By Kathryn Holmes
By the time the summer 2023 was winding down, I was preparing for the beginning of my sophomore year at the University of Florida. I resigned from my summer job in my hometown in South Carolina, had maintenance on my car for the long drive to Gainesville, and prepared myself for the busy semesters ahead. I felt a sort of unease as I made my preparations, a sense of fatigue clouding my mind. I labeled the feeling as summer restlessness and left it at that. Soon, it was mid-August and I had moved into my new apartment. I had slowly but surely dragged my possessions up three flights of stairs and set them out in the room that I had signed for. It was not only half the size of my roommate’s rooms, but was also rather lacking in the window department – in fact, there were none. I had initially signed a lease there to save money, and I decided that I would stick it out.
Within the first month, I developed severe insomnia. I would often not be able to sleep until 3 or 4 a.m., despite taking any over-the-counter sleep supplements I could find. Classes became difficult to keep up with. I was so fatigued during the day that the world around me existed in a sort of fog, and I had a hard time recounting my days at the end of them. I often woke up in the pitch dark of my little room, unable to tell whether it was day or night. I lost my appetite completely and eating made me nauseous. My bones felt heavy and lead-like; I was out of breath from walking up or down the stairs. All my hobbies began to gather dust in the dark corners of my room. I dropped the classes for my minor, and subsequently my minor itself, because my mind and body were not keeping up. I figured I was depressed. I thought that if I just stuck it out, just pushed myself a bit harder to get better, that I could.
I developed a resentment for my living situation quite quickly. I blamed my lack of window and sad, dark room for my insomnia and depression. In the mornings (or, to be frank, afternoons) when I fumbled through the dark to the bathroom, I flicked on the light and looked in the mirror to find a sullen and sunken version of myself with dark purple bags under my eyes, thinner hair, and dry, cracked skin.
I barely left my apartment. However, I got on the bus to go to campus for office hours for one of my few remaining classes every Tuesday and Thursday. I often missed lectures and could hardly get out of bed to attend, but a very kind TA whom I had met the previous semester helped me tremendously. I never disclosed my situation, but I never needed to. I was always treated kindly and with understanding, and I learned the material and kept up with the class despite the unyielding and oppressive fatigue. It was the one grounding connection to the world that I could count on in that time.
By November, I was worse. I was often short of breath and jeans that had fit me in August slipped down my hips. My exceptionally low appetite and even lower energy began to ring alarms that something else might be going on. I had been so sure that what I was experiencing could only be solved by my own willpower, but as I continued to experience desperate fatigue and brain fog despite a strong desire to fix myself, I figured I should investigate medical alternatives. I made an appointment at the UF Student Health Care Center.
Much to my surprise, the nurse took my concerns and symptoms very seriously and ordered several blood tests and panels to find a potential culprit for my unwellness. Growing up, I had often brought up feeling persistently tired to doctors at yearly check-ups, and I was told every time that my diagnosis of depression was the culprit and that no further testing would be necessary. I was grateful for the nurse’s thoroughness, and I began to feel hope thatthere may be a solid medical solution for the misery I had been experiencing.
Less than a week later, the labs were in, and I had an answer. My ferritin – a protein that stores iron – was alarmingly low, coming in at just 3.8 ng/mL compared to the normal range of 24 to 307 ng/mL for an adult female. I was diagnosed with iron deficiency anemia, which occurs when the body lacks enough iron to produce adequate hemoglobin, the protein in red blood cells responsible for carrying oxygen. Symptoms can include extreme fatigue, weakness, pale skin and shortness of breath. If left untreated, symptoms can escalate and potentially lead to complications such as heart problems or increased susceptibility to infections due to weakened immune function.
Due to my extremely low ferritin levels, I received a referral to a hematologist. While I waited for that appointment, the nurse suggested that I begin to take iron supplements with vitamin C, which aids in the absorption of iron in the body. However, even with iron supplements, it can take several months or longer to replenish depleted iron reserves. Now that I knew what I had going on, I wanted treatment as fast as possible to be free from the debilitating fatigue I faced daily. I made an appointment with a hematologist at Florida Cancer Specialists & Research Institute.
After another round of tests, my doctor decided that the best course of action to resolve my anemia would be three sessions of IV iron supplementation over the course of a few weeks. I received my first iron infusion that day. I was seated in a chair for about an hour while dark brown iron supplement and sodium chloride dripped down the IV. In the weeks following subsequent infusion sessions, the difference was undeniable. I felt energy that I hadn’t had in months, and I no longer wheezed going up the stairs. My insomnia was gone, and I slept well for the first time in a long time. The end of my treatment lined up with the beginning of my spring semester at UF, and I was both able to attend classes and do well.
Iron deficiency anemia is a very treatable condition, and had I sought answers sooner, I would have saved myself a lot of suffering. Previous experiences with doctors contributed to my denial of my illness, and many women face similar challenges. Women frequently experience gaslighting when it comes to their physical and mental health. Health issues such as heart disease may be dismissed as anxiety, autoimmune disorders attributed to depression, or ovarian cysts labeled as mere period discomfort. This pattern often leads to misdiagnoses and the trivialization of serious health concerns, with women’s symptoms downplayed or not taken seriously by medical professionals. I am sharing this story in the hopes that other women can recognize the need for self-advocacy in their health and understand that gaslighting in women’s healthcare is real and harmful. My own belief that my symptoms were just in my head caused unnecessary suffering, but it doesn’t have to be that way for others. Educating both doctors and women on the gender discrepancies in healthcare can improve female health care and ensure that treatable conditions are addressed properly.
Kathryn Holmes is a third-year public health major.
“My public health story” essays originated from an assignment on public health storytelling for a public health messaging and dissemination course led by Brittney Dixon-Daniel, Ph.D., M.P.H., director of the Bachelor of Public Health program.