit would cost me. $35 pesos ($3). Yep, $3 to see a doctor without an appointment. I would definitely be back.

This incident reminded me of one particularly silly bout with pink eye while in Peace Corps training. As I mentioned, I have gotten pink eye about once a year my entire life. Sometimes it's bacterial and sometimes it's viral. I used to get pink eye so frequently, I'd travel with my own bottle of sulfa drops - a miracle cure, depending on the type of pink eye you've got.



I had pink eye during field-based training in Danlί, Honduras. One thing we like to tout about the Peace Corps is the free health insurance. So, I was taken one morning via Peace Corps white van to a doctor's office. The Peace Corps staff member with me thought my "ojo rojo" (red eye) was hilarious and everyone else was pretty much freaked out. I was calm. Another bout of pink eye. Would it be bacterial or viral this time? This particular bout of pink eye left my eye red, puffy, and oozing pus. I know, gross. But it was quickly treated.

Honestly, the worst part about pink eye in a tropical climate is not being able to wear contacts. During my normal life in perpetually cold San Francisco, I can wear my glasses every day. But when I want to swim, or even run a long distance, glasses just don't cut it. And I'm not about to go without. So I put in my handy contacts. And I'm good to go. Until I'm not. Because inevitably, I will get an eye infection. I know I will. And I do.

So why didn't I get LASIK all those years ago? Somewhere in between all that travel, everyday life, and eye infections, my eyesight was still getting worse (along with my pesky astigmatism). My eyesight has since tapered off, but now the years are numbered before I'll need reading glasses too. I know many LASIK candidates who wear glasses for driving now. A few years without glasses? I didn't necessarily need that.

Plus, glasses have become a part of who I am. They are me. Just like having brown hair and brown eyes, I wear glasses. It took me many years to be okay with wearing glasses in public (I worshipped my contact lenses for the 10 years I wore them). And I'll still wear them when playing sports. But I've become okay with wearing glasses. And I've noticed many women have as well. No girl had glasses in middle school. Everyone was getting contacts. But now, I have several friends and even an aunt who got married wearing glasses. After all, we don't expect men to get contacts, even for their weddings. So why should women have to?

The answer is we don't. Despite ridiculous websites like this one, a Wikihow entitled, "how to look good in glasses (for women)." Totally absurd. Just wear your glasses. You'll not only look good, you'll also see well. It's win-win.

I am proud of my decision to wear glasses, even if I'll never be able to wake up and see clearly without them. Even if it means sleeping with a watch to be able to read the time while in bed, or wearing glasses in the shower so I can see where I'm walking (and also find the shampoo). And yes, my glasses break. And contacts dry out my eyes. And my eyes get infected. And I'll never have cool sunglasses (I have prescription ones, but because my prescription is so strong, the lenses are in super small frames which looks silly). But, I'll look like me. And that's what makes me the happiest.

Wednesday, September 3, 2014

fifteen

During my last trip to Mexico I had the privilege of attending a traditional cultural event: a Quinceañera. Having been to many bar/bat mitzvahs (including my own), I figured I knew a little something about teenage coming of age parties. But having never been to any party in Mexico, let alone a large party in a small Mayan village, I guess I really did not know what I was getting into.

Here are the logistics of a modern day Yucatec party.
1. Party starts at 11pm. And everyone attends (including babies, children, families, grandparents, and even dogs).
2. Dinner is served at midnight. There is nothing to drink except Coca-Cola. Nothing else.
3. Dancing (and music so loud your ears can't stop ringing) gets going around 1am.
4. Party ends anywhere from 6am to 8am.

I left the party at 2am, having to drive half an hour home via dusty dirt roads. I was the first person to leave the party. Eating dinner at midnight left me feeling icky and itching to get home to bed.


Being a novice in regards to Mexican party rules, I was warned ahead of time, "these parties are hard to handle if someone is not used to the hours." So in a sense I knew ahead of time about the late hours. But there was absolutely was no way I was going to miss attending this once in a lifetime Mexican cultural experience.


