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Category Archives: Work

Pregnancy and ADHD…

You know that thing called pregnancy brain? You know that thing called ADHD?

In general, my state is the love child of the two of them. I feel hazy most of the time. I lose time, not knowing where it went and what I did with it. I forget things. I have trouble getting anything significant done. I am distracted.

And my hyperactivity is nowhere to be found. I feel hazy and a bit lethargic. I’m more tired than usual, I suppose that’s part of the why.

Class is a nightmare. I spend the day just trying to not fall asleep or fall off my chair. I can’t focus one bit.  Their way of educating me is still not a way in which I can learn… and I leave with muscle aches and a horrible mood.

I mean, I don’t want to complain too much and generally my mood is good, but there’s just this one part that is frustrating.

Next time I’m going to make sure to enter pregnancy with a better level of physical fitness.

Next time I’m going to have more of a plan set up before hand. Hah. Hah. Hah.

Next time I probably won’t be working irregular shifts though, that will help a lot.

Irregular shifts don’t help me at all, despite not doing nights. Having to plan every single day doesn’t work for me. I need some sort of structure in my week, so I can spend my scarce mental focus doing more important things than figuring out how and when I’m going to get my exercise in this week, for example, because most of my options are screwed over because of work.

 
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Posted by on November 23, 2015 in ADHD, ADHD in women, adult ADHD, Busy Baby, Work

 

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“I don’t believe in labelling kids….”

Today I gave a presentation about ADHD for my group of GP registrars. Just this morning I joked that instead of giving a presentation I should have filmed myself trying to make the presentation and just show that. By this time I am permanently off my meds and I think the max focus time for this presentation was 5 minutes. 

Still impressive that I managed to make something coherent out of it. Suppose it’s one of the things I learned it 29 years of ADHD: the skill to make a rough draft for a project in less than 10 minutes.

Anyhow. 

So these are a bunch of doctors. 

I was just running through some basic stuff. 

And two of them didn’t really believe in helping these kids by ‘labelling’ them. After all, if pedagogic measures can help some? 

I tried to explain that if pedagogical measures solve the problem there is no ADHD. That these kids need more guidance. That you help them to understand themselves and to deal with their relative impairments. Yes but doesn’t everyone have their issues? We all have to learn to deal with our issues. Yes, but you all don’t end up screwing up your life because of it. Aren’t they just lazy? No. 

Honestly, from one of them it made sense. She was in my mentor group and I feel like I get it now.

She doesn’t want to get it. 

Makes sense why my trying to explain my ADHD issues in mentor group didn’t help much. She wanted to hear that I use it as an excuse. She didn’t care that I only offered as an explanation while I struggled on to make things right. 

There wasn’t time for much of a discussion. 

I’m not really sure if I really was going to put in the effort. If people don’t want to hear they don’t want to hear. 

TDH reminded me that it didn’t matter because I know the truth.

Because to be honest, it’s hard not to take it personally despite the fact that I didn’t mention my own ADHD to the general group.

Then I was thinking. 

Perhaps I’d rather have ADHD than a mind that works like that. 

 

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One Flu over the….

How’s that?

I’m home sick. Yesterday evening I was feeling just too tired and could’t figure out why.
I was also feeling a bit emotionally labile….

This is what happens then:
1) I start getting frustrated with being low on energy
2) I may or may not cry because life is horrible enough to not allow me enough chance to do whatever I may think caused this fatigue. (Sleep, in this case). I never consider ‘illness’ as the primary problem, despite being, you know, a medical doctor. Har. Har. Har.
3) I start worrying about my mental health, solely because depression is one of the things I fear most. I get annoyed with myself for being ‘weak’.
4) I tally my options to solve whatever basic thing I think is the problem.
5) I worry about the impact of another bout of depression on my life.
6) I decide to eat healthier, get more excercise, and rest more.

7) It finally crosses my mind that, rather than some psychological issue, I may simply have caught some kind of virus. Or something somatic.
8) I decide to wait and see.
9) If I turn out to ‘have something’, I’ll still try and find ‘more healthy’ explanations for the problem. Illness is about the only thing where I maintain an avoiding coping strategy… I get stuck in denial.

