single mom...dad off playing war.. what do I do?

[2DEG]

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After getting a divorce, why would anyone ever want to try out marriage again?

Apparently, "marriage" is the number one cause of divorce.

S.

 

[Rendar5]

you misspelled "mispell". that is awesome.

yes, i agree. It is so ironical, is it not (yes, that "ironical" was intentional)?

 

[1Path]

I don't get this - could you explain it?

My mom has fibromyalgia and it hasn't done anything to disuade me from wanting to help people.

Ya know, only a greedy, "prestigous" physician could put their foot in their mouth so well!

The OP may also want to search the forums of www.msapas.net where there are some awesome resources for single Moms on the forums page!

PS- I was a former premed divorced Mom too and always heard people talking baout how hard it is to be a single Mom. But THAT certainly didn't stop me from declaring myself an MD/PhD applicant LONG before I remarried! 😉 EVERY mom needs support, single or not. In fact, I think it's going to be harder to be a married Mom since men are so dam high maintainence. It's like having an extra kid around!!! 😡

 

[etudiante04]

Ya know, only a greedy, "prestigous" physician could put their foot in their mouth so well!

The OP may also want to search the forums of www.msapas.net where there are some awesome resources for single Moms on the forums page!

PS- I was a former premed divorced Mom too and always heard people talking baout how hard it is to be a single Mom. But THAT certainly didn't stop me from declaring myself an MD/PhD applicant LONG before I remarried! 😉 EVERY mom needs support, single or not. In fact, I think it's going to be harder to be a married Mom since men are so dam high maintainence. It's like having an extra kid around!!! 😡

 

[PreMedMommy]

Apparently, "marriage" is the number one cause of divorce.

S.

That's funny right there, I don't care who ya are.

 

[tigress]

PS- I was a former premed divorced Mom too and always heard people talking baout how hard it is to be a single Mom. But THAT certainly didn't stop me from declaring myself an MD/PhD applicant LONG before I remarried! 😉 EVERY mom needs support, single or not. In fact, I think it's going to be harder to be a married Mom since men are so dam high maintainence. It's like having an extra kid around!!! 😡

lol, I guess I got super lucky then, because I'm much more high maintainance than my husband.
(Husbands don't get PMS and start weeping randomly. Women are weird and inscrutable! Men have very basic needs to meet to make them happy 😛)

 

[Obedeli]

Ya know, only a greedy, "prestigous" physician could put their foot in their mouth so well!

The OP may also want to search the forums of www.msapas.net where there are some awesome resources for single Moms on the forums page!

PS- I was a former premed divorced Mom too and always heard people talking baout how hard it is to be a single Mom. But THAT certainly didn't stop me from declaring myself an MD/PhD applicant LONG before I remarried! 😉 EVERY mom needs support, single or not. In fact, I think it's going to be harder to be a married Mom since men are so dam high maintainence. It's like having an extra kid around!!! 😡

Am I missing the joke here?! I don't get it. Anyone can claim my mom has _____. What does that mean. I don't in ANY WAY TAKE BACK ANYTHING I SAID ABOUT FIBROMYALGIA! It is COMPLETE BULLCRAP and is a code word in medicine for pain in the arse patient. If you don't believe me, ask another resident. For those who don't believe me, just PM in 4-5 years after you have had your share of these painful people.

 

[Rendar5]

Am I missing the joke here?! I don't get it. Anyone can claim my mom has _____. What does that mean. I don't in ANY WAY TAKE BACK ANYTHING I SAID ABOUT FIBROMYALGIA! It is COMPLETE BULLCRAP and is a code word in medicine for pain in the arse patient. If you don't believe me, ask another resident. For those who don't believe me, just PM in 4-5 years after you have had your share of these painful people.

Fibromyalgia patients are a pain in the ass but on quick searches in medline, I found studies which showed that FM patients had associations with certain conditions (like hypermobility), and here's a recent article that has found differences in gait between FS patients and healthy controls. Point being that EBM provides us w/ sufficient reason to believe that it is a real condition. People saying it isn't are most likely fed up w/ patients who are a ****ing pain in the ass who don't really show laboratory differences and who they can't help, so they just figure that there's nothing wrong w/ the patient but in their head. Seems like just a rationalization to make them feel better about their inability to both treat and see a disease. Anyhoo, FM is a rheumatologists domain, so if I see anyone coming in w/ what might possibly be FM (****ing hard to tell, too). I'm just referring them away because they really are likely to be a pain in the ass patient that I can't do **** for.


