How do you cope with the feeling "I may get this disease"

[The Angriest Bird]

By definition, we as medical students mature into doctors by learning all these bad diseases. This depressing message is just overwhelming me. Fortunately, my defense mechanisms are working really well, but I wonder how you guys cope with this feeling.

I'm an MS2 now and I have learned these sad facts,

1. There are many diseases out there to kill you.

2. There are still many diseases out there to kill even though you are in your 20s and your family medical history is excellent.

3. For many bad diseases, a) there's no warning sign b) fast onset + rapid poor prognosis c) You can do absolutely nothing to prevent them. E.g. many forms of cancers + autoimmune diseases.

4. You may be spared, but how about your family, my parents and my future kids?

I'm guessing that as I grow up into a full-fledged doctor, I will be so desensitized that they don't bother me anymore.

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[PeepshowJohnny]

You have a MUCH higher chance of being T-boned by a drunk driver than you do of catching any of the disease you read about.

Personally, I worry less about dieing of Wegener's Granulomatosis or Acute Myelogenous Leukemia than I do about having my insides turned to mush, my bones snapped, and my brain shook around in my skull like a kid with a Christmas present in a motor vehicle accident

 

[humuhumu]

Definitely makes you appreciate life (and good health) a little more.

An important part of our training as physicians is to always ask ourselves when we see a patient, "What's the worst thing this could be?" That's why we spend so much time learning about uncommon yet potentially deadly diseases, ones that we could save the patient from if we catch them in time. I think that's an emphasis that distinguishes us from other health care providers. But it also makes us somewhat paranoid....

 

[MattD]

By definition, we as medical students mature into doctors by learning all these bad diseases. This depressing message is just overwhelming me. Fortunately, my defense mechanisms are working really well, but I wonder how you guys cope with this feeling.

I typically take the route of somatizing vague symptoms relative to the disease, hypermonitoring my body to pick up more symptoms, convincing myself that I MUST have said rare disease and will die soon, then getting better when i realize that the symptoms have been going on long enough that if I really WERE sick, I'd already be in the ground.

Sad, but true

 

[LJDHC05]

There are approximately 200 carcinogenic compounds in coffee (Robbins and Cotran PBD, Pg. 446). Alcohol has negative effects, UV has negative effects, fatty foods have negative effects, healthy foods have negative effects, sitting on your arse studying pathology has negative effects, smoking has negative effects. Those, in combination with your HLA types and the 3-7 recessive mutations you're unknowingly harboring are pretty much enough to do anyone in eventually.

Me? I pretty much start the day off with a tall steaming cup of cancer, following it up with a side of metabolic syndrome around lunch time, and then I go and dimerize some thymidine residues while lowering my risks of cardiovascular disease with a run around campus. After dinner, I usually worry if my stools will be bulky enough with the roughage that I'm eating. I especially like to end my day with a refreshing, frost brewed hepatic steatosis risk factor. You get the drift.

You can either spend your life worrying about it, or live your how you want and minimize your risks where you can. And if you do worry about the statistical improbabilities, you might as well buy a season ticket for the lottery because you'll be just as likely to win some cash as some of the zebras you'll have to know in depth.

 

[TopsyKrett]

Don't get too obsessed with all those bizarre diseases you are learning about. Oh, and don't take yourself too seriously.

 

[humuhumu]

There are approximately 200 carcinogenic compounds in coffee (Robbins and Cotran PBD, Pg. 446). Alcohol has negative effects, UV has negative effects, fatty foods have negative effects, healthy foods have negative effects, sitting on your arse studying pathology has negative effects, smoking has negative effects. Those, in combination with your HLA types and the 3-7 recessive mutations you're unknowingly harboring are pretty much enough to do anyone in eventually.

Me? I pretty much start the day off with a tall steaming cup of cancer, following it up with a side of metabolic syndrome around lunch time, and then I go and dimerize some thymidine residues while lowering my risks of cardiovascular disease with a run around campus. After dinner, I usually worry if my stools will be bulky enough with the roughage that I'm eating. I especially like to end my day with a refreshing, frost brewed hepatic steatosis risk factor. You get the drift.

You can either spend your life worrying about it, or live your how you want and minimize your risks where you can. And if you do worry about the statistical improbabilities, you might as well buy a season ticket for the lottery because you'll be just as likely to win some cash as some of the zebras you'll have to know in depth.

This is classic. Strong work.

 

[Blade28]

That fear will pass.

You'd think all med students (and, later, residents) would avoid smoking, drinking, and drugs; only drive within the speed limit; always wear their seatbelt; exercise, eat right, etc. But they don't.

