Tomorrow I get to interview someone with less experience than I have for a position my boss apparently thought I was so unqualified for that he didn't even bother to tell me I was unqualified before announcing that he was recruiting someone.
I've been told I can be intimidating.
I'm curious to find out if this is the case. :coldasdeathglare:
That kind of schedule is okay on a short-term basis, but as a way of life... no wonder you are stressed. Do you at least get to eat breakfast and do your homework on the ferry? Relax with a cocktail on the way home? Perhaps if you could cut back a bit on the exercise schedule, then you wouldn't have to work off all those cookies, ice cream and pretzels because you would have more time and wouldn't be so stressed??
I dunno, Jess, it sounds like a killer to me. I did it for one semester, school four nights a week, an occasional Saturday class thrown in, and I was a wreck at the end of it. And my commuting time including school was half an hour less than yours. I only managed it because there was light at the end of the tunnel (and it was not a train)!
I am new to the website and am looking for some advice. I'm in my 20's and have had digestive problems since I was in high school. I actually recently finished medical school and it was while I was in med school that I started to consider that maybe I actually had a real issue. I've always had issues with allergies, eczema and a red bumps on my arms, low back, knees, tops of my feet that no allergist/dermatologist could really figure out. GI wise, my issues were bloating, stomach pain and cramping, malabsorption-like stool. Pretty much everyone in my family has an autoimmune condition. I'm short-statured and was a "late-bloomer." Starting in my 20's my hair started to thin, my nails started to peel and crack really easily, I became anemic (iron supplements didn't help) and I had 3 stress fractures within a 4 year period. I went to GI doc about a year ago and funny enough the only test I had was a colonoscopy which was fine. No blood tests. Over the past year things got worse and I had more bad GI days than good ones and started to have problems with lactose intolerance. I spent 4 weeks specifically doing a GI rotation and during that time, pretty much diagnosed myself with celiac disease. I did what you're not really supposed to do and started a trial gluten-free diet without a formal diagnosis and have been doing it for about 3 months now. I feel so much better, my skin has cleared up, my nails are growing out stronger and my anemia (measured my looking at skin color, inner eyelids, and subjective measure fatigue).
My basic question is, if I feel so much better on a gluten-free diet and have pretty much decided to continue with it either way, is it really necessary to go through the formal diagnosis? I'm about to start my medical residency and the thought of going back to gluten for the testing while trying to keep up in residency is terrifying. Any thoughts?
Hi, and welcome to the forum. Good to have a doctor on board
Most of us start a gluten free diet out of exasperation at the inability to get anyone to take us seriously and order the right tests. And then once down this path there doesn't seem to be any place to turn around which does not involve ludicrous suffering. We know what's wrong, we know how to cure it (well, for a lot of us we have to find out what else we are intolerant of also , so why do we need the diagnosis? Who are we trying to satisfy by getting the diagnosis is probably the better question to ask. If the spouse/partner needs it, if the family needs it, if the school needs it for a special meal/education plan? These have been issues some of our members have faced. If you personally are happy with the self-diagnosis (and you are the doctor ) and you have none of the foregoing issues, then what is the point of a formal diagnosis. You don't need a doctor to tell you you have cut your thumb (but you might need him/her to suture it). In this case, all you need a doctor for (and who knows, maybe you can order this yourself or have a colleague do it) is to order the blood tests to check your nutrient levels and make sure you are not deficient in B12, folate, D, calcium, zinc, magnesium, ferritin (and also check your thyroid levels); these are all things that tend to get out of whack most often for us.
Now this is the perspective of a happily self-diagnosed person. And I don't at my age see myself applying for an insurance where the diagnosis could be a handicap which is another aspect you could take into consideration, having this on your medical record.
