Ask your doctor if Shift Work Disorder is right for you

Last week, we were watching TV, and a commercial about “shift work disorder” came on.  A rugged older gentleman in a flannel shirt was explaining about how he hadn’t realized how his job might be affecting his sleep patterns and quality of life, until his doctor asked him what hours he works.  I laughed out loud.  Then the commercial (which was for Nuvigil – used to improve wakefulness) went on to tell you to talk to your doctor, and then it went through the lengthy list of side effects, you know – the usual drill.

I think it is awesome to have dialogues about what’s going on in people’s lives and what might be improved, whether it’s with a prescription or other changes in lifestyle.  And if having an official diagnosis helps more people figure out what’s going on and what they can do about it, more power to them.  Just… personally, I find it absurd that this wouldn’t be a natural line of thinking.  I think about this kind of stuff all the time.

I don’t work overnights (and am so glad for that), but I do have an “off” shift.  Otherwise known as the “B-shift.”  (My co-worker pronounces “shift” as “trick,” so I might interchange the two words from here on out – just a heads up.)  I work 3pm-11:30pm.  It is currently 12:50AM as I write this; I’ll probably go to bed by 2AM.  This is what I do, Monday through Friday.  It means that I never see my partner during the work week.  We have to catch up via telephone, notes, and emails, which is sometimes extremely frustrating.  It means that I don’t see much of anyone during the work week.  Like, some friends are going out to dinner for someone’s birthday?  Sorry, can’t make it.  You’re going to the movies?  Sounds like fun.  I stopped being jealous over the stuff I was missing out on a long time ago.  Better to just accept it.  And, on special occasions, I can always just call in sick or work a half day or something.

I’ve found that there is often a natural camaraderie amongst people who work strange hours.  For example, I’ll sometimes go to the grocery store, still in uniform, around midnight, and the cashier always wants to tell me what time she gets off work.  And if I haven’t been in a while, she’ll ask, “Where you been?”  Maybe the summer has passed by (I work like normal people during the summer), so I’ll say, “Oh, I was on a different trick.”  And she’ll say, “That’s always the reason!  Whenever I haven’t seen someone in a while, it’s because their trick changed.”

So, essentially, shift work disorder is a medical condition that can be diagnosed and treated by a doctor.  (Phew!)  It occurs when your job calls you to duty and you end up fighting against your natural circadian rhythms.  It’ll cause insomnia when you’re trying to sleep, and ES (excessive sleepiness – so relieved that there’s a medically coded shortened version for this term!) while you need to work.  Shift work disorder was invented in 2011 to help people figure out why they feel tired.

Whoa.  Ok, lemme try to go back to the point where I do think this is all positive if it helps people improve their lives.  I just worry people will see an ad on TV, or their physician will bring it up with them first, and they’ll just mindlessly pile on more pills to the over-medicated masses.

Like I mentioned, I don’t work overnights, so my experience is not nearly as extreme as many people’s.  But I do want to point out that I feel like my work / sleep schedule has actually created MORE room for circadian rhythms to do their thing, according to the seasons.  It seems only natural that people would feel the need to sleep more during the winter months, if they could.  But I’d imagine most people’s schedules don’t allow for extra sleep.  They have to get up with their alarm and get to work.  Me?  I can sleep as much as I want, apparently.  I don’t generally have much going on in the mornings or early afternoons before work, so, often I’d let myself sleep 9-10 hours a night when it really seemed like I naturally tended toward this, roughly November-February.  (A luxury, I know.)  I was actually starting to feel concerned about all the oversleeping (I was wasting so much time!), but it abruptly righted itself; in February, I could no longer sleep in.  As if, my body knew that spring was on the way and I better start getting ready!

Brand new diagnoses coming soon:

– sitting-on-the-couch disorder
– texting-while-driving disorder
– junk-food-for-lunch disorder
– gender identity disorder
Oh, wait…


Continued quest to find a new doctor (a good fit?)

I have been seeing a doctor that I don’t like for about a year, in order to access testosterone.  I’ll be going to his office tomorrow actually, hopefully for the last time.  For a few weeks now, I’ve been actively trying to find a doctor that I would want to go to.  My therapist thought she had a good lead on someone who works with trans* patients, but it turns out this person works with adolescents and young adults.  Whoa, when did I stop being a young adult?!!!!  According to this doctor, it’s when I turned 27.

I really wasn’t sure where to start.  As far as I was aware, I had exhausted my resources for trans* specific health care.  Ideally, what I’d have done next was turn to all my local trans* friends, and ask them who they see and who they’d recommend.  But, I’ve been out of the loop for a while now, and it felt daunting to drop in on a social group or support group just to ask about this.  So I turned to my local gay alliance’s resource webpage and wrote down the names of a couple of “LGBT friendly” doctors.  I narrowed it down somewhat arbitrarily because, hey, I gotta start somewhere.

I called the first number and left a message.  Then called again 2 days later.  And again the beginning of the following week.  And a 4th time the next day.  My faith was waning; it hit me it was probably a really bad sign I couldn’t get through to anyone.  I finally got a message back from them, but I’d started to lose interest and was already moving on to the next doctor.

I got through immediately and asked if this doctor was taking new patients?  I was told that if I’m a friend or family member of a current patient, then yes.  Or if I was being referred to her by a doctor of any sort, then yes.  Wait, you need a referral for a primary care physician?!!  I asked, “In what form should this referral take?  Like a note from a doctor or an email?”  “No, you just tell us their name.”  I said OK thanks and hung up.

So basically, I can see this doctor through the powers of nepotism and name dropping.  (Warning, I’m still highly suspicious of doctors.  Doctors, please, prove me wrong!)  I felt more determined than ever to see this doctor, just on principal, because I think this policy is fucked-up.  She should either be taking new patients or not taking new patients.  Period.

I called my therapist (technically, she’s a doctor) and asked her if she would refer me to this doctor.  She said sure, she’d do whatever, and that she’s never heard of needing a referral for a PCP.  She suggested that maybe I just misunderstood, and they just want to know how I heard about / was referred to this doctor.  So when I called back, I gave them the benefit of the doubt, but it was reinforced that yes, I need a verbal referral.

I then said that I have a therapist who will vouch for me.  (The term “vouch” was never actually used, but that’s what seems to be going on?)  I was then put on hold, and they seemed to be attempting a stalling tactic.  She (receptionist) said she is short staffed and busy, could I call back Thurs. or Fri. of this week?  I was assured that I’d be able to make an appt. at that time, and I was directed to name-drop whoever at that time.

So I followed these directions and finally got an appointment!  (For 3 months from now.)  A few days later, a packet of paperwork arrived in the mail, and I immediately opened it and started to peruse.  Their pamphlet states, right on the cover, “Designed by Women / Delivered by Women / For Women Like You.”

Whaaaaa?  Apparently, I got myself a doctor through a women’s health group without even knowing it!  I just have to take a giant step away from this situation and laugh.  And laugh and laugh some more.

Is this going to be a good fit?  I thought it through quite a bit, and decided that I’m going to try it.  And I’m going to make my decision based on the doctor, and not the Women thing.  Because really, although I am definitely not a woman, I am closer to a woman in some ways, and closer to a man in other ways.  And being at this health center is not going to mess with my identity or psyche or ego.

As long as they can understand what I am saying to them, as long as they can use my preferred name and male pronouns, and as long as I’m getting good treatment, I will be proud to go here.

(And if it doesn’t work out, then it doesn’t work out.)