Treatment and Recovery

I've been thinking about the ways in which we treat patients. There are quite a few options available for doctors nowadays. We can use medications, talk therapy, exercise, surgery, and the list goes on.

There's something that strikes me about those methods though. They all cause pain in some form. Whether it's emotional, mental distress or even physical pain, they cause some level of discomfort.

Surgery is the extreme example. It's the final Hail Mary pass. Doctors don't come to decisions of surgery lightly; even the cut-happy surgeons don't like to perform surgery if it's not in the best interest of the patient. It's because it's traumatic. It's painful as hell for the patients.

Although the show is overly dramatic and extreme, there's a closing monologue from an episode of Grey's Anatomy (6.12) that actually illustrates this point fairly well.

In surgery, the healing process begins with a cut, an incision, the tearing of flesh. We have to damage the healthy flesh in order to expose the unhealthy. It feels cruel and against common sense, but it works. You risk exposure for the sake of healing...

It's true. You have to injure the healthy parts in order to treat. Chemotherapy and radiation damage healthy tissue in order to kill tumors. Antibiotics kill the healthy bacteria in the process of taking out the nasty bacteria. Exercise actually causes muscle to tear--they're only microtears, but tearing nonetheless.

But the tears help to build new muscle.

So now we're damaged. The bad has been removed, but we still have a long road of recovery in front of us. And recovery is painful.

As I think back on the surgeries I've had, recovery was terrible. Each was terrible and challenging in it's own way, but still terrible nonetheless. But the pain eventually fades and we forget about all of that (until the next surgery, that is). Recovery takes time, but it does happen.

And actually it's pretty amazing how quickly our bodies can recover from the trauma we cause it. Even if it's just a small trauma, a swollen knee, for instance. We change our gait to favor the other knee, almost subconsciously. We learn to turn our whole bodies to look to the side if we have a stiff neck. We avoid the foods that cause heartburn. We do anything to avoid the pain until the injury heals.

It's true, the healing process takes time and is extremely painful. We may never be back to 100%, but the entire process starts when we remove the bad parts. The bad bacteria. The bad tumor cells. The bad memories. So maybe the treatment, although traumatic and painful, is really the best thing for us in the long run.

I just wish surgeons would remember to tell their patients that you'll feel like complete shit after surgery, rather than the "You'll feel some post-op discomfort" bull they usually spew before going under the knife.

So to my classmates, let's be honest with our patients...The road to recovery is going to be hard. The first few days are always the worst. But you can do it. And I will be there to support you along the way.

Oh and here's a script for a few pain pills to get you through the worst of it. ;)

Awesome news!

Okay, I have some great news y'all. This evening I tested 6 people for HIV. In all my years as an HIV/AIDS Prevention Peer Educator, I haven't actually tested anyone.

Until now!

Over the next few weeks I will actually be testing several more as part of a research study through UNMC's Public Health school in conjunction with the Douglas County Department of Corrections. As I've said previously in a blog post, Douglas County has staggeringly high rates of STD infection in comparison to the state and national averages. The number of participants for the study is pretty low, but it's at least a start!

It was great to get back into the prevention education sphere, even if for a short time! I'm looking forward to the next 3 weeks while I get to keep testing and educating!

pre-test weekend

I have a test tomorrow. And because of that I didn't have the time to write a full blog post in a single day, so here's a day-by-day update of how I spent my weekend.

Saturday
Today was a long, full day of studying. Now my brain is a bit mushy, so apologies in advance if this post isn't the most coherent thing I've ever written. 

One nice part about today's study adventure is that I got to make this: 

I love arts and crafts! I had to go to the children's section to buy this pad of paper
made by Crayola for toddlers who are working on their gross motor skills... 

Yeah, that's a nephron. Well a stylized version of one with a color coded representation of ions and other substances that are filtered, reabsorbed, secreted and excreted in the kidney. Each person has an average of 2 million of these little suckers. It's pretty impressive how much control our kidneys have on the stuff we pee and the stuff we keep in our blood! 

I needed a bit of a break from studying, so I made these lemon sugar cookies with a lemon cream cheese frosting. They are DELICIOUS, if I do say so myself!

I've been eyeing this recipe for several weeks, I'm glad I finally got to make them! 

Now back to a few more hours of studying before bed!

Sunday
I didn't get as much studying done today as I would have liked, but I think my brain appreciated the break (that being said, I did still get several hours of studying in!). I sure hope that I've retained something for tomorrow's exam!

I got to have a little bit of fun today though. Originally I was supposed to go to a show with my friend Beau, but he couldn't make it last minute, so my dad came up and went with me instead! The show was Potted Potter. It was a parody of all of the Harry Potter books. It really wasn't the best show I've ever seen, but it still was moderately funny.

The funniest moment is when they called an audience volunteer who was 10ish year old girl Ginny Weasley because she had reddish-brown hair. She wasn't thrilled about it. And then another audience volunteer--10ish year old boy--laid the smack down on one of the performers who was acting like a golden snitch. This little boy made the performer face plant; it was pretty impressive! 

