Would this keep someone from becoming a doctor?

[Mastashake]

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I was reading something about the long hours that residents put in, and its making me very scared...

I have a sleep problem. I need large amounts of sleep to function. Sometimes I still feel tired after 10 hours of sleep at night, and I hate the fact that I can't sleep on less. I've tried to deprive myself in the past, only letting myself have four hours or something like that, but the problem is I start falling asleep throughout the day. I've actually gotten into an accident from falling asleep at the wheel (fortunately for me, I was safe, my car received minimal damage, and the people in the oncoming lane I spun out into were able to stop).

I was told by an ex of mine that I stop breathing during the night numerous times. This tells me I have sleep apnea, I would think. But that's neither here nor there. I really want to become a doctor, but I'm afraid my constant fatigue and need for sleep will keep me from realizing my dream.

I'm not looking for medical advice. But I would like to know if some of the residents here had this same problem, how they would try and address it. Its so frustrating to not only be able to sleep so much, but feel like I need to in order to function. I'd hate to think of myself falling asleep in crucial moments of dealing with a patient (I'm sure I'd be fired), and considering I REALLY want this, it would be so painful if this kept me from realizing my dream.

 

[Winged Scapula]

Regardless of whether or not you are looking for medical advice, I am going to give you some.

It sounds like you have a problem which is interfering with your life and placing you and others in danger. Therefore, it warrants work-up and this would be true if you were telling me that your life's dream was to work in a bowling alley, rather than be a doctor.

 

[Korrigan]

I was reading something about the long hours that residents put in, and its making me very scared...

I have a sleep problem. I need large amounts of sleep to function. Sometimes I still feel tired after 10 hours of sleep at night, and I hate the fact that I can't sleep on less. I've tried to deprive myself in the past, only letting myself have four hours or something like that, but the problem is I start falling asleep throughout the day. I've actually gotten into an accident from falling asleep at the wheel (fortunately for me, I was safe, my car received minimal damage, and the people in the oncoming lane I spun out into were able to stop).

I was told by an ex of mine that I stop breathing during the night numerous times. This tells me I have sleep apnea, I would think. But that's neither here nor there. I really want to become a doctor, but I'm afraid my constant fatigue and need for sleep will keep me from realizing my dream.

I'm not looking for medical advice. But I would like to know if some of the residents here had this same problem, how they would try and address it. Its so frustrating to not only be able to sleep so much, but feel like I need to in order to function. I'd hate to think of myself falling asleep in crucial moments of dealing with a patient (I'm sure I'd be fired), and considering I REALLY want this, it would be so painful if this kept me from realizing my dream.

Not to offend you, but this post displays some of the arrogance that many patients have these days concerning their own medical problems OR their lack of understanding of the intense training doctors receive. You seem to want to be a doctor and are practicing diagnosing yourself, i.e. you "feel" that you have sleep apnea.

You may be right, but believe me that you have no idea what having sleep apnea means. Sleep apnea is a silent epidemic, it kills many people and is linked to various manifestations such as pulmonary hypertension. A primary care physician would probably have you do a sleep study which could identify sleep apnea, or another problem. Your family practice doctor could explain to you the physiology of sleep apnea and pulmonary hypertension and how this disease really could kill you, but nobody has time for that. You actually do need to go to your doctor as you appear to have a medical condition. No one on SDN can diagnose you without examining you and most likely doing a sleep study.

What does your post say? It says that number one you are too arrogant to go to a doctor, (or too ignorant), and completely ignorant that residents can not offer you good medical advice over an internet forum. Secondly, you don't have appropriate concern over killing people on the highway or about falling asleep on a patient in only how it relates to you, i.e. that you might be fired.

I have read literally thousands of pages of medical text and read a ton of articles a week, and I get a relative of patient standing in a room of a patient telling me that they don't understand my diagnosis and think it must be something else. For them I would politely explain some pathophysiology when I could be using the time to check up on other patients.

