a note on med clearances

Remember this post?

I do.  I remember how stressed we both were that I'd get Class 2 Medical Clearance and Joey'd be posted somewhere I couldn't go.  How we fought to convince the doctor that I was cured of my depression and how relieved we were when I got my Class 1 Clearance.

What I wish I'd known then that I do now -

1.  Even though I told the psychiatrist evaluating my mental health that I'd learned how to manage my depression with running and yoga, she did not pass that information on to Joey's CDO (career development officer).  While I appreciate the respect of my privacy (and HIPAA), we were posted somewhere impossible to run long distances (and never by myself) or follow a regular yoga practice because his CDO didn't have all the information.  While we discussed with his CDO our desire to have children while at our first post, the CDO didn't know the only anti-malarial safe for pregnancy exacerbates depression and that the medical officer I spoke to upon receipt of our posting strongly advised me to wait to get pregnant until we left Abuja.

2.  Just because you don't feel depressed in Des Moines or Washington, DC, does not mean you won't feel depressed in Abuja, Nigeria.  And the stressors that you faced in DC and managed with running and yoga will be exponentially compounded by hardship when you leave the U.S.  The people evaluating medical clearances take this into account and if you have to convince them you're ok, you should consider "worldwide availability" and if you'll really be okay no matter where you go.

If you already have low-level anxiety and depression, imagine how you might feel after an explosion at a place you've shopped many times (http://saharareporters.com/news-page/exploion-rocks-abuja-shopping-center), or an explosion outside a new bar you were so excited to discover had Miller Light (http://www.thenationonlineng.net/2011/index.php/news-update/51337-explosion-rocks-abuja-nightclub.html), or an explosion near your friend's house (http://www.reuters.com/article/2012/04/26/us-nigeria-bomb-idUSBRE83P0NR20120426), or a siege during a layover (http://af.reuters.com/article/topNews/idAFJOE80T00P20120130) of which you can see the fire from the airplane, or a bomb in a church on Christmas Day (http://www.dailymail.co.uk/news/article-2078450/Bombs-kill-32-Catholic-churches-Christmas-Day-mass-series-explosions-rock-Nigeria.html), or a bomb near the Embassy (http://www.bbc.co.uk/news/world-africa-14677957), or an explosion at a market the night after you've eaten dinner there (http://www.bbc.co.uk/news/world-africa-12099176).  It takes going to a crowded supermarket from routine to utterly terrifying.  

3.  An officer's posting is based on the medical clearances of all of his family members, not just the officer's.  We recently learned that despite what we'd heard otherwise, the department does not direct (*just a reminder - this is not official*) officers whose family members have lower medical clearances to places where those family members cannot accompany the officer (remember, AIP (Afghanistan, Iraq and Pakistan) assignments are never directed) for medical reasons (think about it - they can't - it would be discriminatory and illegal and probably against many federal EEO and ADA statutes).

Thankfully the new nurse practitioner here is really great and has been a tremendous help to me ever since my near-panic attack in the grocery store last week.  Not to mention we only have a little more than 20 weeks at post, and I'll be out of the country for over half of them.  My longest remaining stretch in Nigeria is only four weeks, and it's not til November.  I can handle that, especially after almost four weeks of finding my zen in Thailand in October and with the bright light at the end of the tunnel on December 1.  As my friend, K., told me when I first got to Abuja, "If you can handle this place, you can handle anything."