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On Being a Patient |

Lovenox Hurts

Samantha M. Jaglowski, MD
[+] Article and Author Information

From The Ohio State University, Columbus, OH 43210.


Requests for Single Reprints: Samantha M. Jaglowski, MD, The Ohio State University, 320 West 10th Avenue, 406C #1 Starling Loving, Columbus, OH 43210; e-mail, samantha.jaglowski@osumc.edu.


Ann Intern Med. 2009;151(8):585-586. doi:10.7326/0003-4819-151-8-200910200-00015
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When I was an intern, my program director told me that one of the things she liked best about me was my ability to stay cool under pressure. I wryly responded that maybe I just didn't have enough sense to know when to worry. We chuckled, and then I spent the next 3 years proving my point. After my first daughter was born during my second year of residency, it never occurred to me that morning sickness should resolve with the birth of the baby, if not some time before. When I started having severe positional neck pain, I blamed poor quality of sleep. I had always had the occasional migraine, but they were easily aborted with ibuprofen, caffeine, and a nap—when they became more frequent and harder to relieve, I pinned it all on stress. I thought I had benign positional vertigo when the room started to spin every time I looked up and to the right. Once my twins were born and I started an oncology fellowship, I expected to feel completely exhausted all of the time. My daily routine was to get up, vomit, get ready for work, drink a cup of coffee, vomit again, take a couple of naproxen and drink another cup of coffee, go to work, struggle through a 12-hour day without looking up or to the right, and do all of this without giving anyone any reason to believe anything was wrong. This went on for almost a year. I was utterly convinced that my symptoms were all in my head, no pun intended, and I was irritated with myself for not being able to handle a little sleep deprivation. It wasn't until I started having neuropathic pain shooting down my face in a dermatomal distribution and could only get through the day by taking leftover prednisone prescribed for my dog that I realized I might be in trouble. I had an MRI, followed by staging studies, followed by surgery to remove a grade-2 ependymoma that was obstructing my fourth ventricle and invading my brainstem, all in the span of 3 days—resulting in a whirlwind shift from being a doctor to being a patient.

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