Gynecologists and spilled iced tea. Honestly.

This piece is inspired by hubby-to-be working late, a relaxing massage from my fantastic coworker, and one too many local craft brews. I want to take you on a journey from the Spring of 2015.

I am anxiously sitting in the waiting room of the gynecologist’s office. Many of you may know that us women have a majestical organ that can grow human life, but also requires an annual oil change. The nurse calls my name and I follow her to the exam room, barely staying upright on my jello legs. At this period of my life, my anxiety was still quite welcome and made a daily appearance. Pair that with a stranger, cold metal, and you have a damning combination. My blood pressure was so high that the sweet nurse looked quite frightened. What can I say? I like to keep people guessing. Anyway, I made it through the appointment and wobbled to the parking deck to retrieve my dignity and vehicle. I drove out of the deck, only to realize it was a cash only payment system. Let’s be honest…I have not carried cash since 2004. So, I had to promise to mail a $5 check to the cashier within one week. MAIL A CHECK, PEOPLE. I did mail such check because my catastrophic thinking pattern convinced me if I did not send in the money I would go to prison and rot on death row. I digress.

I scheduled another appointment right after the doctor’s office because that is a great idea when you are riddled with semi-crippling anxiety. My meeting was with the Physician’s Assistant I was going to shadow in the upcoming fall for my clinical rotation in my Masters program. It was my duty to find a health provider, set up a meeting, and create a mentor-style relationship. My logistical mind decided that the gyno and this medical facility were close in proximity so it would make perfect sense to schedule them on the same afternoon. My anxious brain quickly vetoed the idea, but canceling was not an option.

I wore workout clothes to the gyno appointment because who doesn’t want their doctor to think they are a stellar, fit, healthy human who works out for 329 minutes a day. So, I packed a cute business casual outfit for my meeting with the Physician’s Assistant. I decided to run to a Chick-fil-a and enjoy a quick lunch. Unfortunately, nausea used to be a common anxiety manifestation…so I was essentially dry-heaving chicken nuggets in the parking lot. Casual.

Now comes the time to change outfits. All goes well. I decide to take a nice sip of my iced tea and then it happens. The lid cracks and dark brown liquid pours all over my white chiffon blouse. In panicked mood, I exit my vehicle to look to see if I have another shirt in the trunk. As I step out of the vehicle, my high heel gets caught in a grate in the road. My heel snaps off. So now, I have one broken pump and a stained shirt. The time crunch is kicking in and I need to make a decision. I decide to put on the workout clothes in the hopes this prospective teacher will see me as a sassy fitness guru.

I enter the office and ask for the Physician Assistant. The receptionist asks me if I am a patient. Not a good start. Fast forward…I met with him…it was a decent interaction…I cried all the way home.

What is the point to this story? Perhaps my judgement is clouded by the hoppy deliciousness of local beer. The point is this…it is really not that serious. I ended up having another preceptor take me as a student, graduate with a 3.9, and got a job. It always works out. Even the moments that feel chaotic and overwhelming always lead to the correct path. Anxiety makes the small moments hard and gives too much power to stupid and trivial things. None of it matters in the long run. It always falls into place. I wish I would have learned to take things less seriously…but now I value that knowledge. Laugh at yourself, at the world, at this blissful chaotic thing we call life.

Love and Light.

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For fellow craft beer enthusiasts…this Thai Wheat by Second Self is stellar. Cheers to not taking life too seriously

 

 

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“Crazy” is in this year.

Over the past 80 years, there has been a constant rise in the prevalence of anxiety and depression and no one really knows what is causing it. Let that permeate your mind and sink in. This year, I have treated about 1,000 patients in primary care/urgent care settings and 30% of them have a history of anxiety or depression. That data is staggering. My school requires me to input data into a server that organizes information for us to see trends and learn about common themes in healthcare. When I adjusted the settings to display the ratio of patients:mental health issues, I felt a surge of intense questioning. The Association of Anxiety and Depression claims that the prevalence of these disorders is significantly lower. Why?

Perhaps people who are feeling depressed or anxious are more likely to seek medical care, thus skewing the data? Regardless, why are we seeing this dramatic increase and why is this not considered a massive public health crisis? Most of my adult life has been dedicated to questioning things and annoying most of the people around me with my theories…BUT THIS IS A BIG DEAL, Y’ALL.

My database has tangible evidence that suggests about 1/3 people deal with anxiety/depression. I believe that number is even higher because of the lack of accurate reporting. A lot of people do not have the self-awareness to even recognize something is off with the mind and psyche, so who is to say 1/2 of people are actually on this mental health train?

I want to play a guessing game with you. Think back to the last time you saw a medical provider. Perhaps it was your annual physical or an episodic meeting. Did your provider ask you about your mood/stress/energy? As a future provider, I recognize that time is of the essence and you can not perform a full blown psychoanalysis on every patient. With that being said, I value the importance of a handful of screening questions. I try to ask my patients, “how is your energy level during the day/how are you handling your stress/what do you do to for self-care?” It takes about 2-3 minutes and opens the door for a emotional connection.