For you I would say that you should consider that you have an unscientific irrational approach to your own care and are very ignorant about what illnesses can hurt you and also ignorant about what treatments are available and don't understand the seriousness of your condition. Please go to a doctor, before killing my one of my kids on the freeway.

 

[Decepticon]

What does your post say? It says that number one you are too arrogant to go to a doctor, (or too ignorant), and completely ignorant that residents can not offer you good medical advice over an internet forum.

Or maybe he/she wanted to avoid a lock-up of the thread, due to admin viewing this as a seek for medical advice, which goes against the forum rules.

I have read literally thousands of pages of medical text and read a ton of articles a week, and I get a relative of patient standing in a room of a patient telling me that they don't understand my diagnosis and think it must be something else. For them I would politely explain some pathophysiology when I could be using the time to check up on other patients.

I understand that this is a hassle. But bear in mind that doctors do mistakes all the time, and that many patients feel more comfortable when they have a more thorough explanation of the condition. I think it is kinda sad when a patient has to be a professor on diplomatic discussion, to avoid stepping on a doctor's toes, if he/she seeks full understanding of his/her condition.

And if the questions themselves are a function of character traits, you aren't very likely to be of medical help by blaming people of e.g being arrogant. I am speaking to you from a PATIENT perspective, I am sure that you have read 10000 pages on this already.

For you I would say that you should consider that you have an unscientific irrational approach to your own care and are very ignorant about what illnesses can hurt you and also ignorant about what treatments are available and don't understand the seriousness of your condition. Please go to a doctor, before killing my one of my kids on the freeway.

I think coining your advice as personal accusations might not be the best way to persuade Mastashake to see a doc. But perhaps your experience is different. And perhaps it feels good venting.

 

[nonesuchgirl]

Regardless of whether or not you are looking for medical advice, I am going to give you some.

It sounds like you have a problem which is interfering with your life and placing you and others in danger. Therefore, it warrants work-up and this would be true if you were telling me that your life's dream was to work in a bowling alley, rather than be a doctor.

Seconded, big time.

The next time you fall asleep at the wheel, you- or someone else- might not be so lucky.

 

[RTrain]

Not to offend you, but this post displays some of the arrogance that many patients have these days concerning their own medical problems OR their lack of understanding of the intense training doctors receive. You seem to want to be a doctor and are practicing diagnosing yourself, i.e. you "feel" that you have sleep apnea.

You may be right, but believe me that you have no idea what having sleep apnea means. Sleep apnea is a silent epidemic, it kills many people and is linked to various manifestations such as pulmonary hypertension. A primary care physician would probably have you do a sleep study which could identify sleep apnea, or another problem. Your family practice doctor could explain to you the physiology of sleep apnea and pulmonary hypertension and how this disease really could kill you, but nobody has time for that. You actually do need to go to your doctor as you appear to have a medical condition. No one on SDN can diagnose you without examining you and most likely doing a sleep study.

What does your post say? It says that number one you are too arrogant to go to a doctor, (or too ignorant), and completely ignorant that residents can not offer you good medical advice over an internet forum. Secondly, you don't have appropriate concern over killing people on the highway or about falling asleep on a patient in only how it relates to you, i.e. that you might be fired.

I have read literally thousands of pages of medical text and read a ton of articles a week, and I get a relative of patient standing in a room of a patient telling me that they don't understand my diagnosis and think it must be something else. For them I would politely explain some pathophysiology when I could be using the time to check up on other patients.

For you I would say that you should consider that you have an unscientific irrational approach to your own care and are very ignorant about what illnesses can hurt you and also ignorant about what treatments are available and don't understand the seriousness of your condition. Please go to a doctor, before killing my one of my kids on the freeway.

This seems uncalled for, IMHO. WS already strongly suggested to the OP that s/he see a doctor, which is excellent advice. The OP is a pre-med and is not trying to hide that fact or present him/herself as having more medical knowledge than s/he really does. Obviously the question touched a nerve with you, but a good-faith question here from someone with less knowledge than you is not the same as the patient who comes to clinic with a stack of printouts from the internet to tell you how to treat her.

