the reason for my long silence

At long last, I can break my silence and explain why I’ve been away from this blog for so long. It’s because I was afraid I would spill the beans before the time was right.

I am pleased to announce that Hubby and I are expecting, and I’m due at the end of April. The ultrasound pic at the right was taken about 6 weeks ago, during my 1st appointment at the High Risk OB (consultation regarding my ADD medication).

So far, things are going well for both me and the little one. Our offspring has a good strong heartbeat, and it danced around a ton during the ultrasound! We have our real ultrasound next month, and will have more information then about its development thus far. The pregnancy has been quite easy for me overall. I had very little morning sickness, other than some food aversions and mild nausea at odd times of the day. It only lasted for about 3 weeks, and the worst of it went away when I stopped taking the fish oil supplement (prenatal vitamin adjunct).

A note about fish oil that’s relevant for ADDers, pregnant or not: This might sound stupid, but do not try taking it at night. For a month, I took it with my regular prenatal vitamin at dinner, and I had insomnia for that entire month. It was miserable. The insomnia decreased when I switched to taking it in the morning, and it helped a little bit with concentration. Notwithstanding, a single capsule was murder on my stomach. Maybe it wouldn’t have been so awful if I hadn’t been in the middle of morning sickness, but I’m also not convinced that it wasn’t the cause of the morning sickness itself.

Medication has been a bit tricky, at least at first. I was switched to a new pdoc around the same time I had the positive pregnancy test. Amazingly, my new pdoc has ADD, and she’s been amazingly helpful and supportive with troubleshooting my medication. We tried various options: I dropped back to 10mg of ritalin 3x/day, then 5 mg 3x/day, on the way to the goal of 0 mg of ritalin 0x/day. I was frustrated and miserable at 5mg, and barely functional at 10mg, but I stuck with that dose for a month before going to the aforementioned high risk OB consultation. The three high risk OBs I’ve now worked with in that office have actually been the most supportive of my medication. One of them even said to me, “If you need this medication to function, you need it to function. Period.” Their acceptance was amazingly refreshing. Of course, the reality is that we won’t know for some time if my medication has done any harm… keep your fingers crossed for us, please!

Work issues have been resolving themselves. I met with my department chair today to let him know about our upcoming addition, and he was very supportive. It looks like we will be able to put some plans into place in advance to handle my inevitable absence at the end of the spring semester, and I have some decisions to make about using my summer funding, stopping the tenure clock for next year, etc. I have time to make these decisions, fortunately. This was a big relief, but it’s really the small things at work that have made it more stressful for me this semester. For example, I outgrew most of my work pants around 6-8 weeks of pregnancy, and now I’m starting to outgrow my work shirts. I don’t look particularly pregnant, just  a bit pot-bellied… The second “minor” issue is H1N1 flu. It’s going around on my campus, and I’ve had at least a dozen students out sick with it. I was able to get the H1N1 vaccine over a week ago, but still have a few days until I will have full immunity against all the nasty germs my students are sneezing and coughing all over the place. Yuck!

All in all, everything’s going far better than we’d anticipated, and I can only hope that things continue to go this smoothly between now and the end of April!

ah, summer (part 3)

About 2 months ago I posted about my experiences teaching over the summer. I had a student with severe ADHD in my small class, and it made the class a unique challenge.

This morning I received my course evals in that class.

Three students accused me of unfair treatment and favoritism because I was “too nice” to my student with ADHD.

Yes, they actually used these words in my evaluations.

I know for a fact that 2 of these 3 were students I’d had to threaten to physically separate the day before because they wouldn’t shut up for the 80 minute lecture (the “eye rollers” mentioned in the post from 2 months ago; these two students plan to be psychologists after completing their undergraduate degrees. HA!). The third student was one of their friends.

Apparently I was supposed to kick the ADHD student out of my class when they asked repeated tangential questions instead of dealing with them and moving on. Apparently it’s also unfair that I gave copies of my lecture notes to the student with ADHD.

Never mind that that this student was also paying for the course and actually displayed interest in the material, and that the student with ADHD had accommodations that guaranteed them access to my lecture notes as well as other types of support in the course.

