M.D.s with IBD

email: IBDpatient2patient@yahoo.com

I want this to be a way for medical students, scientists and health care professionals to share advice, concerns or stories about becoming a health care professional with IBD. No one should come away from reading any of the content hereon out feeling pressured into writing or disclosing their story or medical information. This series is NOT intended to be a venue for pressuring others to disclose medical information. Maintaining the privacy and integrity of medical information is of the utmost importance and I reserve the right to not post or delete content from contributors who I feel may be pressuring other individuals in any way.

With this said here is the prompt:

“Please share with us your journey with IBD through the perspective of a current or future health care professional. For example: Has it influenced your decision to pursue medicine or your career path within medicine? What, if any, are the current or perceived boundaries you do or expect to face? What advice do you have for aspiring physicians or scientists with IBD?”

If you have further questions or to submit a response please contact me at IBDpatient2patient@yahoo.com. All email correspondence will be 100% private.


Shelly

University of South Carolina School of Medicine

M.D. Candidate, Class of 2017

Second year, second semester of medical school: for most, it’s a time to gear up for national board exams. I spent most of that semester in a hospital bed. I was diagnosed with ulcerative colitis and I had it bad. Within six months of my diagnosis, I had failed a handful of conventional treatments and contracted a case of C. diff that was not responding to antibiotic therapy. I had a proctocolectomy and now live with a jpouch. I spent about six months of the last year with an ileostomy. I had to take a year off off school to attend to my illness but I’ll be starting my third year of medical school in July.

My journey is unique in that my diagnosis came after I had already decided to pursue a career in medicine. I never had my heart set on a medical specialty before being diagnosed, and the complications of being immunosuppressed left me feeling as though I had fewer options in terms of branches of medicine I could pursue. It was not until I volunteered at Camp Oasis, a summer camp for children and counselors with IBD run by the CCFA, that I came to realize my disease could also be my calling. I fell in love with the strength, tenacity, and optimism of the boys and girls at camp. As a pediatric gastroenterologist, my ulcerative colitis could be a blessing and tool with which I could better understand my kid-patients and explain their situations to their parents. My disease became my inspiration and strength.

I cannot speak extensively about what it’s like to be a medical professional (in training) with a chronic illness, as I’ve been ill for such a short period of time. However, I feel I can speak to what it is like to be a patient with a medical background. I feel as though doctors and nurses sometimes treat me differently upon learning what I do. Sometimes I tell them outright or other times they guess. (I suppose “my anti-muscarinic drug” isn’t a phase used by a typical patient.) Some physicians will not bother to use conversational language when talking about my condition or symptoms, and instead stick to the exclusive language taught in medical texts and journals, much to the annoyance of my mother. Other times I feel pressure to already have answers to my own question or have diagnosed my symptoms, for I’m going to be a doctor after all. Almost always I feel as though doctors tend to take me more seriously and I have fewer communication gaps between relating my symptoms and receiving treatment. (One might also keep in mind that the only experiences I’ve had are my own; I can’t be sure if my designation as a “medical student” is really the explanation or if it is the seriousness of my condition or that I’m just a clear communicator.)

My time spent as a patient will change the way I relate to my patients in the future. I envision my office will have a framed picture of me, full moon face, to show my pediatric patients when they ask about the steroids. I will be sure all my patients can spend a week at Camp Oasis, regardless of their ability to pay. I will design a better on-call answering service that patients don’t feel guilty for calling, because our symptoms are scary and it is so easy to get used to a symptom that is simply NOT okay. (“How much blood in the toilet is too much blood?” for one.) I want to be able to comfort parents that, even though there isn’t currently a “cure” for their child’s disease, there are treatment options that can give your child back the prep in their step and light in their eyes. And I will work with families and patients to get treatments just right, because the physician is not the most important member of the medical team — the patient is.

To any other medical students (or hopefuls) struggling with a chronic illness, I might suggest this: be honest and open about your situation. I know sharing my story has made it much easier for me to cope, has opened the door for me to hear about others struggles and taught me about the private battles that everyone fights. You are not alone in your journey, although your situation my be unique; know when you need to push yourself, and know when you need to take as break; and ask for help, or else nobody will know you need it. Good luck!

Follow my story at www.shellystory.tumblr.com or on Twitter @UlcColitisProbz


   Anonymous

Similar to a previous poster, I’m also a second year medical student in the US diagnosed with Ulcerative Colitis. I began experiencing symptoms towards the end of my senior year in undergrad. I found myself in and out of emergency clinics while receiving a series of misdiagnoses; the only thing that helped me to feel better was diet modification. I applied to medical school after graduation while conducting research during my ‘gap year’. I had a couple of months where I was relatively symptom-free, which I now understand were periods of remission. However, my health slowly deteriorated over the course of the year.

