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How the hell do you revise pathophysiology with ADHD?

01 March 2014

I am a clever girl. I am also unable to wrap my head around the concept of revision. I don't know if this is me being weird or if this is an ADHD-related issue or what but I am seriously struggling.I know other people are struggling too and I am not trying to make this sound like I am worse off than they are. Just thought I should get that in first.

From when I was a kid, my brain analyses what I am trying to do and says: OK, I get it, you can do something else now. This does not mean I REMEMBER the thing I have just read but my brain says: I read that and understood it, let's move on. And from that moment on, I am unable to concentrate on that topic because my brain is bored, even though my memory has not yet absorbed the info and committed it to memory, ready for regurgitation in the exam. Every time I try to revise the topic, my brain goes: "Yeah yeah, you know this already, do something else, something I don't know yet." It is as if my brain says: I understand the concept, so I don't need to know the content.

Example: in this exam I will probably be asked to compare and contrast Diabetic Keto Acidosis (DKA) and Hyperosmolar Hyperglycaemic State (HHS). I have read the differences and similarities. I understand why things happen when I read my book, I nod and think: yep, seems good. I close my book and try to answer the exam question and I am utterly lost. I can not list signs and symptoms, nothing but the very very basics. So I open my books again, read the chapter again and my brain goes: "Why are you reading this again, you just read this and you already understand it. I AM BOOOOOOOOORRRRREEEEEEED."

I have read all the exam topics. I understand all of them. But hardly remember any of it.

In true ADHD-style, I try to trick my brain in to thinking I am doing something new. I do this by trying to find a new way of revision. That way, my brain will pay attention for a bit because it is a new way of absorbing information. So I started the revision for my pathophysiology exam by printing off all the lecture slides and all my lectures notes. For a few days I read and read and took notes. Then I could feel my brain going: "Lalalalaalaaaa.....I'm not listening anymore." I tried for a couple more days but nothing went in.

So I thought I might try oral revision: no writing, just talking with fellow students about the material. That worked for a couple of days.

Then I thought: how about group-mindmapping? I got a few students interested, we went into a classroom and wrote all over the whiteboards, made mind maps, lectured each other on things we were sure about. It worked really well. So well that different students showed up each time.

After 4 sessions, my brain said: "Lalaalaalaaa......Why are you doing this? You know all this. Move on!"

So this morning, I decided I would answer questions from previous exams and compare my answers with answers from a few fellow students. We arrived in the library, set a timer for 10 minutes and picked a random question:

Compare and contrast signs and symptoms of chronic bronchitis and emphysema.

I KNOW the answer to this. Or at least, I UNDERSTAND the answer to this. Unfortunately, when we all compared our answers, my answer was vague, repetitive and quite shallow. I did not mention hypercapnia, hypoxia, digital clubbing, cor pulmonale...nothing. My answer wasn't wrong. It just wasn't enough. I could not reason it through. I could not remember. These 2 diseases are quite similar and quite often people have signs & symptoms of both. So how the heck can I differentiate between the two if I don't understand the pathophysiology behind each of the symptoms. Why is someone with Chronic Bronchitis more hypercapnic than someone with Emphysema? They are both struggling for breath so why the different outcomes?

Part of it is probably nerves. If I had 20 minutes for each question, here is how I wold be able to answer the questions:

1) Think of the disease
2) What is the first thing that happens? Which process goes wrong, which enzyme causes that, etc.
3) What does this lead to (i.e. what sign or symptom does this cause?) And WHY?
4) What happens after that & what signs/symptom does THAT cause? And WHY?
5) And so on.... And WHY?

That way, I will 'walk through' the illness and logically come up with many of the answers required.

Unfortunately I have only 10 minutes per question and so what I need to be able to do is:

1) Give a list of signs and symptoms, the order does not matter as long as you list enough of them to pass! Also, this is not a patho-question so just list signs and symptoms and you do not need to explain why things happen and why this symptom occurs. GO!

And I just can't do that. I just do not understand how to do that.

All of this obviously on top of the exam stress everyone feels and the ADHD-related inability to plan or remain concentrated for longer than 30 seconds.

This post may sound really self-indulgent and navel-gazing. Like I am saying: I have it worse than you, feel more sorry for me. It is not meant like that. I am just at the end of my tether with this. Because there are only so many different methods of revision I can come up with. And for this exam alone, I have already tried 5. What if I can not invent any more for the next exam. Or, God forbid, the re-sit of this one?

PS: I only started writing this blog post because I was looking online for tips and hints on revising when having ADHD. It is now an hour later, I have not revised yet and also not actually looked for any of those tips....I got distracted. Ugh.


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