Monday, August 26, 2013

I Want Them to Know

I'm applying to medical schools now. I haven't had the best experience with school or with doctors, or even with life in general. There are things I can't tell the medical schools--things both good and bad--because they don't want applicants who have chronic health conditions (it makes us look bad as applicants). These things are important, though, so I'm posting them here.

I want them to know that I'm a good student, no matter what my grades say. I want them to know that I know my Organic Chemistry 2 and Biology cold, despite the grades I got in those classes. I want them to know that crap happens, and that my health has messed up my test-taking more than once, but that it doesn't mean that I don't know the material.

I want them to know that I've wanted to be a doctor my whole life, and that nothing else is even a thought in my head. I want them to know that my bad experiences have made me want to be a doctor more, not less.

I want them to know that medical school will not be easy for me, but that I will do my best. I want them to know that I will do whatever it takes to make it through with the most medical knowledge I can accumulate. I want them to know that I understand that medical school and residency and fellowship will be physically demanding, but that I consider myself up to the challenge (assuming there's always coffee at hand).

I want them to know that there will be times when I am not myself, and that it's okay. It's not okay to penalize me for what I am completely unable to control if it only happens once in a while.

I want them to know that I am sensitive, physically and emotionally. I want them to know that my social skills are self-taught, and that I'd really appreciate a book of social protocols (like the Liaden Code of Conduct which, unfortunately, only exists in the Liaden Universe series). I want them to know that it's okay to tell me that I did something wrong, but that they shouldn't be overly harsh on me. People confuse me sometimes.

I want them to know that I can be a good doctor despite my physical incapabilities. I will not give up on CPR just because my arms hurt like hell after the first three compressions. I will not leave an OR because my back and legs hurt. I will not go home early because I have a migraine. I probably won't even complain about any of that stuff. Therefore, I should not be brushed off because of them.

I want them to know that, as a doctor with chronic diseases, I will understand patient compliance and the emotional aspects of living with diseases better than most doctors.

I want them to know that I want to be the inspiration that keeps people going. I want to be the person that tells her patients that they can do it because I did. I want to stand there and say that I know it isn't easy, but that if anyone knows they can live their life despite their challenges, it's me.

"My wish for you/ Is that this life becomes/ All that you want it to/ Your dreams stay big/ Your worries stay small/ You never need to carry more than you can hold" ~Rascal Flatts

Sunday, August 25, 2013

Sensational

One of my first symptoms was an indescribable sensation in my legs. It felt awful, and the only thing that helped it even a little bit was walking. Of course, once I stopped, the feeling was unbearable, and there was nothing I could do about it.

At night, I'd sleep with my legs up on a huge pillow, and I'd take both Aleve and Benadryl so I could sleep.

Heat made it infinitely worse. So much worse, in fact, that I dreaded the next summer, because I was so unable to deal with it.

Now that I think about it, I wonder if I had RLS, or something like it. I still get the feeling sometimes, but not ever as bad as it was that first summer.

I had some transitory numbness and tingling in my hands and feet, some pain with no cause (which I still have). I was often afraid of burning my hands because I couldn't tell if things were hot--but only sometimes. It came and went as it pleased.

Since then, things have changed a lot. Now, my body is overly sensitive to the strangest things.

I love the way clothing feels. I can waste an hour rubbing my hands over and over a pair of socks. It sounds ridiculous, but it feels awesome.

I can't wear turtlenecks anymore, even though I used to love them. I can't handle the feeling of something on my neck.

I get cold a lot, though I'm usually hot. I get cold at weird times, too, and for no apparent reason. (Migraines and nausea and lack of sleep make me cold, but that used to be it.) I happen to be freezing now. Go figure.

Sometimes, for no reason I can understand, singing annoys my body. Singing is one of my favorite things, and when I can't sing, it scares me. I worry that I'll never be able to sing without making every hair on my body stand on end. I worry that my dream of doing something with music will never come true. I worry that everyone will ask me to sing and I won't be able to--and they'll all wonder why.