Gait Posture. 2005 Nov;22(3):210-8. Epub 2004 Nov 5.

Women with fibromyalgia walk with an altered muscle synergy.

Pierrynowski MR, Tiidus PM, Galea V.

Human Movement Laboratory, School of Rehabilitation Science, McMaster University, Hamilton, Ont., Canada L8N 3Z5.

Most individuals can use different movement and muscle recruitment patterns to perform a stated task but often only one pattern is selected which optimizes an unknown global objective given the individual's neuromusculoskeletal characteristics. Patients with fibromyalgia syndrome (FS), characterized by their chronic pain, reduced physical work capacity and muscular fatigue, could exhibit a different control signature compared to asymptomatic control volunteers (CV). To test this proposal, 22 women with FS, and 11 CV, were assessed in a gait analysis laboratory. Each subject walked repeatedly at self-selected slow, comfortable, and fast walking speeds. The gait analysis provided, for each walk, each subject's stride time, length, and velocity, and ground reaction force, and lower extremity joint kinematics, moments and powers. The data were then anthropometrically scaled and velocity normalized to reduce the influence of subject mass, leg length, and walking speed on the measured gait outcomes. Similarities and differences in the two groups' scaled and normalized gait patterns were then determined. Results show that FS and CV walk with externally similar stride lengths, times, and velocities, and joint angles and ground reaction forces but they use internally different muscle recruitment patterns. Specifically, FS preferentially power gait using their hip flexors instead of their ankle plantarflexors. Interestingly, CV use a similar muscle fatiguing recruitment pattern to walk fast which parallels the common complaint of fatigue reported by FS walking at comfortable speed.

 

[1Path]

Am I missing the joke here?! I don't get it. Anyone can claim my mom has _____. What does that mean. I don't in ANY WAY TAKE BACK ANYTHING I SAID ABOUT FIBROMYALGIA! It is COMPLETE BULLCRAP and is a code word in medicine for pain in the arse patient. If you don't believe me, ask another resident. For those who don't believe me, just PM in 4-5 years after you have had your share of these painful people.

Whether it's a condition or not is really a moot point as far as I'm concern (and BTW, I never said my mother has this condition). What's of greater concern to me personally is your seemingly lack of compassion for your patients. So what's worse, a pain in the a$$ patient or a pain in the a$$, "prestigous" doctor?

And since you're a doctor (or claim to be) why don't you prescribe yourself some Xanax and lay off the caps in your future posts.

 

[tigress]

Well fibromyalgia really is a pain in the ass. Sure, some of the patients are really sick. But most of them should be treated by a psychiatrist. That doesn't mean they don't feel real pain. They DO. But the pain is psychogenic in nature, which shouldn't make it sound like I'm saying it's fake. We take psychiatric conditions more and more seriously these days, but for some reason if you tell a fibromyalgia patient that their illness might be a physical manifestation of depression, they get pissed off for not taking them seriously. It makes no sense to me. We have a lot of evidence that many illnesses are affected by psychological state (Crohn's being well studied in this regard), so why can't illness be actually caused by a psychological state? IT CAN!

Okay, enough of my ranting. Fibromyalgia is a pet peeve of mine, too. Not because I don't have compassion for the patients, because I definitely do. It sucks to have to live with pain and fatigue all the time. It's just that people get so upset if a doctor suggests that it might be caused by depression.

One thing that is a real pain in the ass in the neurology clinic where I work is people faking seizures. Apparently it's pretty common. I mean, obviously the patient has issues and deserves compassion, but a doctor can't help but feel manipulated when stuff like that happens.

If I get flamed too much for this post maybe I'll just delete it. I just wanted to defend Obedeli a bit (although he does seem a bit over-excited).

 

[1Path]

If I get flamed too much for this post maybe I'll just delete it. I just wanted to defend Obedeli a bit (although he does seem a bit over-excited).

Great post and informative too! I don't think most people mind it when docs/future docs educate while showing compassion but when they don't, well let's just say that is a MAJOR petpeeve of mine.

Honestly can't ANY patient potentially be a "pain in the a$$"? I woman that's 41 weeks pregnant? A manic depressive who won't take their meds? An 85 year old women who won't let you perform a pelvic exam?? A man in the ER with an erection that won't go away? I'd imagine the list is endless and I haven't started med school yet!

