June 1: 'Duh' epiphany
My posting now is a combination of the shock (as usual) that it's been a few weeks along with my general disinterest in doing anything else at the moment.
Work: less stable. They laid off two of the billing girls Friday last. I had a talk with G, more changes will have to come. Reimbursements are down substantially. This is how medicine is going to go, it's 'new normal'. I'm in a difficult position, because how the practice has flourished, and by extension allowed them to be so generous with me, is part of the problem overall. Let me hasten to say that they aren't doing anything wrong or illegal, just playing the game. But the game is changing.
You may have already noticed, but by the time I post on here I've already done the necessary ruminating, planning and recognition. Sometimes the issues are much more obvious to everyone else than to me, and reactions often can be 'what took you so long to recognize that?'. So before I launch into my latest epiphany, let me update you on life....
The last three weeks have been somewhat busy, but not extremely, and with a lot of down time as well. A few more doctor's appointments that usual. Pulmonary doctor was not impressed with my sleep history, but we agreed that a sleep disorder needs to be ruled out. So a sleep study is scheduled for June 10, right up the street and very convenient. They promise to not cut my hair or shave my head! Had an eye appointment the 17th, need a new prescription, not unusual. Worked last Friday. Dentist on Tuesday: that was unpleasant. In 50 years I have never had a cavity, until now. Three of the damn things, with a 'watch' on a fourth. They were able to fill all of them, fortunately covered by my excellent dental insurance. Weekends with stuff off and on, I always give myself one day of almost total rest, rarely schedule more than two things to do on the other weekend day. Had a couple meals with people, stayed in while on call Memorial Day. This past week was easy, then, with only working two days and less stress tests than usual (also, therefore, a little concerning).
Yesterday and today the floor was refinished, the last of the storm damaged stuff to be done on the house. I knew it was scheduled, but didn't think about the practical stuff until Wednesday night when I suddenly realized I had to pack up some things, move stuff onto the porch, decrease chance of anything breakable being out. So I packed up lamps and such, moved the small photos from the bookcases, etc into boxes, worked for about two to three hours to get things handled. They finished today and the floors look great, except one of the major issues was taking care of where tape had been placed and then ripped off the top layer of wood in the bedroom, and it still doesn't look right. Otherwise, they are so shiny you could skate on them. It's hot, but not too bad, low humidity, a breeze; I'm trying to not turn on the AC yet as it's still cooling down overnight and not that humid. With not being able to walk in my house I spent time on my swing, studying for my Boards at the kitchen table, and then finally several hours on the couch last night. Today an easy day as well.
So why am I boring you with all this minutiae? Because I don't think this is a huge amount of activity, at any point. This is how my life goes. Why, then, am I ALWAYS utterly exhausted? Well, gee, maybe because I have a heart condition? Maybe because even this 3 or 4 workday schedule is still too much?
As a concrete example: the flooring guys moved my furniture back in place, but I know it will take me weeks, literally weeks to months, to get everything back in place again. This is a certainty, because despite the fact that I've been back in the house since late January there are still tons of things out on the enclosed porch that I haven't had the energy to deal with. (The porch is basically another room, but doesn't have any insulation, so does get too cold during winter months, has an AC unit for hot.) I had to stop repeatedly Thursday night and Friday morning because of getting not just tired, but the bad place of nauseated and dizzy, which then takes days to recover from.
I'm tired of living in my constant state of mess because I'm too fatigued to cope with stuff. I'm tired of having everything categorized into urgent, immediate, needed and wouldn't-it-be-nice with only the first two categories ever getting any attention, because after that I'm just too tired. There are dozens of things that have never been coped with, despite my being here for six years now and in better health the last 2-3 years, but are still not done because there just isn't enough energy. (Cleaned off my kitchen table and found a work holiday party picture still out--from 2011.) There is the time--except it's spent resting because my body is so overwhelmed it just shuts down. I'm tired of being tired, even after days of rest.
And so here's the 'duh' moment: I have a heart condition. I avoid saying 'bad heart' because it isn't a bad heart, it's a splendid heart that has stood me in excellent stead and coped with way more than anyone would have thought possible both before and after diagnosis. It's an incredibly wonderful heart which has withstood more emotional and physical and surgical traumas than possibly any other heart out there. It's just not a normal heart. While it's allowed me to recover beyond the medical community's wildest expectations, it does have it's limits. And I'm finally, almost six years after the last surgery, coming to terms with those limits.
