#all I do is burn myself out trying to do my job

[scientia-rex]

Hi Dr. Kristophine, do you have any advice on what kind of information doctors need for medical issues that are more nebulous than "my knees hurt"? I've been feeling Weird and Bad in a way that has me concerned, but I'm afraid to make an appointment because I don't know what to say that will get the Weird and Bad feeling across in an actionable way. Going to the doctor takes SO much energy that I don't have to waste and I don't want them to just take a blood test and say everything's fine go home (again).

The best thing you can do with medical information you're trying to prepare for your medical provider, as a lay person, is be as specific as possible.

-Location: Is it one place in particular, or everywhere? Does it stay in one place, or move around?

-Timing: When did it start? Did it come on suddenly or slowly? Does it happen continuously? Does it come and go? Is it always there to some extent, but it gets better and worse? On a scale of 1-10, with 1 being fine and 10 being the worst you can imagine, how bad is it at its best, and how bad is it at its worst? How much time does it spend really bad vs only kind of bad?

-Quality: If it's pain, is it aching, burning, stabbing, dull, electrical zap, etc.? If it's not pain, what is it? Is it discomfort? Is it weakness--i.e., you can't do that thing? Is it fatigue--like maybe you can still push through doing the thing but it feels like you're trying to wade through mud to do it? Is it a racing heart, sweating, pressure?

-Triggers: Does something in particular set it off? A time of day, a food, an action, a medication, a thought? A surprisingly common trigger for migraines is sitting still with your neck in one position. (New research suggests that necks are critical to migraine formation, to which I yelled out loud at the paper, no duh!) There may be triggers you haven't noticed; try keeping a symptom diary, where you note down when you have episodes and what you were doing beforehand, what you ate that day, menstrual phase, etc. Any detail that you can remember, whether or not it seems relevant at the time.

I cannot tell you how many times I've dug deeper into a chronic issue only to discover that the patient can, in fact, tell me what the trigger is, but because it's something important to them, they simply haven't noticed. May subconsciously even avoided noticing. Do you get migraines every time you DM? Do you need to work a stretch break into your D&D session?

There can also absolutely be multiple triggers--I know I'll get migraines if I don't sleep, if I'm sick, if I sit still for too long, if I have dental work, etc.

So bring in all the info you can. Write it down if you're afraid you'll forget. Don't hand it to the MA, too many doctors will go "oh my GOD they brought a LIST how high-maintenance" and tune out. Hang on to it but tell them about everything.

I don't expect patients to be able to tell me "I believe I've had a left radial styloid fracture" but I do expect them to tell me "I fell and tried to catch myself with my left hand and now my wrist hurts," and that's good enough. The rest of it is my job. When it's something more vague, like "I started feeling different and bad about six months ago," any other information helps. Did you start a new med around then? Are you going through menopause? Do you struggle with anxiety? Do you have first-degree relatives (parent, sibling, or child) with genetic disorders, autoimmune disorders, etc.? Do you have a history of anemia? Are you vegan? Have you started having night sweats and unexplained weight loss? Did you recently travel internationally? This can go a lot more different directions than a hurty wrist, so bring in all the info you can.

And keep in mind that modern medicine is very limited--much more so than most people think. There is an excellent chance that medicine will not be able to diagnose your condition. It may still be able to offer treatment. It may fall on your shoulders to manage it as best you can, knowing that doctors don't have answers. Nobody can tell me why I have chronic pain, and I don't mean as in "I've asked doctors and they don't know," I mean "I've personally scoured the literature and had the relevant and appropriate tests and no one can know at this phase of medical knowledge." So I deal with it, I've stopped trying to push myself past my reserves because people who can't admit to ignorance tell me to, I keep my painful body moving because that helps, I do PT, I take a multivitamin occasionally because I know my diet sucks. I manage.

There are not always right or wrong answers--I don't take gabapentin, because I don't want the sedation and kidney exposure, but patients with my exact symptoms might find it helpful and may find the risks and costs worth the benefits. My mother, who has whatever it is that I have, right down to the tricky stomach, from whom I presumably inherited it, has taken medication at different points in her life, depending on how much pain she was in and what other responsibilities she has, and that is perfectly reasonable. Autonomy matters. People have to be able to make these choices for themselves, with assistance but not paternalism from their medical professionals, because the math is different for everyone.

[bitchesgetriches]

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[midnight-moth]

Regrettably the inhalers I got are not making me not cough. I’m so tired.

Ps I ranted so hard in the tags and I guess here is the cw for that. I just am not having a good time.

[opens-up-4-nobody]

The way that the sun hits leaves and clouds. I feel like I could watch the colors change forever. If I could slow down for that long.

[house-in-the-backyard-trees]

For once I would like to work at a place where me calling off doesn't result in a guilt trip. Sorry I'm the only responsible employee there but I was literally hyperventilating at the idea of letting my manager down bc I woke up and instantly started bawling about everything and could not face work. And my stomach has been murdering me from all the anxiety I've been dealing with so I literally can barely function anyway.

[surreal-duck]

messing around a bit

[arcaneyouth]

this shit really makes it hard to want to do anything to distract myself

[mittentroll]

HEY YA’LL, I’m still fucking alive and its something I’m celebrating today!! 🌈✨💕🌻

[toytulini]

mental health just straight up plummeting

[stuck-in-the-ghost-zone]

if i was absolutely FORCED to go back in time to high school i think the one thing i would change would be. being more involved w the theatre kids

[theladyem]

i need to shout into the void but i sincerely need a win

[saintslips]

neg -

[undyinglantern]

logically I don’t even think I’m doing horribly (the guy training me told the manager I was doing “pretty well” about handling a “mini-rush”) but mentally my mind keeps telling me oh he’s just lying because we keep getting out breaks at the same time and since I’m practically tailing him of course he’s say that to be nice during the only opportunity to speak to the manager. Only since I’m around and can listen in is he saying something nice.

[autistic-shaiapouf]

Am I thinking too much?? Is that what's happening??? Am I considering too much at once???

[opens-up-4-nobody]

...

[sycophantzealot]

"you cant save everyone" i can do. i really really want to . please let me