Monthly Archives: June 2014

Testing God

I had dinner with a friend last night who is a certified nurse assistant. We were talking about my lupus as I have been feeling really fatigued recently and my latest bloodwork came back with some abnormalities. She listened patiently which I appreciated, and then told me to fast and pray and God would heal me.

She told me a story about how she had a patient whom she cared for at home. A woman with terminal cancer and a prognosis to live for only two weeks. My friend cared for her and prayed with her and convinced her to stop all her medications. When the lady went to see her doctor, her doctor said her labs came back better. She ended up living for six more years.

These miraculous stories inspire me and worry me at the same time. I whole heartedly believe that God can heal anyone of anything, but as a trained physician I don’t believe in discontinuing all medication or stopping all treatment. I’ve had several patients refuse medication, telling me that God will take care of them, and they don’t need drugs. I’m impressed by their faith, but concerned about their eagerness to stop life-saving treatment.

I guess the way I see it is that God has the ultimate power to heal by faith, but that doesn’t mean we should test Him. I believe God created different herbs and plants so that we can make medications to help people. I also believe God gave us special talents to become doctors,healers, nurses, and scientists, and He uses us to do His work. These are my thoughts, what are yours?

Work Environments

As many of you know,  I have been job hunting. My first job after residency was a complete nightmare, and I am terrified of getting into another situation like that.In my interviewing process, I’ve come to notice there are three types of work atmospheres- profit driven, patient centered, and physician friendly.

My first job was very profit-driven. My employers were so focused on the bottom line that  patient care and my physician well-being was suffering. The administration would make sure the schedule was double-booked and I would be pressured to order unnecessary tests and referrals. Medicine becomes like factory work, just putting forth product to pay the bills.Every day was a battle with my ethics and the miserable feeling of coming home knowing I was unable to care for my patients the way I wanted to.

In the completely patient centered environment, the focus is on the patients and providing the best care without regard to money or cost. A doctor could spend as long as the patient needed and handle all issues in one visit.The doctor would always be accessible. They would stay late, come in every weekend and holiday, and always be on-call. seems like an ideal practice model, but leaves a lot of room for a physician to be taken advantage of, and not be able to make the money necessary to run the practice.

In a physician friendly atmosphere, the doctor’s lifestyle takes priority. They would only have to see ten patients a day and still make enough money. They could choose only to see the friendly, compliant, and easy patients and refuse to see the demanding, untrusting, and challenging ones. They wouldn’t work weekends, or evenings, or ever be interrupted at home for a patient calls. A great situation for the doctors and their families, but not so great for the patients.

I think the ideal practice is a combination of all three. There has to be a drive to work harder and have the ability to earn more and be rewarded for going above and beyond.There also has to be an environment where a patient can have the access to quality care, and have the time to discuss most of their issues. And there has to be an environment where the doctor is not overworked or over stressed, and can focus on giving the best care possible. I truly hope I can find a balanced practice, and that wherever I go, I will be able to practice medicine the way I believe.

Take time to rest!

Well I’m finally moved in and am starting to unpack. I have to say yesterday was a grueling day, even with the movers. We have two sets of stairs in our place, and it was a lot of running up and down. I woke up early this morning completely drained, but I knew I had a lot of work today. I got up, ate some breakfast, helped the cable guy set-up, and started to open up boxes. And then it hit me.

Sheer exhaustion. Like I had been hit by a truck and thrown across the street. Ok, so I’ve never been hit by a truck before (thank God!), so I don’t know how that feels, but I felt pretty crappy. Just achy, and foggy, and lethargic.

I realized that I wasn’t going to get anything done without some much needed sleep. For a long time, I’ve felt guilty about taking naps when there was work to be done. I always feel like I can just work through it. But I realized I can get more work done in less time when I am well rested, than when I am dead tired.

I think it’s really important, especially for people with chronic illness, to listen to your body.Pushing yourself when your body is tired, not only produces inefficient work, but also hurts your body. Our bodies need rest, and our pain, fatigue, cloudiness, is our bodies’ way of communicating that. I took my little nap, and am awake and refreshed! Now, let the unpacking begin!

Ask the Doc- How did you manage your wedding with your lupus?