At those times, singing makes my skin crawl, it feels like metal is screeching in my ears, it brings tears to my eyes. It isn't the sound, it's the vibrations through my body.

The other most annoying sensation? Long hair.

I've donated my hair twice--once when I was 14, once when I was 17, and now, at 20, I'm going to do it again.

The second time I'd donated it, I'd been living with fibro for a year. My hair was annoying, but it wasn't physically uncomfortable.

By the second year after I'd donated it, it had crawled past my shoulders and was growing down my back. And it itched.

No one I know has ever heard of anything like it, and I'd never experienced it before. To this day, my back itches when my hair touches it. This has been going on for two years. I'm ready to get rid of it. And I don't think I'll be able to do this again.

I love donating my hair. I think of all the kids with cancer who had long, curly hair and get short, curly wigs. The longer I grow my hair, the longer their wigs will be. Additionally, my hair is a weird color, and I can't imagine that many people donate curly hair with my coloring. I hate that fibromyalgia could keep me from doing it again.

Regardless of fibro, I happen to be very, very, VERY happy that I'm donating my hair next week. I like it better short.

Thursday, August 22, 2013

Sometimes

Sometimes it's hard to remember that I'm a person, rather than a mess of things that don't work properly.

Nothing in particular happened to make me feel like I've completely fallen apart. I've finally seen my podiatrist, who diagnosed me with flat feet and a very collapsed ankle as a result of this stupid thing. He refuses to do anything until my new orthotics come in because he says that it's impossible to differentiate actual damage and pain from the flat feet. (So I've been using a combination of taping my arch up and a tightly wrapped ace bandage doing the same to help--which it actually has been.)

My blood sugar is, for the most part, holding steady--no major surprises. I had a 170 on Sunday night from sesame chicken (which I haven't made in a while), but it was probably from the fever I'd had for two weeks rather than the food. I had a 70 today, for reasons I don't understand. C'est la vie.

My fibromyalgia is neither worse nor better, though I think I'm going to try taking CoQ10 (a supplement with no real side effects but has been shown to help certain muscle problems that stem from issues with mitochondria, which it seems fibromyalgia stems from). I want to ask someone first, be it my endocrinologist, my rheumatologist, or even my pulmonologist. I probably need to see my rheumatologist sometime this year because I have pain in certain joints that just refuses to go away.

My breathing is fine--or as fine as it ever is (though exercise seems to help for a couple of days and I haven't done any lately).

I haven't had any major allergic reactions or sudden realizations that I'm more allergic to something than I thought I was. Even my eczema has been behaving pretty well lately.

So I don't know what it is that makes me feel like I'm drowning in my body's prison tonight, but I am.

I hate being in constant pain. I hate knowing that I have to eat something because I have to take Metformin, a multivitamin, two vitamin C's (it keeps me from getting colds, which usually leads to bronchitis, which has variably bad breathing outcomes), vitamin D, and Zyrtec. I hate craving sweet, cakey foods but knowing I shouldn't eat them. I hate the fact that I gained nearly six pounds this summer for No. Reason. I hate the fact that a patient asked me what my Tummietote was today. I love the thing, but I know that patients wonder why I'm wearing a thick, bumpy black band around my waist.

I find something interesting--maybe it's just me.

There's so much of me that's hidden from the rest of the world. I write, I sing, I play guitar. I'm donating my hair for the third time in a few weeks. I'm left-handed. I'm really, really good at science and math. I type fast. I have truly terrible handwriting. I love to learn. I hate clothes shopping, but I can (and have) spend hours in Target. I love planning every bit as much as I love going places or doing things. I love, love, LOVE music.

The health stuff is more hidden in that I actively hide some of it. The things that don't impact my functionality are well-known by the people around me. They probably think that diabetes and allergies are my central focus because those are what they hear about. In fact, I think fibromyalgia has the harshest impact, but I don't talk about it because it actually has the capacity to destroy my life. I don't tell people when I'm in pain or when I'm too tired to do something (unless the only thing I have the energy for is sleeping). I often will push myself to do things I don't have the strength to do rather than cancel plans or admit that I'm not up for it. I'm so desperate to keep fibromyalgia from controlling my life that it is, in fact, controlling my life.