In the past year and a half at least, option 7 was usually the outcome. But that’s the effect of having a mental health history. Mental health will never be something I can count on, my risk of a recurrence of depression is 95% based on general data, my risk of relapse in anorexia is somewhere along the same line. (Yet, at the moment, I can’t imagine relapsing into THAT. I just know the risk is there.) I have ADHD, that’s just how I’m wired, and that won’t change. (Though, adequate management of that may reduce the risk of the prior problems).
Meanwhile, somehow in life up till now, I’ve internalised a message that I shouldn’t whine, and that all physical complaints are whining. The problem with that is that, while I logically know this is not true and I am in fact more of a sucker-up than a whiner, I have a hard time taking my physical complaints seriously and taking proper care of myself.
It gets even harder when people respond with ‘it’s not that bad’ or ‘don’t complain’. I don’t complain, I mention a problem. I may not even ‘show’ it, because in the above mindset ‘acting normal’ is the only option. If I have, for example, a very painful persistent foot cramp somewhere, I will try to not show I’m in pain, try to subtly ‘walk it out’…. and I guess the impression is mostly that I’m weird rather than I’m in pain. If I matter-of-factly say I almost passed out from the pain, I mean I was trying to get somewhere while feeling like, for example, my belly is being crushed by an elephant, and the pain was so severe I had to sit down to prevent passing out.
It doesn’t help me to take my body seriously if any doctor who sees the above history thinks of ‘panic attack’ before thinking of ‘asthma’ if I am short of breath.

 

So back to yesterday. I was feeling exhausted. I put out my outfit for the morning, got stuff ready and went to bed, worrying that I may be pushing myself over my limits but not knowing how to solve it because really, I’m just a bit tired.
And then I couldn’t sleep.

Not because my mind was busy, my mind was remarkably quiet.

No.


I got a headache, but not my normal right-sided headache (mild migraine?), it bounced all over my head. Quite annoying. And all my muscles started hurting, making it very hard to be comfortable. Paracetamol didn’t help, but I did find myself hot then cold and going through chills despite 1000mg paracetamol. Was great fun. All started within 2 hours maybe.

And this morning my throat was sore, and come to think about it, my cough is no longer related to asthma. The latter had begun to stabilise after the cold or something I caught a few weeks ago… also turns out that an empty inhaler is pointless. Anyway.

I decided to be wise, and call in sick, hoping it would reduce my sick time, hoping the problem is just fatigue and I’ll be fine halfway through the day. I’m partly proud of myself, partly worrying that I’m overreacting and should have gone to work, partly trying to figure out when to go back to work and…. what I should get done when. That’s also a bit of a denial of the truth: I spent my morning in a painful feverish half-sleep, my main activity of the afternoon was to go to the grocery store (I live alone, and I need to eat if I want to get well sooner) where I sort of had a few dizzy spells and the whole thing was just awful and painful, my wrists hurt which makes writing a bit challenging (I can rest my wrists while typing) and in general staying upright is a challenge. And I am very very tired. And cold. Or hot. So no, I can’t expect to get much done. And I’m not sure how I expect to get through uni tomorrow either, that’s a bit more challenging than picking up something to eat, drink and some paracetamol.

I’ve had the flu shot…. hopefully it has at least SOME benefit….

 
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Posted by on April 14, 2014 in Random, Rant, Work

 

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Staff Frustration Desk

Confession: I nearly punched a lady today. And I need to vent, else I may end up punching her next time.

It started with an e-mail sent in January, telling us to have a badge made to access the uni buildings. The buildings belong to the academic hospital, and the badge needed to be made at the staff service desk despite the fact that we’re not staff. Oh, and we were only allowed to phone for an appointment (an appointment for something that is normally done without, yes) in March, after we started our programme.