For anyone who has had a wedding, you know it can be a very busy and stressful time. I had my wedding on September 1, 2013. It was a beautiful day, but it took a lot of work getting there. I had nine months to plan my wedding which was in another state where my family lived. Believe me, there were multiple times when I thought the stress of it all would send me into a flare. Here are some tips on how I got through wedding planning and the big day.

First get organized. Make a list of the things you need to get done, divide them up, and schedule them. So today I will call florists and bakeries. Sunday I’ll go dress shopping. Monday, I’ll go check out some venues. Being able to put everything down on paper, and knowing when you are going to take care of each thing, makes life much easier. You want to avoid doing too much at once. Give yourself a few small tasks or one big task a day. The wedding magazines are really helpful in letting you know when certain things need to be done. Tackling things one at a time, will prevent you from burning out and help you stay right on track.

Delegate, delegate, delegate. I cannot stress this enough. Many hands make light work. I had a lot of help from my bridesmaids, mother, and sisters. So someone was in charge of making decorations, another mailing out invitations, then another checking out places for rehearsal dinner. Get the future hubby involved, it’s his wedding too! Having that kind of help is essential. Now, if you’ve got a little extra money, hiring a wedding planner is a great idea. Some venues wedding packages even come with one.

For a lot of people, dealing with family can add to the stress. Everyone has their opinion of how the wedding should be. My parents have some Indian traditions, and at some point I realized I couldn’t avoid them, even if they added to my costs. The best way to handle this is compromise. Remind then kindly that it is YOUR wedding, but you respect their wishes as well. These are the people you love, and this day is meaningful for them too. See if you can find a common ground. Fighting only causes unnecessary stress for everyone.

The day before the wedding is very important, and I highly recommend not having anything strenuous planned. If possible get things done two days before the wedding. The last thing you want to be doing is working right up to the wire. The day before is a good time to relax, spend time with the fam, or even get a massage/spa treatment. Make sure to get plenty of sleep the night before, eat a good breakfast the day of, and make sure there are snacks and water at hand in your dressing area.

When the big day comes, relax and just let go. Accept that every little detail might not be done, but it is going to be special.If you can, assign a close friend or family member to be in charge of resolving or deflecting any issues, so the only thing you have to focus on is you and your husband and the amazing new life you are committing to. Pace yourself, know your body, and know when to rest. It’s Ok to take a break during pictures or sit out a dance or two. ( BTW it helps if you bring a cute comfy pair of shoes for walking/dancing during reception). If you are drinking, pace yourself too. Alcohol does tend to hit people with lupus harder than other people, so keep in touch with how you are feeling, and save a little energy for your wedding night 🙂

Planning a wedding can be a strenuous thing, but it is totally worth it. It is such a joyous day of being able to share you and your husband’s commitment with the people you love. No matter what happens it will be perfect, because you are marrying the love of your life.

Moving

Well, I am moving in less than a week for my husband’s job, and I am starting to stress out big time. I’m not good with change, and this is a lot of change all at once. We are moving to a completely different city one hour away from where we were before. It’s taken the four years that we’ve lived here for me to finally get comfortable and make friends, and now we’re moving. There isn’t a bone in me that wants to move, and I’ve seriously been dreading moving day.

We will have a new home which I love, but I will admit I’m nervous about because of the stairs. Normally stairs aren’t a problem. I do the stair master at the gym, which, BTW ladies does wonders for the booty. But when I’m having joint pain, or a really bad flare, I worry about getting in and out of the house. It was a concern before I chose this place, but it was the best choice due to location and space.

Then there’s the job hunt. I’ve interviewed at a few places, but I haven’t signed a contract yet. I have this huge fear about about getting stuck in a miserable practice that is completely profit driven, instead of patient centered. I had a really horrible experience with my first job that I was at for two years. I’ll tell you the story sometime, and you’ll understand.

And the packing is making me crazy. It isn’t just that it’s physical labor but it’s emotionally taxing. I am very sentimental and I save everything. I’m talking receipts from a romantic dinner my husband took me too three years ago and clothes that I wore in high school (they will NEVER fit me again). Moving is the best time to de-clutter, and I’ve had to grudgingly throw away a lot of things that I’m seriously attached too.