 

[spicedmanna]

You have a MUCH higher chance of being T-boned by a drunk driver than you do of catching any of the disease you read about.

Personally, I worry less about dieing of Wegener's Granulomatosis or Acute Myelogenous Leukemia than I do about having my insides turned to mush, my bones snapped, and my brain shook around in my skull like a kid with a Christmas present in a motor vehicle accident

I don't have the statistics to support your assertion, but I agree nonetheless. It meshes with me intuitively.

OP, you are worrying excessively. Go out every once in a while and do something fun. Hang out with some healthy folks with a good love of life. There are many things we cannot control in life. Focus on what you can control and let go of the rest. Don't forget to take time to enjoy your life. You may find yourself worrying less.

 

[34140]

More than what can happen to me....after taking embryo...i am so scared of becoming pregnant with all these different things happening to the baby!

 

[Ashers]

More than what can happen to me....after taking embryo...i am so scared of becoming pregnant with all these different things happening to the baby!

Just wait til you're on OB/gyn and see all the stuff that can go wrong in labor to lead to an emergent C-section. After 5 weeks, the number of vaginal deliveries I saw finally outnumbered cesareans. I was just about convinced that the C/S rate was 75%.

 

[t33sg1rl]

I think I value each day a little more after seeing all these 20somethings in the hospital with one foot in the grave. I never really understood what "having my health" was all about before.

 

[baylormed]

The worst part is going to be knowing exactly how many things can go wrong in a hospital. I am guessing most of us will at least once in our lives (if we haven't already) will set foot in a hospital as a patient, or at least as the relative/friend of a patient.

You guys remember when you trusted doctors because, well, they are doctors and they should KNOW, right? I am going to miss those days.

 

[Ashers]

The worst part is going to be knowing exactly how many things can go wrong in a hospital. I am guessing most of us will at least once in our lives (if we haven't already) will set foot in a hospital as a patient, or at least as the relative/friend of a patient.

You guys remember when you trusted doctors because, well, they are doctors and they should KNOW, right? I am going to miss those days.

What's better is ending up in the hospital because of a pathology you're studying and on drugs you've just had lectures on... then even while you're lying on a bed, on the way to the OR, MDs still pimp you, and multiple MDs come to see you post-op to explain the pathophys in detail. Sometimes, even the residents you're now on a rotation with remember hearing about the "med student whose H&H dropped and needed emergent surgery." Good times. After my little incident in the hospital, any slight stomach ache, I was afraid I was going to need surgery again.

As for trusting doctors, I've never really did. My dad used to tell me stuff "wouldn't hurt," and it always would.

 

[Allerian1004]

Ashers you are totally right about being pimped about medical conditions even in the hospital as a patient. During my senior year just as a pre-med the MD was asking my about the landmarks used in lumbar punctures (the procedure I was having :-( and why there wasn't a chance he could paralyze me).
And in response to getting some rare disease you learn about it happens even to us.
I have a very rare genetic electrolyte wasting disease that they didn't find out I had until I was 22. Or with autoimmune disease, yes they suck but you live on. I was dx with Lupus early in my college career. Although I have been through times of being very very ill there are also times of being closer to normal. And my mom was just diagnosed with a form of Lupus as well. (Lovely family history).
Even though you have a potentially terrible disease you still learn how to live with your limitations. Can I go out drinking with friends? Nope (stupid methotrexate) can I go out late to parties? Nope... need my sleep so I can make it through classes. Yes, I won't be able to do certain specialties but that's okay. I'll still be able to be a physician and that's all that really matters. Whatever disease you get, you'll learn how to live within your limitations.

 

[The Angriest Bird]

Whatever disease you get, you'll learn how to live within your limitations.

Thank you for the nice words. In fact, I do have a bad disease. I have Tourette's disease. I don't expect you to even remember this disease unless you are studying for Step I. Tourette is no fun, and I'm still on 0.5mg of haloperidol per day. It's below the therapeutic dose but it works for me like magic. My tics used to be involved with my facial muscles, but I have somehow trained myself to "tic" my gluteal muscles instead. So I still have tics you just don't notice them. I'm actually pretty proud of myself.

 

[Blade28]

Thank you for the nice words. In fact, I do have a bad disease. I have Tourette's disease. I don't expect you to even remember this disease unless you are studying for Step I.

Props to you for controlling this!

BTW, EVERYONE remembers this disease, but in its more common form of "Tourette's syndrome."

