what did I accomplish today?

Umm…nothing?

For someone who led such a high intensity life only a few years ago, I still can’t get accustomed to this new reality. I’m way too young to retire but I had worked at such a pace for so long that I FELT ready to retire! I hadn’t taken any meaningful break since I was 18 years old when I started my premed course of study while working. My twenties were spent in medical school (4 years), internship (2 years) and then residency (4 years). I got married right after all that. I started a real job (80 hour work weeks) and had the first of four children two years later. Four children in eight years. I spent my thirties having them and my forties raising them. All the while still working. In the last decade I worked full time for eight years until I got really sick with Sarcoidosis. I was sick long before the diagnosis but just thought it was exhaustion and overwork. After being diagnosed I continued to work because I’d been trained to work despite discomfort. I was trained to perform whether sleep deprived, hungry or sick. I went to work with a fever, conjunctivitis, stomach bugs and waited to be sent home. As an anesthesiologist, you can’t call in sick because an entire day’s operating room schedule of operations won’t take place without you. So you go to work unless you are unconscious. Often, it’s not until early afternoon that another anesthesiologist finishes his/her room and can then take over your room so that you can go home.

At home at the end of each day, I would start my second full time job feeding the kids, doing homework, giving them all the attention they needed to make up for the fact that I wasn’t present in the mornings. I was riddled with guilt for not being there in the mornings to make a hot breakfast and see them off to school. After all, I had to leave the house between 5:30 and 6:00 AM depending on the job. First case of the day is a 7:30 start. The anesthesiologist has to be at peak performance to set up their room, safety check the equipment and draw up the proper drugs in the proper dilutions and label them correctly. There is nobody overseeing you, nobody to guard against errors. It’s you alone. If you make a mistake, you might kill someone. And that’s not the end of the stress. You have to design an anesthetic that won’t kill the patient depending on what comorbid illnesses they suffer from. This one has a bad heart and can’t handle a full anesthetic but you have to keep him asleep enough that he has no awareness. The next one has a bad liver and needs much smaller doses of drugs so that you don’t cause further liver damage. The one after that is a bleeding emergency that came through the ER and can barely handle anesthesia! And so the day goes- quickly, until your room is finished. Which you don’t know when it will be until it happens. Cases get added throughout the day, and depending on your position in the line of “on call”, you’re more or less likely to leave. Oh, and sometimes you are number one on call and you work overnight too.

I was always a hard worker, did more than was expected, until I started feeling sick. Even then I’d work but with the crippling exhaustion, started begging to leave earlier. But the job wasn’t geared for that, and I finally had to switch out of anesthesia. I learned geriatrics and worked in assisted living. I loved the flexibility of the job. I was managing for a couple of years until I couldn’t work at all due to the paralyzing fatigue.

It’s been a bit over a year since I stopped working. At first the break was a welcome thing. I needed the rest so badly. On good days I completed house projects that I never had time for- organizing storage spaces, cleaning baseboards and hard to reach spots that hadn’t been touched in years. I painted some walls and stained some furniture. I expected to feel better rather quickly, as I’d finally been approved for the infusions I was waiting for. But instead, overall, I feel worse, gradually, almost imperceptibly. The time is punctuated by periods of well being which leave me thinking that I’m getting better. But always, reality hits and I’m knocked off my feet again. These days, I don’t have any energy. I barely drive. I let my husband drive me to places and I sit when we get there. At home I’m either on the couch or in bed, saving my energy for the necessary errands. A big day shuttling a child to the doctor, or a large grocery store trip will wipe me out.

I forgot to mention that during my fast paced years I also ran almost daily. I woke up at 4:00, had coffee and took the dog for a run in the dark. I needed those runs. They energized me when I was starting to feel fatigued but was still unaware that I was sick. They improved my sleep and my mood and lubricated my day. I couldn’t imagine not being able to run.

If I ran now I wouldn’t function. Not only do I have no desire to run, I can barely find the energy to walk the dogs.

And in case anyone has the question that the docs love to ask, I am not depressed. I am actually happy and motivated and looking forward to the many projects in my head!

But it is taking me a long time to get used to the idea of not accomplishing more than the minimum that needs to get done. I still get that initial morning anxiety of “oh there’s so much to do!” It’s like a phantom pain of the mind. Then I relax as I realize that no, I’ll just have to pick up the kids later and get dinner made, maybe clean up the sink if I can today.

How long can one go on like this? I have no answer for that. Like the many health issues, I hold no answers regarding the future. But I’m ok with that because, for the most part, life is good.

M

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