(5 of 5) Day 4 of the Temperature Regulation Study

Today is the short day of the study, but definitely not the easy day. I guess, because we have done all of the temperature regulating tests, they need to get an idea of how amazingly athletic I am. Perhaps they do this test on all the subjects, or perhaps they were awed by the imposing figure that I cut and decided to check to see if I had any superpowers. Either way, I don’t want to disappoint them.

With Matt and Naomi (aka Nurse Ratchett)

Much fewer sensors are attached to my body and after a short warm up on the bicycle, we get right to it. We start out at a resistance of 79 watts on the bicycle, because that is closest to my weight in kilograms. Every minute, they raise the resistance by 20 watts. I have no idea what these numbers refer to in the real world, so I will refer to them as a superpower quotient. I started off at a 79 superpower quotient continued to pedal to a 139 superpower quotient and then I gave up. So, that should give you an idea of my power. Your welcome.

Back to the hotel, a quick shower and I am at Dallas, Fort Worth airport waiting to go home. I had intended to take a yoga class last night, but did not have the energy. The tests are not easy, but they are not that difficult either, so I was surprised when I was feeling a bit depleted. Overall, I am pleased with my performance. I was worried that my deemphasized cardio regimen might hurt me, and I am sure that I would have gone further, longer with more practice. But, I am satisfied.

I would say that the biggest surprise for me was the act of blogging causes a detailed look at the events of the day. I found myself, throughout the day, having an experience and thinking, ‘take note of that, it would be good to add it to the blog.’ In some ways good, because I would be more attentive. In some ways bad, because it pulled me out of the experience. I think that the mindset is useful when you are having a series of moments that you want to bring extra attention to and to be able to recall later, otherwise I would suggest not.

I also found it interesting to talk analytically about my day-to-day life experience with the burns and how they impact me. Of course, for the most part, they have minimal impact now that I am well beyond the burn. I now find that I shy away from being outside during really hot or really cold days and I sweat more than average. My life is pretty average and normal. So much so, that I am surprised when people hear the story of the burns and make a big deal about them. At this point in my life, they are simply scars, nothing more. Others that have more significant scarring or scarring in more obvious places will probably experience more impact on daily living.

In a few hours, I will be home. I hope to be in bed and asleep shortly after that. Tomorrow I teach my regular class and I am working on the 300HR Teacher Training this weekend. Back to the real world where I don’t pedal while watching Netflix and there are cookies out on the counter at 8PM.

I am looking forward to the next round of service; The Veteran’s Day Class on November 11th, 2017 that will send Vets to a Yoga Teacher Training. Learn more at Boundless Service. #HelpingVetsHelpVets

(4 of 5) Day 3 of the Temperature Regulation Study

Spoiler Alert: I had about 18 inches of wire sent up my nose, and down my throat so that they could measure my core temperature. If the description makes you queasy, don’t watch the video at the end of this post; I recorded the removal of the wire.

You want to stick what, where?!?

My day started out fairly normally, little did I know, that before the day was out, there would be a man standing over me jamming rubber tubing up my nose, telling me to, ‘it will all be over soon enough.’

Truthfully, it was not that bad, Matt was as courteous as only a Canadian can be, considering that he gently, almost lovingly, inserted 18 inches of thin tubing up my nose, then hands me a bottle of water and tells me to take small sips through the straw that is taped in place. The water in small sips is to help send the tube towards my stomach. Once in place, it was surprising easy to manage. I had to fight an initial gag reflex, but that dissipated relatively quickly. Within a few minutes, it felt like I had some snot lingering at the back of my throat. I had a frequent urge to swallow to try and clear it, but that died away as well. Once accustomed to it, the strangest sensation was that when I would swallow, I would feel a gentle tug on my nostril because the wire was taped in place so that I could not swallow it.

Halfway through today’s test. Notice the glisten of sweat on my body and the long wire emanating from my nostril.

Today’s test was slightly different: I pedaled for 30 minutes at room temperature. Alternating periods of snorkel and snorkel-free. Then, they raised the humidity in the room periodically, looking for a particular reaction that I will describe a bit later. The other interesting fact was that Matt pulled out his garage door opener and waved it near my belly to discover that the pill I swallowed yesterday was still active.