But did I mention the actual event started at 7:30pm with a Catholic Mass? Oh yeah, I went to that too (to take pictures for the family).


Family photo with the Priest

I also consider myself extremely blessed to have been welcomed in to such an important milestone for this humble and religious family. I haven't known the family long, but they immediately invited me in and treated me like an extended member of the family. This is typical of the Yucatec hospitality I have come to know and love.

But almost nothing else about this 
quinceañera was typical. Beforehand, I decided to read a little about the significance of a 15th year party for a girl. I assumed the importance was because turning 15 indicates the girl is ready to marry. Turns out I was correct. Not too difficult to figure out. And, fortunately, no longer a modern day practice.

I found a lot more about quinceañeras that I didn't know. A quince, "constitutes a ceremony on a girl’s fifteenth birthday to mark her passage to womanhood, to give thanks to God for his blessings, and to present a young woman to the community."
1 Sounds about right. There's more. "The young woman’s fifteenth birthday begins with a Misa de acción de gracias, or mass to give thanks for a completed childhood."1 Check. Next, "around the celebrant are seated her damas (maids of honor) and chambelanes (escorts)."1 Check. But then, traditionally, "the festejada, or adolescent woman celebrating the birthday, is seated at the foot of the church altar resplendent in an elaborate pink or white formal dress."1 Did I see this? No. Pecque wore a turquoise dress.


Pecque and her attendants post-mass

At the Quinceañera I was frequently asked, "do you have this kind of party in the U.S.?" My answer was always, "Yes. There are quinceañeras in the U.S. But we also have additional types of similar coming of age celebrations, depending on the culture. And some people even celebrate the 16th birthday more as a custom than a religious celebration."

Which led me to think about Pecque's turquoise dress. "The origins of [the Quinceañeraare shrouded in the history of the Mexican people. As with so many things Mexican, it combines both Spanish-Catholic traditions with a rich indigenous heritage."1 But there was nothing Maya nor Yucatec about this party. 

For example, men in the Yucatan typically (and often) wear shirts called guayaberas. Women wear white dresses with embroidered flowers called huipils


                    
Lucy in a huipil and her escort in a quayabera              Young Pecque in a huipil with her sister Lucia in a huipil

Five years ago, at her sister Lucia's Quinceañera, Pecque's sister wore a huipil. So did 10-year-old Pecque. Lucia had a traditional Quince, which consisted of a Catholic Mass, family photos, and a small reception on site at the church.

What Pecque had last month was a glamourous party. And not a traditional quinceañera. 


Pecques' attendants, cakes, and gifts

Not traditionally Mexican. Nor Mayan. "Every region in Mexico [has] added their own local traditions and customs to the European-derived balls. Regional and local traditions as well as the economic status of the celebrating family exert an influence on the ceremony, determining the atmosphere of the religious service and the party."1

But this not a wealthy family. They do not travel, don't wear new clothes, don't needlessly spend money. In other words, I have no idea how they could afford this celebration. It was an expensive affair; one in which the tiny little town of Ixil (try to find it on a map) found its inhabitants out dancing at the municipal building until 6am. What was this humble family trying to prove? That they could throw an expensive party for their town? It was a fun event, but at what price?

The morning after Pecque's quinceañera, the sun rose; everyone packed up and went home. And Pecque awoke to find herself no longer the center of attention. Her turquoise shoes, turquoise dress, and turquoise eye shadow were now gone. But at least I was there to take the pictures.

http://www.learnnc.org/lp/editions/chngmexico/218

Tuesday, August 19, 2014

foodmap

I haven't felt well for a long time. So long now that I don't remember what living without pain feels like. After months of increasingly frequent episodes of acute pain, along with a lot of free time on my hands, I finally decided to do something. What I mean is, against my natural instincts, I went to the doctor.

And that's how I ended up with an unclear diagnosis: probable fructose malabsorption, lactose intolerance, gluten intolerance (Celiac), and irritable bowel syndrome. The all encompassing term to describe my digestive system ailments is that I have a "functional gastrointestinal disorder" or FGID for short.