 

[Doctor Bagel]

Am I missing the joke here?! I don't get it. Anyone can claim my mom has _____. What does that mean. I don't in ANY WAY TAKE BACK ANYTHING I SAID ABOUT FIBROMYALGIA! It is COMPLETE BULLCRAP and is a code word in medicine for pain in the arse patient. If you don't believe me, ask another resident. For those who don't believe me, just PM in 4-5 years after you have had your share of these painful people.

i am so glad you're going into an area where you'll have practically no patient contact. sure, some patients are crazy and need psych referrels, but some people have legitimate pain. if you've ever had a loved one or friend with fibromyalgia, you'd be a bit more sympathetic.

 

[tigress]

Honestly can't ANY patient potentially be a "pain in the a$$"? I woman that's 41 weeks pregnant? A manic depressive who won't take their meds? An 85 year old women who won't let you perform a pelvic exam?? A man in the ER with an erection that won't go away? I'd imagine the list is endless and I haven't started med school yet!

That's so true. Even just a well child visit with annoying parents, or a chronic diabetic who has trouble complying with medications and such. I think a lot of medicine is probably a pain in the ass. At least the doctor I work with seems to think so. It's really sad, actually, that her clinic days are her least favorite days. She says she still loves seeing patients, but it's just such a hassle. But then one time I was a noncompliant patient (I didn't take medication as directed), and it really brought home to me the fact that everybody in the equation is just trying to do their best, usually. Most people don't WANT to be sick (sure there are exceptions), and they don't want to be annoying to the doctor, or be noncompliant, or whatever.

Not that any of that makes it easier for a physician going through the day who is faced with a particularly annoying patient. 😛

 

[Doctor Bagel]

Well fibromyalgia really is a pain in the ass. Sure, some of the patients are really sick. But most of them should be treated by a psychiatrist. That doesn't mean they don't feel real pain. They DO. But the pain is psychogenic in nature, which shouldn't make it sound like I'm saying it's fake. We take psychiatric conditions more and more seriously these days, but for some reason if you tell a fibromyalgia patient that their illness might be a physical manifestation of depression, they get pissed off for not taking them seriously. It makes no sense to me. We have a lot of evidence that many illnesses are affected by psychological state (Crohn's being well studied in this regard), so why can't illness be actually caused by a psychological state? IT CAN!
.

this is true, and it'd be nice if we got to a point where psychological illnesses had less stigma, so maybe these patients wouldn't be so offended. i wonder, though, if people who do think mental illness is a sign of weakness are people who are more likely to have their depression manifest itself in psychosomatic ways. personally, i've suffered from depression and have never had any symptoms of pain associated with it, but i'm always pretty willing to admit that i'm just depressed. of course my story is just anecdotal, but i do wonder -- i have lots of claimants who are on claim for probably psychosomatic pain issues, and my hunch is that most of them are pretty ignorant about mental illness and live in communities or environments where it's very stigmatized.

this is one reason why med/psych seems like such a cool field. non-somatic pain and depression play off each, too, so it's tricky. when your back hurts a lot because you have a diagnosable herniated disc, and you can't do the things you used to do because of your back, you might become depressed. then, your back hurts that much more because you start to focus on the pain and what's wrong in your life.

 

[cosmo]

.

 

[Rendar5]

are they faking seizures or having psychogenic seizures? Because the latter are a real type of seizures.

Well fibromyalgia really is a pain in the ass. Sure, some of the patients are really sick. But most of them should be treated by a psychiatrist. That doesn't mean they don't feel real pain. They DO. But the pain is psychogenic in nature, which shouldn't make it sound like I'm saying it's fake. We take psychiatric conditions more and more seriously these days, but for some reason if you tell a fibromyalgia patient that their illness might be a physical manifestation of depression, they get pissed off for not taking them seriously. It makes no sense to me. We have a lot of evidence that many illnesses are affected by psychological state (Crohn's being well studied in this regard), so why can't illness be actually caused by a psychological state? IT CAN!

Okay, enough of my ranting. Fibromyalgia is a pet peeve of mine, too. Not because I don't have compassion for the patients, because I definitely do. It sucks to have to live with pain and fatigue all the time. It's just that people get so upset if a doctor suggests that it might be caused by depression.

One thing that is a real pain in the ass in the neurology clinic where I work is people faking seizures. Apparently it's pretty common. I mean, obviously the patient has issues and deserves compassion, but a doctor can't help but feel manipulated when stuff like that happens.

If I get flamed too much for this post maybe I'll just delete it. I just wanted to defend Obedeli a bit (although he does seem a bit over-excited).