 

[PeepshowJohnny]

I have a very rare genetic electrolyte wasting disease that they didn't find out I had until I was 22.

I'm sorry to pry into your medical history, but if you wouldn't mind saying, what disease is it? I just happen to be curious. Gitelman's? Bartter's? Gordon's?

 

[The Angriest Bird]

I'm sorry to pry into your medical history, but if you wouldn't mind saying, what disease is it? I just happen to be curious. Gitelman's? Bartter's? Gordon's?

LOL renal physio

 

[Ashers]

Props to you for controlling this!

BTW, EVERYONE remembers this disease, but in its more common form of "Tourette's syndrome."

I always thought it was an easy thing to remember because it's stereotyped so bad in movies... What about Bob?! Deuce Bigalow: Male Gigalow...

It wasn't until I took psych M2 year that I actually understood what's really involved in it though.

 

[78222]

Everytime i read about a terrible disease and think I have it I go "hmmm, compared to medschool, that wouldn't wouldnt be that bad"

 

[45408]

I don't sweat it. The only thing that scares me is acute pancreatitis or pancreatic cancer.

 

[Allerian1004]

I'm sorry to pry into your medical history, but if you wouldn't mind saying, what disease is it? I just happen to be curious. Gitelman's? Bartter's? Gordon's?

It isn't certain whether I have Bartters or Gitelmans unless I do genetic testing. However, we think it's Gitelman's since I've had Mg wasting as well as K and I didn't present until 2 years ago. Taking steriods for my lupus made the K wasting a lot harder to control.

 

[Ashers]

I don't sweat it. The only thing that scares me is acute pancreatitis or pancreatic cancer.

If you ever get depressed, start worrying more about pancreatic cancer.

 

[PeepshowJohnny]

It isn't certain whether I have Bartters or Gitelmans unless I do genetic testing. However, we think it's Gitelman's since I've had Mg wasting as well as K and I didn't present until 2 years ago. Taking steriods for my lupus made the K wasting a lot harder to control.

Hey, thanks for sharing. I know it's cliche, but I'm sure with your experiences with chronic diseases are going to end up making you a better physician.

 

[Blade28]

I don't sweat it. The only thing that scares me is acute pancreatitis or pancreatic cancer.

Pancreatic CA I understand, but why pancreatitis? The pain?

If you ever get depressed, start worrying more about pancreatic cancer.

Impressive, you're the first med student I've seen that knew this fact! For bonus points, do you know why?

 

[Ashers]

Pancreatic CA I understand, but why pancreatitis? The pain?



Impressive, you're the first med student I've seen that knew this fact! For bonus points, do you know why?

That I've got no idea, but I've been wondering about since they told us in path last year. Even studying for step 1 and the psych shelf the books didn't say why. 2 articles I just saw are retrospective showing that pancreatic cancer is associated with depression. With theories of anti-5HT receptor-Abs and depletion of CNS 5HT.

 

[45408]

Pancreatic CA I understand, but why pancreatitis? The pain?

Rapid onset with the potential for death, I guess. The idea that your pancreas can digest itself in a day is pretty crazy, IMO.


Like I said - I don't really worry about this stuff, because I'm going to die of a heart attack if my prostate cancer doesn't kill me first.

 

[Blade28]

Rapid onset with the potential for death, I guess. The idea that your pancreas can digest itself in a day is pretty crazy, IMO.

But there are a lot of other things that can kill you more quickly.

With theories of anti-5HT receptor-Abs and depletion of CNS 5HT.

Wow, again, I'm impressed! I read something similar - that perhaps the pancreatic CA released serotonin inhibitory substances that may trigger depression.

 

[Katya00]

My Mom died of pancreatic cancer last November. As of now, there are no good treatments for the disease, and prognosis is very bad (98% mortality after 5 years). There is no way to screen for it, and it is believed to be hereditary. People with strong family histories are actually getting their pancreas removed, so to avoid getting the disease (and becoming a diabetic for the rest of their lives). I tend to believe there is a pretty good chance I will end up with this cancer, and if I do, an even better chance it will kill me.

This doesn't keep me up at night, so I don't think all the other possible things I can get will keep me up either. There is not much I can do about this except get screened regularly, and try to take care of myself. What can you do? Something will get you in the end, but you shouldn't let it get you (mentally) while you're still alive.

As a doctor, I hope that I can gain some recognition for this cancer, because it strikes so many people every year, and barely any of them are survivors. My Mom's oncologist called it an "insidious" cancer, because it strikes quietly and quickly, and usually by the time you know what you have, you are dead in a couple weeks. I hope by the time I am practicing there will be some better methods to offer patients than just pancreas removal.

