In Which I Obsess About Things Over Which I Have No Control

Thursday, January 31, 2013

Alternate title for today's entry: Every Friggin' Day in Alison's Life.

I was talking to Ken the other night before bed and he was complaining because he was tired, but he couldn't stop thinking about what he was going to teach the next day, all of the grading he had to do, and other job-related things.  I said that that was how I lived every single day of my life; unable to shut off my brain, always thinking about something (usually multiple somethings), and generally being disturbed by many of them.  He kind of stared at me and asked how my head hadn't exploded yet.  I shrugged.  It's just the way I am.

But really, I think I spend... probably 90% of my waking hours worried or concerned about something, and most of those somethings are things over which I have little to absolutely zero control.  Surprising no one, my current obsession concern obsessive concern is PA school and decisions about the future related to same.  Before I wrote my last (actual) post, I had been all gung-ho for PA school.  Must go to PA school, being a PA is my destiny!  Go Team Physician Assistant!  ::waves flags::  Then I had to go an have the (long-time coming) psychological revelation about medical school and how hey, yeah, that actually still IS a possibility (albeit a slightly deranged one).

So I'm waiting for this USP news, which is making me feel like assaulting my mailbox every time there isn't anything in there except bills and mail for the old tenants (Sidenote: Why does someone think that NJ Web Design exists in my apartment?).  I stupidly allowed myself to peruse the PA Forum online, and two people had posted that they were accepted, although I am only inclined to believe one of them because one said he received an email on January 7th and I spoke to the admissions person on January 15th and she said that they hadn't mailed any decisions yet... so whatever.  The other person didn't say when she had been accepted, so who knows.  In any case, my brain went into overdrive thinking about how if they were accepting people, why hadn't I heard about MY fate yet, and clearly, I was destined to be rejected.

On top of that, I now am torn about even wanting to get in at this point, because now there's the bug of "oh hey, med school is a (slightly deranged) possibility" and if I did get in to PA school, then I'd feel obligated to go because I spent time and money (and excessive amounts of brain space) trying to get accepted... and to turn down a sure way into clinical medicine for a year of expensive stress/classes/exams and a mere possibility of getting into medical school seems... foolish.  Of course, then my brain goes down the rabbit hole of not getting accepted to PA school and going the route of reapplying to med school, which would involve a year of classes, studying for and retaking the damn MCAT, and the actual reapplication process.  The next logical (illogical?) step in this insane journey is then to contemplate post-bacc options.

Penn has 2, but I think I'm more suited to one than the other... of course, if I would just get my ass to the office during walk-in hours (which happen twice every Wednesday), then I would find out.  There's an online program offered through the University of New England College of Osteopathic Medicine, which would be ideal, but it's expensive and doesn't offer payment plans or take financial aid.  Overall, it's less expensive than the Penn programs, but Penn takes financial aid and there's a chance that CHOP might reimburse me up to $4,000 a year for that (because it's an actual program, not just random classes).  And then there's always the community college, but the classes aren't convenient (as in, they run in the middle of the day, not helpful Camden County) and I have to actually sit in a community college class, which we all know makes me homicidal.  Drexel has a whole mess of post-bacc programs, but they're all full-time except for their night program, which takes 2 years to do, which is annoying.  This morning I had the even MORE deranged thought of, well, if I have to post-bacc full time, then maybe I should do that... but that is just NOT an option when there ARE part-time or evening options.  I mean, it's an option in the sense that yes, it's something one could do, but I am pretty sure that it would be a terrible idea for me... what with the needing an income and benefits and such. 

So, now I've spent time and space detailing all of these things and I still have no control over what happens.  I either get accepted to USP or I don't, and then... then I have a little control over what I do.  Either I go to PA school or I don't go to PA school and I decide to spend the next year taking classes and praying that I get into med school, and once again, I have no control over what happens in that regard.  Obviously, the underlying psychological issue in all of this is how much I crave control and how infrequently I can exact it over my life, which is what clearly gives me agida.  Sigh.  The answer is to learn to "go with the flow" but I just don't think that's how I'm designed.