I can still remember what it felt like sitting in that doctor's office in April, begging him to tell me that he found something, anything that could explain my symptoms. I remember his answer, too: "Why would you want a potentially life-threatening disease?"

It isn't that I wanted to be diagnosed with lupus or Sjogren's disease or anything else potentially scary, it's that an explanation, a possible prognosis, a possible treatment, were the only ideas, however far away and abstract, that were keeping me going. The idea that I might one day become too incapacitated to be useful is terrifying--especially given all of my talents and loves. There are some things I can handle--diabetes, Hashimoto's, food allergies--and there are some things I can't--deafness (because of music), lack of enough motor skills to type or play guitar or piano. I've already lost most of my ability to hand write. My guitar playing is not as good as it was--and not because I'm out of practice. I'd been playing for nearly a year when I woke up one morning and could hardly hold my guitar, let alone play it. It was like my heart had been ripped out. I think I've regained most of it, but I went from being my guitar teacher's prized student--according to her the best she'd taught in 30 years--to being clumsy and barely able to pluck out a tune in one night. It could happen again.

I had a very scary time about a year ago when I wondered if I could even become a doctor. There are days when I have a significant cognitive impairment. Everyone says they don't notice it, but I do. Some days, if you tapped on my nose, I couldn't tell you what it is, even though I know what it is. There are days when I can barely process other people's speech, let alone create my own. Sometimes this can be overcome with enough caffeine to make my brain rattle around in my head, sometimes it can't. I practically failed a Genetics test on one of those days (I ended up with an A- in this class, so you know that that wasn't usual for me). And then I wondered: if I can't pass a "simple" biology test, then how can I safely treat patients? And yes, that scared me for a long, long time.

And I have to wonder if my flat feet were caused by this damned disease, too. I know that my ankle issues are definitely worse because of it, because it seems like I'm more fragile because of this damned disease.

I truly feel that I do not function at a good level on a regular basis. I often don't feel well, I'm almost always in some minor amount of pain. I'm always, always, always tired, no matter how much I sleep and no matter how much coffee I drink. I honestly don't remember what it's like to feel good. I get by, sure. At the end of the day, I function well enough to get decent grades and get through the day, but I could be doing so much better. I think of all the students, all the pre-meds, all the people who don't understand the material on the same level I do but are getting better grades, anyway. It makes me sick to think that my lifelong dream of becoming a doctor--something I'd be really, really good at--might not happen just because of some horrible disease I never asked for, could not have prevented, and can't do anything about.

When I get like this, I have a friend who likes to tell me that I get more done with the limited amount of energy and strength I have available to me than anyone else she knows (this coming from a person who does more than I could ever imagine). It just makes me wonder what things would be like if I were a fully functioning, capable person whose ambition was reflected in the things she did and whose intelligence was reflected in her grades.

I realize this is a long post. If you're still reading, you're really, really awesome. Everyone feels like this sometimes, and I don't feel like this often. I don't know what set it off, but I feel much better now that I've let it out. If anyone has any words of encouragement, I'd appreciate it!

"Sometimes I don't want to be better/ Sometimes I can't be put back together/ Sometimes I find it hard to believe/ There's someone else who can be/ Just as messed-up as me" ~Skillet

Friday, August 16, 2013

Puzzle Pieces

Sometimes it's hard to put the pieces together and figure out what's wrong. It doesn't necessarily matter what bothers what, except for potentially preventing it from happening again. Other than that, it's another frustration about living with multiple chronic diseases.

For example, on Sunday I went swimming. 

Now, swimming lowers my blood sugar much more than running does (strange, right?). Usually, if I have ice cream first, I'm fine. Now that's a good excuse to have ice cream. (And I just realized that that was completely irrelevant, but it's still part of my swimming routine.)

No matter whether I'm in the pool for exercise or playing (with my sister or little kids--no one's too old to push their sister's head under the water), swimming makes me cold. I know that this happens, so I come prepared with a long-sleeved shirt and a sweater. 