I am livid and disgusted. Apparently as a professor I’m responsible for controlling everybody’s annoying behavior in the classroom, but I’m still unreasonable to expect neurotypical normals to shut up and leave their cell phones alone.

an ADD-friendly adaption of the 10-10-10 plan decision making

This morning I was watching the Today show as I prepared for work. I usually have it on while I get ready, as it’s a great way to keep on schedule in the morning. The segments are short, and they regularly announce the time, so it’s a lot harder to procrastinate with constant, cheery reminders. Today Suzy Welch was on the show promoting her new book 10-10-10: A Life-Transforming Idea.

Granted, this is an oversimplification, but the gist of the 10-10-10 plan is that whenever somebody needs to make a decision, they should stop and ask themselves about the consequences of that decision/action in the next 10 minutes, the next 10 months, and the next 10 years. The best/right decision is the one that leads people to  where they want to be 10 minutes, 10 months, or 10 years later.

I was intrigued by this simple plan both as an ADDer and an academic who professionally studies issues related to this, but also because I’d intuitively come up with a way to do this on my own, and have been using a modified version of this strategy for at least the last two years.  I can see how this would be particularly challenging for ADDers, who might end up feeling overwhelmed by the 10-10-10 plan.  I know that this strategy could be difficult to employ in the heat of the moment, but I think it’s worth it to give it a try, with or without an ADD-friendly modification.

Part 1: Set aside a few free moments and figure out where you want to be in 10 months and in 10 years. If this seems too distant, think in the increments that work best for you. I tend to think about where I want to be 6 months, 1 year, and 5 years from now. I write these down in one of my notebooks, and keep notes on the steps to reach these goals (i.e., what I’ve accomplished, what I still need to do, back-up plans in case things go wrong along the way). Revisit this plan on a regular basis as suits you, and make changes as your life and goals change. Knowing what you want out of life makes it easier to do the second part, which is the ADD-friendly modification.

Part 2: A short-term modification of this strategy is key for staying on track in day-to-day life, particularly for getting through those “off-track” moments. I suggest a 1-1-1 approach. Whenever I catch myself doing something counterproductive (e.g., procrastinating on Facebook, not doing whatever is on my daily list, etc.), I take about 30 seconds and ask myself “How is this getting me where I need to be in in one minute? In one hour? In one day?” If I’m having a really bad procrastination day, I ask myself “What am I doing in this one moment that is going to keep me from meeting the day’s goals? How else will I go off track for the rest of the week and month if I don’t keep on track right now?” (Disclaimer: As beating yourself up can be counterproductive for ADDers, I don’t recommend bringing out this second set of cognitions unless your motivation is at major lows).

As all the ADD books say, it’s all about small steps and keeping yourself motivated. Knowing where you want to go is a big part of this, and structuring your life so you can get there is another important piece.

new rules for my blog

Part of the reason for my long absence was that I was contemplating ending this blog. On one hand, it started to feel like a personal liability, and on the other, I didn’t feel like I was meeting my goals for starting the blog. For the time being, I’ve decided to keep it going, but there are going to be some new rules.

Regarding it feeling like a liability… Non-academics might think academics are paranoid about protecting their “private selves” from the public at large (e.g., students and their parents), but let me assure you that there’s good cause for our paranoia. For example, my students regularly try to “Friend” me on facebook so they can see my profile and photos. Also, when candidates are on the job market, it’s not unusual for search chairs to “google” them to see what else is on the web in their name. Consequently, I have to be vigilant about the information that is publicly available. In sum, I blog anonymously for a reason. I ask that you please respect me on this matter, even if you know me in the real world.  I’ve opted to change my policy on comments so I may have better oversight. From this point forward, all comments will be moderated and will not appear on posts until I’ve approved them.  Don’t let this hold you back from commenting… just respect my privacy and your comments will show up as promptly as possible.

The reason I blog anonymously is because much of what I’ve written here details my personal journey with the mental health system in addition to my experiences as an ADDer in the academy. I do this both for my own benefit and for others out there like me.  I started this blog was to find other academics stuggling with the same types of issues, but unfortunately, there aren’t very many out there or my little blog hasn’t reached them.  I hope that this situation continues to improve, and that we can build a network of addled professionals together.

how to schedule exercise

After a prolonged hiatus, I am back! The grant(s) are in, and I finally feel like I’m reasonably on top of things again.