Knowing that I will lose the info, I pinned it to my task bar in Gmail. The only problem is, I don’t see the task bar on my phone. Not in iPhone’s mail app, not in the official Gmail app. Considering I need to link the ‘to do’ to the email I found it a bit too complicated to have this task in my phone. Result: I only remembered when I couldn’t phone. And when I did actually manage to remember during office hours… I got no answer. And again. (This is a lovely example of people not getting how hard it is to get simple things done with ADHD, actually, especially if it’s combined with Murphy’s Law). Mind you, I had all the time in the world to phone them and phone them again and again in the last week of February. But I wasn’t allowed to.

So last Tuesday, I went to the actual desk to see if I could be helped. I went along with a co-worker who had problems with their ‘service’ (as in; the badge wasn’t working). There were 3 ladies, doing nothing. One tended to my co-worker. The other two watched. After a few minutes, I asked them if anyone was going to help me.

Lady: Oh, sorry, I thought you were just standing there along with her.

Me: No. I still need to have a badge made.
Lady: Oh. Do you have an ID document with you?
Me: Yes, my driver’s licence. (In Holland your licence is a valid ID. )
Lady: Oh, but I need an identification document, not an -(Eh, whadya know. The Dutch have 2 words for ‘identification’. Now how do I translate this then? )ID.  You have to make an appointment.
Me: sigh. Really? I have already tried to phone you guys a few times and now this.
Lady: Yes, sometimes we’re not available on phone. I’ll give you an appointment and then you bring something you can identify yourself with, such as your ID card or passport.
Me: The police accepts my licence as a valid ID, that’s why I no longer have an ID card! (I’m getting slightly irritated here). Well then, what do you have?
Lady: If you like, you can also phone for an appointment.
Me: I’m here now. I don’t like to phone you because you don’t pick up.
Lady does something in her computer.
Me, talking to co-worker (making a half-joke to help keel my cool): Well, if it’s about identification only, one could also show a foreign passport. Or foreign ID card. A passport is a passport.
Lady, chipping in: No, you can’t show a foreign passport. I need your social security number. That’s why I need your passport.
Me, slightly baffled: My social security is on my drivers licence, and you can actually use a drivers licence to do a social security check with. But I don’t even work here. (I am now also standing there with my pen in my hand and my planner open, mind you!)
Other lady, chipping in: It was on the news the other day, it’s true, identification is not the same as ID and we need your social security number because you get the same form as employees.
Lady: And we need your bank account number for the 15-euro warranty. And the same rules apply to you when it comes to ID as for employees: passport or ID, no copies.
Co-worker: come on, this isn’t worth it.
Me: Just give me the appointment please.
Lady: 8:30 tomorrow?
Me: I’ll see if I can make it, I don’t know where the class starting at 9 is but it should be fine. (Inwardly being irritated because this means waking up half an hour earlier)
Lady: You can just phone tomorrow morning if it doesn’t work out.
(Right. I have your number on speed-dial….)

So, the next morning I got up half an hour earlier, but ended up missing my train by a second. I decided to get some coffee and catch a later train to be on time for class, as there was no way I was going to be able to run for the 8:30 appointment anyway, as I was suddenly feeling really unwell. Inside Starbucks the cause of the unwell feeling became clear: I was having an asthma attack. No idea why, actually. Sorry service desk ladies, but breathing was actually more important than trying to search for your phone number in my e-mail and then being submitted to more of your nonsense.

In my head I would have gone back yesterday, but due to my work not being entirely predictable, I ended up having to rush to get to the physio.

