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| One cannot post too many copies of the stock phto guy who bears the uncanny resemblance to 4th-year med student cutie pie. |
- Almost-doctor (4th-year med student) cutie pie paid his visit this morning and pronounced me out of commission for the rest of the week. It seems my hemoglobin levels are in the cellar or even lower. there's no obvious cause. The consensus (the med students have to discuss my case with actual MDs) is that it's likely a case of too much work and not enough sleep, recreation, and fresh air, since I haven't exactly been hitting the clubs on a regular basis, or, ore precisely, not at all. Life should improve a bit when I'm allowed to run again. It's amazing what running just a mile or two can do for a body.
- The condition is all presumably a combination of ridiculous studying hours, not being able to exercise for so long because of the foot, and the lovely stomach virus from a few weeks ago. It's irritated to being capacitated when I'm not even sick, but I'm supposedly lucky not to be sick.
Because it was early enough that Matthew was still home,
Almost-Dr.Cutie pie didn't bring a flunkie. This was good
because the 4th's year students make the flunkies draw blood
and do the injections. There's nothing quite like being a guinea
pig when it comes to having blood drawn. Injections aren't
quite so bad. I could do that, but my veins aren't the easiest in
the world to pinpoint. The 4th-year student talks the flunkie
through the procedure, but that's of limited value when one is
being stabbed repeatedly. After the flunkie's second attempt
Almost-Dr.Cutie pie didn't bring a flunkie. This was good
because the 4th's year students make the flunkies draw blood
and do the injections. There's nothing quite like being a guinea
pig when it comes to having blood drawn. Injections aren't
quite so bad. I could do that, but my veins aren't the easiest in
the world to pinpoint. The 4th-year student talks the flunkie
through the procedure, but that's of limited value when one is
being stabbed repeatedly. After the flunkie's second attempt
yesterday (they only get two tries per patient, but I didn't know
this) I asked if i could just do it myself. The 4th-year guy said I
could try, or he would do it himself. I let him do it.
Until Monday, I'm allowed to play my musical instruments,
watch as much TV as I want provided that it's not medical
videos, go for walks (I have a note to carry with me in case an
@$$hole professor accosts me and asks why I wasn't in
class), have very light social activity, and sleep. I'm not
allowed to study or even to read non-medical literature.. I
didn't ask about blogging because no one there knows I blog.
didn't ask about blogging because no one there knows I blog.
On Sunday someone will show up here and jab at my veins
until they can get enough of my blood to determine whether or
not my blood contains enough hemoglobin to keep a gerbil
alive. The results will presumably be positive, and I'll then be
back in class for the final week of instruction before finals.
This incident is really of little concern. People overwork
themselves all the time, and sometimes they either get sick or
develop anemia. my adviser's concern is that if it is happening
to me now, what is going to happen in my third year of med
school and in my year of internship. He said it may be that I'm
pushing myself harder and working more hours even that a 3rd-
year student or intern is required to do, in which the problem
won't be a problem. Otherwise, he said, I may need some sort
of 504 plan to modify my workload. As long as I demonstrate
mastery of the skill set and content, it's all kosher.
I can either worry about it and make things worse, or I can
cross that bridge when I come to it. All I really know is that if i
hadn't studied like a crazy person up to this point, no one,
including my adviser, would be advocating for me to the
degree that is being done. My mom says I did this to myself,
which s true, but for no good reason, which is arguable NOT
true. I'm being cut slack now to the extent even that the clinical
professor who dislikes me because of a single negative
encounter has no power to impact me. I don't think the
other profs would be standing in his way to the degree that they
are had I not worked my head off. Hard work usually pays off
even if it's too much hard work. I am aware, however, that if i
get myself into the same situation, the powers tha be will not be
so sympathetic the next time, so I will not allow there to be a
next time.
hadn't studied like a crazy person up to this point, no one,
including my adviser, would be advocating for me to the
degree that is being done. My mom says I did this to myself,
which s true, but for no good reason, which is arguable NOT
true. I'm being cut slack now to the extent even that the clinical
professor who dislikes me because of a single negative
encounter has no power to impact me. I don't think the
other profs would be standing in his way to the degree that they
are had I not worked my head off. Hard work usually pays off
even if it's too much hard work. I am aware, however, that if i
get myself into the same situation, the powers tha be will not be
so sympathetic the next time, so I will not allow there to be a
next time.
I've said all I care to say about this non-illness. My next post
will be more positive in outlook.
will be more positive in outlook.
Ugh... Glad your med student is at least cute. I hate dealing with medical people... As a patient, anyway. ;)
ReplyDeleteHonestly, get better Alexis!
ReplyDeleteI can empathize with your situation. I am currently in the same state. Platelets and hemoglobin are low, as they have been since April. A 5 year old relative of a relative ran into me on his tricycle on Sunday, and I have a giant bruise on my leg from the impact, along with a bunch of other mysterious bruises that I have no idea how they got there. I am supposed to follow up with my hematologist. The next step they said at my last appointment is a bone marrow biopsy, that I don't want to go through for obvious reasons. Fun times, fun times.
ReplyDeleteAre there any foods high in dietary iron that you enjoy? I know you had a bad experience with beef a few days ago, but a steak may not be a bad idea.
Becca, this is somewhat worrisome. Now it's not just my dad telling me not to make any diagnoses, but my profs as well, who tell ALL of us we don't know what the hellwe're tlking about and so we should keep our mouths shut So I won't specify anything since I don't really know what I'm talking about, except to say it sounds like a particularly nasty form of anemia, and you probably know what I'm talking about, but isn't quite so nasty in its milder forms and may not recur. Regardless, age is in your favor.