And I hope I get to do all the things I want in life before pancreatic cancer or whatever else strikes me down. Or at least most of them

 

[Ashers]

Wow, again, I'm impressed! I read something similar - that perhaps the pancreatic CA released serotonin inhibitory substances that may trigger depression.

Thanks. =) I tend to remember random facts. Hopefully I'll be able to impress the residents and attendings when I'm on surgery (and my ortho elective -- where pancreatic CA isn't as big a deal) and not just the internet.

 

[Blade28]

My Mom died of pancreatic cancer last November. As of now, there are no good treatments for the disease, and prognosis is very bad (98% mortality after 5 years). There is no way to screen for it, and it is believed to be hereditary. People with strong family histories are actually getting their pancreas removed, so to avoid getting the disease (and becoming a diabetic for the rest of their lives). I tend to believe there is a pretty good chance I will end up with this cancer, and if I do, an even better chance it will kill me.

I'm sorry for your loss...but just wanted to point out a few things.

I think you're generalizing a bit here. Depends on what kind of pancreatic CA. Treatment and prognosis depends on location, spread, stage, etc.

And the genetic basis may depend on presence of any familial syndromes (e.g. MEN).

Just so there isn't a misunderstanding that ALL patients with a family history of pancreatic CA go ahead and underdo total pancreatectomies. This isn't commonly done.

 

[EMH]

I take solace in the fact that the body you're in on earth is just a temporary residence.

 

[Katya00]

I am not suggesting people get total pancreatectomies, I am not planning on getting one. I'm not sure it would be worth it in the end, especially since I don't know that I WILL get pancreatic CA.

If you do talk with oncologists (or even most doctors) about pancreatic cancer they will point out that 1) there has not been a good chemotherapeutic drug found against pancreatic cancer to this point, and they are limited on choices for treatment 2) pancreatic cancer doesn't seem to respond that well to other types of treatment (radiation for instance) and 3) by the time it is diagnosed, most people are already in the last stages of the disease. My Mom lived a year (and actually went into a brief remission) because she was enrolled in an experimental drug trial (oxaliplatin is the name of the drug if anyone is curious). Even with this chemotherapy the average "extra" time a patient lives is only about a month more versus patients treated conventionally. And this average difference is 3 vs. 4 months. When my Mom was diagnosed the doctors thought she would only live 4 weeks.

There also isn't a genetic test at this point to determine if a person is carrying the gene(s) making them more susceptible to developing the cancer. When the genetics are more understood I will definitely get a test, and then make my choices based upon that.

 

[Terpskins99]

By definition, we as medical students mature into doctors by learning all these bad diseases. This depressing message is just overwhelming me. Fortunately, my defense mechanisms are working really well, but I wonder how you guys cope with this feeling.

I'm an MS2 now and I have learned these sad facts,

1. There are many diseases out there to kill you.

2. There are still many diseases out there to kill even though you are in your 20s and your family medical history is excellent.

3. For many bad diseases, a) there's no warning sign b) fast onset + rapid poor prognosis c) You can do absolutely nothing to prevent them. E.g. many forms of cancers + autoimmune diseases.

4. You may be spared, but how about your family, my parents and my future kids?

I'm guessing that as I grow up into a full-fledged doctor, I will be so desensitized that they don't bother me anymore.

You know, I've had kind of the opposite perspective. Medical school has taught me how friggin resilient the human body can be despite all we do to screw it up.

And I'm actually comforted learning the medical reality versus myths/urban legends that are out there.

Yeah, reading about all these illnesses can be pretty depressing. But it also reminds me to appreciate a healthy life that much more. Good grief, I'm in my psych rotation now and I am VERY grateful I am not going through what some of these patients have to.

 

[Medica2010]

haha or.... when you actually have a disease (i have had asthma my whole life, and i think by now I would have grown out of it) and you learn all the little ways that you have a higher risk of dying... you can die from the flu! your medicine can cause a hypersenstivity! some vaccinations can make you sick! ect...

i feel really bad for my one friend in class who has type one diabetes. every day it's: check out this ulcer you could get! ketoacidosis! etc etc

 

[Depakote]

I'm terrified I could wind up with Scurvy... after all, it's come up 5 times since I started school, it must be pretty common.

On a more serious note, I really don't worry about these things that much. I'm here to make as big of a difference as possible while I'm here... if that winds up being a little shorter that I was planning, that will be a disappointment but I'll have made an impact.

 

[mjl1717]

If you ever get depressed, start worrying more about pancreatic cancer.

