Dx: Med student. Tx: Valium.

I woke up at 6am feeling perfectly fine.  I went to the library and studied for the 3 hours before class.

At 8:30 am, I stopped being able to move my neck.  I realized this pretty suddenly – it was incredibly stiff and not only couldn’t I move it to either side, but it hurt like the dickens on extension.  But I didn’t have a fever, so aside from looking up “rapid-onset meningitis”, I tried to put that out of my mind and go to class.

I usually sit with Jenny and two other friends of mine.  When they saw what my range of motion was, I didn’t even have to explain before they were all over me to go to the ER.  I protested, told them I didn’t have a fever – but I can’t lie, I was secretly in agreement that I probably had meningitis and would ironically die of it in the middle of our microbiology unit.  So I let them successfully peer-pressure me to the Student Health Center (The ER idea was beyond ridiculous, so that was my final offer).

My temperature was 97.1.  I texted them back that I either had a genetic dysfunction of interleukin-6, or I did not have meningitis, and I was pretty sure I knew which of those two possibilities was more likely.  But I still could barely move my neck, and something about the neck pain might… might have made me tear up a bit when the doctor examined me.  (Maybe.  I also could’ve been a superwoman who is stoic and cool and unfazeable.)

After a very fancy neurological exam, do you know what I was diagnosed with, dear reader?  Stress-related muscle tension.

Unbelievable.  And because that punchline wasn’t quite surreal enough, the doctor told me the usual prescription is NSAIDs and a benzodiazepine.  (Did a doctor literally just tell me to take a chill pill?  Because that’s awesome.)

Luckily, after a few questions he decided to give me a prescription for a straight-up muscle relaxant instead.*

The funny thing is, I’ve been feeling pretty great about how well I’ve been managing my stress level – just taking care of business instead of complaining about it.  Heck, I even went out last night instead of studying, just because I understand that balance is important.  What more can I possibly do?

I think the logical conclusion is that all the stress I wasn’t admitting to had to go somewhere, and it chose my trapezius.

*  I know there’d be no shame in taking a benzo, and that it would double as a muscle relaxant anyway.  But not getting that prescription still makes me feel like I successfully passed some sort of “okay, you’re not that stressed” test.**
** Well, unless I just looked like somebody who’d try to sell them for cash.  In which case, the doctor would be severely over-estimating my street smarts, so, you know, that’s cool too.
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16 thoughts on “Dx: Med student. Tx: Valium.

  1. Wow. Med school is definitely hazardous to your health. I definitely would have freaked at first and thought meningitis as well. Hope the muscle relaxant works!
    (by the way, it could be worst- one of the first years at my school started losing her hair…)

    • Oh man, yeah.

      Thanks. The muscle relaxant made me too sleepy to study, but it definitely worked. I’m glad I didn’t try to tough it out – it was pretty ridiculous to not be able to move my neck.

  2. Putting on my massage therapist hat and as a veteran of neck pain myself…

    Get a massage (schools have cheap rates)

    Use a hot pack. Regularly. Very very effective. It’s like a low tech muscle relaxant.

    Massage your own occiput–lay down and use your fingers to grind in there, it may be a bit tender, but that’s normal (digging into those muscle insertions is pretty good at releasing the rest of the muscle unless the problem is really hardcore).

    Keep neutral posture, no more craning over books or laptops. Stack pillows in your lap to get them at eye level. Switch to a desktop where the screen is at eye level.

    Get a nice firm foam pillow and find a position for sleeping that is pain free so your muscles have a chance to relax and rest. Pain = perpetuating the problem.

    Try to learn not to hold tension in your neck. This one took me a while and it’s tricky in my opinion. Eventually I got mad and just said NO to my body very firmly and that seemed to flip the switch. Not super helpful or technical, but a place to start.

    M

    • Thank you for writing this out, it’s awesome advice!

      I’m definitely going to ask around for some massage therapist recommendations and buy a hot pack – that makes a lot of sense.

      I actually do get what you mean about trying not to hold tension in my neck. It’s hard to get in the habit, but it sounds like, along with adjusting my posture, it’s just something I’m going to have to work at.

      • No need to spend money on a hot pack. Fold a washcloth in half, fill with rice (or dried beans), and stitch the sides closed. Microwave for a simple, inexpensive heat pack.

      • Look for someone certified in either Neuromuscular which is medically based or Positional Release (PR goes by a couple names, I like Orthobionomy however the guy who developed it was a raging alcoholic with magical thinking who believed we could eventually just work in the aura, I skipped the hoo doo and focused on the actual work, which is very effective. Myofascial therapy is another form of PR.)

        The nice thing is if you have trigger points (Neuromuscular) you can learn where they are and treat them on your own and save yourself the trip to the massage therapist.

        M

  3. You should have totally taken the benzo AND the muscle relaxant. It’s a great combo for tension. I highly recommend.

    • Not gonna lie, we haven’t done psych drugs in pharm yet, so I just assumed cyclobenzaprine WAS a benzo like he had mentioned. Only found out when I got home and wikipedia’d it that it was actually just a muscle relaxant.

      But yeah, that does make sense. I had valium before getting my wisdom teeth taken out, and it helped a million times over.

  4. To continue the list of med school induced ailments, I got TMJ pain around the time I took step 1.

    Recommendation from my dentist: less stressful lifestyle. Right.

    Luckily it went away and hasn’t come back. Yet.

  5. My medical-school-induced condition of choice is some bizarre, pseudo-TMJ syndrome. Since about the start of clerkship, I’ve had incessant clicking in my jaw on the right side, and that sensation of fullness in my right ear.

    Doc told me to take Robaxacet Platinum (apparently that works?) but it’s done nothing.

    The things we do for school, eh?

  6. Pingback: USMLE: Week 2 | Action Potential

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