ReplyDeleteTake care and please keep me posted. And tell that little relative of a relative to learn the rules of the sidewalk or to stay off tricycles, although he (or she) may ultimately have done you a favor by drawing light to the situation.
I don't take any internet diagnosis seriously, although I have learned a lot from patients similar to me. If the idea or suggestion is not totally ridiculous I will bring it up to Dr. B. If you'd like to pontificate, I won't hold it against you.
ReplyDeleteFor you to ponder, there are a few ideas on the table.
HLH is what they are monitoring for. Any time my counts drop I am at risk for falling into that cycle. They also mentioned that it could be part of my autonomic dysfunction. It is typical for Dysautonomia patients to have anemia, specifically in Pandysautonomia. And then the obvious, Aplastic Anemia, however with everything that I have going on, for this to occur independently of other dysfunction does not make much sense.
I was particularly worried about the third option you mentioned: A. A. But I'm not a doctor yet.
DeleteI was particularly worried about the third option you mentioned: A. A. But I'm not a doctor yet.
DeleteI suppose the treatment for autonomic related conditions would revolve around the underlying condition, though if they are unable to determine they would probably treat as though it was Aplastic Anemia. Should this be related to hemophagocytic lymphohistiocytosis, I would need to consult with Rheumatology again to come up with a game plan for treating that condition. When I talked to Hematology when I was inpatient the best that they could suggest is genome sequencing (that's all that they suggest anymore, even though they know that this may also prove to be inconclusive, like my Mitochondrial DNA testing was). When I was first diagnosed with HLH in 2011, there were only 4 identified genes related to familial HLH. I was diagnosed with secondary HLH because of my complicated health history and my genetic testing did not come back positive for any of the identified genes. Chances are it's a mix of both autonomic dysfunction and HLH, as in autonomic dysfunction causes secondary HLH. As long as they can keep it from progressing we're good. When I was diagnosed with HLH in 2011, they had no idea so they let it go until it was serious. My liver and spleen have been cooperating, and my ferritin is lower than normal, so given that we're good. Like you, stress is not kind to my body. For me it can make my autonomic symptoms worse, so I am keeping it low key until my Summer classes.
DeleteI suppose the treatment for autonomic related conditions would revolve around the underlying condition, though if they are unable to determine they would probably treat as though it was Aplastic Anemia. Should this be related to hemophagocytic lymphohistiocytosis, I would need to consult with Rheumatology again to come up with a game plan for treating that condition. When I talked to Hematology when I was inpatient the best that they could suggest is genome sequencing (that's all that they suggest anymore, even though they know that this may also prove to be inconclusive, like my Mitochondrial DNA testing was). When I was first diagnosed with HLH in 2011, there were only 4 identified genes related to familial HLH. I was diagnosed with secondary HLH because of my complicated health history and my genetic testing did not come back positive for any of the identified genes. Chances are it's a mix of both autonomic dysfunction and HLH, as in autonomic dysfunction causes secondary HLH. As long as they can keep it from progressing we're good. When I was diagnosed with HLH in 2011, they had no idea so they let it go until it was serious. My liver and spleen have been cooperating, and my ferritin is lower than normal, so given that we're good. Like you, stress is not kind to my body. For me it can make my autonomic symptoms worse, so I am keeping it low key until my Summer classes.
DeleteIt makes sense that the treatment would revolve around underlying conditions since they're considering it secondary. what concerns me is that if they really don't even have a clear battle plan for diagnosing it, how effectively are they going to treat it. Then again, they've kept you going up to this point through some pretty nasty stuff, so they must be doing something right.
DeleteAnd the ever-present disclaimer: I don't know what I'm talking about.
Now that you have the time, get as much sleep as you can. It sounds like it could be stress getting to you. I know that you have trouble getting enough sleep. Yoga is the best exercise for stress. It is designed to relax you.
ReplyDeleteThere are many articles on the internet that have titles like 5 yoga poses for stress or 7 yoga postures for anxiety or 8 yoga poses for insomnia. I have been doing yoga since age 12 and see that the body needs to be stretched daily for it to operate the way it should.
I say the following since I can feel it. Yoga poses are designed to stimulate the endocrine system glands. This causes them to produce hormones that make you feel good and help you in every aspect of your health. Since Jet Li won the national fighting championship of China 6 times in a row, they have declared him a national treasure of China. You are my national treasure and you should treat yourself as a national treasure.
Dr. McCall M.D. wrote "Yoga as Medicine: The Yogic Prescription for Health and Healing." He is a board-certified internist. I don't know what that is, but it sounds good! Dr. Mehmet Oz says about this book, "Read this to find out why we teach our patients YOGA!"
ReplyDeleteI found a webpage where Dr. McCall says what yoga does. He says it improves flexibility, prevents cartilage and joint breakdown, builds muscle strength, Betters your bone health, Increases your blood flow, Drains your lymphs and boosts immunity, Drops your blood pressure, Regulates your adrenal glands, Makes you happier, Lowers blood sugar, Helps you focus, Relaxes your system, Maintains your nervous system, Helps you sleep deeper, Boosts your immune system functionality, Prevents IBS and other digestive problems, Gives you peace of mind, Increases your self-esteem, Gives you inner strength, Benefits your relationships, Keeps allergies and viruses at bay, Encourages self care and Supports your connective tissue.
Here is a saying, Alexis, "Take care of yourself, so you can take care of others."