I completed the episodes of ‘Abstract’ yesterday, so today I was watching ‘Stephen Fry in America.’ It is interesting to watch a foreigner explore America, they always see things slightly different than we do as Americans.

Once the humidity begins to tick upward, they ask that I refrain from swallowing because the saliva in my mouth is slightly cooler than my core. So, like a wrestler trying to make weight, I am spitting into a styrofoam cup. While the room did get warm, it was never unbearable. After about 10 minutes, I am told that when my core temp raises by 2 tenths more, we are done. Almost 5 minutes later the test is complete, I stop pedaling, they open the door and turn up the fan.

It is the evaporation of sweat off of the body that cools it down. Because severely burned skin no longer produces sweat, it is more difficult for the body to cool. The more burned skin a person has, the more prone they are to overheating. It can be quantified.

By monitoring my body temperature in a heated and humidified room,

my legs are blurry because I am pedaling so quickly

they can determine at what point my body has lost the ability to regulate my core temperature. Instead of maintaining a stable internal temperature, everyone’s body temperature while spike at a certain point, but a person who cannot sweat as easily will spike earlier. When they notice my temperature starting to rise, they know that they have reached the threshold.

What I found very interesting about this is that they kept the temperature constant and increased humidity periodically. The 2 variables affect temperature regulation. They body can regulate temperature when it is hot and dry, but when it is hot and humid, the body struggles because the sweat will not evaporate. So, the next time you hear someone spouting on about ‘dry heat,’ know that there is some truth to it.

This is why you might find overhead misting systems in public spaces of the southwest; it provides additional moisture on the skin to cool it down. And for those who are not able to produce their own surface moisture, external sources are quite beneficial. (Does it also make your hair frizzy? This question is beyond my ability to address)

A few hours after the wire and tube have been removed from my nose, I have no lingering affects. I am aware of the back of my throat, but it feels similar to periods of excessive post-nasal drip; I am simply aware that it has had more contact with objects than usual. I am not sure if I have pooped the first thermometer-device, but I have not been checking my poops very closely so it might have happened. Rest assured that you, my faithful reader, will be the second person to know, when it happens.

I quickly drank a liter of water after the test. Between the sweating (I can sweat from the body parts that are not burned, and they sweat extra), and spitting in the cup, I was fairly dehydrated. It did not feel like a lot of work at the time, but I am drained now. It must have been more taxing than I realized. They were not able to give me any information about my personal reaction to heat and humidity because they need to analyze the data. Although, I don’t know how useful that information might be so I suppose it does not matter.

All told an interesting day. I have one more day of tests and tomorrows is fairly short, but intense. Then I get on the plane to head back home. One aspect of this experience is that it has moments of challenge, but at the end of the day I am back in a comfortable hotel room. Others are not so lucky.

I am not a religious person, but I do believe that we should help those that we can. Some days, it is as simple as acknowledging another person, other days it means giving something a bit more meaningful. The one phrase from yoga that I always return to is, lokah samasta sukhino bhavantu; may all beings be free of suffering.

And on that note, lets watch a video of wire being pulled from my nose!

(3 of 5) Day 2 of the Temperature Regulation Study

burn scars + grafted skin coverage

Day 2 of the study to observe how burn scars impact temperature regulation went much more quickly. Partially because I knew what to expect and also we got many of the preliminary data recordings out of the way, yesterday. Plus, I had the added surprise of swallowing another internal-temperature-monitoring device. I either passed the other one that I swallowed yesterday (but I would think I would notice. I may be reporting on that experience tomorrow), or the battery died. It is supposed to have a life expectancy of 30 hours, but…[insert your typical complaint about modern technology or manufacturing here].

this was my day, today.

The experience today was nearly identical to yesterday, except that the room is kept closer to room temperature.

We talked about general observation and experiences. They told me that most test subjects (is lab rat a derogatory term?) won’t drink water during the test. The reason is that the water is kept at body temperature so that it won’t impact the temperature results and most people don’t like drinking water that warm. I must say it is not my favorite thing, but I definitely prefer drinking water during exercise to not doing so. They measure the amount of water that I drink so that they can factor that into the results.

Some of my stats

During the testing phase, they ask me a few times throughout the test to rate my comfort with respect to temperature and exercise. Am I cold -> comfortable -> hot. I am hardly working -> working at an average rate -> working very hard. One was on a scall of 1-6, in 0.5 increments and the other was on a scale of 5-16, single digit increments. I am not sure why they are not using the same scale for both; perhaps people would be inclined to use the same number for both measurements.