What I mean by unclear diagnosis is that, despite pretty definitive testing methodology, my food intolerances are each on their own continuum. I am somewhere on the spectrum for what I can tolerate (for example, I'm very low on the Celiac spectrum). According to my team of GI doctors, the understanding, and subsequent diagnosis, of digestive disorders is relatively new in the gastrointestinal world and these doctors (specialists) are still learning what it all means.

What it means to me is the difference between living life to its fullest, and not being able to leave my home or even sleep most nights. My intolerances have become debilitating, to say the least. And I still don't really understand them quite yet. At the beginning of this journey I had a feeling I'd be working with a GI for the long haul. And, true to form, I am. I'm working with three amazing GIs, have taken five tests (more to come), and, of course, spend every day reading about every possible condition on the internet. WebMD is a good, if not insanely dangerous, companion, since my medical training consists of being the daughter of a doctor (meaning not very solid).


My lactulose hydrogen breath test.
Used to diagnose small intestinal bacteria overgrowth (SIBO)

Unless you've been living under a rock, you know that there are a million stories going around the internet about how humans should avoid gluten, stay away from dairy, and eat like cavemen. Despite being an avid learner, reader, and internet browser, I am not a food fad subscriber. 
The thought that I may have to cut out entire portions of a certain type of food I love to eat is scary for me. I don't typically discriminate against food.

But I am now on a diet. Or at least I will be shortly. Once we know where the pain is coming from. First up, my small intestine. I'm finishing round one of a high dose antibiotic treatment. Xifaxan, the antibiotic of choice, targets my gut specifically. Whatever bad bacteria has infiltrated itself into my small intestine, its days are numbered. Xifaxan will kill the bad bacteria, keep the good. Pretty powerful stuff. 

Except that I can't get Xifaxan. After weeks of back and forth with doctors, pharmacies, and insurance companies (in at least two countries) Xifaxan is out of my price range (approx. $2K for the 42 pills I need to complete a two week regimen). Instead, I'm on a much harsher all encompassing antibiotic; Cipro. A travelers go-to miracle drug, its job is easy; kill all the bad bacteria in my gut.

But, it doesn't end there. I'm currently also using elimination diets to find out which specific foods I can and cannot tolerate. Almost everyone I meet has a suggestion for what I should eliminate from my diet. I hear a lot of, "you can't eat dairy, right?" and "if you tested positive for Celiac (which I did), then you can't have any gluten." But only I know what exactly I can and cannot eat. Because my gut is also not a food fad subscriber.


Once the bad bacteria is gone from my small intestine, it will be time to rebuild the good bacteria and manage the stomach pain (by watching what I eat). So, fad or no fad, I will be living a low FODMAP diet. 

FODMAP stands for "Fermentable, Oligo-, Di-, Mono-saccharides and Polyols." I realize that's a lot of vocabulary, but it really means that simply restricting FODMAPs from a diet has been found to have a beneficial effect for sufferers of irritable bowel syndrome, SIBO (small intestinal bacterial overgrowth), and FGID. That's me in a nutshell.

FODMAPS are a group of short-chain carbohydrates that are not very well absorbed in the gut (small intestine). These carbohydrates are easily fermented and cause fluid to enter the large bowel. Reducing the total amount of these fermentable sugars may improve IBS symptoms.


THIS IS WHAT I CANNOT EAT:

The low FODMAP diet list was provided to my by my doctor. It doesn't look like any fad diet I've ever seen. But that's because it isn't a fad. It's a lifestyle prescribed for me by a team of specialists.

What am I supposed to eat for the rest of my life? According to the low FODMAP plan, I can eat spinach, plain chicken, white bread, white rice, and potatoes. Ugh. Fortunately, over time I can introduce new foods into my diet to see if I can tolerate them or not. It's like learning to eat all over again.

I will admit that when I started to look into this diet plan I had no idea where to start. I needed a list of foods to eat. And a list of foods not to eat. And I needed it to be all encompassing. Should I eat any sugar at all? How will I know if what I'm eating is made from glucose, fructose, lactose, galactose, or sucrose? It has been overwhelming, to say the least. At least there's an app out specifically explaining the diet plan. 