The only goal I’m not meeting so well right now is exercise. I’m not getting enough, particularly since moving to New City, where I am forced to drive everywhere because there is no infrastructure for walking. This is troubling because exercise is good for health, good for helping to minimize ADD symptoms, and can help with sleep (see helpful posts by Tara and Jennifer Koretsky on this very topic).

The problem with exercise is fitting it in my schedule/life. When I wake up in the morning (7 am), I’m groggy and need my morning caffeine and a bite to eat. Then I shower, get ready, and go to work for the day (arrive around 9-9.30). Three days/week I teach until after 6 pm, and on those days, I am ravenous for dinner once I arrive at home. I eat dinner. Then I’m too full to exercise, and it’s too late, as it will end up “revving me up” too much for me to sleep at a normal hour. Go to bed. Sleep. Repeat.

I fear having to set my alarm and start the day any earlier because I’m already pretty worn out by the time I’m done teaching class. I don’t function well at 6 am, particularly not on an empty stomach.

I’m curious… how do other academics (with or without ADD) make this work in their schedules without driving themselves crazy?

a clarification on my November post about knowing more than my doctor

I *loved* this comment from PreMedAA so much that I’m going to write a whole post in response to it. This comment followed my early-November post about my annoyance with my new psychiatrist.

The background for readers who don’t want to refer back to old posts (plus filling in some gaps I’ve previously omitted to help hide my real identity): I switched shrinks when I moved to a new state over the summer. Hubby and I knew that we wanted to start to try for a family sometime this autumn, which was my first in a faculty position after 3 years in a health sciences postdoc. Having discussed the issue of medication and pregnancy at length with my old shrink (a fellow in geriatric psychiatry at one of the best psychiatric hospitals in the nation who I very much  miss), I was keenly invested in seeking the best care possible in my new setting. My old shrink was supportive, and asked me to keep in touch with her about my treatment in this new setting. My old shrink appreciated that since Hubby and I have started talking seriously about kids, two limitations have been foremost on my mind: a) I’m able to work up to my full potential because of ritalin, and taking a 2-year break from it in order to conceive could potentially tank my chances for tenure, and b) having spent 9 years in pre- and postdoctoral training, I’m no longer a spring chicken. If we’re going to start a family, we need to start trying soon, or we risk running out of time.

S0, imagine my dismay when I called for an appointment at my new university’s med center specialty AD/HD clinic (in July) and found out I’d have to wait 2 months in order to get an appointment (September). My dismay was further magnified when I met my new doc and discovered how inexperienced she was. I brought up the pregnancy & meds issue at our first appointment in September. She promised to do research before our next appointment, and wrote me a prescription for the SSRI I take for PMDD (note: she wrote it for the bi-weekly dosing, which is quite standard for treating PMDD). When I came back in October, she hadn’t yet done any research on pregnancy & ritalin. I brought up the research I’d done on my own and with my old doc. She promised to look into it and get back to me. When I came back in November, she still hadn’t done any research and seemed to have forgotten about the bi-weekly dosing of SSRIs for PMDD (despite having written the prescription herself just weeks before). She promised to consult with her network of supervisors and colleagues, and assured me she would call me in a week. I had to call her a week later to remind her of our phone appointment. She was rather unprepared when she called me back, and asked me to come in before Thanksgiving for a short chat in person about the literature & promised to bring an important research publication. I made (& paid for) the extra appointment, for which she ran 30 minutes late. She forgot to bring the article (promised to fax it, but it still hasn’t happened & I’m not holding my breath), but still couldn’t say anything conclusive or provide me any strong evidence for any option during pregnancy. She pushed really, really  hard for my trying fish oil, which apparently shows decent efficacy with young children (alas, if I were only in the 2nd grade and just learning simple multiplication instead of spending my days doing matrix algebra…).  So I’m still on hold, and yet can’t get another appointment in the clinic until  early January.

So, my hubby and I have put off trying to conceive for an additional 6-7 months, and 4 months of that delay is due to my new shrink being inexperienced and inefficient. I’ve also wasted a total of 4 hours of my semester in the waiting room filled with people who function at a far, far lower level than I do… and to put this in practical terms, 4 hours = the preparation of 1 full lecture or 4 written pages of a research article.  The bottom line is that I sought a specialty clinic thinking it would save me time and effort, and I probably could have received better treatment from a GP.

(I suspect that quite a few ADDer readers have had similar treatment experiences. My situation is anything but unique.)