I noticed yesterday that my discomfort was relatively high at the beginning of the test. Over time I acclimated and felt more comfortable even though it was just as warm in the room as it was at the beginning and I was more fatigued. Yesterday, I found myself trying to remember what the last rating I had given so that I could rate my comfort relative to that reading, rather than to my overall comfort; it seemed unlikely that I had grown more comfortable as the test progressed, but I had simply adapted to the experience.. I was told that this is common and can be taken into account.

Today, without the heated room, the exercise was much more tolerable. I pedal for a total of 1 hour at a moderate pace. There is still the alternate periods of wearing the snorkel and the breath test (you can see a short video below of the test). But, without the added heat, the day passes leisurely. I almost feel guilty, sitting in a room, wearing a few sensors, watching Netflix and pedaling at a comfortable pace.

All geared up and ready to breathe

During a recent conversation, someone remarked how life-altering my burn experience must have been and how I must still carry the experience with me. My response was that eventually, all scars become stories and nothing more. While the burn was a traumatic experience, there was little trauma surrounding it; my life was comfortable, I had little stress outside of credit card bills and the only time my life was in danger was in moments of road rage on the highway.

I believe that I soldier who survives a burn has a very different recovery process. Because my burn was not enmeshed in a struggle of life-or-death and because I was not fighting for my country and my team, I think that my emotional separation from my burn experience was an easier transition. The last anxiety attack that I experienced was about 5 years after the burn; considering the severity of the trauma, that is pretty good.

While I have experience recovering from trauma (who doesn’t), I have no experience with a soldier’s life and struggle. That is why I am really happy to be able to use my experience to help soldiers, through this burn study and also through the Helping Vets Help Vets class in November.

Twenty-two vets commit suicide every day because they do not receive the support they need to help them through their recovery. If you check the sidebar, you will see a small study conducted by the VA that shows yoga and meditation can be beneficial for PTSD treatment. We will be sending vets to yoga teacher training because who knows how to help a vet better than another vet.

Get more information about the Helping Vets Help Vets on the front page and about the fundraising page  and VEToga Teacher Training by following the links.

(2 of 5) 1st day of Temperature Regulation Study

All hooked up and ready to pedal

I arrive at 10am and meet the folks that are running the test. The first few hours are spent going through paperwork, getting some baseline measurements such as height, weight, blood pressure, etc. They show me the room that the testing will occur in. It looks like a walk-in freezer that you would find in a restaurant except for two things: There is a window in the door that allows you too see, a recumbent bicycle and a bunch of monitoring equipment inside the room. And the room contains recumbent bicycle and a bunch of monitoring equipment.

I will be coming to this room for 4 days, each day’s test is slightly different. Today, I will be pedaling at or about 75RPM in a warm room. For 10 minutes at a time, they will place a snorkel in my mouth and I will breath through it. Something about the exhales gives them information about what is happening on the inside. I will pedal without headgear for 15 minutes, between the snorkel-in-mouth testing period. Three times during the test, they will place a different snorkel in my mouth. This one will contain nitrogen and by measuring the amount of nitrogen I exhale at the end of the 30 second test, they can tell how much blood my heart is pumping with every beat and how oxygenated my blood is. I will also be hooked up to various heart-measuring and temperature-checking devices.

 

Temperature monitoring pill that I swallowed

But wait! There’s more. I am going to swallow the small pill-looking thing. They will hold a device that looks like a garage door opener near my lowest ribs and the device will tell them what my internal temperature is.

One of the pieces of preliminary information we gathered was determining 3 different categories of scarring: the percentage of body covered in burn scars and grafted skin, the percentage covered in grafted skin alone and the donor sites (where the grafts come from). For the curious, I have 30% scars and grafts, 20% grafted skin and 15% donor sites. We used a pretty cool app from Johns Hopkins to determine these percentages and the people I am working with were nice enough to share the images with me. I am going to post the photos on a different day because I don’t want to use up all the cool pictures on day 1 of the test.

I should note that when I mentioned I would  be blogging about the experience and asked permission to take pictures, the people running the test were enthusiastic and excited.