P.S. It's silly to start with "Not to offend you, but..." when that statement is always followed with something that is almost guaranteed to offend or insult.

 

[lexrageorge]

...
I have read literally thousands of pages of medical text and read a ton of articles a week, and I get a relative of patient standing in a room of a patient telling me that they don't understand my diagnosis and think it must be something else. For them I would politely explain some pathophysiology when I could be using the time to check up on other patients.

...

So, a pt. doesn't understand your diagnosis, and you feel put out that you have to take some time to explain?

As an aside, I personally know of one case where the primary doc refused to biopsy a woman's mole, saying it was just a benign skin blemish; it turned out to be melanoma, and the woman eventually died from it. So, don't be too suprised when patients question your holy wisdom that you hand down from on high.

 

[Korrigan]

I happily answer patient's questions about their diagnosis, healthcare, etc. . . But the OP on this forum shows a certain tone of irresponsibility that needed to be nipped in the bud with some tough love as perhaps hundreds of people could read it and think that they could just find a way to "deal with" whatever sleep disorder they have like narcolepsy or sleep apnea. It was an irresponsible post for the poster to make and sorry, I wouldn't have done this in college.

Sometimes with some patients you have to tell them point blank that their hemoglobin A1C of 14 (seen it) will cause them to die early. There aren't any ways to sugar coat this. I had a patient like this and had to tell them that they run a high risk of becoming blind, having a heart attack, kidney disease, etc . . . talk with them about their relatives who died in their forties from diabetes. They told me that no one every explained it to them like that before in such detail and didn't know they could lose their eye sight, just that their doctor told them that their HgA1C was too high! If you can't tell patients how they are obviously running a risk then you shouldn't be in medicine IMHO.

There is a lot of denial in medicine and you will see patients who refuse to believe that they have a serious medical illness, don't take their medications, and then die. BTW, I would be happy to consider biopsying almost anything a patient was concerned about regardless of my estimation of he chance of malignancy.

 

[Korrigan]

So, a pt. doesn't understand your diagnosis, and you feel put out that you have to take some time to explain?

I meant that sometimes patient's don't believe the diagnosis but don't ask for a second opinion and start to denial their illness. I happily explain to my patient's the diagnosis, I haven't felt "put out" sometimes frustrated, but obviously as a physician you will have uncomfortable feelings and that is beside the point, it is what you do that matters.

 

[michaelrack]

I But I would like to know if some of the residents here had this same problem, how they would try and address it. .

I have treated many doctors with sleep problems, mostly attendings, but also a resident or two. The way they addressed it was they went to their primary care doc who referred them to me, or they called my office directly.

 

[Mastashake]

Not to offend you, but this post displays some of the arrogance that many patients have these days concerning their own medical problems OR their lack of understanding of the intense training doctors receive. You seem to want to be a doctor and are practicing diagnosing yourself, i.e. you "feel" that you have sleep apnea.

For the record, the only reason I haven't gotten confirmation on this is because I don't have any health insurance. Sleep studies are well into the thousands, as are CPAP machines. I have a feeling, nothing more, that apnea is my problem as I've been told I stop breathing numerous times through the night, so I just threw this tidbit in here as a detail.

Whether its apnea, or narcolepsy, or I'm just a heavy sleeper I feel is irrelevant to the question I asked. I appreciate your response, and I actually agree with you that this is something I should get taken care of, if I only knew how (and I'm NOT going to ask that here, because it is an inappropriate place to do so.)

I have treated many doctors with sleep problems, mostly attendings, but also a resident or two. The way they addressed it was they went to their primary care doc who referred them to me, or they called my office directly.

Thank you very much sir, and thanks to everyone else who answered my question, including you, Dr. (not Mr. 🙂 ) Scapula.

BTW, I no longer fall asleep at the wheel. When my condition first started it I would try and push myself and ended up getting these results. Now I make sure to get plenty of sleep, and PULL OVER when I'm feeling drowsy, no matter what. Believe me, it scared me way more than it scared you guys to be drifting off behind the wheel... 🙁

 

[Pinkertinkle]

Are you overweight?