And so, I will end this post without any real closure or development, other than to say... violent crime against mailboxes is not the answer, being a grown up is hard, and I need a nap.

- A

Quoteable Clinical Research

Friday, January 25, 2013

Installment #2 of "Quoteable Life" - The Clinical Research Edition!

Speaker: This is an infographic. I don't know what an infographic is, but this is one.
Me (whispering): It's a graphic with information on it?
Doctor (also whispering): How do you know that it's not information with a graphic on it.
Me: Excellent point.
Doctor: Quite ambiguous.
Me: Yes, we need to operationally define "infographic".

"We should use Valium more often..." 

Pathologist: What animal might these cells resemble?
Attending: A honey badger!
Pathologist: NOT a honey badger. An OWL.  That's why they're called Owl Cells...?

"The pathologist said that he has the pathology slides and the report from the liver of our international patient... problem is that it's actually pancreas... so I told him to do his best."

Surgeon: We don't need P values!
Me: False.

"Maybe you COULD put a stent in a mouse..." - Surgeon

"Yeah, I'll talk to you later. I have to go do some science," - One attending to another

Attending 1: So, is this lymphoma weird enough to fall under the "weird lymphoma that needs other stuff" catergory? ::gestures wildly::
Attending 2: ... what?!

"The exclusion criteria are... you can't be dead." - Attending

"Her mom only believes in Eastern medicine, and the daughter has a heart condition, and so she used to pass out when she raced.. and her mom said she didn't have enough love in her heart... and I was just like, NO! Her sodium-potassium pumps don't work!"  - Research Tech

In Which I Am STILL Terrible at Waiting

Thursday, January 24, 2013

And so life goes on, as it is wont to do.  I guess it's better than the alternative...?

Still no word from USP, but I would have been shocked if I heard anything in week one of "within the next two weeks".  I have been trying not to obsess about it, but... I'm me, so that's not going very well.  The good news is that I haven't physically assaulted my mailbox, so there's that.  I am betting that we'll all find out sometime next week.  If we don't... I may have a seizure.

All of this rumination on a single topic has brought some interesting things to light, though.  In numerous therapy sessions, I have said, "If someone asked me if I wanted to go to medical school, I would go... TOMORROW."  I also have said, to numerous people (including my therapist), that if I could surgically remove the part of my brain that makes me want to be a clinician, I would.  However, in lieu of a lobotomy (which I think is mostly frowned upon these days and would definitely tank my productivity and what ability to focus I have left), I guess I will have to deal with my life passion being something that is, at best, ridiculously difficult to achieve.

There's a real possibility that I will, once again, be rejected from all of the PA schools that I applied to this year.  That would, in short, blow goats.  It would also mean that I would spend the next year taking classes to boost my science GPA from the measly 3.1 where it currently sits... and I'll have to retake my GRE, because 2012 was the last year my scores were still "good".  I was talking to Levi about all of this, and how annoying it was going to be to do this, and also mentioned how if someone offered me acceptances to both PA school and med school, I'd pick med school, every time.  He brought up the obvious point.  "Alison, if you want to go to med school so bad, and you have to retake classes and a test anyway... why not just retake the MCAT and reapply to med school?"

And then I came up with 327 excuses as to why that was insane/impossible/ridiculous/outrageous/impractical... and did I mention completely insane?  Because it is.  One by one, Levi shot down my excuses, some of which were gems like...

Me: I'm too old.
Levi: That's ridiculous.  You had people in their 30's and 40's in your class.

Me: I can't do it.
Levi: It will be hard, but you could totally do it.  It might not be fun all the time... or ever... but you could do it.

Me: I want to have kids!
Levi: When were you planning on it?
Me: Like... in a few years?  Like 4 or 5?  Maybe? 
Levi: So med school would fit in there, yes?
Me: Yeah... people have kids in residency... I guess.
Levi: Problem solved.  These things are not mutually exclusive.  Difficult, but not incompatible.

