This is a guest post by Kate. Kate is a nurse practitioner, financial independence junkie, travel fanatic, and homeschool mom. She blogs at On Our Way World. We have no financial relationship at this time. I hope to introduce this is as the first of many “Patient Perspectives” presented on this web site. If you are interested in writing a Patient Perspective post geared at helping medical professionals remember why they chose the path that they did and how financial independence is important, shoot me an email. Take it away, Kate!
It started with a funny feeling… somewhere between an itch and an ouch – not quite right, but I couldn’t really define what was “wrong.”
You know the patient that shows up in your office and says “hey doc – something’s not right, but I couldn’t tell you what it is”? That was me.
My eye was – sore? Tired? I couldn’t tell. But surely, nothing was really wrong, or I would have lost vision – right?
Had I lost vision? I realized I wasn’t totally sure. I’ve never been so thankful to be the lone car on the freeway as I was when I decided to cover my “good” eye while driving to see if I had – in fact – lost any vision. The fact was, I could barely see out of that eye.
I started my shift at the hospital and went about my day because, as a staff nurse, that’s what we do. Finding someone to cover your shift when you’ve been disemboweled, let alone when your eye is a little sore, is practically impossible.
I ran into one of the hospitalists and pulled her aside – “I seem to be OK, for the most part, only I can’t see out of this eye. Can I just ignore it for a bit?”
Of course, the answer was a resounding “no”. I knew it, but I was hoping someone else would tell me to just ignore it and let it go away.
Our hospital provided access to UpToDate, which was a blessing and a curse on that day – although we all poke (gentle) fun at patients who plug their symptoms into WebMD and come to the office, diagnosis in hand… what I did was the same thing, on a much more expensive platform.
“Loss of vision”
“Young adult, female”
In looking at the evidence, it was obvious pretty quickly that there was only one thing it could be – optic neuritis.
And that could really only mean one thing – multiple sclerosis.
Another Day at Work?
Of course, like any good nurse, I had to get sick on a Friday afternoon. I made an appointment at the only optometrist who could see me. I went in, and told him what I thought I had. He confirmed what he could – near complete vision loss in my right eye. But – he couldn’t tell me what it meant.
I went back to work after because – hey, I’m a nurse. It’s what we do. I just happened to run into the on-call neurologist making his rounds. He wasn’t a doc I was particularly close to – a good guy, as bland as cardboard-flavored ice cream, but a solid neurologist. He also happened to have a special interest in MS.
I pulled him aside (because who doesn’t love a Friday afternoon curbside consult, amiright?) and told him what I knew so far. A quick exam in the locker room confirmed a little more – an afferent pupillary defect on the right, consistent with optic neuritis. I’d need an MRI, which even with my considerable charm I could not get scheduled until Monday.
“Scattered lesions, consistent with multiple sclerosis. Cannot rule out malignancy”
(A word to radiologists here… can we just once, please, rule out malignancy?!)
The rest of the day is a blur. Honestly, the next 6 months were a blur.
The next step
I had just graduated nurse practitioner school. None of this was supposed to be happening. I’d gotten my dream job as a nurse practitioner with the hospitalist service, and now… this.
I got a round of steroids to treat the optic neuritis. I started a new (and incredibly stressful) job. To pour salt in the wound, I spent half my time covering the acute inpatient rehab unit, where books on “how to deal with function loss in MS” taunted me like horrible little reminders of what my lot in life was certain to be.
I don’t think there was one specific thing that pulled me out of it – time went by, and I could still walk. I wasn’t wheelchair bound, and in fact, after the optic neuritis I’ve never had another symptom.
The lesions are there, and changed enough over time to qualify what I have as “true” multiple sclerosis (rather than the earlier stage and less dramatic sounding “clinically isolated syndrome”). I started medication for it shortly after diagnosis. I get MRIs yearly (every 2 years, now, after a little wheeling and dealing with my neurologist).
Discovering Financial Independence
We didn’t discover the concept of FIRE until after my diagnosis, and I’m not sure what my perspective on it would have been had we discovered it before my diagnosis.
What I do know is this – Financial Independence is important. So is enjoying the path to get there. We could save more aggressively and reach FI earlier. But I also might not be able to walk in 5 years.
I think my outlook is bright – the first 5 years is highly predictive in MS – and my 5 years have been stellar. As good as they can be when you have a lesion-y brain. But that could change. So I’m going to take that vacation now, and if I can still do it in 5 years, or 10, I’m going to do it again. I’m going to work a little less, and hustle a little less, and chase my kids around the park a little more – because in 5 years, maybe I’ll still be able to – but maybe I won’t.
It’s Not All About FIRE
Reaching FIRE and not having anything to show for it when you get there – no health, no family connections, no memories – is not, in my opinion, worth it. I still hustle, and I still work long hours- but I try to balance that with time spent making memories with my family, and enjoying the health I have now, while I still have it. I hope it lasts well into the future, but if it doesn’t – I want to do everything I can now, while I still can.
I’ve also worked hard to craft a career that can be done from anywhere, location-wise, so that we can have the freedom to adventure now. We’ve chosen to homeschool our kids for a number of reasons, but the freedom to spend time together, travel, and have adventures, are chief among them.
I’ve spread my eggs in a few baskets so that if the time comes that I am limited in some way, I can still provide for the family.
I still love being a nurse practitioner, and I hope to do it for the foreseeable future; even when we reach financial independence I hope to continue working – but having a fallback option is a good idea for anyone, particularly someone in a position like mine.