What can I say? It's a process.
So, I'm going to start accepting those limits more. And, possibly more importantly, that they aren't going to change. Things will not get better than they are now from a physical standpoint. There is no more 'fixing' to be done. This is as good as it's going to get. Please understand that I'm not complaining, but finally recognizing that this is the most my body can do, and it's telling me that the current amount is too much. It shouldn't take an entire weekend to recover from working 3-4 days a week, with few other demands.
What does this mean? It means I'm finally going to do what everyone thought I should have done years ago: I'm going to start looking at going on disability. I've fought the good fight, given my body enough time to see if it would improve, gone through years of struggle because it was the best thing to do financially. But I think I'm done.
As far as I know, no one from my work life reads this, and if you do, please keep this to yourself. I did give G a heads up, and this is not something that I'm looking at in the next couple of weeks or even months. According to my contract, if either side is terminating the employment then three months notice is required. Not sure if that applies here, but I'm not going to leave them in a lurch. And it may not even entail leaving completely, since apparently you can earn up to $980/month, which would be a help. Maybe by this time next year? That doesn't sound to most people like it's a big announcement, I'm sure. But considering that up until recently I'd been telling myself that I was just going to have to struggle through until at least 62 years old, thinking about next year is a big change in my thought process. Further proof of all this being a good decision is my overwhelming sense of relief that my current schedule and constant fatigue is going to have an foreseeable endpoint. That's always been the acid test with me: does it hold up as the right decision, or are there niggles of doubt? No niggles, just trying to figure out all the practicalities of doing this.
So, as much as is wise, I will let you know the progress. Thanks for checking in, Laurie
P.S. Just realized that I hadn't mentioned: it's Board recertification time again! The scourge of all PAs: having to put your life and employment on the line by taking a comprehensive exam every six years to keep our certifications. Major stressor. Scheduled for June 14, which means there would be time for me to re-take it again before the end of the year. Back to studying....
Work: less stable. They laid off two of the billing girls Friday last. I had a talk with G, more changes will have to come. Reimbursements are down substantially. This is how medicine is going to go, it's 'new normal'. I'm in a difficult position, because how the practice has flourished, and by extension allowed them to be so generous with me, is part of the problem overall. Let me hasten to say that they aren't doing anything wrong or illegal, just playing the game. But the game is changing.
You may have already noticed, but by the time I post on here I've already done the necessary ruminating, planning and recognition. Sometimes the issues are much more obvious to everyone else than to me, and reactions often can be 'what took you so long to recognize that?'. So before I launch into my latest epiphany, let me update you on life....
The last three weeks have been somewhat busy, but not extremely, and with a lot of down time as well. A few more doctor's appointments that usual. Pulmonary doctor was not impressed with my sleep history, but we agreed that a sleep disorder needs to be ruled out. So a sleep study is scheduled for June 10, right up the street and very convenient. They promise to not cut my hair or shave my head! Had an eye appointment the 17th, need a new prescription, not unusual. Worked last Friday. Dentist on Tuesday: that was unpleasant. In 50 years I have never had a cavity, until now. Three of the damn things, with a 'watch' on a fourth. They were able to fill all of them, fortunately covered by my excellent dental insurance. Weekends with stuff off and on, I always give myself one day of almost total rest, rarely schedule more than two things to do on the other weekend day. Had a couple meals with people, stayed in while on call Memorial Day. This past week was easy, then, with only working two days and less stress tests than usual (also, therefore, a little concerning).
Yesterday and today the floor was refinished, the last of the storm damaged stuff to be done on the house. I knew it was scheduled, but didn't think about the practical stuff until Wednesday night when I suddenly realized I had to pack up some things, move stuff onto the porch, decrease chance of anything breakable being out. So I packed up lamps and such, moved the small photos from the bookcases, etc into boxes, worked for about two to three hours to get things handled. They finished today and the floors look great, except one of the major issues was taking care of where tape had been placed and then ripped off the top layer of wood in the bedroom, and it still doesn't look right. Otherwise, they are so shiny you could skate on them. It's hot, but not too bad, low humidity, a breeze; I'm trying to not turn on the AC yet as it's still cooling down overnight and not that humid. With not being able to walk in my house I spent time on my swing, studying for my Boards at the kitchen table, and then finally several hours on the couch last night. Today an easy day as well.