You will probably get lots of opinions on this. Just mine to start you off
Additional info on my tests and symptoms. Celiac panel blood test results; Transglutinase antibody result was 63. Reference ranges 0.0-19.9 is negative, 20.0-30.0 is weak positive and over 30.0 is moderate to strong positive. Next Gliadin IGG AB result was 81.4. Reference ranges = <20.0 negative, 20.0-30.0 is weak positive and >30.0 is positive. Finally, Gliadin IGA AB result was 97.1. Reference ranges = <20.0 is negative, 20.0-30.0 is weak positive and >30.0 is positive. According to my Dermatologist they had never seen higher numbers for positive Celiac. On to the dreaded rash. Periodically throughout my life I would get little bumps that would cluster on my elbows and around my lower leg/ankle area that was horribly itchy. I would scratch incessantly. When the the top was scratched off the bumps they looked wet and I would keep scratching until the skin bled and it still was terribly itchy and stinging a bit. I would use anything I could over counter. Doctors gave me various creams and antihistamines but nothing really helped. It seemed to come and go. I always had bouts of constipation and diarrhea with a bloated tummy and gas which has worsened over time. This took a back seat to type 1 diabetes diagnosed in my late 20's and a life of endometriosis. Now in my late 40's somehow I managed to enjoy life and appeared healthy most of the time but had many ups and downs. Then the rash started 2.5 years ago following a viral bout. My knees began to itch and small bumps were forming on my right leg knee to my ankle. It came with a vengance and just seemed to get worse and spread to other areas in clusters. I had been seeing my doctors but everyone was treating this as an allergic reaction. It spread to my elbows, low back and backside, on my arms and elbows. I couldn't sleep at night without icepacks. It has not responded to any kind of medications or by limiting my exposure to external triggers. Through all this I discovered I am allergic to Casein and am receiving shots for molds, dust mites, pollen etc. Now I have found by avoiding gluten the rash does improve but I think that if this is DH that I may need Dapsone or something to help me get over the hump. Currently it is slighty improved I believe from avoiding gluten over 7-10 days. My leg cleared but has tiny dark scar spots however now my back and backside are worse. I had to resume gluten for the DH biopsy on May 4. It starts with a itchy or stinging feeling that I scratch and the bumps kick in. The scratching continues until they look like little open sores some with blood and the surrounding skin is red and raised. Ice packs do tend to help a bit but only with the discomfort. It looks just like the pictures on the internet. Ocourse I don't want to be a type 1 diabetic with Celiac but I am up to any challenge if I could just get some closure on this. I sincerely appreciate all the education and experiences that are shared here. I never felt the need to join in a diabetic forum as that disease is pretty straight forward. I wish it was the same in diagnosing Celiac.
Your rash does sound like a typical DH pattern. They tend to be a deep red, with blisters that burst, both intensely itchy and hurting, and fade to a purple then white scar over time. It is such a shame they did not think of DH before, and did not tell you to continue eating gluten up until the biopsy (endoscopy and DH). It could have saved you much grief. I am fairly certain that you will definitely be diagnosed with DH and it is possible that had you continued eating gluten until your biopsy that could have been positive too (although there are sometimes false negatives there). (I did not see what your biopsy report said - if that mentioned inflammation or other indications of celiac disease.) The fact that the rash improved during the time you were off gluten is a good sign. You would have to give it longer than 7-10 days before considering taking medication in addition to going gluten free.
Regardless of what your testing reveals, I would definitely advise you to totally avoid gluten for a good 3-4 month trial once your testing is done. And by the way, make sure the dermatologist biopsies the skin adjacent to the lesion, not the lesion itself. Some doctors don't know this. I guess two weeks is not THAT far away to wait for this although probably every day is misery for you.
Keep in touch and let us know how things turn out.
We keep going round and round on this issue here on the forum. Celiac vs. gluten intolerance. Neither of them are allergies. Gluten intolerance seems to be basically the same as celiac except a gluten intolerant tests negative on the blood tests and the endoscopy. Gluten intolerants seem to be susceptible to the same complications of gluten consumption as celiacs. Some say that a gluten intolerant is just a celiac-in-waiting
Think back to how you used to feel as a child at the time you were biting your nails. Were you going through a stressful time? Were there conflicts in your life? It could just simply be a reversion to a behavior that got you through something when you were young, and you are using it now to get you through the adjustment of eating gluten free, which is not an easy one.
Did you (or anyone else) have dizzy/vertigo spells before they were diagnosed with celiac? In the past couple years I have had a few incidents of mild constant vertigo and a couple serious dizzy spells, though they seem to be caused by sudden elevations of humidity, heat and air pressure. I spent nearly a month feeling dizzy while I was in Japan during the summer (extremely humid), and have had a couple heat-related dizzy spells. I've put it down to dehydration. But could people with undiagnosed celiac be prone to these conditions??? I could be completely off base, but what do you think?
I had a terrible spell of vertigo for 6 months, which resolved spontaneously. Don't think gluten related. The one symptom that was definitely related was dizziness and fainting from gas and bloating pressure. Haven't had this happen since gluten free. (I have always felt faint when I get too hot; don't relate this to gluten though.) I guess I am just a dizzy kind of person--must be because I am blonde
It does get to be a dilemma; what should I eat versus what can I not afford not to eat, and what is making the difference anyway. After gluten and soy, nearly all nightshades (occasional potato and a slice or two of tomato in a BLT), and most outright corn--not including corn syrup--my husband asked if I wanted some corn on the cob. I said just a very small piece, and only gnawed off a few kernels, and it didn't feel right. On the other hand I've eaten a few corn chips and a cracker and not had any problem. But then there come those sleepless nights and the palpitations out of nowhere, and you think, oh sheesh, where did that come from? I hate the thought of a food diary but it might be the only way. Why do there have to be so many things???