Of course, it happened last Sunday. It was about 80 degrees that day and the pool was 86. This is totally normal for me. But I couldn't get warm (usually I can't until I take a ridiculously hot shower). 

Even after my shower, I was still cold. No fever supposedly,  but I was freezing. 

I woke up the next morning feeling fine. I went for a run on Monday night, and I was freezing after that, too. The only thing that bothered me was my ankle (which has taken a rather strong dislike to running). 

It happened again on Tuesday night, for no reason. 

On Wednesday I was freezing all day. The doctor I was shadowing has a very cold office,  but I couldn't get warm. Lo and behold, I had a "fever" of 99.8. And I had to go to a wedding. 

I took an Aleve for the fever and the mild headache that had been nagging me all day. It helped neither, and the headache went away on its own after a few hours. I came home with the same fever I'd had apparently all day. 

My ride threatened that I shouldn't go to work on Thursday, but I told her that I'd only been having fever at night. I actually called to tell her that I didn't have fever on Thursday morning (99.6, no real chills after I got dressed--and no, I'm not proud of lying to her). I dressed a little warmly, partially because it was cold and partially because I didn't want to freeze all day again. So I was hot all day. And I came home with a fever of 100.3. Gee, no wonder I was hot. 

The highest temperature I've seen today is 99.6. Nothing I've had is really high and I feel fine, minus the weird body temperatures. I'm still cold, which is just getting annoying. 

What is it? Do I have a virus? Is something autoimmune bothering my ridiculous body? Is my body rebelling against exercise? 

I know better than to run when I have fever, so I haven't since Monday night. I'm not thrilled, because I'm afraid I won't be able to force myself back into it. 

I dissect everything--why my knees hurt, why my blood sugar is high, why I'm tired. It's annoying that the obvious answers are "I have fibromyalgia", "I have diabetes", and "I have fibromyalgia", respectively. But I need to find the deeper reasons, the things that annoyed those conditions, so I can keep it from happening again. It's unfortunate, because exercise somewhat annoys the fibro, eating annoys the diabetes, and everything annoys something in my crazy, messed-up body. It's like an overtired three-year-old; everything will make it scream and cry and whine. It doesn't know what it wants. 

All I know for sure is I want some chicken soup and maybe some weight loss out of the deal because of the appetite I seem to have lost.

"Shrouded in proof, you're the mystery/ You're the truth that lives within the world we see" ~Skillet

Sunday, August 11, 2013

Deep Thoughts

I had a different post planned for tonight--one about which disease to attribute issues to. After the conversation I had with a friend tonight, though, I have something else I need to say first.

I'm different from most people. We all have different life stories, but mine is so extreme that it's in a category by itself. Several books could be written, each about a different crazy thing that happened to me. That doesn't bother me--in fact, it's usually a source of pride that I've had such a diverse, crazy life.

There are things that I like to "forget." If you asked me about them, I might have to think about it to remember everything--or even that it happened at all. Every once in a while, stuff comes up from a forgotten part of my past, and I dredge everything up again.

I'm not going to share the story here because I'm afraid of who will see it. To most people, it wouldn't seem horrible. To a fellow religious Jew, though, it's a nightmare. (Yes, I'm a religious Jew, and that was also a post that I was going to write--even before tonight. I'm saving it for another day.) Suffice to say that, as a whole, we're not very accepting of people who are different within our own social circles. Revealing some of the things I did as a kid and early teen would be suicidal in an almost-real kind of way.

There are a lot of things about myself that I don't generally tell people I don't know well, but there are few that I never, ever tell anyone. Most people I speak to for long periods of time will find out that I have diabetes, that my mother died, that I'm a religious Jew, that I have a sister. Some might get to hear about my crazy medical history. These are things that just come up, and I don't actively hide them.

There are other things that I don't actively hide, but they almost never come up. One would be the crazy, seriously messed up friendship I had with someone I just can't handle speaking to anymore. Another would be how badly I was bullied in elementary school. These things aren't secrets, exactly, but I don't like to think about them.