 

[Rendar5]

Great post and informative too! I don't think most people mind it when docs/future docs educate while showing compassion but when they don't, well let's just say that is a MAJOR petpeeve of mine.

Honestly can't ANY patient potentially be a "pain in the a$$"? I woman that's 41 weeks pregnant? A manic depressive who won't take their meds? An 85 year old women who won't let you perform a pelvic exam?? A man in the ER with an erection that won't go away? I'd imagine the list is endless and I haven't started med school yet!

I think FM patients can probably be more of a pain in the ass than other ones. guy w/ an erect dick for 4 hours? u can deal with it. U can see what's wrong, u can treat it, and they don't come back for it (unless they're a sickle cell patient and they'll come back for it when it happens again. and u can see their disease, it's apparent w/ lab tests. Fibromyalgia to a lot of people seems like a made-up disease made by a patient who is just complaining about made-up symptoms cause it's not readily apparent

And tigress, u say it's a result of depression. I know there's a strong connection, but is there anything which actually shows that depression is not secondary to FM? It's just a bad habit I see all the time from scientists who give us our info that they'll jump to cause-effect when they see association, and often just assume which is the cause and which is the effect. I honestly don't know much on the subject. Just wondering what the leading theory is and if it's been proven.

 

[45408]

I have three words: TAKE YOUR TIME. I know at least several people who are just now applying to med school at age 40! There's no reason to rush EVERYTHING at once, and in the process, accomplish NOTHING. Take things slowly - a few classes at a time. Build up good grades over a long period of time. Don't take 20 credits while working full time while raising two children - there just isn't enough time in a week. If you take 8 credits a semester, work a little less than full-time, and have your family (his mom?)/friends help with your children, this can be done.

Take the time to do things right.

 

[tigress]

are they faking seizures or having psychogenic seizures? Because the latter are a real type of seizures.

I'm sure we see plenty of psychogenic seizures in our clinic, but that's not what I'm referring to. I mean the people who KNOW they are faking their seizures and seem to just want attention or something. Like one (very large) woman once "had a seizure", and when the nurses came into the room she was grabbing them and almost hurt one of them, so one of the nurses suspected that the woman was faking and suggested that they get some ice and pour it on her (I guess that's the first thing the nurse thought of) so the woman looked at her and stopped "seizing." The nurse thought the woman was faking because of the way she seemed aware of things going on around her and was sort of talking even though she looked like she was having a grand mal seizure, and apparently was moving around the room in a purposeful way (sitting on things, not really falling, etc.).

And tigress, u say it's a result of depression. I know there's a strong connection, but is there anything which actually shows that depression is not secondary to FM? It's just a bad habit I see all the time from scientists who give us our info that they'll jump to cause-effect when they see association, and often just assume which is the cause and which is the effect. I honestly don't know much on the subject. Just wondering what the leading theory is and if it's been proven.

No, you're right, I don't have any proof. That's just my impression, and something that makes sense to me. It's very possible that depression is secondary to the FM. OTOH, often when a FM patient is given SSRIs she/he sees a significant improvement in the FM itself. That's why SSRIs are basically one of the first-line treatments of FM. And, like I said before, I think probably a certain percentage of "fibromyalgia" patients actually have some organic disease process that just hasn't been diagnosed. That complicates the picture.

In the end I guess we just always take patients as seriously as possible, and always try to be compassionate. Even the woman faking the seizure was doing it for a reason, and truthfully I do feel bad for somebody who feels they have to do that to get attention. But if I were actually in the situation, with the woman pulling on my ID strap around my neck and almost choking me, I would understandably be upset.

 

[Anastasis]

Well fibromyalgia really is a pain in the ass. Sure, some of the patients are really sick. But most of them should be treated by a psychiatrist. That doesn't mean they don't feel real pain. They DO. But the pain is psychogenic in nature, which shouldn't make it sound like I'm saying it's fake. We take psychiatric conditions more and more seriously these days, but for some reason if you tell a fibromyalgia patient that their illness might be a physical manifestation of depression, they get pissed off for not taking them seriously. It makes no sense to me. We have a lot of evidence that many illnesses are affected by psychological state (Crohn's being well studied in this regard), so why can't illness be actually caused by a psychological state? IT CAN!

Prob because mental illness has such a stigma in our society. Think about it, I know tons of people who think that depression isn't real, so by implying that something may be related to depression, in their minds, you're saying it's not real either.

Just a thought.