So why am I boring you with all this minutiae? Because I don't think this is a huge amount of activity, at any point. This is how my life goes. Why, then, am I ALWAYS utterly exhausted? Well, gee, maybe because I have a heart condition? Maybe because even this 3 or 4 workday schedule is still too much?
As a concrete example: the flooring guys moved my furniture back in place, but I know it will take me weeks, literally weeks to months, to get everything back in place again. This is a certainty, because despite the fact that I've been back in the house since late January there are still tons of things out on the enclosed porch that I haven't had the energy to deal with. (The porch is basically another room, but doesn't have any insulation, so does get too cold during winter months, has an AC unit for hot.) I had to stop repeatedly Thursday night and Friday morning because of getting not just tired, but the bad place of nauseated and dizzy, which then takes days to recover from.
I'm tired of living in my constant state of mess because I'm too fatigued to cope with stuff. I'm tired of having everything categorized into urgent, immediate, needed and wouldn't-it-be-nice with only the first two categories ever getting any attention, because after that I'm just too tired. There are dozens of things that have never been coped with, despite my being here for six years now and in better health the last 2-3 years, but are still not done because there just isn't enough energy. (Cleaned off my kitchen table and found a work holiday party picture still out--from 2011.) There is the time--except it's spent resting because my body is so overwhelmed it just shuts down. I'm tired of being tired, even after days of rest.
And so here's the 'duh' moment: I have a heart condition. I avoid saying 'bad heart' because it isn't a bad heart, it's a splendid heart that has stood me in excellent stead and coped with way more than anyone would have thought possible both before and after diagnosis. It's an incredibly wonderful heart which has withstood more emotional and physical and surgical traumas than possibly any other heart out there. It's just not a normal heart. While it's allowed me to recover beyond the medical community's wildest expectations, it does have it's limits. And I'm finally, almost six years after the last surgery, coming to terms with those limits.
What can I say? It's a process.
So, I'm going to start accepting those limits more. And, possibly more importantly, that they aren't going to change. Things will not get better than they are now from a physical standpoint. There is no more 'fixing' to be done. This is as good as it's going to get. Please understand that I'm not complaining, but finally recognizing that this is the most my body can do, and it's telling me that the current amount is too much. It shouldn't take an entire weekend to recover from working 3-4 days a week, with few other demands.
What does this mean? It means I'm finally going to do what everyone thought I should have done years ago: I'm going to start looking at going on disability. I've fought the good fight, given my body enough time to see if it would improve, gone through years of struggle because it was the best thing to do financially. But I think I'm done.
As far as I know, no one from my work life reads this, and if you do, please keep this to yourself. I did give G a heads up, and this is not something that I'm looking at in the next couple of weeks or even months. According to my contract, if either side is terminating the employment then three months notice is required. Not sure if that applies here, but I'm not going to leave them in a lurch. And it may not even entail leaving completely, since apparently you can earn up to $980/month, which would be a help. Maybe by this time next year? That doesn't sound to most people like it's a big announcement, I'm sure. But considering that up until recently I'd been telling myself that I was just going to have to struggle through until at least 62 years old, thinking about next year is a big change in my thought process. Further proof of all this being a good decision is my overwhelming sense of relief that my current schedule and constant fatigue is going to have an foreseeable endpoint. That's always been the acid test with me: does it hold up as the right decision, or are there niggles of doubt? No niggles, just trying to figure out all the practicalities of doing this.
So, as much as is wise, I will let you know the progress. Thanks for checking in, Laurie
P.S. Just realized that I hadn't mentioned: it's Board recertification time again! The scourge of all PAs: having to put your life and employment on the line by taking a comprehensive exam every six years to keep our certifications. Major stressor. Scheduled for June 14, which means there would be time for me to re-take it again before the end of the year. Back to studying....
posted by Laurie @ 5:36 PM
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