Feb 25, 20235 min read

The clinical year begins!

Updated: Feb 25, 2023

Hello dear readers-

The clinical year has begun and everyday is bringing new specimens that I recognized from my studying last year, and now get to experience in all their glory. Last year, as a just-for-fun project, I designed a screen-printing graphic to go on a sweater for anyone who was interested in something that says “pathologists’ assistant” on it. It is not affiliated specifically with the program, just a small creative endeavor to help combat the imposter syndrome and let us show some pride for the profession.

The new, super cool, sweater I designed (production by Underground Printing in Morgantown, WV)

Updates

Currently, schoolwork includes weekly quizzes and an exam on the last Friday of every month. The exams cover everything we learned last year, plus a few new things. These exams are test-prep for the board exam I’ll be taking at the end of the program. Knowing that my board exam preparation is built into the program is a great relief, otherwise I’d have to figure out a way to organize and pace all that studying on my own!

My days usually look like this:

Get up around 6, do some yoga and take my time getting ready before work

Go to the lab and do some grossing! - I'm told that I'll probably be getting some pancreaticoduodenectomy specimens at this site, which I'm very excited for!

I may review some interesting slides with the pathologist near the end of the day or around lunch

Get back to my lodgings, take a quick nap, and then either study or engage in some self-care, whatever is needed that day.

I’ve already completed my first rotation at UHC in Bridgeport, WV where I got to crawl my way through my first 100+ specimens and start to grow my confidence in my grossing skills. Per advice from some of the professors in the program, I’m keeping a spreadsheet and a log to keep track of the bigger cases I complete.

I’m currently writing from the Marietta Memorial Health System hospital in Marietta, Ohio. Marietta is a great little town full of American history and friendly people. Everyone in the lab is very understanding of my student status and I am always afforded time to study if work gets slow. Marietta uses a dictation system instead of voice-recognition, which means I don’t see my dictation as I’m grossing. A lot of people have trouble making the switch, but personally I think it is making me a much more efficient grosser as I’m not knit-picking my dictation constantly.

I made a trip to Cleveland last weekend and went to the art museum, botanical gardens (where they were having an orchid show), and a short visit to Lake Erie.

Reflection and Disease of the Day - Combo edition

Instead of discussing a specific condition, I’d like to talk about a very common thing among students, chronic pain, and a possible approach to dealing with it during a very stressful time.

It is common for students to experience chronic musculoskeletal pain while in any level of school. Chronic pain is closely associated with stress, and the physical, emotional and intellectual demands of school can be good conditions to create pain. It’s important to remember that pain, while obviously a biological phenomenon, is also an environmental, social and mental health issue. Acute pain (eg. a broken leg) is our body’s way of communicating to us that we need to rest and allow our bodies to heal before we can use the injured area. Chronic pain, however, is a very different phenomena.

Since the beginning of the program I’ve started experiencing temporomandibular joint (TMJ) pain, and associated muscle spasms, ear pain, headaches, and even eye pain. Last year I was in physical therapy for neck pain that was supposed to also help with my jaw. Being in pain is a fantastic way to compound stress, making it even worse. So how do we treat this? Especially when you are moving every 6 weeks and so can’t go see a regular physical therapist or chiropractor? How do you treat a (partially) stress-induced problem when you cannot remove the cause of the stress?

I can only tell you how I have dealt with this problem. Everyone’s experience and solutions are going to be different. In my experience, I have had success with this process:

1) Start tracking my symptoms and do some research

I use an app to track my mood and TMJ pain so that when I talk with healthcare providers, I can give them concrete data about my pain and how it relates to my mental health. It also means I don’t have to try to remember and estimate these things on the spot during doctor’s visits.

Researching musculoskeletal pain (MSP) is a tricky thing and can leave you feeling more hopeless than ever as you read testimonials from people who have been in pain for decades with unsuccessful surgeries and long-term opioid prescriptions. Remember to look for specific solutions to your problem. If your problem is muscle pain and spasms, look for solutions to that problem. If your problem is joint pain, or headaches, look specifically at the answers to those problems. Make a list of options and discuss them with your doctor. Get focused about what solutions are possible for YOU.

2) Check my current medications

I realized that the manufacturer of my anti-depressant prescription changed a few months ago when I switched to a mail-order pharmacy. When I realized this, I requested they send me the generic medication from the manufacturer that works best for me, which drastically improved my mental health. I also checked to see what the side effects of my current prescriptions are to see if they may be exacerbating the problem.

3) Assemble my information and TALK WITH MY DOCTOR

I had a telemedicine appointment with my primary care physician in Washington state and gave her the whole story of my chronic pain starting from the beginning of the program. I listened to her say everything she, as a physician, is required to tell me about possible solutions, even the ones I’ve already tried. Doctors are much more receptive to, and collaborative with patients that listen to what they have to say! Then I brought out my questions about my options and explained what won’t work for me and why.

4) Self-care

Once I had the problem to a manageable place, I was able to start changing some lifestyle components. I accomplished this mainly by reestablishing some stress-relieving habits, like doing regular yoga, meditation, and physical therapy exercises.

5) Re-evaluate and don’t give up

As I continue to monitor my symptoms, and re-evaluate the current strategies and adjust them as needed. Pain is constantly changing, and one thing will likely not work forever, and that’s okay.

Resources for pain (and references for this post):

The Pain Management Workbook By Rachel Zoffness MS PhD

“This Book Changed My Relationship to Pain”, The Ezra Kline Show – NY Times podcast