So, now I’ll deal with PreMedAA’s lovely comments…

Would you have preferred for the resident to attempt to cover her ignorance and simply take her ‘best educated guess’?

A physician at any level may not have confident answers on the tip of their tongue, especially if their patient has a keen grasp of pharmacology and medicine.

I agree with you; no, I wouldn’t want her to ‘cover’ by making a guess, but a competent medical professional in a specialty clinic shouldn’t need 3-4 months to come up with an answer to this sort of question, regardless of who the patient is, or how threatening the patient’s competence is to the physician’s ego. It’s not like ADD is a new condition, and I’m hardly the first woman who wants to get pregnant without tanking her career by going totally med-free.

Stating that you know more about something than a doctor may or may not be true. Your ‘knowledge’ may have been garnered from secondary sources or your educational background may be insufficient to properly digest the primary pharmacodynamics proposed by the manufacturing company. Your doctor is not a CPS or PDR, if they were, those compendiums wouldn’t exist.

Actually, I have a Ph.D. in the health sciences, and my research specialty is self-regulation, the set of skills directly impacted by the medical condition of AD/HD. It takes longer to get a Ph.D. in  my field than it does for a M.D. to complete medical school, and I have 3+ years of postdoctoral training on top of that. Furthermore, I’m 2+ years past diagnosis, and have been very actively involved in my treatment. This has included spending a great deal of my free time reading the literature on AD/HD and medication. Yes, I read the primary sources, and yes, I understand them, even the “yucky” stats part in the middle. In short, I have more years of research training in the field, and unless my doc has ADD herself, then most likely I also have more first-hand experience.

If you were particularly impatient, which you claim to be, then perhaps stating your acceptance of her consultation of her reference books in your presence would have saved you both time, as its likely that she didn’t feel dragging out the books in front of you would inspire much confidence, which you could have offered to alleviate.

For pete’s sake… the November post as just a blog entry, not a direct transcript of my conversation with my doctor. I actually would respect her more if she had dragged out her reference books. Of course I consented to allow her to consult with colleagues and do further independent research. I’ve repeatedly told her that I understand that residents are still training, and have also repeatedly expressed a desire to consult about primary references (i.e., current research). She’s the one who’s not been willing or able to meet me halfway on this. How much more open, supportive, and non ego-threatening can I really be? How long should someone be reasonably expected to wait?

You claim to know more about treating ADD/ADHD than your 1st year psychiatry resident-attending physician which is unlikely unless your a physician yourself and in the case of Adderall…at least a pharmacologist.

I’m not writing anything else about my specific academic credentials because I risk outing myself, and that’s  not a good thing pre-tenure.  Just a few points… a) she’s a 1st year resident, not an attending; b) it’s “you’re,” not “your,” and your sentence structure doesn’t make much sense; c) finally, if you’d bothered to read any of my other entries, you’d realize that I take ritalin, not adderall.

But since you don’t have time to permit your physician to ensure the validity of her counsel, then perhaps you ought to consult with a pharmacist about the possible effects of your drug regime on pregnancy…and perhaps they would be familiar with your atypical SSRI rotation.

The possibility that you havn’t done this already on your own suggests that such comments in regard to having a superior clinical knowledge of your diagnosis may not be advisable on your part, especially towards a medical professional.

Doctors are not gods, and the rest of us are not “lesser” beings.  Contrary to the belief of many MDs, they don’t know everything, they do make mistakes, their time is no more valuable than anybody else’s, and they don’t deserve to be treated any better or worse than anyone else.  I’ve given her plenty of time, and she’s wasted it. As a faculty member who is currently working 60+ hour weeks, I don’t have time or the patience to train somebody how to do their job OR remind them about how they’ve treated my condition at previous appointments. In these circumstances, I shouldn’t have to bend over backwards or jeopardize any aspect of my future in order to keep them from feeling badly about themselves or their abilities.

I know more about ADD/ADHD than my psychiatrist

It’s annoyingly official… I know more about treating ADD/ADHD than my new psychiatrist (1st year psychiatry resident). I asked her today about medications & pregnancy and she said that she’d have to get back to me about it… and amazingly, this is a specialty ADD/ADHD clinic in my local university hospital.

In the same conversation, she also tried to order me to take my SSRI for PMDD continuously instead of in two week cycles. Actually, she’d never heard about people taking SSRIs in two-week cycles for the treatment of PMDD.

