Self-care for Medical Students: Reflection by Nicola McFarlane

 

The module was the top of my list when I made my SSC choices because I always like to try a module that offers a different aspect of the medical course.  I like to have a wide variety of knowledge and am always open to new ideas and I thought this module would offer me an insight into things I had not experienced before.  In terms of my own self care I was interested to see how well I was really looking after myself and to see how I could improve.  In terms of my future patients, I wanted to be able to offer advice not just based on drugs and conventional medicine, but to be able to help them in other ways which may or may not have been taught on the current medical curriculum.  We are taught that the patient is more than just their condition and that in order to be a good doctor we must treat the whole patient, but I was still unsure as to what this meant before I began the self care module.  Another reason the module appealed to me was because it was coordinated by a doctor.  This was quite important for me because as a doctor I knew Eunice would be able to relate more than most people to the problems medical students and doctors encounter which prevent them from being self caring. 

At the beginning of the module, we were faced with a question on what self care meant to us.  Looking back at what I wrote, having come to the end of the module,  I found it interesting to see just how little I knew about self care before.  To me self care meant looking after myself mentally and physically because to look after other people, I had to be healthy myself.  A healthy lifestyle for me meant eating the right amounts of different foods to maintain a balanced diet, getting about 8 hours of sleep per night, exercising regularly and having time to wind down and relax.  All these things are obviously very true however I have come to realise self care is so much more than those basics.  The aspects I have chosen to reflect on are diet and sleep because I feel learning about and changing these have had the biggest impact for me.

Diet

I consider myself to have a healthy diet.  I cook everything myself from scratch so I know exactly what goes in my food and I eat as little fat and sugar as possible.  That’s not to say I don’t enjoy coke, popcorn and chocolate at the cinema every now and then but in general I’m not a fan of take aways or any other food that has high fat, high salt contents which make me feel quite ill soon after eating them.  Over the past few years however, I have developed what can only be described as Irritable Bowel Syndrome, after ruling out other causes.  I didn’t suffer greatly with it at first but after some months it became so bad I had no confidence when going out anywhere, opting for jeans and a top rather than a dress which showed just how bloated I was every time I ate a meal.  I was in pain after eating, had altered bowel habits and yet I couldn’t work out what it was that was causing the discomfort.  I tried eating more fibre, taking fibre supplements and more recently have moved on to peppermint oil before meals but nothing seemed to be working.  During the self care module we explored the pros and cons of different foods and I realised there might have been a link with something in my diet and my bowel problems.  I tried making a change in my diet for about 5 days at a time and didn’t initially see any benefit with the exclusion of gluten or wheat but I did notice a difference when I eliminated dairy from my diet.  I didn’t actually realise how many times a day I took dairy products until I was consciously making the decision to stop them and I found it difficult at first, but after a few days of eating my meals and not feeling as sore and bloated afterwards, I realised there was a link between the dairy products and the way I was feeling.  The changes, despite being small have been very evident to me but I know I will not see major results until I continue for another while and my body is completely dairy free.  Because dairy was the last thing I tried to eliminate I am still on my dairy free diet and intend on staying dairy free as much as possible.  It is difficult when you’re out for dinner or when someone makes you tea and serves it with milk, but I know it will just make me feel unwell if I take it and on occasion I’ll most likely just put up with it.

Caffeine was another major problem for me with me consuming around 12 cups of tea a day.  I really enjoy the taste of tea and always thought I mainly took it for the taste, but after some experimenting with decaffinated tea over the module I have discovered my need for tea is very much a caffeine addiction, regardless of how much I enjoy it.  We were given the option of having deccaffinated tea during the break each day and I decided to take a break just once each day to test out what other kinds of tea I could potentially enjoy.  This led to me slowly cutting my caffeine intake each day by 2-3 cups and having a decaffinated version instead.  I still have my cup of caffeine in the morning but eventually I would like to be able to enjoy tea without the caffeine addiction.

Sleep

Growing up I never had a good sleep pattern.  Music, figure skating and voluntary commitments meant my homework and studying was often started at 8 or 9pm each night, finishing at around 2am with me getting about 4 or 5 hours sleep before getting up to do it all again the next day.  Looking back now I can see how unhealthy it was and how exhausted I always felt, yet it has continued like that ever since.  I always considered myself to be my best and most productive at night time and yet during this module I have discovered that it is not actually the case.  We learnt that the optimum time to go to sleep is 9pm according to our physiological body clock.  To me this is not practical with the modern way of life, however I did decide I was going to get into bed around 10pm to read a book and try and get to sleep earlier each night, setting my alarm 45 minutes earlier than usual in the morning to try and get into a new routine.  At first despite getting into bed to wind down it took me a long time to fall asleep, but after a few days of an earlier alarm I felt increasingly tired after just a few pages of my book at night.  Soon after starting the change in routine and going to bed earlier I discovered I was actually waking up before my alarm every morning, something which I never managed before.  I began to see the benefit in the new routine; I now had time to make and eat breakfast in the morning rather than doing the usual of throwing some tea into a travel mug and running out the door. I made healthy filling lunches to do me later in the day and I didn’t feel stressed by the time I got to where I was meant to be.  There have been exceptions over the past few weeks where I have gone to bed extremely late and as a result have either struggled to get out of bed when my alarm has gone off or I’ve just slept through it completely and obviously these will continue due to modern life and busy schedules, but in general I have now made the decision to continue with the routine as much as possible because the benefits definitely outweigh any social implications.

Overall I greatly enjoyed this module and found it a lovely change from the normal clinical side to the medical course.  I was able to take time out to explore what was best for me and I know I will be able to incorporate this new knowledge in my life from now on.