I wonder what it says about me that there's one story that people never hear about?

I think there might be five people who have heard this story--and maybe two of them have heard it in its entirety. The person I spoke to tonight had no real reason to hear everything, and she isn't the kind of person to push for information. (For the record, I wouldn't have minded telling her.)

Does everyone have secrets? Are there deep, dark parts of your life that you'd rather forget? (Actually, now that I think about it, I have two secrets, but one of them comes up way more often, so I remember it even though I don't talk about it.)

This person I was speaking to tonight suggested that I write an article about my story and send it to a Jewish magazine or two. It's a story that, in its entirety, is a heartwarming and really, really nice story. I'd send it without any real names, but no one would publish it. (It would really fit better in a small book, but that's really not going to happen.) Remember when I said we as a whole don't accept what's different? Well, no one would publish this story for that very reason. The fact that everything turns out well in the end doesn't excuse, in their minds, the things I did in the past.

Maybe I should type the article up. It wouldn't hurt to try, right? The worst thing that could happen is that someone in the editor's office gets a good laugh, right? Why am I so afraid to try? Could it be that I'm afraid of people recognizing me through every attempt to disguise myself and my family?

And now I see that it's far easier to write a blog post about how I feel about my crazy, messed up body than about my crazy, messed up life.

"Times will be bad, times will be good/ Things I wish I hadn't done and some I wish I would" ~Skillet

Thursday, August 8, 2013

Funny How It Works Out

If you'd asked me to describe life when I'm 20 when I was six years old, I would never have painted a picture of where I am now.

If it had been up to me, the only things that would be the same would be that I would wear glasses and that I'd be pre-med. That's it. Honestly.

When I was seven, I switched schools. I ended up being severely bullied from the 3rd grade until I graduated 8th. I also developed "asthma", which wasn't diagnosed until I was ten. Three years of being told I was a couch potato.

When I was ten, I was diagnosed with basically untreatable asthma. While I might have seen asthma in my future, I never knew that there was such a thing as untreatable asthma.

When I was fourteen, my mother was diagnosed with cancer. Though it had been a fear of mine, I was blindsided.

I also developed a severe allergy to nuts when I was fourteen. I developed a bunch of other allergies then, too--which I probably could've seen coming, considering I always had lots of allergies. And I was diagnosed with Hashimoto's disease.

When I was sixteen, my mother died of cancer. Nope--never saw that one.

Also when I was sixteen, I started having symptoms of what we're currently terming fibromyalgia. I also was finally diagnosed with reactive hypoglycemia, which I'd had symptoms of for years.

When I was nineteen, my father was diagnosed with cancer.

I'm twenty now. I was finally diagnosed with "fibromyalgia" this year. I was finally put on meds for my persistent high blood sugars--even though my endocrinologist has still never said the word "diabetes" to me.

After expecting everything to somehow be wonderfulawesomeamazing, all I have to show for myself is a TON of health issues and a very, very strong family history of cancer.

I promise--there's a point here.

This summer, I was exposed to a lot. I think the first practical thing I learned was that patients aren't seen as people sometimes.

People hate it when doctors look at them like a specimen rather than a person. Having been on both sides now, I understand it better.

Today I was shadowing a cardiologist. All of the patients were men--except for one.

The men just stripped their shirts off, no problems, no questions asked. The woman got a hospital gown in shirt form.

When the doctor went to listen to her lungs, he couldn't lift up the shirt--he had to have her unsnap it. So he's standing behind her, I'm standing more in front of her, and her chest is basically completely exposed. No matter how hard I try, my peripheral vision still catches some of what she's trying to hide.

I'm part of the same species as her. I'm even a member of the part of the species that shares equipment with her. Modesty is important--I really, really understand that. But I wasn't seeing a woman's breasts out of the corner of my eye--it was like that part of her didn't exist for the moment.

This has happened periodically throughout this summer. I see parts of patients that I know they don't want me to see, but it's like that isn't what I'm really seeing. I unconsciously take a step back when I see something like that, and I'm able to separate in a way I didn't think was possible.