I’ll call her in a week to talk about ADD meds & pregnancy. I had to promise to not get pregnant in the  next week until she’s had a chance to do her research.

I respect that there’s a learning curve and that new doctors need to be given allowances to learn how to practice medicine… but I don’t have time for this, and think I need to find a new doctor.

dealing with students with ADD (or students who possibly have ADD)

I’m having trouble to varying degrees with 3 students, 1 of whom has a ADD/ADHD diagnosis, and 2 who don’t but quite possibly would qualify. The problem is that all three are struggling, but don’t seem willing to do the  work necessary to be successful in college.

It bugs me that I think this because I know that with ADD this isn’t really the case…

My diagnosed student had a major meltdown around the time of the first exam, so I cut hu some slack and let hu retake it a few days after the class. Hu did better, but still barely passed. Now hu thinks that they can call me by my first name (‘Addled’ versus ‘Dr. Academic’), and has requested additional accommodations above and beyond hu’s official letter from the office for students with disabilities. I’m ok with obliging, provided the student does better and passes my course without my having to entirely gut my standards.

The two students who aren’t diagnosed have all the symptoms (“I can’t listen to you in class and take notes simultaneously!” and “I can’t read the book without falling asleep!”) but are very resistant to even considering an evaluation (Certainly I don’t push the issue, nor mention why their statements raise red flags for me personally…). They just want accommodations without a diagnosis or documentation. The “book sleepy” student showed up in my office the day a paper was due and I had to walk hu through it section by section before hu saw that hu had missed a major portion of the paper entirely. The “distracted note taker” spent a large chunk of time tonight telling me all about hu’s upbringing in gristly details (TMI to the extreme). Both have significant testing anxiety issues, and both are struggling in the course.

I just don’t get it…. from my perspective as a good student, if there was something out there that could help me do better, I’d want to learn about it and consider it. These students are clearly concerned about their performance, but just don’t seem open to taking the initiative and responsibility for their own learning.

But they’re really  not unique in this respect. Nearly all of my students are whiny, lazy and irresponsible.

Maybe this feeds in to why so many “neurotypical normals” view ADD as an excuse for laziness… they’re really all lazy, but the fact that some people have a medical label for it somehow “confirms” that it’s somehow more true of some people than of others.

A paper was due in one of my classes today, and 1/3 of the class failed to turn it. One of my students turned it in despite being ragingly drunk. Interestingly my “add likely” students both turned theirs in on time. I am dreading listening to all the whiny excuses the remaining third will try to spin tomrrow…

1 week finished and 14 weeks left to go

Whew! All I can say is that these last 3-4 weeks have flown by. They’ve been fun while being so busy, and I cannot fully express how *happy* I am in this tenure-track position in comparison to my postdoc. This clearly says something about my postdoctoral environment, as well as my new department!

Teaching. Classes started last Monday, and I’ve now taught two lectures from each of my two classes. I think it’s going as well as can be expected so far. Most of the time my students stare up at me blankly, but occasionally something I say gets a small chuckle. I think I’m coming across as sufficiently approachable, because I’ve had a slew of student emails over the past week, and one of the small groups in one class had a serious discussion about the virtues of “country-grown” marijuana versus “city-bought” pot (I pretended to put my fingers in my ears and said “I’m not hearing this” in a sing-song voice).

There was a glitch in my class preparation process, however, and I’m not as prepared for the second class as I would like. When I was negotiating my contract for this position, the chair of my department promised that I could teach class #2 “out of the box” because the class is well-developed and “most of the preparation will have been done” for me. Alas, this is not the case, and I’m still having to do quite a bit of prep. I think I can handle it, but it’s going to make this semester a bit more stressful than I’d anticipated. One problem I’ve run into is that it takes me too long to prepare my lectures. Ideally I’d get 1 lecture (1 hour & 15 minutes) finished in 3 hours of prep time, but it’s probably taking me 4 hours to get it done. This hour might not seem like a lot, but cumulatively, this means an extra 30 hours per semester for each class. Do any readers who are educators have ideas for how to cut this time without cutting corners? (Admittedly, this is part and parcel of being a new professor, and things will be better next semester when I’m only having to prep 1 class instead of two).