Me: Ken will think I'm insane.
Levi: Have you even TALKED to him about this?
Me: ... no.
Levi: Don't be dumb.  Talk to your husband.

Me: It's expensive!
Levi: Life is expensive.  PA school would be expensive. Med school is just more expensive.

So... I did.  And, not surprisingly, Ken did NOT think I was insane (and in fact, asked why I always think that he's going to think that I'm insane).  He said that it "totally made sense" and that if it's what I really wanted, then I shouldn't half-ass it just because I was afraid.  He said that he would support me doing whatever I decided to do, whether that was applying to med school, applying to PA school, or staying at my current job.

Regardless, it all still feels completely, batshit, crazy.

The good news is that since I need to take the classes anyway, they're good for whatever I want to do.  I can study for the MCAT (because studying never hurt anyone), even if I decide not to take it and take the GRE (the only thing I would have to study for the GRE is the math, and that wasn't too bad last time).  In a year, I might not want to apply to med school (doubtful), but who knows.  Choices are good, right?

So, yes.  If I get into USP, I will go and do the PA thing, because damn it, I am tired of being up in the air and having to go through application cycle after application cycle.  It is exhausting and expensive!  But if life has other plans in store for me... now I have two options.  I'm looking into the post-bacc programs at Penn, and will be meeting with someone about them next week on Wednesday (if it stops being painfully cold outside so I can walk a few blocks to their office).  There's also an online post-bacc program through UNECOM, but it's pretty expensive (like Penn isn't...?).  There's always the community college route, but that isn't THAT much less expensive and it's really annoying to go down to Blackwood multiple times a week.  We'll see.  Who knows.  Maybe this will all be a moot point because I'll get into PA school.  I guess I will find out... soon?

In other news, I found a doctor who actually wants to treat my stupid symptoms!  I saw a rheumatologist on Monday, and after she spent a decent amount of time listening to my history and examining me, she came up with what I had heard before.  That is, that my symptoms are real, and mostly relatable to autoimmune disease processes, but none of them SCREAM for a particular diagnosis.  I was ready to be bummed out.  HOWEVER, she said that she has a few patients like that, and instead of doing nothing (which helps no one), she treats them for what they MOSTLY sound like.  In my case, that's lupus.  She took blood and urine for a full panel of autoimmune testing (Lupus, Celiac's, RA), as well as some vitamin deficiencies and who knows what else.  I am waiting for her to call me with the results (hopefully today?), although I am betting that they will be PAINFULLY normal.  That's okay, though, she's regardless of what the blood says (unless it says that I should be treated with something else), I will remain on what she prescribed on Monday.  She put me on Plaquenil, which is apparently an anti-malarial drug (bonus, I won't get that?) that also works as a Disease Modifying Anti-Rheumatic Drug (DMARD).  They're not sure HOW it works in Lupus or RA, but it somehow modifies the immune process that leads to inflammation and the subsequent symptoms, especially fatigue, rashes, and joint pain.  I started taking it on Tuesday and so far, I haven't had any of the nausea or vomiting that usually comes with the drug.  She also put me on Prilosec for my horrifically bad heartburn, as she said that the NSAIDs that I've been taking for my joint pain have probably been ripping up my stomach.  That is potentially the reason that I've been getting so sick after I eat.  So, add 2 more pills to the pile, I suppose!

Yes, these are all legal.
And on that note... I'm going to get going.  Have to navigate my way through the various bridges and tunnels to get to my 1:00 meeting.  I could just walk outside, but it's friggin' freezing and I found a way to get from my office to the main hospital without leaving the indoors.  I kind of feel like a hamster in one of those Habitrails...

Mine are not this colorful. :(

... but I stay warm!

Have a good one, all...

