Weekends before any tests are pretty killer in medical school. You essentially study every waking hour, rain or shine, personal problems or not, because you HAVE to. If you don't, you won't be prepared in time. There's very little that can stop you from studying the weekend before the test. I actually had the opportunity to test my threshold this weekend.
I always wake up to study around 8 AM on the weekends since it's my prime study time. I studied for about four hours before I decided to ride my bike over to the gym for a little cardio-related break. At the gym I started having this annoying pain in the lower right quadrant of my abdomen. I also noticed that my stamina was not up to par and I was really falling behind my usual cardio pace. I cut the workout short at 30 minutes since the pain was increasing and I still had to ride my bike back home, uphill.
By the time I get home I decide that my pain is the result of IBS-induced gas pressure. I took a warm bath to relax, got into my PJs and decided that I could handle the pain and continue studying. It's just gas, afterall. The pain became so bad that I could no longer sit up comfortably and it was incredibly hard for me to rise from my couch. I crawled into my bed to try to massage my gi tract and to do a few tried-and-true yoga positions that are good for this sort of gi malady. The pain increased.
After two hours of trying in vain to massage the pain out of my lower right quadrant, I realized that this intense pain was not moving. I ran through my differential diagnosis in my head: IBS, diverticulitis, reproductive issues, appendicitis. Appendicitis appeared to be winning as far as symptoms were concerned so texted Vijay to contact his sister (who is AWESOME), a physician, to see what she thought. He was not able to contact her and he begged me to let him contact his dad's friend, also a physician. The pain was so bad that I conceded and soon got a call from Vijay's dad.
Vijay's dad and I discussed what it might be. He was pretty sure it was my period and I kept telling him, "No, no-- it's not. I think it's GI related" so he gave me the number of his doctor friend. I was in just enough pain to call this guy, a stranger to me, and talk about the innermost details of my GI tract. Dr. Patel told me a few more things that solidified my thoughts about appendicitis and he said that if the pain got worse, go to the ER.
I decided to call my mentor at the medical school who did his residency in Internal Medicine. He also said the same things as Dr. Patel. If the pain got worse, go to the ER. Appendicitis is an emergency and can be dangerous if you let it go for too long.
The pain was so bad that I decided to suck it up and go to the ER. It's not like I could study with the pain, anyway. At least maybe now someone could help me. I call Zach to see if he can take me, assuming he's still at school studying. Zach agrees, but tells me that the whole family (Wife, toddler + twin infants) are coming too since Zach had a drink or two when he got home. I feel AWFUL because I didn't want to uproot the WHOLE family on a Saturday night, but I was in enough pain that I allowed it.
His wife drops us off at the ER that belongs to the medical school and Zach and I walk in. It doesn't seem too crowded and hey, we're medical students so we figured we'd get in and out quickly.
Two and a half Matthew McConaughey movies later....
I'm doubled over in pain, still waiting in the ER waiting room. The ER was filling with more and more people, people in stretchers, people crying out in pain. There's a toddler next to me eating something putrid smelling which does NOT help my nausea (the whole night I had been suppressing dry-heaves). I can't answer my phone, I can't text. All I can do is focus all of my mental energy on making them call my name into the ER.
Zach decides to walk into the back of the ER to see if he can inform any of the ER residents that we're medical students and I'm doubled over in pain and need to study for my cardio exam. He's gone for about 15 minutes and when he gets back he says he didn't have any luck finding anyone to help us.
We wait some more. The ER continues to fill with some of the most interesting people and smells that I've ever encountered. I hear more ambulances approaching the emergency department.
I decided, despite the pain, that I'd much rather die in my bed at home than to die in this waiting room. I tell Zach that if it gets worse overnight, I'll just come back in the morning when there are hopefully less people in the ER. He reluctantly agrees and we called his wife to come pick us up. By this point I feel awful because I inconvenienced that ENTIRE family just for me to wait in the ER without seeing a doctor.
I get home around 9:45 PM, sit on the couch in a way that isn't excrutiatingly painful and continue studying for my cardio exam. I figure that whatever I have can wait until Monday when I can schedule an appointment with my doctor and/or pass out in pain in class and get the kind of emergency care I need.
Post script addition: Instead of worrying about the seriousness of the pathology going on inside my abdomen, the entire time I wondered how I would manage to finish studying for the test if I had to have an appendectomy. What scared me the most was not having an operation itself, but the effect it would have on my cardio grade.
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