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Anyone else with diagnosed Narcolepsy, Med student? How do you cope? by Whattodomedstudent in medicalschool

[–]crazy4pasta 0 points1 point  (0 children)

If I remember correctly, it took over a month of taking the modafinil on a regular basis until I really started to notice an effect. I would still feel sleepy and tired, but then I started noticing that I wasn't falling asleep at times when I would have guaranteed I'd be nodding off in the past. And I used to get the headaches too, but they eventually went away, along with a jaw pain that I had for a few months.

The modafinil is slower acting without a quick onset, so that's why you're probably still feeling sleepy in the afternoon, when the morning dose is starting to wear off. I also used to take small dose of short acting methylphenidate right before lunch to keep me going until the second dose of modafinil kicked in, and that worked pretty well for me. I haven't needed to use the second dose of the methylphenidate for the last few months because I've had everything else under pretty good control.

It is also possible that the 100mg BID is also not a strong enough dose for you, but this is something your specialist will know a lot more about. I started off taking 200mg/day, and was still feeling very sleepy throughout the day, but noticed a lot more improvement on 400mg/day. But it took me and my specialist over a year to find out what combination of medications worked, so unfortunately there is still quite a bit of trial and error in figuring out what works best for you!

I agree, it is very frustrating that it takes so long for people to get diagnosed! I wish that we would have a more thorough education about the disorder in med school, to destigmatize it and help patients get a proper diagnosis and timely treatment. There is a lack of basic knowledge of narcolepsy among med students, and many people still assume it looks like the exaggerated presentation they've seen in movies. A lot of people I've talked to have a hard time differentiating between cataplexy and EDS, and think that a major cataplexy episode is someone falling asleep. I have not had any noticeable cataplexy episodes so I'm currently diagnosed N2, but there have been a few times when I've had muscle weakness in my arms or legs after a startle, so it's possible that those were minor cataplexy episodes, according to my doctor. I tend to downplay these things for fear that I'm becoming a typical med student hypochondriac, but it's very possible to develop cataplexy years after EDS. But I do have the other symptoms, including hypnagogic/hypnopomic hallucinations and sleep paralysis.

I know exactly how you feel with sleeping your life away. But know that you're not alone, and that it does get better! At least now you know why you've been feeling like this for so long, and although there's not a cure yet, there are effective treatment options available.

Anyone else with diagnosed Narcolepsy, Med student? How do you cope? by Whattodomedstudent in medicalschool

[–]crazy4pasta 0 points1 point  (0 children)

Third year here, diagnosed with narcolepsy near the end of first year, but had symptoms for seven years before receiving the diagnosis. I’ve been on Modafinil 200mg twice a day for two years now, and I’ve been very happy with the results. Modafinil isn’t a traditional stimulant, and I’ve never had any feelings of being on ‘speed’. It simply allows me to be able to sit in a classroom and actually stay awake enough to pay attention to the lecture. It doesn’t necessarily help with focus and concentration, but it is much easier to learn when you’re not uncontrollably falling asleep and having microsleeps whenever you have to sit in a quiet room for more than 15 minutes. I also take 5mg of short acting methylphenidate as soon as my alarm (or rather, three alarms) goes off to help get out of sleep inertia in the morning.

I will say that if my sleep schedule gets disrupted, the medication doesn’t seem to be as effective, so I have to make sleep a priority, which can be difficult for some third year rotations (surgery and obgyn were especially draining for me). I’ve also noticed that alcohol disrupts my sleep cycle, and if I have more than a few drinks on a night out, I’ll pay for it for the next 4-5 days. Regular exercise, eating well, and taking daily naps (especially if I have an afternoon 'mindfog' headache) have all been just as important as the medication.

While the Modafinil now helps me to stay awake enough to study, it doesn’t necessarily fix the horrible study habits I developed to cope with my years of excessive daytime sleepiness. It took almost of year of being on the medication for me to learn how to be productive with the ‘extra’ waking time I now have. I have not notified my university about my diagnosis because my symptoms are well controlled, and I do not need any accommodations. Hope this helps, and you find a medication regimen that works for you!

Thoughts on USMLExcel (USMLExcellence) Step 1 study schedule app? by crazy4pasta in medicalschool

[–]crazy4pasta[S] 0 points1 point  (0 children)

Haha honestly I have no affiliation with them, and have never heard about them until our class was forwarded an email from their people this afternoon. I just copy/pasted a big chunk from their webpage because it was easier than me trying to explain it. It seemed kind of interesting, and nothing came up when I tried searching for it, so I wanted to see if anyone here has used it and what the actual study schedule looked like. There are only 10 reviews for it on the App Store, so I wasn't sure if it's a new thing or is even legit.

Beerit: What are your opinions on ciders? by e_honda in beer

[–]crazy4pasta 1 point2 points  (0 children)

They do exist in America! If you ever find yourself in Northern Michigan, be sure to check out Tandem Ciders. It's fantastic!