I have scoured the internet looking for physicians, surgeons in particular, with narcolepsy and have been unsuccessful. I've always wanted to become a surgeon and was recently diagnosed with narcolepsy. I am a very determined person and have been able to push past this condition since HS and am just now receiving treatment with Xyrem and Provigil. I'm just wondering if any doctors with narcolepsy could give me some insight on how they made it through residency and all.
Doctors With Narcolepsy??
Posted 25 July 2013 - 03:07 PM
I am a medical doctor with narcolepsy and cataplexy and have been treated with Xyrem and Adderall for about one year. I believe that if your symptoms are reasonably well controlled on medical therapy, and you are able to take the occasional afternoon 20 minute nap, you should be able to do as well in medical school as if you did not have the disease.
Regarding a career in surgery, you can choose to pursue training in one of the subspecialties of surgery that has shorter operative times. By the time you are in a position to enter a surgery residency program (immediately following medical school) you will probably find that a substantial amount of surgery will be performed in regional centers of excellence using a combination of robotic techniques and micromanipulators as the surgeon watches the surgical field on a 3D video monitor.
You should keep in mind that when you graduate from medical school and enter a residency training program, you will be considered an employee and as such your narcolepsy will qualify you as an individual with a recognized disability for which your employer will be required by federal law (Americans with Disabilities Act) to make reasonable accommodations for your limitations. In this scenario you would first be accepted by a residency training program and then once you have your acceptance in hand, then you could choose to disclose your condition to the institution's human resources department. That department would work with your department to make the necessary arragements to create an environment that is most conducive to mitigating the symptoms of narcolepsy.
We all can hope that with continued research, there may be better treatments available for us by the time you are ready to enter a surgery residency, perhaps even a cure.
I have every belief that you should be able to hold your own in medical school and in a surgery residency program. Being determined is a great complement to effective medical therapy for those of us with narcolepsy and cataplexy.
Best of luck
Posted 14 August 2013 - 05:16 PM
I was diagnosed with narcolepsy during my first year medical school (onset was probably 10-11yo age). I had briefly considered going into surgery during my 3rd year med school, but ended up concluding that it would not be the right choice for me or for the patients.
Obviously there were a lot more factors that went into deciding against becoming a surgeon; but an episode of cataplexy (which ended up making a scene since I knee-buckled as usual and fell off of the surgical stepstool) in the OR was the last straw.
Having said that, I am NOT writing this to prematurely discourage you. It would all depend on the severity of your symptoms, the presence/presentation of your cataplexy, and how well-controlled you would be while on medication. I have definitely met an amazing cardiothoracic surgeron who has significant narcolepsy symptoms when off-meds.
As for myself, I am currently half-way in my residency, doing tolerably well. I did have to increase the dose of my meds and take an extra med for 24+hr calls, and I do spend a big chunk of my free time sleeping.. but what resident doesn't, right? In fact, everyone in residency is perpetually sleep-deprived, I blend right in!
Joking aside, I think being narcoleptic actually helps me adjust to the day/night sleep schedule change. A lot of my co-resident have difficulty falling asleep after night shifts, but it's not a problem for us narcoleptics to fall asleep regardless of time of the day (especially with Xyrem). And Provigil/Nuvigil tend to keep your mood up and bright, which always helps.
So far I have not had any issue with falling asleep at inappropriate timing, nor have I slept through a pager. I have disclosed my diagnosis to a few people in my residency that I've worked most closely with, and no one believed that I am narcoleptic since my symptoms are so well controlled.
Bottomline - retrospectively, I probably could have become a surgeon even with narcolepsy. I don't regret my decision since I am very happy in my specialty right now, but don't discourage yourself preemptively. You can (and will) pull through it.
Posted 15 August 2013 - 11:13 AM
I would like to share my story that may help you in your decision. I am a physician, board certified in emergency medicine for the past 25 years. I have obstructive sleep apnea (OSA). My diagnosis was delayed due to the early thinking that obstructive sleep apnea was confined to the obese. I also training in the days when it was not unusual for interns and residents to arrive at 5am to review labs and other test results prior to surgery, clinics in the afternoon, and then on call all night in a busy trauma center. This translated to 36 hours without much sleep every 3 days. This actually leveled the playing field for me since everyone suffered from sleep deprivation in those days. However, this also led to a delay in my diagnosis of OSA. My state of being was so improved after starting CPAP the residual tiredness was thought to be due to not having completely normal sleep. I was diagnosed one month ago with narcolepsy without cataplexy by MSLT. I had been having problems managing multiple patients over the past 6 years or so. I would slow down my pace to avoid making mistakes and I was running out of work arounds. Neuropsychological testing four months ago revealed problems with cognitive set shifting (see Cognitive deficits in narcolepsy J sleep Res. (2006) 15, 329-338). I look forward to starting Sodium Oxybate in the next week or two.
Based on (my) current understanding of narcolepsy and OSA, I have had these issues for years and compensated without treatment (though I felt like I had to put forth 175% effort. Therefore, with treatment you should do well. Some studies indicate having high intelligence is helpful, probably because of compensation using other areas of strength (on a conscious and subconscious level). That being said, I think if you are currently being treated and your symptoms are well controlled you most likely can pursue a career as a surgeon with some adaptation. I cannot recall if you have the cataplexy component. If you have the resources you might want to seek an opinion from the Stanford’s narcolepsy clinic or other large center that most likely has expertise in this area.
Posted 25 September 2013 - 05:23 PM
I once wanted to be a surgeon. I now practice outpatient internal medicine.
I knew I couldn't pursue a surgical career because of the confusion I get when woken up during REM sleep. There are nights from internship where I do not recall entire conversations with nurses. I wasn't diagnosed until the end of residency because everyone is sleep deprived. I thought I was just tired. Then I started falling asleep eating, or not remembering falling asleep.
Surgery is a hard life, narcolepsy is a hard life. Both of them together in my head was not a feasible option for me. I need regular sleep. I need a regular schedule or my automatic behaviors increase.
Will you be able to take zyrem while in residency/fellowship. Call will be a required aspect of your job. If you miss it on those days, how is that going to affect you?
Posted 26 November 2013 - 06:57 AM
Posted 26 November 2013 - 02:31 PM
I'm a second year medical student with narc, I am considering specialties with would be best for me, any suggestions for narc friendly specialties?
How about dermatology- outpatient- no rounds- no interrupted nights