Health history - should I tell them?

[ofthesun]

Over the past 6-8 years, I've coped with some pretty brutal TMJ (temporomandibular joint) dysfunction. Symptoms have been heavy daily headaches aggravated by talking, sleeping, eating, (pretty much anything etc.) and a steadily deteriorating right joint.

Since graduating in 2004, over the past two years, my primary attention has thus been in resolving this. I was finally able to get to the heart of the issue several months ago and can now say with certainty that besides my childhood, my joints are the healthiest they've ever been and are getting better every day. For the first time in ages, they no longer restrict my activities - consciously or subconsciously - in any way, and this is rapidly becoming a thing of the past for me.

Barring my triple jaw surgery of 2003, this treatment has been almost completely self-directed. TMJ dysfunction is not something physicians, ENTs, dentists, oral surgeons, periodontists, or any other medical professional really offer much help for. All of this has definitely taught me a lot about medicine, how doctors may best face the unknown, and how I face adversity.

In addition, because having this issue has made almost any activity besides sitting at a desk and working quietly up until just recently pretty uncomfortable, it explains why my grades and independent activities have been strong (3.91, 34Q) but yet my interpersonal/leadership could definitely be better.

Despite this, so far, I have decided not to mention any of this in applications. Instead, I have glossed over the time I've lost to it and EC shortcomings that have resulted from it. I have made this judgement thinking that such a debatable medical history may be construed by admissions committees as a potential source of weakness in the future and thus be held against me.

However, with interviews approaching and my everything still improving, I am considering the possibility of re-assessing this and sending in a letter detailing my history to append my application. For better and worst, this would give the schools a fuller picture of my past, opening the door to its discussion during interviews and in my final review.

My primary priority is getting into school, and I solely wish to tell them what will give my application the strongest consideration.

Based on this idea, what do you think? How might they most likely take this information if I offer it?

Thanks.

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[riceman04]

Over the past 6-8 years, I've coped with some pretty brutal TMJ (temporomandibular joint) dysfunction. Symptoms have been heavy daily headaches aggravated by talking, sleeping, eating, (pretty much anything etc.) and a steadily deteriorating right joint.

Since graduating in 2004, over the past two years, my primary attention has thus been in resolving this. I was finally able to get to the heart of the issue several months ago and can now say with certainty that besides my childhood, my joints are the healthiest they've ever been and are getting better every day. For the first time in ages, they no longer restrict my activities - consciously or subconsciously - in any way, and this is rapidly becoming a thing of the past for me.

Barring my triple jaw surgery of 2003, this treatment has been almost completely self-directed. TMJ dysfunction is not something physicians, ENTs, dentists, oral surgeons, periodontists, or any other medical professional really offer much help for. All of this has definitely taught me a lot about medicine, how doctors may best face the unknown, and how I face adversity.

In addition, because having this issue has made almost any activity besides sitting at a desk and working quietly up until just recently pretty uncomfortable, it explains why my grades and independent activities have been strong (3.91, 34Q) but yet my interpersonal/leadership could definitely be better.

Despite this, so far, I have decided not to mention any of this in applications. Instead, I have glossed over the time I've lost to it and EC shortcomings that have resulted from it. I have made this judgement thinking that such a debatable medical history may be construed by admissions committees as a potential source of weakness in the future and thus be held against me.

However, with interviews approaching and my everything still improving, I am considering the possibility of re-assessing this and sending in a letter detailing my history to append my application. For better and worst, this would give the schools a fuller picture of my past, opening the door to its discussion during interviews and in my final review.

My primary priority is getting into school, and I solely wish to tell them what will give my application the strongest consideration.

Based on this idea, what do you think? How might they most likely take this information if I offer it?

Thanks,
ofthsun

I think it would be in your best interest to bring it up especially since they are going to wonder why you are lacking EC's. TMJ is rough...congrats on fighting it and improving.

good luck!

 

[mogues80]

TMJ, thats rough. I'm glad you're doing much better. I myself have a chronic condition that resulted in 2 weeks hospitalization, rheumatoid arthritis. Since my hospitalization in 2004, I've been extremely healthy. I included my experiences in some of my essays and therefore the interviewers were aware of my past and some brought it up. Taking the positives from the experience, it gives you the patients' perspective and is a great learning experience, though not one anyone should hope for. All in all, it was good conversation material. Some interviewers may bring it up, but mostly they want to know your perspective of being a patient.
No school can discriminate on the basis of medical condition as long as you're able to perform as a doctor. In my opinion, no committee would discriminate even unintentionally, they will look at your experience as a plus in patient experience and empathy.

As for your question, since you haven't included the illness in your essay, it most likely will not be brought up. I wouldn't mention it unless a specific question leads you into that experience and you can use it as an anecdote.

Good luck on those interviews.

 

[ladyVA]

I would even just send in a letter just like the post you wrote here - it was very well explained and logical and would make me think that you, as a patient, would have very important insights into medicine (as you mentioned).

Good luck - you deserve it.

 

[ofthesun]

Thanks all for the feedback. So far the vote is slightly in favor of writing the letter, and I think that is what I will do.

I get the impression that the only way this could hurt me is if they deem my past TMJ as a barrier to my successful future practice, in which case they would have to notify me of their concern and allow me to defend myself, which I would be completely comfortable with given my current condition.

If that's all there is to it, I definitely see no reason not to send it now ... Does anyone have any experience (or even well-founded conjecture) to support the 'nay' position on this? Is there something the posts above are missing?

Thanks again.

 

[tacrum43]

Thanks all for the feedback. So far the vote is slightly in favor of writing the letter, and I think that is what I will do.