Today I went back during lunch break. There was one lady. I don’t know if she was there the other day too; she looked like many Dutch women do.
I waited patiently for 5 minutes while she finished a phone conversation about the weather and the like. I waited another few minutes while she did another phone call, actually in order to not help a lady in front of me. (‘It can’t be done today’ is not helping).
She then stares at me without saying anything.
Me: Hi. I’d like to have a badge made.
She: You’d like to make an appointment for a badge?
Me: (slightly irritated by her rude approach): No, I want the badge. I have my passport.
She: We only work with appointments. I can give you an appointment to make a badge.
(Making a badge takes 5 minutes, for the record)
Me: Look, I have already spent too much time on this. I’ve phoned you several times, no luck. You couldn’t help me the other day, and I couldn’t make the other appointment due to an asthma attack. I don’t have your phone number any more. I am getting fed up with this. And you do work without appointments, you helped several of my co-workers without appointments.
She: Well, I can’t help you now, I can give you an appointment because there is someone else who I have to help too. This is a busy time.
(There was a nurse who just walked in. One other person, yes. You weren’t too busy to chat about the weather while I was waiting….)
Me: This is getting ridiculous. What time do you close this afternoon?
She: I can give you an appointment for 4pm, or 4:15
Me: I can try for 4:15, but I have a test which is supposedly till 4:30.
She: I need a time you are sure about. What day?
Me: I am a GP trainee, I have no times I am sure about because things tend to be unpredictable. I don’t work in the hospital, so I can’t just hop by. It’s hard to give you a precise time that actually works for me. (I check my planner, and see that the coming week is particularly hard. )
She: Well, just like the GP we work with appointments, so you have to make an appointment at a time you can be here. All your colleagues made appointments, you had a letter about it so you should know exactly what the rules are. There are too many of you, we can’t help you all at once, we only have that kind of thing for medical students because they come in groups. Most of you come on uni day. Tuesday 8:30?
Me: (concentrating too hard on not losing my temper by this time, swallowing my remark about walk-in surgeries and receptionists doing lots of stuff without appointments because I remember my co-worker’s ‘it’s not worth it’ remark from the other day. I’m boiling mad over her arrogance, rudeness and the fact that she’s actually lecturing me over this.) The letter was an e-mail, sent months ago, I no longer have it handy. I phoned, you did not answer. You helped some of my colleagues without an appointment. And I have no guaranteed time I can be here, I don’t live in Uni City. Tuesday 8:30 is not fine; I am on call the evening before. Tuesday lunchtime is not guaranteed because I’m working half a day and doing half at uni. My only possible option is Friday morning, I start work at 12, but that would mean coming in just for that.
She: Friday at 12 then?
Me: I start work at 12…
She: Friday at 9?
Me: Like I said: I have to come in especially for this and I’m not doing that at 9AM. 11? (calculating that I’d need to get to the practice too, it’s a detour to get to this hospital first. Still using all my willpower not to punch her) I can try and see if that works.
She: You can also phone in the morning, when you know how your day will work out.
Me: I won’t know how my day work out in the morning better than I do now.
She: Do you want to make an appointment now, or do you want to phone me in the morning when you know better how your day will work out and when you’re certain you can make it?
Me: Look, I’ve already wasted too much time on getting a badge. Can you give me the 11AM appointment, I’ll try to make it, that’s another hour of my free time, you know.
She: You can phone me when you know better too. I can give you the phone number again?
Me: (wondering what part of ‘unpredictable’ means it’s predictable in the mornings…) I am not going to phone you in the morning. Give me the appointment and I’ll try to make it.
She: Ok, next friday at 11 and don’t forget your ID and bank info.

Right. She had all the time in the world for this and chatting about the weather, but not 5 minutes to make the badge. She probably kicks on this ‘power’ she has, but she wasn’t worth the trouble I’d get in for throwing a fist at her, even though she deserves to find out just how mad she makes people. Thanks to her crap, I was late back at class. And I finished the test at 4PM, but showing up to get it sorted out would not have worked. I didn’t ask for her manager, I wanted to get to class.

And now my ADHD mind has to remember to take the right form of ID with me on Friday because I’m not carrying a passport with me at all times. And I have to waste my morning off on this crap. I tried to file a complaint against them, but the university hospital website has no easy access to info like that, and phoning them via the general number is pointless. She has no idea how complicated it is for me to get there with all the stuff at 11AM on Friday morning. And that will actually be over 2 months this simple task, that needs to take no more than 20 mins total including phoning them, has been on my mind. I can think of so many things I’d rather do than leave home an hour early in order to deal with their crap just to get a badge I’m not even sure what I need it for.

