Tuesday, September 15, 2009

Normalcy

It occurred to be today, as I surreptitiously took a pill and washed it down with soda from Noon Conference, that I'm actually pretty normal. Yeah, I've had my issues- and I've started the process of telling my story via my blog, but right now, I take medication, I see my doctor every so often, and I'm actually living a relatively normal life.

Of course, I have the aggravation that goes along with having a chronic illness- I have to make sure I've always got health insurance. Sometimes my health insurance doesn't cover the full cost of my medications (as in right now) and I have to beg the drug companies to supply me with free meds. Also, I have to make sure when I travel that I bring my medications with me, enough not only for the duration of my trip, but also a little bit extra should something unexpected occur. I was on vacation earlier this year and had the opportunity to stay longer than initially planned. Sadly, I didn't have enough medication. I could have had my doctor call in a few days of medication, but I would have had to pay out of pocket. So, I went home as initially planned. Had I actually had extra medication, I am sure my sunburn would have been much worse than it was. So maybe I was lucky. But, anyway, it's just one of those issues anyone with a chronic illness can probably relate to.

In a way this helps me with patient care. I'll ask patients if they can afford their meds. When they cannot, I actually can point them in the direction of helpful resources.

Another advantage is that I am very knowledgable abut the meds that I take, and this can sometimes give me the appearance of having read a lot. On rounds, when I pipe up, "Well, perhaps Wellbutrin isn't the best because it lowers the seizure threshold..." it might appear that I spent the previous day poring over UpToDate.

6 comments:

ChristinePAS said...

I'm in the same boat - bipolar in PA school (now clinical rotations) but stable enough and doing well enough in the past few months to feel pretty 'normal.'

I, too carry a day's worth of extra meds with me most of the time, and I always bring a couple extra days (or just the whole dang bottles) when I go out of town. Unfortunately, I forgot my meds entirely when I went to my interview at Duke, so I felt like crap, and big surprise - they didn't accept me. Oh well, they're really expensive anyway.

I've also had the same thing happen where I look like I've been reading a lot. My last preceptor was surprised at how much I knew - which meds worsen anxiety, extrapyramidal side effects, and so forth. I'm hoping it will help me on my psych rotation (which I just started), but I really only know about treatment for bipolar disorder, anxiety, and unipolar depression... that leaves a lot of areas where my knowledge is sketchy.

Anyway, I just wanted to say that I can certainly relate, and I'm glad you're doing well. Take care. :)

Anonymous said...

Hey Emily,

I too can relate. I'm a 3rd year in med school, struggling along, but doin better than I was during 2nd year. I check out your blog whenever I get a chance, thanks so much sharing.

I was wondering if you ever went through a stage of denial, thinking you could beat this on your own. I started seeing my psych about 2 years ago, and through this time I've been through lithium, welbutrin, ritalin, trazadone, effexor...I feel like the meds don't do much. Welbutrin does help with the smoking though, haha. yea thats a fun habit to hide as a 3rd year.

the strange thing is, i feel that I deal with the situation better if I ignore it. if i dont take the meds, dont think about it, and just try to focus on school. i do still talk to my psych, and she of course tells me this is stupid and I'm playing with fire...

anyway, this turned into a lot of rambling. very few people know about my diagnosis and so I rarely discuss it with anyone. It's really uplifting to see someone in a similar situation doing well...
I hope the application process is done for you now and those interview invites start coming in.

what field are you trying to go into?

good luck
bipolar 3rd year

Chunx said...

Your blog was a nice find. I'm a medical student, as well... and I just found out a couple of months ago that I've probably been bipolar my entire life.

Last year I started my second year of medical school and spiraled. Suffice it to say, after a suicide attempt, I was forced to take the year off.

It was frustrating to deal with the psychiatrist at first because nothing worked... They were operating under the assumption that I was suffering from MDD and prescribing me SSRI after SSRI that just made the suicidality worse and worse.

Finally, they decided to put me on Lithium and everything seemed to change.

Now I'm back in my second year of medical school, learning how to balance myself, learning how to deal with the inevitable ups and downs, and still coming to terms with the fact that I have a chronic illness that I will have to treat throughout my entire life.

Today, I was shadowing a doc who was making fun of one of the patients and said "Well, obviously their bipolar was pretty well-managed, because otherwise they wouldn't be so high-functioning." I wanted to lay into her... I got into medical school without ever knowing I had been bipolar. It's an illness, it's debilitating, but it doesn't define us.

There's my rant. Thanks for the awesome blog!

Chunx said...

I am also a medical student with bipolar disorder. I've just recently been diagnosed (during my second year of medical school) and learning how to deal with my illness, fend off the suicidal tendencies, and balance myself out... all while preparing for Step I and doing the whole medschool thing.

My first year, my brain always seemed foggy. I couldn't concentrate, I couldn't focus, I couldn't retain anything. Then, my second year hit and I lost it... attempted suicide. I was forced to take the year off and "get my shit together."

My initial diagnosis was MDD. Then, it was atypical depression. Then, it was treatment resistant atypical depression because all of the anti-depressants they were giving me made me worse. Then, finally, Lithium was prescribed and things rapidly got better.

I've restarted my second year of medical school. Things are still pretty rough, but it's amazing how much my cognitive capacities have improved. Learning is much easier when your brain is functioning. :)

Thanks for the blog... It's awesome! It's nice to know that there other people like me out there that have the same kinds of problems but have found ways to make it work (as the great Tim Gunn would say).

Anonymous said...

Hi Emily,
I really enjoy your blog. I have bipolar type II and I'm currently finishing my fourth year at uni after taking some time off to deal with the illness. I've always wanted to go to medical school, but I question whether or not I'll be able to handle the stress. In particular, my triggers seem to be exams. I was wondering a) what your personal triggers are and b) how you've learned to deal with them. If per chance you have struggled with stress from the academic side of things, I'm also wondering what your thoughts/experiences are in dealing with the stress of clinical rotations (ie being in the hospital) and how you would compare the two.

Thank you!

PS I hope you matched well for your residency and good luck with your licensing exam!

Emily Forest said...

My triggers surround lack of sleep. Exams are stressful too, but I think even when I have trouble with exams, it really comes down to sleep loss. First and second year I budgeted my time very carefully and did not pull all nighters like my friends. During the clinical years it was really tough and I had to take time off. Now I've figured out how to manage better. When I did overnight calls, I'd take my Seroquel in several small doses during the night, instead of in one big dose before going to bed. I also had to make sure I slept on post call days.

I wasn't sure if I could do it either. That's why I took so much time off- I'm 31 right now. I don't regret going to med school at all though!