 

[Incandescent]

For the record, the only reason I haven't gotten confirmation on this is because I don't have any health insurance. Sleep studies are well into the thousands, as are CPAP machines. I have a feeling, nothing more, that apnea is my problem as I've been told I stop breathing numerous times through the night, so I just threw this tidbit in here as a detail.

Whether its apnea, or narcolepsy, or I'm just a heavy sleeper I feel is irrelevant to the question I asked. I appreciate your response, and I actually agree with you that this is something I should get taken care of, if I only knew how (and I'm NOT going to ask that here, because it is an inappropriate place to do so.)

Thank you very much sir, and thanks to everyone else who answered my question, including you, Dr. (not Mr. 🙂 ) Scapula.

BTW, I no longer fall asleep at the wheel. When my condition first started it I would try and push myself and ended up getting these results. Now I make sure to get plenty of sleep, and PULL OVER when I'm feeling drowsy, no matter what. Believe me, it scared me way more than it scared you guys to be drifting off behind the wheel... 🙁

to the OP -

your profile says you are pre-med...are you a student? perhaps you could be seen at your university/school health center for a discounted fee.

check the internet for any free clinic in your area and they might be able to help you get the care you need. is there a medical school nearby? perhaps the med students run a free clinic.

or, save $100 and make an appointment with a general internist. don't NOT go because you assume you'll need a sleep study. maybe you won't. maybe it isn't sleep apnea. how will you know for sure until you are seen? get the preliminary eval, and perhaps your internist can help you get the care/studies you need from there.

but make no mistake, you need care. your health is important - stop at NOTHING to try and get access to medical care.

Good luck.

 

[Incandescent]

I have read literally thousands of pages of medical text and read a ton of articles a week, and I get a relative of patient standing in a room of a patient telling me that they don't understand my diagnosis and think it must be something else. For them I would politely explain some pathophysiology when I could be using the time to check up on other patients.

This is terrible. Explaining disease processes to patients and their families is your f*cking JOB as a physician. It is ABSOLUTELY a part of your job description.

Stop whining and making the rest of us - who also read thousands of pages and read tons of articles - look bad.

 

[Mastashake]

Okay. I have an appointment for this very issue Monday. I go to a semi-free clinic, and the guy there is really cool. I've also been told to get insurance if for no reason other than to only have to pay my yearly deductible. But that's REALLY off topic. Thanks for the concern, anyway. You all are or will be truly great physicians if you're willing to put the time and effort into posting for some guy on the internet like me, especially with everyone's busy, busy schedules. 🙂

But with that, I think this conversation should end. Its not that I don't appreciate the responses, but I really don't want to get banned or something because someone thinks I'm asking for medical advice. I'm really sorry if it seems that way, I did my best to keep the focus of the conversation on how to overcome adversity rather than the cliche, "does this look like a rash to you?" sort of medical advice question. 🙂

I'm not a kiss up (I get kind of silly and crazy in the unmoderated forums), but I really like this message board and don't want to get in trouble. But I can't thank you guys enough for the advice, and empathy you have shown towards me. But since my initial question has been answered, I will gracefully bow out of this thread, and bid you all adieu. 🙂

Edit: Also, thanks for refreshing my self-confidence (I WILL DO THIS!), also. I guess my problem is very insignificant to some of the issues others face (autoimmune diseases, diabetes, etc.) At least mine can be treated, and with minimal compromise to my everyday life. I guess I am grateful for that, and everyone's posts, even some of the harsher ones, have told me that this is really not a big deal, and can be treated. Most of all it shouldn't under any circumstances be something that stands in the way of me and my lifetime goals. 🙂 THANKS FOR THE MORAL SUPPORT, it was EXACTLY what I was needing!

 

[Blade28]

Just a gentle reminder for everyone to keep this discussion (and all others in SDN) civil in the future.

As the OP's original question has been answered and "I think this conversation should end" was posted above, I'm closing this thread.