None of the ‘reasons’ they gave me is true. In fact, I doubt there is any real reason why my licence wouldn’t do, other than the institute’s bureaucracy. Fair enough, simply saying there’s nothing she can do would have done.   While another person may have responded less impulsively, this kind of behaviour from her side would have had them fired at McDonalds. I would fire them if they spoke to my patients like that. The whole idea of a staff service desk is to sort stuff out for people, not to bully them.

And I still want to hit her. Shake her. Scream at her. It’s not even really about personal offence, I am mostly frustrated because I can’t just get this simple task done. It’s about the ridiculousness of the situation, and the stupidity of the fact that these women can do this. I don’t want anyone else to deal with it.

 

So, dear Large Institute University Hospital: I think you need to re-source the humans in your human resource team. This deserves a price for most kak service of the year.

 

 
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Posted by on March 28, 2014 in adult ADHD, Random, Rant, Work

 

The troubles of ADHD and going back to uni…

I’ve been in the specialist training programme for two weeks now, and while it’s pretty serious stuff, I can’t help but find myself funny sometimes…. I’m just trying to manage and make it work with my alternative mind…

* Today I got startled by the same prank dummy three times. When I see an elderly person on the floor, my first response is Safety-ABCDE…  So essentially I almost resuscitated a dummy filled with toilet paper three times.

* Then, when I was supposed to use a test patient at the out-of-hours-service intro course, I actually managed to open a real patient file. Hey, how was I supposed to know Testington (altered name but you get the point) was a real name?

* I’ve spent two hours trying to read the assignment. I started panicking when it required me to read ‘chapter this and this’ in a book on communication skills. I still don’t know exactly what the assignment is, my plain text retention is that low. And then I got frustrated when, at the end, they mentioned the system used at my uni. All this frustration for something I already know. 

* I still haven’t gotten round to reading a book about talking.

* Step 1 in my assignment was: reread literature and notes from med school on communication skills. Communication skills was a do-class at my uni, and while we had literature I suppose it was all in the uni library. I may have looked at it because ‘you will be doing a simulation of a bad news convo tomorrow and we’ll be filming you’ is pretty motivating to look for a few tips if you’re in second year. I threw out all my lecture notes because I moved a few times in between. But, always keen, I dug into my cellar box. No lecture notes, no hidden and forgotten literature. What I did find was an evaluation booklet for my Internal Medicine clinical rotation….

* Speaking of communication skills, I find watching Scrubs quite useful.

* Speaking of lectures, I think I was pretty bad at attending those anyway.

* Meanwhile I’ve figured out about 5 creative ways to examine children who are bent on not being examined.

* I got myself a new planner, as I already lost overview of my small one.

* Apparently my ‘if all else fails please read instructions’ approach scares others in my group. I suppose it does require, ahem, a special kind of mind. We did a learning style test, and I was all in the ‘experience’ learning corner. Yes, I may jump in first, but that doesn’t mean I’m not observing and thinking WHILE jumping. My IQ can keep up with my ADHD if required, remember? And thanks to hyperfocus I can learn more in 5 minutes than others can in 20, linking it to all of my senses if I’ve just experienced the problem.

* Channeling my ADHD actually makes for a few brilliant differential diagnoses. And a doctor who is razor sharp in case of emergency (adrenalin still beats concerta by far!).

* That being said, I’m on new territory for me. I’ve spent most of my career so far dealing with extremes. I’m insecure, and I find myself being truly surprised when people ‘buy’ it because I’m still wondering if I’ve missed something….

But, what I do find absolutely fantastic is that I’m not the only one in this job who isn’t perfect. I’m not the only one who doesn’t have all the answers, in fact, I’ve been told that I’ll never outgrow the occasional foot-in-mouth-moment in general practice. It’s a combination of run-of-the-mill things, surprises, personal stories, puzzles, brilliant ideas and what-the-hell moments. Definitely not for the faint-hearted. It’s guts, grace and genius combined.

 

 
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Posted by on March 17, 2014 in ADHD, General Practice, Work

 

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The up side of night shift…

… whether or not you have ADHD, mind you.