With all the stress and change, I’m starting to worry about having a flare. And that’s when I realize, I just need to stop, take a deep breath, and know that everything is going to be OK. Life is going to be full of change, especially when I have lupus. I just have to have relax and have faith that I’m on the right track. God’s got a plan for me far better than I could even imagine.

My Story: Part 8- Faith

I think the the part of my life most affected by my diagnosis with lupus was my faith. At the time before my diagnosis, I was on a roll. I was doing really well at work, was in the running for chief resident, on my way to becoming a licensed physician. I had a really awesome boyfriend and flourishing relationship. My body was getting in shape and I was confident. I felt good about myself and my life. I felt powerful, and I felt like my life was finally in complete control. I was self reliant and could do everything on my own. I didn’t need anything or anyone because I had it all.

But then it happened. I was diagnosed with lupus and my whole world came crashing down. I no longer was in control of my body or my life. And that’s when I realized I needed God.

Now, I grew up Christian and attended church weekly for the most part. Religion was always a part of my life, but it was something I just did out of habit, maybe even out of guilt or obligation. It was never really a personal thing. There were times when I had felt close to God, but it wasn’t constant. It was only during times of need.

And now another time of need presented itself. But this time it was very different. I had never had an issue in my life before that would cause such a drastic and complete change in my life. And here I was completely lost, and life was completely out of my hands. But it was in God’s hands. He was in control. It didn’t mean that life would be easy, but now I knew I had Someone who cared for me and could heal me.

Through the blessings and the trials my faith in God grew. I would like to say that my faith is and was always strong, but that’s not the truth. As I got better, I would start to feel
like I didn’t need God again. Or when I was feeling really sick or hopeless, I would doubt God’s love and plan for my life. But as time has passed, and I have witnessed the healing and the love, I have learned to trust in God and His purpose for my life.

I know that we all have different beliefs, but I wanted to share mine because it’s such an important part of my life. It is not my intention to push my beliefs on anyone else. My personal relationship with God has formed the person I am today and has developed my perspective on life.

For those of us who are believers, I think it’s very important to be strong in our faith and continue our support for each other in prayers. If anyone would like to be added to the Prayer Corner, please let me know.

Ask the Doc- Do most doctors recognize fibromyalgia as a real illness?

So before I begin, here is a brief, informative article about what is fibromyalgia.
http://www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Fibromyalgia/

Ok, to answer the question. If you would have asked me if fibromyalgia was real five years ago, I would have said “no”. Even after I was diagnosed with fibromyalgia, I still wasn’t sure if I believed it was a actual diagnosis. Now, after years of dealing with the disease, I understand fully that fibromyalgia is a true illness.

As far as my colleagues and other physicians go, I think they have differing opinions. Perhaps their views are dependent on their specialty or how much experience they have had with the disease. I think the majority of rheumatologists use the diagnosis easily, while the majority of PCP’s accept the diagnosis, but maybe are not as readily able to apply it.

Fibromyalgia is a chronic pain syndrome which was made as a diagnosis of exclusion, meaning when all other things were ruled out, then we could call it fibromyalgia. There are no definitive laboratory or imaging tests that are done to prove fibromyalgia, only tests to prove that it is not something else. Also fibromyalgia is often found with other diseases such as rheumatoid arthritis and lupus, which makes it unclear if it’s fibromyalgia or just a part of another disease.

There is non- laboratory diagnostic criteria, such as a certain number of 18 tender points on the body,same level pain for at least 3 months, and having no other disease to explain the symptoms. Although there is criteria, you don’t necessarily need to meet all the criteria to be diagnosed with fibromyalgia. Having diagnostic criteria for fibromyalgia supports the concept of fibromyalgia as a real disease.

There are many treatments for fibromyalgia depending on what symptoms a patient has. As the FDA approves drugs for the treatment of fibromyalgia, it does make it clearer in the mind of a physician that fibromyalgia is a true illness.

So in summary, I believe fibromyalgia to be a real illness, and as there is more information, more diagnostic and treatment methods, more doctors will feel comfortable in giving the diagnosis of fibromyalgia and treating patients accordingly.

Please continue to send me your questions, so I can answer them in a post. Also, please keep in mind I cannot give out any personal medical advice.