Research. This will cut into my research time this semester, but I think I can ride out my postdoctoral momentum enough to get a good evaluation this year. Last summer’s “forced march” paper has been conditionally accepted for publication pending minor changes; I’ve made all but two of the changes and can probably send it back late next week. I have another “revise and resubmit” that needs to be finished before December, and a couple of other papers in the works with various co-authors.

I really, really wanted to start collecting pilot data for my next research study this autumn, but yesterday I found out that I probably won’t be able to do so until the winter. This is because my application for a grantwriting workshop has been accepted, although I didn’t really want it to be. What this means is that for the next two months (while prepping for two classes, keeping up with the pubs I’d started in Postdoc City, and just generally learning how to be a professor), I’ll write a full grant with the intent of submitting it to NIH in February. I’ll also participate in one-on-one critique sessions with a nationally-known grantwriting guru, and work with other faculty at my university in this workshop. I should be excited about this, because the selection process was competitive, and it’s an honor to be chosen to participate. However, I’m not very keen on it because I’ve already got so much going on. This is just one more thing to do in the next two months, and I’m afraid it’s going to entirely upset the balance of the apple-cart. I’m trying to keep my eye on the prize: This program will force me to get the grant written sooner rather than later, which can only help a procrastinating Adder like me. Plus, I’ll get helpful feedback from a grantwriting pro, which will hopefully lead to a better score and better chances of getting federal funding (translation for non-academics: getting millions of dollars from NIH or NSF is a very, very good thing for doing good research and will go a long way towards my getting tenure). “No pain, no gain” will just have to be my motto for the next two months.

Being an educator with ADD. Managing my medication in order to get through my classes has worked out ok. I teach both of my classes on the same days, and the second class is scheduled for the early evening hours. In order to have coverage for most of the day and both class periods I have to take my first morning dose of ritalin an hour later than normal (i.e., 9:30 instead of 8:30). It’s working out ok, and I don’t have to take any medication in the middle of class, either.

This is the only thing going right with my medication situation at this time, unfortunately. I had my last appointment with Med Shrink in Postdoc City in late June, which ended up being a phone appointment because our moving schedule was so messed up. I’ve been banking ritalin for the past year so I’d have enough to last until I was established in New City, and in June Med Shrink said she’d drop another prescription in the mail so I’d be completely covered. The prescription never arrived, but I didn’t stress about it because of my banked ritalin. Last week I thought I’d try to make an appointment at the psychiatric clinic here, hoping I’d be able to get in within a couple of weeks, because I’m running short on my SSRI for PMDD but am still doing ok with ritalin. Imagine my dismay when I couldn’t get an appointment until the first week of October at either the psych clinic OR my new primary care physician! So, I emailed Med Shrink, told her that the first mailed prescription never arrived, and asked her for a big favor… she came through and offered to drop the prescriptions in the mail to me. But, yet again, it’s a week later, and no prescriptions have arrived. I hope there’s nothing strange going on with the mail… what do you do when you need medication but can’t get in to see any doctors?!?

That’s all on this end for now. I’ll try to be better about posting now that the school year has begun again, but it might be a little dicey with the grantwriting process over the next 2 months.

recovering from the big move

I am still recovering from the big move to New City, so this entry will be short. All in all, it wasn’t fun, and included such highlights as:

• My car breaking down in the middle of a major intersection in Old City on the way home from picking up the moving truck (leading to about $600 in repairs)
• Our closing date changing twice
• Having to spend 2 nights in a really crappy hotel in New City with two very unhappy cats
• Having to extend our moving truck rental an additional 2 days to deal with the closing date changes
• Our moving help suddenly couldn’t help us unload the truck in New City, so we had to unload the truck by ourselves and a little bit of help from a local teenager
• Hubby damaging another moving truck as we tried to return ours (thank goodness for insurance!)
• Our cable/internet company creating problems which are still not completely resolved

Hubby had to go back to work just 3 days after we closed, and we’d already planned to spend the following two weekends out of town, so I’ve been stuck with the brunt of the unpacking in the meantime. Consequently, our house is only about 60% unpacked. I am still missing some crucial items and this is slowly driving me insane (e.g., the USB cable for my PDA).

I am still trying to work, but am not making much progress. It also seems that my ritalin has stopped working, which is making this quite a bit harder. I guess I’ll need to find a new doc sooner than I’d anticipated!