I was almost constantly bleeding, I felt tired all the time, and my dietary modifications were no longer helping as much. For a variety of reasons, I was also stressed out a lot, which I now realize definitely did not help my symptoms! Because of the misdiagnoses I had received previously, I was very hesitant to see any doctors. Instead, I continued to hope that modifying my diet would alleviate my symptoms. Unfortunately, that was not the case. My overall condition continued to get worse, and it limited my productivity – there were times when I could not complete experiments in lab because I was literally too afraid and tired to leave my apartment for any period of time.

Once I decided what medical school I was going to attend, I moved to that city during the summer and sought care at one of the local GI clinics. My first doctor there was actually a graduate of the school I now attend – he was incredibly supportive, and arranged for immediate endoscopies, both upper and lower. I received my diagnosis of UC the morning after my school’s White Coat Ceremony – at the time, I was relieved to finally know what was wrong with me. However, I had no idea what a diagnosis of IBD meant, as I had not even heard of the disease before.

My first year of medical school was, in one word, a rollercoaster. I went through a series of treatments, many of which only worked temporarily. I had to be hospitalized briefly because of side effects from one of them in particular. I was still always tired, my diet was restricted, and I felt somewhat isolated from my friends because I would often not have enough energy to do things with them whenever we were not studying. My condition was still getting worse, and that affected my grades. There were times when I wanted to quit school, but thankfully I was able to get through things, and a couple of months ago I finally went back into remission after starting one of the biologic therapies.

Not everything about UC has been bad though. Having IBD forced me to become more health-conscious and to have a greater appreciation of “health” in general – I am always grateful for the good days, as opposed to before my diagnosis when I took my health for granted. It also gave me a first-hand perspective of chronic disease, and I hope that this well help me to better relate to my future patients. Finally, I am lucky in that I have had a group of friends here who have supported me throughout my time in medical school thus far. They have bailed me out at least a few times, and I am grateful for their support.

Since I am still in the early stages of my training, I do not have a ton of advice. However, there are a couple of things I would suggest. Most importantly, make sure you have a strong support group, even if that group is small – friends, family, etc. You will likely need their help at one point or another. Secondly, do realize that things will not necessarily be easy – any form of health professions training will be rigorous and demanding, and having a chronic disease will certainly add to your stress. That is not to say that things will be impossible – however, just be prepared to work hard and accept that at times, your abilities may be limited, and that is ok. There will be brighter days!


Anonymous
I am a 24 year old medical student and was diagnosed with Crohn’s in 2013. I had just started medical school when the cramps became unbearable. I had previously attributed them to side effects from my appendectomy two years previously (which I now know was my first flare up). However, I finally attended my local A&E (ED) and was diagnosed that same day.
While balancing my first year of medical school, I tried the liquid diet, steroids, azathioprine and Humira all with no success. I finally accepted surgery and in summer 2014 I had a right sided hemi-coloectomy. My recovery was quick, uneventful and I currently take azathioprine to maintain remission. I have recently discovered that I have passed second year, so this story ends on a high note so far.
At this point, I must say my medical school were brilliant. They were supportive, offering me the chance to restart Year 1 after surgery if need be and advising me on things I’d never considered. However the medical journey of this diagnosis was never my real priority. I was always thinking in the back of my mind, how was this affect my career? I dreamed of being a doctor for so long and getting accepted to medical school seemed like the final hurled. How wrong I was.
This disease potentially changes everything. It bars me from entering the British Navy as a medical officer. Should/when it returns, poor sleep and eating habits will exacerbate flares. This doesn’t sound great for a career in Emergency Medicine (EM), known for it’s 9 to 5 and lavish lunch breaks. My true dream is to work for Medecins Sans Frontieres (MSF) after a few years of EM training. Yet, I doubt the third world has fridges to keep my Humira in should Crohn’s return.
Crohn’s has left me in this wilderness that none of my fellow classmates seem to understand. I am having career options shut off, before I’ve even graduated. Crohn’s plays a constant role in my life yet I don’t want to let it define my life. But I have no template to follow. My knowledge of Crohn’s before my diagnosis was small at best and I still feel like I’m trying to keep my head above the water. Who can I look for inspiration? Where are the fellow doctors who have travelled this same path? There is just an empty void.

I tried local support groups but they just seem to want to talk about being ill constantly. Sorry, but no one needs that negativity in their life. I need a role model, someone who has done this and come out the other side. How do you balance the demands of patients with the demands of the toilet? Patients will come to me one day asking the same questions, but as of yet I have no answers.

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