I've also been thinking a lot. For example, if I choose not to go on a low FODMAP diet plan, will the bad bacteria come back? What about even if I do stick to the plan? And am I doing myself long-term harm by having eaten off the charts before?

To help answer some of my questions I have armed myself with books, websites, and of course my incredible team of doctors. My goal is simple: to live pain free. I think I'm on the road to learning how its done. But I'm a long way from having any clear diagnosis. 


In my immediate future are more tests; more watching and waiting and elimination diets. And possibly antibiotics. And when its finally time to get down to diagnosis, I'll have to undergo a small intestinal biopsy performed with an esophagogastroduodenoscopy (EGD). I'll spare you the details, but tissue samples will to be taken from the cell wall of my duodenum and varying parts of my small and large intestines and colon.

All I have to say is bring it on. I know it may sound a little backward to say I have to limit my fruit, vegetable, and wheat intake, but trust me that I do. I just want to get through the day without being in constant pain. And I also suspect that keeping my stomach healthy will contribute to my overall health and longevity. I'm in this for the long haul.

For more up to date research, including Xifaxan (Rifaximin) for treating SIBO and IBS, as well as more information about a low FODMAP diet, check out this article recently published in Health. http://news.health.com/2014/08/11/experts-issue-guidelines-for-treating-irritable-bowel-syndrome/

Monday, August 11, 2014

one-track mind


Outside of Mérida, Yucatán, along the road leading through Acanceh, past numerous tiny villages, lies the town of Cuzamá. Cuzamá is known today for its three cenotes (sinkholes) and attracts thousands of Mexican visitors every year, especially in the summertime. If you don't get confused and turn around on the way to Cuzamá, you will come upon a parking lot and a whole lot of tourists. From there, it only took us about half an hour for our horse-drawn carriage to arrive. Because about seven kilometers down a 150-year-old railroad track sit three pretty incredible cenotes. If you haven't had the pleasure of swimming in a cenote before, I highly recommend it. These freshwater sinkholes form when the limestone earth is fractured, allowing rainwater to seep into the fractures. The water running through these fractures dissolves more and more limestone until eventually caves form. Swimming in cenotes is one my favorite things in life.


Cuzamá wasn't always known for its cenotes. One hundred and fifty years ago, the Yucatán was at the center of henequen production. Haciendas, aka plantations, were erected all over the state and railroads were set up all throughout the peninsula. A horse drawn cart that runs on railroad tracks, called a truc, was the means of transportation used in the old haciendas during the 19th and 20th centuries.


Our truc arrived and I took my seat. I let the horse lead us along the track down the road to the cenotes. However, I quickly noticed, there was only one railroad track. One. I thought long and hard about this at first. One track, I thought. That must mean we all go in one direction at once and then all return at the same time.

Except that is not what happens. Every time we get a little momentum and rhythm going, another cart and horse appear heading straight toward us. So we quickly get off our cart, lift the truc and move it off the rails, wait for the other cart to pass, put our cart back on the track, and get back to it. This process continues like this every 5 minutes for 45 minutes.

video
I captured the art of moving the truc on and off the track to let the other carts pass

Why isn't there a second railroad track? I had to ask. My driver told me, "the railroad is 150 years old." Well, okay, that's amazing. But why not build a brand new track next to the old one and then in another 150 years you'll have one 300-year-old track and one 150-year-old track? The driver didn't seem to appreciate my additional questions.

But I couldn't just let my curiosity go. In 150 years did no one ever take the initiative to make life easier?

The answer is no. But I still wanted to find out why. Not surprisingly, the internet doesn't have any information about this. So I started to ask the locals. Why only the one track?

The answers soon started pouring in. One day the henequen just ran out. Voila, it was gone. And the haciendas? Abandoned. And the railroads? First, the iron was sold in pieces. Then the roads were paved over so cars and buses could drive on them. Modernism took over the 
Yucatán.