 

When time permits, I love to teach patients about stress management through alternative methods: belly breathing, guided meditation, and yoga. All this is hunky dory, but back to the point…

What is causing the constant rise in anxiety and depression?

Unsolicited advice/theories I developed that probably hold 7% scientific value:

  • technology
    • after a weekend in the woods, my mind and body are in such a calm state. Being off the grid and “disconnected” is therapeutic for my adrenal glands and neurotransmitters
    • social media (I REALLY spend too much time on that crap) is a forum for “look how amazing I am” and drives feelings of inadequacy
  • food
    • our culture sucks at eating, let’s be honest
    • the era of processed food, sugar, add added hormones is essentially destroying our brain’s ability to regulate emotion and stress hormones…no big deal
    • hypoglycemia can mimic feelings of anxiety and that tends to be an issue when we eat such a high sugar diet–leading to fast metabolism of food and a massive blood sugar crash (you should probably apologize to your pancreas)
  • birth control
    • who doesn’t love good old oral contraceptives…ok, ok, too far, I get it.
    • the estrogen component in most OCP is detrimental to the mind
    • my anxiety was drastically reduced when I changed to a very LOW dose of estrogen
    • all the smart brain docs tell me that estrogen negatively impacts serotonin and norepinephrine
  • lack of community
    • although we are the most “social” generation via social media, we are actually the loneliest
    • in the 1930s-1950s, farming was a critical aspect of society and most people lived on land with many family members and spent very little time alone
    • some people believe that a large social circle will buffer the impact of anxiety/depression, thus serving as protective
    • when is the last time you drove to someone’s house to talk to them instead of text them? Exactly.

My commitment to the medical community is to discover trends and determine how I can make a tiny positive impact in the world. Maybe that is through developing more screening guidelines or writing a self-care novela as a free gift with purchase. “Thanks for getting a Pap today, enjoy your free guide on how to take care of your mind and body.” All jokes aside, I have a lot of questions and a lot of energy to figure them out (thanks to the shit ton of green tea I guzzle). I want to solve this dilemma and save the world. All in a day’s work.

Why do you think we are seeing the consistent rise in anxiety and depression? Comment below!

Love and Light.

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Sources: (http://nymag.com/scienceofus/2016/03/for-80-years-young-americans-have-been-getting-more-anxious-and-depressed.html)

Hybrid.

Modern medicine tends to fixate on diagnosis and treatment, whereas a wellness lifestyle focuses on education, self-awareness, and prevention. Instead of merely treating disease, the wellness lifestyle addresses its causes-what lies beneath the disease and its symptoms.

-The Essential Life

In 5 short months, I will be a family nurse practitioner. My journey in medicine started a decade ago when I began volunteering at a local hospital. At the ripe age of 16, I learned about getting my hands dirty. I mean that metaphorically and literally. Seeing patients in the hospital fascinated me. During a lunch break, I ate my stale bagel and reflected on my experience.

Why did she wait so long to get a check up? Why did he give up on his health? Why doesn’t she seem to care about what is happening to her body?

My thoughts were, perhaps, non-traditional lunch break thoughts. However, I was truly curious why people waited until the brink of death to seek help. I grew up going to the doctor for annual check-ups and learning that preventative health was important. I understood that physical fitness and healthy foods were important. I have carried those core values into my professional life.

So, the question of the hour is this…can you achieve wellness by practicing both complementary and traditional medicine? Is there a market for the nurse practitioner who will prescribe:

  • increased physical exercise
  • essential oil diffusion for stress management
  • antibiotics for strep throat

The hybrid of preventative medicine, wellness, and disease management is possible. I’m just not sure how to achieve it. I see the value in both practice styles. The benefits of holistic, complementary medicine:

  • patient autonomy
  • inexpensive interventions
  • 1,000s of years of anecdotal experience
  • natural
  • less extreme side effects

Let’s play devils advocate and discuss benefits of traditional medicine:

  • societal support
  • greater amount of evidence based practice
  • variety of double-blind research studies
  • mainstream education through medical school
  • quick support/treatment of a variety of illnesses

Healthcare is broken in this country. Again, that is a post for a later time. Could a hybrid of eastern/western medicine be the answer to change our health? As Americans, we are some of the most unhealthy people in the world. Participating in a culture of prevention, rather than treatment, will augment longevity. In a perfect utopia, this is how I want to practice medicine:

55 year old patient presents to the clinic with an acute upper respiratory infection. The patient is very physically active, eats a balanced diet, and denies smoking/drinking. My plan for this patient would be to diffuse Doterra On guard+Breathe at night and prescribe traditional pharmacology (inhalers, steroids.)

Is it possible to create this crossbreed of medicine? If any incredibly rich people want to fund my research, do not hesitate to reach out 🙂

My greatest wish is to see people take care of mind, body, and spirit. Treat yourself kindly and create a body that is strong and healthy. When you do get sick, I am here for you…but take the first steps towards prevention and wellness!