Here's where the first bit comes in.

Had I lived the easy, carefree life I'd always expected to live, I might be able to sink into my ability to separate. Some doctors have a way of seeing people in a very...clinical...way. I have that ability, but I can't sink into it. Because when I'm face to face with a patient, they're more a person than a patient to me. That doesn't mean that I get all emotional, but it does mean that I can be distant when I have to be and can still be a human being when I should be.

When confronted with the terrified parents of a four year old newly diagnosed with Hashimoto's disease, I'm not above telling them that I have it, too, and being a living example of the normal life he can live despite it. By the same token, I was able to hold down a five year old boy slipping under anesthesia who kept thrashing around. I remember the feeling of slipping away, not being myself as I held gently but firmly onto his leg.

I don't think I would have been able to retain the human aspect if I hadn't been confronted with what it means to be HUMAN--fallible, weak, powerless on so many levels--if I hadn't been confronted with it myself so many times. Having been the difficult patient, I know the frustration. My patients will appreciate the pain I went through someday, because I've been through more in twenty years than most people go through in a lifetime.

"This is how it feels when you take your life back/ This is how it feels when you finally fight back/ When life pushes me I push harder/ What doesn't kill me makes me stronger" ~Skillet

On Exercise

People who run have always fascinated me. There's something about moving fast and smooth that's so...relaxing-looking. Sometimes when I was younger (before my body had trained my brain to not even think about it) I'd be overcome by these crazy urges to RUN. I remember getting off the bus at sleepaway camp one year and I was so happy that I needed somewhere to put all that crazy, misplaced energy. I went for a run around the camp that ended in a horrible "asthma attack." It was so worth it...

But I resigned myself to never being able to run. I had "asthma", and though there are plenty of asthmatic athletes, those were always the people who could be controlled by meds. And, of course, if they caused an attack, they could just take something and it would go away. But since it never worked like that for me, I could never be one of those people.

I don't know what it was that inspired me to really buckle down and try it, no matter what the cost. There are quire a few of them. And since my brain thinks better in lists, well, here they are, in no particular order.

1. Last summer, I could barely finish a sentence before needing to take a breath. I gained about twelve pounds in three weeks before I decided I had to do something about that. (We have NO idea what caused me to gain so much weight so fast, especially since it was after more than a month of sitting and doing nothing--during which time I gained no weight.) So I went on the treadmill for an hour and forty minutes every morning before work (I was an assistant to a division head in a local day camp). I just walked, but I noticed that my breathing was better during the day. Also, I was less hungry, I had more energy, and I felt better overall.

2. Two of my professors in college run marathons. They were two of my favorite profs, and they both seemed to really enjoy it. One of them pushed me to start running, stating that my breathing would get better, that I'd feel better. I didn't believe her, and I argued with her. (I can't wait to see her this Fall so I can tell her!)

3. Diabetes is a scary disease. It can cause a ton of damage, raise your risk for all kinds of heart problems, and it's overall a terrible thing to have. Exercise reduces the risk of complications from diabetes, but it also lowers blood sugars, which further reduces the risks....What's the opposite of a vicious cycle?

4. Running burns more calories in less time than any other form of exercise. I'm supposed to be losing weight (and I somehow managed to GAIN weight this summer...*sigh*). I can't see that happening, because my weight usually stays the same no matter what I do, with a couple of exceptions. (Those are: when I get bronchitis, I usually lose between 2-5 pounds, which I do gain back slowly over the following months; Passover, when I basically starve for a week and also usually lose about 5 pounds; last summer and this summer, when I gained weight for NO reason.)

5. As mentioned before, the relaxation and the coolness of running...and have I mentioned that I'm the most uncoordinated person ever, and that running somehow seems to help that?

6. My mother's father died of a heart attack. I'm pretty sure her mother died of the same. My father's mother died of a stroke. My father has had high blood pressure for more time than I've been alive. He's also had high cholesterol for forever. I get migraines, which are a risk factor for strokes. Have I mentioned the diabetes risk factor? Let's face it--I have a million factors against me for cardiovascular issues. I want to do everything I can to reduce those.