Another bonus of seeing my dad (other than, you know, getting to see him) was that he brought mini apple crisps that my mom made for me! They are seriously good and I think they're my favorite dessert--for those of you that don't know me (or my father): desserts are really big deal in my family. We love them. Like a whole lot. I love baking and I love eating them. Really, there's not a downside to dessert (yeah, I'm really okay with getting fat if the fat comes from the consumption of dessert). It's hard for me to choose just one favorite. But apple crisp definitely makes the top 5 list!

Well anyway, I couldn't wait to try one of the mini apple crisps. It was absolutely delicious, as expected! 

Seriously, this stuff has to be manna from heaven! You can see my notes underneath the plate,
so we can count the eating time as studying time too....right?

Another non-studying moment came at dinner. As many of my loyal readers will know (haha loyal readers...that was a joke. You may laugh now.), I usually get sushi with my friends the night before a test. Tonight we deviated from our routine because it's the Chinese New Year today! Obviously we needed to have Chinese food to celebrate. We headed down to our favorite Chinese restaurant for some scrumptious fried rice. I had shrimp fried rice so I could hopefully weasel out a few omega 3's to help with my test tomorrow.

Thank you Three Happiness Express! 

Well, I'm spent after a long weekend hovering over my notes. I think I'll head to bed in a few and I won't even care if you judge me for being 22 and going to bed at 8:30 pm. 

I am an ally, it's true.

Yesterday I met a woman. She intimidated me as soon as I laid eyes on her. She was tall (and I mean TALL. To be fair, I met her when I was sitting down. And I'm really pretty small to begin with, so anyone over 5"7' is a giant to me.) and had this air about her that exuded confidence and intelligence. I just knew that she would be the type of person to leave a lasting impression.

I got to hear her life story...she grew up in New York going to a school of ballet and a performing arts school. She trained with the ROTC as a sharp shooter and even tried out for the Olympics! She got a bachelor's degree, several master's degrees and even a doctorate. She's fluent in something like 5 languages. She married the love of her life. She has helped to raise 25 foster children. She has published numerous journal articles about international relations (some articles are even written and published in languages other than English!). She is a professor. And her life story goes on...

Moral of the story: she is awesome. I hope to accomplish 1/4 of the things she has with my life as she has with hers! I was absolutely right about her leaving an impression on my life! I guess I forgot to mention something about her though. This incredible woman is a male to female transgendered person.

Our clinical skills classes yesterday were discussing LGBT** issues in healthcare. After we talked with the wonderful woman, we got to hear from a M4 student who recently has come out as gay. It was interesting to hear his perspective as a newly out person as compared with the woman whose process of coming out/gender reassignment was over 40 years long.

I think it's really great that UNMC talks about LGBT healthcare (caveat: I wish that we talked about stigmas and discrimination against LGBT persons within medical field more, but we don't really do the whole touchy-feely conversations here), because apparently there are not a whole lot of medical schools that even acknowledge that there might be differences in the way that we care for persons of this population. One conversation is definitely better than zero conversations!

Honestly, I was nervous about how my classmates would respond to our speakers yesterday, but today I heard an overall positive response, which was great! I think that it was the first time that many of my classmates had any contact with a transperson (or a parent of a transperson). The way that our small groups operated fostered a very open and inviting atmosphere for questions which I think was very helpful to have the least judgmental response from students.

We were presented some data from a recent study conducted in Nebraska of many LGBT persons during our lecture and I found it surprising the number of LGBT persons who did not tell their physician their sexual orientation (many claimed that they were afraid of being stigmatized by their doc, that they didn't believe it mattered or that they were afraid of being outed by their doc/someone in the office). As someone who is a doc-wannabe and an ally, I hope that my patients feel comfortable coming out to me, so that I can provide the best care possible for them. But I also recognize that the process of coming out is a very personal decision, so I won't force it on them either.

One of the things I am most grateful to my parents for is completely normalizing same sex relationships when I was growing up. I truly didn't even realize that it was apparently a "bad" thing until late middle school or early high school. Some of my best and closest friends are in the LGBT community and I absolutely cannot imagine my life without them in it or with them thinking they needed to stay closeted around me.

I am an ally, it's true. So if you want to talk, hit me up. Heck, if you want to talk and you're not part of the LGBT community, hit me up too. I don't really care what I talk about, let's be real, I just love talking. And listening!

**I know that there is some debate within the community about which letters to be included within the acronym. I am using only "LGBT" because they are the most well known and the most accessible to persons who may not know much about the LGBTQIA (etc) movement. The acronym could include, but is not limited to, any of the following: Lesbian, Gay, Bi-sexual, Transgender/Trans-sexual/Transvestite, Queer/Questioning, Intersex, Ally/Asexual, Pansexual/Polyamorous, Unsure/Undecided, Curious, Other/Omnisexual, Same Gender Loving, etc.