I get the impression that the only way this could hurt me is if they deem my past TMJ as a barrier to my successful future practice, in which case they would have to notify me of their concern and allow me to defend myself, which I would be completely comfortable with given my current condition.

If that's all there is to it, I definitely see no reason not to send it now ... Does anyone have any experience (or even well-founded conjecture) to support the 'nay' position on this? Is there something the posts above are missing?

Thanks again.

Maybe it would be better to wait until your interview, and then bring it up then, rather than writing it in a letter.

 

[tigress]

I don't see how they could say it would be a barrier to your success. People with all sorts of medical conditions go through medical school and become doctors. I briefly mentioned my JRA in my personal statement, and a few interviewers brought it up, we discussed it briefly, and then went on to other topics. Nobody suggested it might hinder me at all.

At this point though I'd say just discuss it in interviews if the opportunity presents itself. If they ask why you don't have more extracurricular stuff, for example, mention your story. Or if you can fit it into why you want to be a doctor, talk about it then.

Good luck

 

[novemberrainne]

I have a chronic condition, also an autoimmune disease, that gives me severe neuralgia, and many other symptoms. I didn't bring it up in my essays or secondaries. I didn't think I was going to bring it up at all, since I was afraid to. After all, I don't have health insurance because companies have rejected me since they consider me too much of a risk, and I didn't want medical schools to feel the same.

It DID come up at two of my interviews, though. I forget what related to it, but I mentioned it in the context of how I've taken care of many family members with specific conditions, as well as taking care of my own condition. I displayed it as a strength, since once one has been through one's own illness, one is more able to relate to patients. Even my husband doesn't understand how health is truly the most precious resource!

Anyway, as a disclaimer, I prefaced the statements about my illness with the fact that some mentors had advised me against mentioning it. I think it came off as just being really honest, which it was. I made my decisions to tell based on the rapport I felt with my interviewers. Sending a letter would be tricky, since there is no body language to read, and some might get the wrong picture.

TMJ is hard to diagnose. I'm so glad that you have been able to dampen the pain caused by your condition. If you don't mind me asking, was it the surgery that helped you, or something else?

Also, to the person with rheumatoid arthritis, how do you deal with it?

Don't answer if you think it too personal, I'm just up for any advice since I face chronic pain as well.

 

[tigress]

It's funny what you say about appreciating health, novemberrainne. I suppose I've had more of an appreciation than most, but it wasn't until I began working full time with terminally ill patients (with ALS) that I REALLY began to appreciate it. Sometimes I go home from work and just hug my husband and feel so lucky to have another healthy day with him. I think perhaps since I've had the JRA since I was a little kid, I've always just accepted it as part of my life and never thought too deeply about it.

As far as dealing with chronic pain, I do have plenty of experience with that. Luckily I'm currently not having any trouble (probably because I'm pregnant; RA often goes into remission during pregnancy). I went off of all medications over a year ago, and thankfully I did very well. But I was on lots of drugs for years. High school was really the worst, before I had the chance to use one of the newer immunomodulatory super-drugs. To deal with pain I often just tried to distract myself, which can be very hard, but you get better at it with practice. Some things that specifically helped also were warm baths, heating pads, etc. I never found that guided mental imagery or whatever was particularly helpful. I need an external distraction, like a movie or a good book.

While all of this is personal, I think it's important to talk about it. Fortunately, med schools and training programs, and physicians in general, are starting to pay more attention to the problem of pain management.

 

[SailCrazy]

I think it would have been great to include in your personal statement, or in a letter to adcoms early on. My thoughts now: better late than never!

Good luck!

 

[ofthesun]

TMJ is hard to diagnose. I'm so glad that you have been able to dampen the pain caused by your condition. If you don't mind me asking, was it the surgery that helped you, or something else?

I'm not sure how helpful this will be to you personally, but if you're interested or curious I can elaborate.
Surprisingly enough, the surgery did little for my TMJ, although it did make my face a bit nicer. What got to the source was recognizing the symmetry/asymmetry of my condition.

You see, in my case, only the right side has ever been problematic. The left has always been 100% perfect. In retrospect, this makes absolute sense.

When I was an adolescent and had the abnormal jaw growth (underbite/openbite) that initiated this all, it took place more greatly on the right side than the left. For whatever reason (perhaps my left teeth contacted better), this led me to overuse the left side and the right musculature essentially atrophied.

Swallowing, speaking, smiling, all began to take place predominantly on the left side, and thus my jaw was constantly being pulled out of alignment towards that side. The right joint began to suffer.

Through it all I believed that the active left side was the result of the TMJ. It was understanding that it was in fact the other way around - the TMJ was a symptom; the muscle imbalance was the source - that I could repair.

I have seen improvement by exercising the hell out of the right side (3-6 hours a day). The muscles all through my face, throat, and tongue have been buffing right up. As they have, my joint is relaxing. At this point, I've stepped back about 5 years in function. I feel like 18 again. The final details are continuing to balance out on a daily basis.

One primary thing I got most out of this is the understanding that cure is not the only thing a physician may provide patients. For years, I was told there was nothing to be done that hadn't already been done, and even came to accept this as well. During those times, all I often wanted was thus a empathetic ear to let me know they understood what I was going through and cared about helping to do something towards a resolution, whether such a resolution would be possible or not.

I've also learned that the human body is a delicate thing. The smallest domino can take it to pieces or put it right back together.

Lastly, I've seen that with insidious conditions like this, it really is hard to see how greatly they affect your quality of life until the smoke finally clears. Now that the haze of discomfort has finally risen (or is rising), I see it for something else, and I feel rejuvenated.

Thanks for the replies all, and best of luck to you guys too.

ps. I sent a letter in and most of the schools told me it will be in my file for interview-only consideration. Good.