Agree, there is a gigantic diference between pancreatic CA and pancreatitis!!

 

[mjl1717]

My Mom died of pancreatic cancer last November. As of now, there are no good treatments for the disease, and prognosis is very bad (98% mortality after 5 years). There is no way to screen for it, and it is believed to be hereditary. People with strong family histories are actually getting their pancreas removed, so to avoid getting the disease (and becoming a diabetic for the rest of their lives). I tend to believe there is a pretty good chance I will end up with this cancer, and if I do, an even better chance it will kill me.

This doesn't keep me up at night, so I don't think all the other possible things I can get will keep me up either. There is not much I can do about this except get screened regularly, and try to take care of myself. What can you do? Something will get you in the end, but you shouldn't let it get you (mentally) while you're still alive.

As a doctor, I hope that I can gain some recognition for this cancer, because it strikes so many people every year, and barely any of them are survivors. My Mom's oncologist called it an "insidious" cancer, because it strikes quietly and quickly, and usually by the time you know what you have, you are dead in a couple weeks. I hope by the time I am practicing there will be some better methods to offer patients than just pancreas removal.

And I hope I get to do all the things I want in life before pancreatic cancer or whatever else strikes me down. Or at least most of them

Im sorry about your loss:

I was under the impression that most pancreatic CA was adenocarcinoma..
Im not discounting your story..
Here is more info for the forum:
When I did my surgical rotation the surgeon did an exploratory laparotomy on one of the psychiatrist in that particular hospital. (I dont remember which symptoms the psychiatrist had) Im there holding retractors at the time. The surgeon feels a hard mass on the pancreas, lets me feel it. He tells the teams thats pancreatic CA.. and IMMEDIATELY and abruptly stops and closes the laparotomy.. Ill never forget him saying "there is nothing I can do"

 

[Blade28]

I am not suggesting people get total pancreatectomies, I am not planning on getting one. I'm not sure it would be worth it in the end, especially since I don't know that I WILL get pancreatic CA.

If you do talk with oncologists (or even most doctors) about pancreatic cancer they will point out that 1) there has not been a good chemotherapeutic drug found against pancreatic cancer to this point, and they are limited on choices for treatment 2) pancreatic cancer doesn't seem to respond that well to other types of treatment (radiation for instance) and 3) by the time it is diagnosed, most people are already in the last stages of the disease. My Mom lived a year (and actually went into a brief remission) because she was enrolled in an experimental drug trial (oxaliplatin is the name of the drug if anyone is curious). Even with this chemotherapy the average "extra" time a patient lives is only about a month more versus patients treated conventionally. And this average difference is 3 vs. 4 months. When my Mom was diagnosed the doctors thought she would only live 4 weeks.

There also isn't a genetic test at this point to determine if a person is carrying the gene(s) making them more susceptible to developing the cancer. When the genetics are more understood I will definitely get a test, and then make my choices based upon that.

Again, I think you're generalizing. There are quite a few types of pancreatic CA - just like there are many types of breast CA, skin CA, etc. For example, adenocarcinoma is a very different beast than insulinoma, glucagonoma, etc.

And similarly, familial syndromes (such as the MEN syndromes) that involve pancreatic CA can be very different from other types of pancreatic tumors.

 

[Winged Scapula]

Again, I think you're generalizing. There are quite a few types of pancreatic CA - just like there are many types of breast CA, skin CA, etc. For example, adenocarcinoma is a very different beast than insulinoma, glucagonoma, etc.

And similarly, familial syndromes (such as the MEN syndromes) that involve pancreatic CA can be very different from other types of pancreatic tumors.

Someone's been studying for his ABSITE!

 

[Blade28]

Someone's been studying for his ABSITE!

Not yet - just retained SOMETHING from Sabiston's, I guess.

 

[Ashers]

Know what I found is hard to not feel like I'm going to get... scabies. I just saw a homeless patient that I'm pretty sure had scabies. At first I thought he had contact dermatitis from using leaves as TP, but then after learning the rash and itching spread from the initial contact region, I think scabies. Immediately after seeing him, I started itching; I guess I'll find out in a month if I have scabies now. At least I don't think I touched him.

 

[boulux]

You have a MUCH higher chance of being T-boned by a drunk driver than you do of catching any of the disease you read about.

Personally, I worry less about dieing of Wegener's Granulomatosis or Acute Myelogenous Leukemia than I do about having my insides turned to mush, my bones snapped, and my brain shook around in my skull like a kid with a Christmas present in a motor vehicle accident

good point...