Henequen is a type of agave plant. The raw fibers from the henequen cactus are shredded, pulled, and wound together to make into rope for hammocks, twine for baling hay, and burlap bags.

Okay, this all makes sense, but if Cuzamá is still using the railroad track, why not invest the plentiful tourism profits into placing a second track? I thought this was a brilliant idea. But the locals had many logical explanations for me. First, the railroad track itself is over 150 years old. That means there is no more track of its kind. And furthermore, there are no local engineers. No one who would know how to place this type of track. I never thought of this before.

Also, there is some speculation that the people of Cuzamá are waiting for the Mexican government to give them the funds to improve the tourist route. There is no one in Cuzamá who will use his or her own profits or capital to add a railroad track when maybe some day the Mexican government will provide the support. Even if they have to wait another 150 years.

In the meantime, I'll head back to Cuzamá any chance I get. And its railroad track will retain its charm, as well as its place in history.

Tuesday, July 29, 2014

start me up

I can't remember the last time I've had to much fun. And learned so much. And made so many new friends so quickly. But that's what happens at Startup Weekend.

If you're like me, you don't run in tech circles. You don't have company CEOs as coffee dates, and you don't spend your free time on Arduino discussion boards. So how is it that I found myself trapped for three days in the basement of a Tech Museum (The Tech Museum of Innovation in San Jose) with these exact people?

I suppose it started when a friend sent me an email about Startup Weekend Bay Area Makers and I immediately signed up. I didn't think much about what I was signing up for. I only knew the event was local, during the weekend, and focused on making things. I'm a maker, so this would be a good program for me; I do make jewelry, after all.

I arrived at the museum on Friday afternoon with a friend (although I would have gone to the event solo), and from the instant I arrived, every single person I met was friendly.

But the participants were also interesting. And highly educated. And worked in Silicon Valley (with actual silicon). 
And made everything themselves. Which caused me to start to think, "who is going to take me seriously?"

I even had to make my own name tag at check-in

After Startup Weekend check-in (Friday evening), the fun and games began. New potential start-up ideas were pitched by about 1/3 of the participants. The best ideas were chosen by the group (90 participants total) and teams were quickly formed. Since I didn't have a specific idea or product to pitch, I had the flexibility to join any team. I found myself gravitating toward a scientific instrument based team for two reasons. 1. It was science (biology) based. 2. I met two electrical engineers signed up with the project and they were kind, welcoming, and funny. It was an easy decision; I had my group.

Slowly more participants joined the group until we became a team of eight. Eight strangers to be exact. We had a quick introductory meeting before getting down to business. I took a deep breath and looked around the room. Once again, I found myself sitting next to some of the most brilliant engineers, scientists (one of our members has a PhD in physics), and business consultants I'd ever met. And then there was me.

The tech creative process

The business development process

52 hours later, I found myself standing in front of a group of participants, museum goers, and very fancy CEO judges, pitching our final product; a hand-held, portable, low-cost, fluorometer. We presented last (not by our choosing). I was so nervous, I don't remember what the other 11 groups presented. We were the underdogs; the only team to barely pull together a company name in the 13th hour. The only team striving to create a low cost scientific instrument in two days. We were the team quietly operating under the radar, asking for coaching and advice at every turn.



                           From initial concept           to MVP (minimum viable product)

But then we won. The whole event - we were the judges choice and also the fan favorite. For once in my life, this left me completely speechless.

Victory

I can't believe how much I have grown these last three days. I know what a flouormeter does (and how it works inside and out). I know that the Spark chip inside our product runs on wifi and uses Arduino. I know that the product has wide ranging commercial use. And I know that I have skills that helped our team win. Plus, I know that I want to work with these people again. Simply put, I know that I met some incredible friends, colleagues, and mentors.

And I know that, at the end of it all, I care about making a difference. And I will continue to dedicate myself to service.

But also hopefully learn how to code.

Interested in joining a Startup Weekend? Check out the website to see if one will be taking place near you: http://startupweekend.org/