Just before the fun begins, I strip naked and the measure my weight in grams (they want a very accurate measurement of water loss). I don’t remember the exact number, but it was around 78million grams, or something. While I sit on the bicycle, they begin sticking pads to my body, testing sensors, looking for the pill that I swallowed by moving the garage-door-thingy around my belly and back and setting up Netflix for me so that I will be entertained during the ordeal. I have a pulse checker on one finger. They add another when they do the nitrogen-breathing test. During the test, they will also be checking certain body parts with a heat sensing gadget that looks like a radar gun that the police use. At one point during the test, they will be placing a small pad of absorbent fabric on my arm in 2 places: One spot that is grafted skin and another spot that is clear skin to compare sweating. Finally, they use another heat-sensing camera to compare the skin that is clear, to skin that was used as a donor for the skin grafts.

It was a lot to keep track of, it is no wonder that there were 3 people managing the test. Luckily for me, my job was to pedal the bicycle and watch, Abstract on Netflix. I might have the easiest job of the lot.

Truthfully, the setup was more interesting than the test. Once I am pedaling, change occurs infrequently: Nurse Ratchet’s voice behind me (she requested the moniker) states that the blood pressure cuff is activating; Matt and Manall comes around to announce that it is time to put one of the two snorkels in my mouth. At one point, a piece of tape holding a wire to my leg breaks free and Matt must try to reattach the wire to my leg while I am pedaling at 75RPM.

The most discomfort I suffer is chafing from sitting for so long and the fact that I am forced to use subtitles on Netflix because I cannot hear over the noise of the heaters and fans.

Once the test is over, I stay put for another 45 minutes. They called this the ‘cool down.’ I am pretty sure that they do this to ensure that I am not going to pass out. I was not doing anything, but they were cleaning the equipment. When we are all complete, I strip down one more time and weigh myself. If I remember correctly, I lost about half a kilogram.

They did say that every day, the test is slightly different. Tomorrow, I will do exactly the same thing, but the room will be closer to a comfortable temperature. There are a few other variations, but I will wait until the day of, to talk about them.

The people running the test are very nice. During the setup, Matt asked if I had a problem with them shaving off a small bit of hair from my leg so that the sensor would stick. At this point, am I really going to say no? He is Canadian, so that may explain his courteousness. Nurse Ratchet (I believe her real name is Naomi) is married to a retired police officer and Manall has lived here, in Dallas her whole life; didn’t even leave for college. They have been very friendly and happy to answer all of my questions, even the stupid ones.

I end up at the hotel with plenty of time to write this blog post, work on the information for the Marketing of Yoga workshop that I am presenting this weekend, and do some writing on the new novel. All in all, an interesting day.

It is interesting to me that this opportunity presented itself at the same time that we are beginning a program to help provide Yoga Teacher Training to Vets. You will be hearing more about it in the coming weeks. #HelpingVetsHelpVets.

(1 of 5) I am helping the military understand how burn scars impact a soldier’s ability to do their job.

Proud of myself that I can still handle chopsticks

As many of you know, I was burned by hot oil in 2003. I don’t know the exact number, but I believe that I have around 30% skin grafts and scarring, mostly on my arms and legs. The most consequential aspect of the scarring is that I am unable to sweat in those areas and that I sweat extra in other areas to compensate. This is more than a cosmetic impact because sweat is a the body’s main method of heat dispersion. What that means is I have a difficult time in excessive heat because my body cannot cool itself down as efficiently as most people.

For the next few days, I will be in Dallas, Texas, taking part in a study. The purpose of the study is to understand exactly the impact of burns are on the temperature regulation. I don’t know all of the details, but I will find out soon. As I understand it, I swallow a small device that will allow the monitors of the tests to track my internal temperature. They will then subject me to some form of torture (cardio exercise) and observe how my body is able regulate the internal temperature.

There is a lot that I do not know: I don’t know why I cannot sweat through the grafts (I assume it is that the sweat glands were destroyed by the hot oil). I don’t know what it is that I am swallowing (I am assured that it is not very large and mostly inert and that it will pass through my system in a few days). I don’t know how hard they will work me (I don’t like cardio so it should not take long to put me under extreme stress).

I am mostly curious; about the process and what they can tell me about my personal temperature regulation. My biggest concern is that I am told I cannot drink coffee in the morning before the testing.

Stay tuned for updates…