– It’s the only opportunity you’ll ever have to make double money while sleeping. If you get the chance to have a nap, that is.

– You’re part of the secret world of the night… the streets are quiet, the houses are dark. The night shift comes out to play…. While crazy remains crazy, there seems to be an extra spooky factor added.

– Daytime, when everyone else is working, is surprisingly quiet for sleeping!

– Time actually seems to fly when you’re half hazy and slow… probably because you’re slow.

– It’s the only time when Here comes Honey Boo Boo becomes interesting.

– At some point sleep deprivation makes you feel high as a kite. Drug fee. Talking to me the day after night shift is like being in the Circle on That 70’s show. Which also is a good show to watch during night shift.

– It makes you appreciate sleep more. In fact, getting to bed on that first night out is just about orgasmic. And it’s the only time you can be fully excited about going to bed and sleep anyway despite the excitement. There is no better night’s sleep than that first night out!

– People admire you: they could never do that. Unless they have to, I suspect.

 
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Posted by on February 24, 2014 in Acute Psychiatry, Health, Work

 

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Shift work and my four-letter-thing

It’s 3:30 AM and I can’t sleep.

It’s 3:30 AM on a Friday morning, exactly 6 days and 12 1/2 hours after starting work after a glorious 4 weeks of normal rhythm…

And I am screwed.

I can’t sleep because shift work shifted me out of my natural rhythm, stealing my sense of when I am.

Sleep deprivation worsens my ADHD symptoms, even the kind of qualitative deprivation caused by, well, getting too bed too late and missing out on those melatonin rich hours before midnight.

I tried to relax and get ready around 11PM. I got distracted, my body no longer responding to ‘I am tired, time for bed’ because with shift work it can’t afford to. Supposedly I should listen to the clock…. Except that time as dictated by a clock has no inherent meaning to me. Listening to a clock costs a lot of attention, something I don’t have when sleep deprived.

I see a circle.

To make it worse, my home is once again crashing into chaos because I am too occupied with just getting through the day, tired and trying to figure out when I am. I used to have a plan, but I lost it in the chaos.

My GP got a little frustrated about me trying to take care of all of my business in one go. I tried to explain that I needed to, before chaos happened. She didn’t get what I was saying, thought I meant I wanted to sort stuff before my training starts.

No, I just needed to ride the wave of relative normalcy and energy before this happened again. Because for example, I still hadn’t made an appointment with the podologist, over a week later, and I really don’t know when I will manage to. It just landed on the massive stack of ‘didn’t get round to in the few days I had’.

The hard part is I have to get my shit together with low energy and no concept of time or regularity. My rather extreme irregular schedule left me incapable of remembering what I am doing the next day, I have no reference to remember it by. I used to be pretty good at that. No point to even try using Sundays as a reference; as a friend suggested… Sunday could be just a work day too. Managing to get myself to church is a massive accomplishment.

And then there is the part where fatigue and confusion and enhanced ADHD screws my plans and makes fun into stress. It’s valentines day. Plan (fun) was to surprise TDH with a living room picnic. I had already forgotten all my brilliant ideas, and now I will be stressed out tomorrow trying to get just a normal meal done because that’s what happens. I am behind on my housework; and I wanted to make something special out of my living room. I have no idea what to cook.

I have no idea what to do in general; this shift work thing severely impairs my limited ability to plan, execute my plans or to simply get anything done.

I can’t concentrate anywhere outside of work. Work is pretty much a clear cut setting. So, yes; I am functioning at work. Yet; my private life is crashing and burning and I am being frustrated by how little I get done. And how overwhelming simple tasks have become; tasks I did while on the phone a week ago.

And then TDH isn’t really helping me set a date for stuff, and I need him, so that’s another thing I’ll worry about and then probably forget.. Only to remember when it’s too late. That’s why I tried to sort it out TODAY.

Because everything is just too much when you combine ADHD with shift work. (Well, in my case anyway)

 
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Posted by on February 14, 2014 in ADHD, Health, Work

 

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