Edit: Just kidding about the lupus, maybe? The rheumatologist called and said that because my ANA and all other labs were negative, that I should stop taking the Plaquenil. My Vitamin D and B12 are so low that she's putting me on prescriptions for those. I.... don't even... whatever.

One Breath at a Time

Wednesday, January 16, 2013

"And everything's gone terribly wrong that can,
But one breath at a time is an acceptable plan, she tells herself. . . "

                                                 - Tamburitza Lingua
                                           Ani DiFranco

Fact 1: I am fabulous at planning things.
Fact 2: I am ridiculously Type-A.
Fact 3: I catastrophize like a PRO.
Fact 4: I am the WORST at being patient.
Fact 5: This is an absolutely horrible combination. 

So, if you have spoken to me, even in passing, in the last 3 weeks, I've probably mentioned (read: obsessively talked about) how I am waiting to hear from USP about my interview for PA school.  When I interviewed on December 19th, they said that we'd be hearing about acceptances in the first week of January.  For those of you playing the home game, that was LAST week.  When nothing came in the mail or email for the entirety of last week, I wasn't ENTIRELY surprised because admissions committees are notorious for saying one thing and doing twelve other things, usually without telling any of the interested parties. I called and left a message on Friday, then emailed on Monday and called another person in admissions... all without any answer.  By Monday night and Tuesday, I was legitimately depressed because as Fact 3 points out, I catastrophize like a pro and had somehow decided that not only had I been rejected, I was going to get rejected from the rest of the schools that I haven't heard from yet, and then I'd have to post-bacc/retake classes which is not only expensive, but time consuming... and I'm not OLD by any sense of the word, but PA school takes 2-3 years and I'd be spending at least a year doing the post-bacc thing... and someday I'd like to have children, preferably before I'm 35, and God knows if I can even HAVE kids.... so I essentially had talked myself into believing that I am never going to get into PA school and that in the process of trying, I will have squandered my reproductive years and subsequently lost both my career and family aspirations... and that because of that, Ken would leave me and my friends would think I was crazy and so then I'd be alone.  Forever.

Basically, I'd be a huge failure at life, the universe, and everything.  

All because I didn't get an email or a large envelope in the mail.



So today, I decided that I was going to call and get someone on the phone at USP.  It took me three separate tries, but I finally got one of the administrative assistants to answer the phone and she transferred me to the Admissions Director, who clearly had silenced her phone once the first week in January had passed and she knew she'd be getting a deluge of phone calls from anxious people like myself.  She told me that no, no decisions had been mailed as of yet and that I hadn't missed anything, and that yes, she had been getting approximately a thousand phone calls a day (probably only a slight exaggeration).  I asked if she had any idea when they'd be going out, and she told me "sometime within the next two weeks" so I guess the "first week in January" was really the "last week in January".  

But hey, I haven't been rejected!  Yet...?  (See, still catastrophizing.)

Anyway, now I can breathe.  A little.  And stop stalking my mailbox.  Sort of.  I told you, I'm really bad at being patient.

And I just want to be able to plan my life, for pete's sake.  It's really annoying to not know what the hell is going on in August... which I realize sounds kind of absurd because August is 8 months away... but Ken and I want to move in July and we have to tell our complex in May whether we're staying, so we're going to start looking in late April for places... which is ALSO really annoying because I'd like to move NOW, or at least know where we're moving in April, because that's only FOUR months away.  

So yes.  Basically, my brain is a disaster, as per usual.  But I haven't been rejected from PA school, so that's good.  

In other news, my joints are KILLING me today and I just want to go home, fill my prescription, take drugs, and lie down under the heated blanket for awhile.  Thankfully, it's just after 4, which means I can do that.  And tomorrow is Thursday, AKA: Almost Friday, and Friday I'm taking a half day because my dad is flying in for the weekend.  I really hope that I don't feel disgusting.  Wishful thinking, perhaps.

And so with that, I am off... into the disgusting, rainy, freezing, wet, mess that awaits outside.  Brr.

- A

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