Today from about 8 am-2:30 pm I spent the day shadowing/rounding with a gastroenterologist who I have been working with at my school. As the day progressed I realized that readjusting to school in January is going to be quite difficult due to my ostomy. Admittedly this was my first day ‘back in the swing of things’ so I may just feel a bit overwhelmed but here are some of the things I experienced today which I expect will continue to be problems.
- Sleep disruption: My ileostomy is quite active and even 8 months postop I am having to wake up twice a night (after falling asleep at around 12 am) to empty my pouch. This assumes I have been able to sleep because I’m not worried about a leak or cleaning up a leak (laundry etc) which always seems to happen in the middle of the night. Currently, I am averaging ~3 hours of sleep/night which is not very sustainable in medical school when you consider spending >8 hours/day between class and studying. Encouragingly, I have had a few good nights sleep recently so I am hoping this trend is reversing.
- Mental distraction: Today I always had my ostomy in the back of my mind and it was just flat out distracting. Sure when I first started school I had almost daily pain, chills, nausea etc but I’m accustomed to that-its basically what the majority of my life has been like. I am concerned about being able to sit down and think for several hours on end without drifting into thoughts about how I am sitting may be messing up my flange. I know this is going to continue to bother me as I know I will feel like I am at some sort of mental ‘disadvantage’ to my classmates. This being said I will not be seeking accommodations from my medical school for extra time on tests or anything of that nature. In my mind this is just a perceived barrier and I should be able to get it done.
- Physical distraction: Today I was wearing khakis with dress shirt/belt and even this business casual look didn’t lend itself terribly well to having an ostomy in my case (your mileage will likely vary depending on stoma location and where your pants/belt ride etc). Furthermore, I had to get up and leave the group on 3 separate occasions when cases were being presented to empty my pouch which I felt like disrupted the whole group. I have worn scrubs with an ostomy and those actually worked pretty well for me as I found the waist band not overly restrictive yet supportive.
- Social issues: There are too many of these to list but the most common is people asking me what class I am in. I’m basically an M1.5 (between 1st and 2nd year) which means nothing and I don’t really know what to say about this to my new classmates. I don’t feel like fully explaining to new people just yet whats been going on-in time when I find some friends I will. Its also a bit awkward because I don’t have to repeat any classes until January since I performed well on my first semester exams so I am missing some of the natural comradery that builds in a class.
Despite these issues it was an amazing day where I learned a lot. Being back in the clinic, visiting patients with all stages of disease ranging from ambulatory (outpatient visit) to inpatient was equal parts fascinating and invigorating. Most importantly today showed me how much I have to learn and how I have a long way to go to adjusting to an ostomy. I feel like these last several months were a kind of ‘personal adjustment’ period and once I restart school I will have a ‘professional adjustment’ where I need to learn how to feel comfortable studying, interacting with patients, wearing dress clothes etc. There is no doubt that I am re-starting medical school in January and the conversation of a reversal has been tabled for the foreseeable future. I am just excited to get back to school and keep learning.