From Michele: They say that you never know what’s going on in someone else’s life. And they say that you can never tell what’s going on in the inside. Nancy Shipley is one of those people whom you would look at in such a way. When you look at her photo and talk to her on social media, she seems like such a strong person, which she is. But what you don’t see is the fact that she has a struggle as well. Her life isn’t always easy as a surgeon, a mom, and it’s further complicated by her “invisible illness” as well.
So I’d like to introduce you to Nancy Shipley. She is one strong, courageous doctor who I’ve had the pleasure of speaking to for the next story. Enjoy her story below.
The common stereotype of the orthopaedic surgeon is a white male, former athlete, forever jock. Well, I don’t fit in many of those stereotypes.
Who Am I Then?
Though I find it funny when friends call me a “jock”, I’m not one in the traditional sense. I’ve always been someone that enthusiastically will try new sports and athletic endeavors. However, I was never really a great athlete in high school or college and I did not participate in organized team sports. In my twenties, I discovered kickboxing, snowboarding and surfing, and then later, golfing and standup paddle-boarding.
What Do I Do?
Not long after starting private practice, I had my son, who is now a gradeschooler. Being a surgeon is somewhat like being an airline pilot. We become accustomed to being in control of high stakes situations. Both being pregnant, anticipating the labor and delivery as well as how life will change being a new parent was exceptionally terrifying to me. I had little control over how things were going to play out.
When the Struggle Started…
Luckily, I delivered a healthy baby boy. It took a bit of time to recover postpartum, as would be expected, but I was surprised at how magnified my neck and sacroiliac pain was during this time. Even at this early stage in my career, I was accustomed after a long day of operating to have some transient aches and pains – it all just comes with the territory.
But this was a little different. As I eased back into my full-time work, I healed from the delivery but it felt like the neck and the SI joint was getting worse.
Was There Something Really Wrong?
There is a phenomenon in medical school that we call medical student’s disease. As a medical student goes through school and learns all the things that can ail us, ranging from the common to be extremely rare and unusual (aka “zebras”), somehow, the medical student becomes anxious and worried that they might themselves have the very disease that they are studying.
I wondered if this was another case of medical student’s disease. If only!
Being in orthopaedics, I was suspicious when a lot of my complaints focused on my SI joint. My training taught me to look at the HLA-B27 marker with a suspicion for ankylosing spondylitis. I knew that this disease tends to affect males more than females, however when females are affected, it tends to manifest more in the axial spine, meaning the neck or back, while also including the typical symptoms of pain and inflammatory arthritis at the sacroiliac joint. It also shows up a little later in life.
I went in for some lab work and found that I was indeed HLA-B27 positive. That, in and of itself does not necessarily make the diagnosis, but when put together with the other symptoms and the x-rays of my pelvis, my rheumatologist diagnosed me with a mild case of Ankylosing Spondylitis.
What Does Ankylosing Spondylitis Mean For Me as a Parent & Surgeon?
I knew cognitively that my disease was mild and that I’m pretty lucky. But as a physician and as somebody who is used to doing activities without physical limitations, it jarred me. There’s no cure, and I knew this diagnosis would be with me for life. I found that together with the postpartum blues that many women experience, this was overwhelming.
For a period of time, this diagnosis made me want to shut down.
Of course in my career as a new surgeon and as a new mom there was no choice but to keep going. It took some time, but it sunk in that this wasn’t going away, and I just needed to adjust and make the most of it.
While I Struggled, I Got Stronger.
As I got stronger and recovered from having a baby, I found myself getting back into exercise which lifted my spirits. Doing a little motivated me to do more – and one of my personal triumphs was training over several months with HIIT, TRX, boxing to enter and complete my first obstacle course race. What was new and different however was that for the first time in my life, I actually felt the effects of over training.
Those with ankylosing spondylitis do benefit from maintaining an exercise program – but there definitely is a sweet spot. I found that there was a threshold at which if I overtrained, it would aggravate and cause a flareup of inflammatory arthritis in my neck, back, and SI joints. The trick was to figure out where that point was. And even though intellectually I knew strength and flexibility contribute to a balanced fitness program, I now had to live it.
This isn’t widely known, the doctors generally make the worst patients!
Instead of being in our accustomed position of control, we’re now in the position of being a patient. Although I have always had a healthy respect for the vulnerability that patients have in that position when they are ill or when they are injured, this gave me a brand new perspective.
What About Now?
I’m still working on not over training, while not under training, and bringing balance to my exercise regimen. It’s my tendency after discovering a sport that I really love to do too much of it and neglect what I consider the other important pillars of having a balance exercise program. For example, a year ago I started to play tennis for the first time. I love it. It requires thinking, balance and coordination, athleticism and it is fast-paced. However, when I play too often without taking the time to do yoga and to remember to strength train, that’s when my symptoms flare and that’s also when I start to see the whisperings of overuse injuries.
I’m in a good place now, even though nothing has changed about my disease – just my mindset. I accepted and embraced the fact that this disease is something that is part of me yet doesn’t define me. I learned that it was crucial to make decisions that would help me stay as healthy as possible and to lead as active of a life as possible. When I remember to do that, it makes me a better surgeon, parent, spouse.
Dr. Nancy Yen Shipley is a board-certified orthopaedic surgeon, with additional fellowship training in sports medicine and arthroscopy.
Her professional interests include sports medicine, arthroscopic surgery, injuries and conditions of the shoulder and knee, fracture care and general orthopaedic surgery.
She has been a featured contributor on KevinMD.com, called “a must-read blog” by Rebecca Ruiz of Forbes, among multiple other online sources of medical news.
In her free time, Dr. Yen Shipley enjoys spending time with her family, snowboarding, stand up paddleboarding, playing (i.e. learning) tennis, and enjoying the great outdoors and the great food in her adopted hometown of Portland.
Biography
If you were recently diagnosed, here are some sources to look into:
Taylor deer says
I’m so happy Nancy is able to maintain a positive mindset and balance in life to move forward from this horrible disease. She is very inspiring to many.
Deb Ferguson says
Yens story was inspiring! Thank you Michele for telling us all about her, and a shout out to Dr Yen!
Way to go!
I deal with pain on a daily basis as well and agree wholeheartedly. You have to keep going forward, and find the best path to keep your body and spirit strong!