Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Career choices regarding AS, looking for advice

Hey folks,

My name is Andy, I'm a 21 year old medical student from the UK. I was diagnosed with AS quite recently following 2 years of symptoms.

Basically, I was wondering if anyone has any advice on how to plan for the future regarding careers;

Within our medical training, there comes a point when we choose to specialise in a certain area. However, I am becoming more and more aware that my condition will probably progress and some tasks will become difficult, if not impossible.
For example, surgeons must stand still for long periods of time, which is already impossible and thus I cannot be a surgeon. I would love to work on the emergency ward, but I am concerned that I will be working until I'm 65 (or older) and I do not know whether such an active, physically demanding job would be suitable.


To sum up, if anyone has any advice on how much AS will affect my work life and whether I need to start thinking ahead to a less intensive career choice, that'd be really useful. I have a while before I have to decide, but right now I feel a little lost.

Thank you very much

Hello and welcome!

I'm a professor in biochemistry, thus advise a lot of students on their way to med school. Having been to lots of different kinds of doctors (like so many here), I feel as though I can give an insiders view.

I think you are correct, anything that would require long hours of standing to do surgery would not be the best. My podiatrist and gastroenterologist do procedures that require standing.

How about rheumatology? or endocrinology? or general practitioner? Seems to be a lot of talking, examining patients, and putting puzzles together. especially the first two. or as a GP you could have your own practice and to some extent make your own hours, especially if you had partners.

My rheumatologist is also in private practice with one other rheumatologist and they seem to have a much calmer existence then the doctors I see in practices associated with our local hospitals.

I think its wonderful that you are in med school! You'll make a great doctor just in that you will relate to your patients so well.

Strutsy on her is a doctor in the U.K. She may see this and come on, or you could PM her.

Anyway, welcome aboard!

Nice to meet You, Andy:



At Your current age, AS is probably quite severe and active, but it subsides to some extent later on.

I know that You are new here, so I would give You the best advice in the world absolutely FREE: Do what You love! You will be good at it and instead of an onerous chain, it will be a hobby for You.

And STUDY KickAS enough to avoid making a career out of this disease; turn it into a minor nuisance, so You can lead a full life without limitations! Life is short enough and difficult enough without allowing AS to rule it even ONE DAY!

Many of us have lost so much to this disease and we do not want to see others follow! There is a better way---OVERCOME!

HEALTH,
John

Hello there Andy,

Jeanna (Strutsy) is AS Kicker that moved to England from Canada and works in medical field... she posts rarely now, but maybe send her an PM (Personal Message) and see if she replies.

Your "limitations" will be impacted how well your AS responds to meds/alternatives/diet. At times I never thought I would be able to work much... at other times I have been able do nearly most I was able to do pre AS (when on azulfadine and at times with diet).

I myself have a desk job... prior as accountant, now as project manager self employed (with wifes business). I have a lot of flexibility with hours now, so that helps.

Take care

Tim

I think you are very wise to think ahead even though you may be able to do any of it. We just never know how we are going to respond to treatment. Our 50 year old son-in-law has been on Enbrel for a number of years and went from not sleeping and barely moving to running Marathons, bike races and triathlons; even an Ironman. He is a Mechanical Engineer but is now heading up a company and does mostly desk work.

I was a public school administrator and was not able to work past 43 but more from Systemic Lupus than the AS.

I used to see a Rheumatologist who was in a wheel chair the last few years of his practice because of AS. It was something he could do as long as he wanted to.

My Pain Management dr. works in a back brace all of the time.

Best wishes in making this decision. I think Sue gave you good advise. I hope Strutsy checks in. She could give you good advise. I agree with Tim to PM her and maybe eventually she will have time to check in.

I know you will be a kind compassionate dr


Possi

Yes, think ahead, but I'd probably suggest to not try and think too limited - if you can cope with things in the first few years, then once you have got through all the basic and specialist study years and have the status of a consultant you may well be able to move into other areas (like more research, or private practice, or setting your own hours) if things get bad - which there is no guarantee of anyway. I think you are right about knocking out possibilities like surgery right away, but that still leaves quite a lot. Rather selfishly I'd say strongly consider rheumatology - would be great to have a few more rheumatologists out there who really understand what they are trying to treat.

Hey there,

The advice given so far is very sound.

My feeling is medical advances, particularly in regards to genetics and epigenetics will have some very near a cure by the time your 30+, if not an actual cure.

If not we'll probably have reverted to the stone age... of course this doesn't answer your question for your immediate future but you can always move forward into a new aspect of medicine, should excellent reliable treatment get so good. My feeling is that it will with genetic specific medicines and possibly a cure via epigenetics that turns off our malfunctioning genes.

I have been in such incredible pain I would have killed myself some time ago if not for some realistic understanding that medicine is progressing rapidly and there is serious possibility of a cure or constant improvement in medication.

'At Your current age, AS is probably quite severe and active, but it subsides to some extent later on.'

Hi Dragonslayer - can you explain that statement.

That's a nice thought and I hope it is true in Andy's case, but I'd appreciate any data on how prevalent that is. It certainly isn't how it's worked out for quite alot of us - maybe it's more the case for men?

Like cemc, I think it would be great to have more rheumies who really "get it"!

Hello, ramakentesh:

Certainly, it has been my own experience that AS was at its worst and most severe in earliest stages; the first decade was by far the worst! Many others have experienced this, also, and the reasons are probably associated with the nature of the advancing disease: Characteristically beginning within the largest structures (proximal in fact to the primary lesion), but as these collagens become consumed, the inflammatory reaction self-limits, due to byproducts and restriction of diffusion (pedesis) the disease becomes less active in the most painful areas, and activity moves up the spinal column into smaller spaces.

This does not mean that AS damage is reduced to any extent; it is just that the pains seem worse over the first several years, but it is more than just becoming 'accustomed' to the pain--more than simple perception; it is actually because the SIJ pain, sacroiliitis, and sciatica really reduce.

Nor do I mean that 'fusion stops pain;' but essentially the pains can reduce once the skeletal damage limits our motion and changes our Osp enough that cells do not die as often or as many.

"To some extent" the pain from AS becomes more manageable and less intense; I experienced this long before NSD results.

HEALTH,
John

But the reasons for this are