7. Fibromyalgia is, supposedly, helped by exercise. So far I'm seeing more joint pain and stiffness with exercise, and I think my muscles might be getting worse, too, but we'll see what ends up happening.

So there you have it! Reasons to run! And the weirdest thing out of all of it?

I'm enjoying it.

"If I had the chance to make one wish/ Every, single moment would be like this" ~Rascal Flatts

Wednesday, August 7, 2013

What They Don't See

I'm very thankful for having chronic diseases that I can, for the most part, hide. It makes things easier in some ways--I don't have to explain anything unless someone offers me food or sees the MedicAlert bracelet on my wrist. But it makes things hard in other ways.

I'll use my recent trip to Maryland to visit my friend as an example.

What she saw:

My best friend, S, picked me up at the bus station and we took the Metro together. We sat on the benches and talked and laughed and enjoyed being able to speak in person. She handed me an iPod full of music we've both recently discovered and we shared headphones the whole way to her stop. We waited for the bus for about a half hour, got on, listened to more music, made each-other laugh really, really hard. We got off, went to the grocery store, walked a mile to the house she's been staying at this summer.

What I saw:

My best friend, S, picked me up at the bus station, after I'd been standing around holding a very heavy laptop case (that I was using as an overnight bag) with an even heavier backpack on my back. The straps dug in to my shoulders and the laptop case pulled and pulled. I felt myself getting dehydrated but I didn't want to drink because we wouldn't be near a clean bathroom for a couple more hours.

We sat on a bench and waited for the Metro. I was happy just to get the backpack off and stretch my back. We listened to music, and I was happy to share the headphones even though leaning over hurt my neck a bit. We sat on a bench and waited for the bus, and the heat made me dizzy. I said nothing.

The walk to her house was brutal. Uphill, uphill, uphill. Some downhill. Uphill, uphill, uphill. My arm ached from the laptop case, the outside of my knee ached where the case kept brushing against it, my back ached from the backpack, my shoulders hurt from the straps. I said nothing.

I enjoyed being with my friend. I really, truly loved it. I have no regrets about going, because the pain is fleeting but our friendship means a lot to both of us.

I don't like to tell people about the fibro and how much it bothers me. I don't like to tell people about my diabetes and how much it drives me crazy. I don't like to complain about how much trouble breathing I have. I don't like to complain at all, really. If I can avoid telling people about these things, then I do.

I doubt anyone I'm shadowing notices how much I bend my knees when we stand for "too long." I doubt they hear my knees crack after standing for five minutes. I doubt they notice how much I drink.

On Monday, the doctor I've been shadowing kept making comments on how tired I looked (he's a pulmonologist/sleep specialist). I was tired, but no more than I usually am. He might've been seeing the leftovers of the bad run I had on Sunday, but more than that I can't account for.

I could've told him about the run. He would've understood. But that would've meant telling him about the fibro, and I didn't want to do that. I left it alone, but I wonder if that makes a difference to him...

"I'll need a little more luck than a little bit/ 'Cause every time I get stuck the words won't fit" ~Faber Drive

Thursday, August 1, 2013

Exhausted

Today was not a great day, health-wise.

I woke up tired, which happens almost every day. I haven't slept much this week because I slept at a friend's house for two nights and I was up half the night packing right before I left. Then I just didn't get my necessary 8-9 hours (which is a goal but not an attainable one--I usually get closer to 6 or 7).

So I was tired this morning. No big deal.

I shadowed in the morning, went to lunch, then went to shadow in the NICU.

I shadowed in the NICU before, when I was part of the program in June. It was a wonderful experience, and I jumped at the chance to do it again.

We changed into scrubs and followed the same doctor around.

The other girls asked lots of questions. In my opinion, asking questions is an excellent thing. However, when their questions cause us to stand in the exact same place for nearly an hour, I don't do too well.

I didn't say anything, but my back started to hurt. Then my knees. I kept bending them so they wouldn't stiffen up too badly, but they did, anyway. They also cracked almost every time I bent them, where that usually happens once every five minutes or so.

My shoulder/neck area started to hurt, but I still kept my mouth shut. At some point I was able to sit down for five minutes, and I was so miserable that I didn't want to get back up.

When I'm walking or moving around, this doesn't happen. But when I'm standing still, forget it. It took me more than an hour to get back to "normal", and even then I still wasn't okay.

I kept dozing off on the train on the way home. Generally the train is pretty safe, and there were lots of people around, but I don't like sleeping on the train. When I woke up to get off, I discovered that the muscle behind my knee and lower thigh had decided to cramp in one leg--and I kept feeling it pull when I moved my leg.

We went to the grocery store, where I just couldn't function. Then we went home, where I made dinner for everyone but me.

I had a BUNCH of Chip's Ahoy cookies and milk for dinner. Honestly, I don't even want to think about how many carbs that was. I don't even know if I spiked from that or not, because I then curled up on the couch and took a two hour nap (with about forty interruptions from the two family members, who don't seem to understand the word "sleep").

I feel better now, but it's days like this that make me nervous.

It could've been the rain. It could've been mild dehydration (even though that usually causes muscle sensitivity in my messed-up body, but anything's possible). It could've been the fact that it was cooler outside than it's been in a while. It could've been that the NICU was warmer than any other place in the hospital. Really, there are so many factors that it's impossible to tell what caused so many problems.

I've never had pain and stiffness in my knees that wasn't resolved after a few minutes of walking. I've never had back pain that wasn't resolved by stretching a bit. Today was more extreme than it usually gets.

If I've learned anything while shadowing, it's this: my health will be a major burden in medical school.

Most med students are uncomfortable standing for long periods of time, but they can do it. I really can't. And no one wants med students to need accommodations, because that makes them "unfit doctors" somehow, which makes no sense to me. Shouldn't taking care of your own health be important, too? Where's the harm in needing accommodations as long as it doesn't affect the quality of patient care?

It's likely that no one else in my med school class will have diabetes. I'm okay with that. But if you need to deal with a low, that's life-threatening, and assuming it doesn't happen too often, no one will get too upset. But if I were to ask for a chair while we present patients' cases in the hallway for three hours, I'd be condemned.

I honestly don't know what to do here. My rheumatologist offered me meds the last time I was there, but I'd prefer not to take them. There are many reasons, but the biggest is that it's an anti-depressant and I don't want anything messing around with my brain chemistry. His view (and it's a good one) is that there's already something messed up in there and that we're just fixing it. He's right--I just don't want to admit that.

There are other factors. He made a point out of not being sure what exactly this is. If it's, say, Lupus, then I'm messing with my brain for nothing--there's something else going on that won't be fixed by a little Lyrica. And though I don't hesitate to take pills that I need, I'm not so sure I need this. It might help, the same way it might not, or might interfere with my ability to think, or sleep, or not be completely crazy.

My joints have been bothering me a lot lately, which could be a source of some of my fears. But it should be noted that medical school is extremely hard--mentally, physically, and emotionally. I've worried about the work and the psychological impact in the past, and I've often thought about diabetes management in the clinical setting--but mostly I've worried about residency and fellowship, not medical school. Now, though, I'm worried about that, too, and I've been thinking about how the hell I'm going to deal with the fibromyalgia/my-body-hates-me crap, too. That stuff scares me.

There will be a talk with my rheum about this in the future. I was told to come back when new symptoms show up or when I think I need to see him, because there really isn't much he can do for me now. It might be later--like when I know I'm accepted to medical school and this will be a definite issue that MUST be resolved, but it will probably have to happen this year. (I'd also like to speak to my endocrinologist, but that's a problem I'll get to when I see him next or the time after that--he's very supportive of my desire to become a pediatric endocrinologist and he'll do whatever he can to help me.)

In the meantime, I get to worry about the AMCAS application, my school's incompetence in transcript building and mailing out, and finishing up my shadowing hours. Yay?

"I know you're scared out of your mind/ But just take a little baby step, baby step/ Right toward the finish line" ~ The Chromatics