BACK IN THE USA

By Michelle Miller, M.D.

I’m back!!!! It has been over eight months since my family returned from our year in New Zealand. This article is a bit delayed because I am still in a daze from the shift back. I have tried writing this article countless times, but feel as if I’m in a surreal, bizarro world every time I start. As a recap for readers who haven’t seen my previous articles or those of you not familiar with my history: I packed my family up for a one year locum general practice position in New Zealand after a recruiter emailed me in December 2020. It was a time in which the stars aligned for this to be possible. I was five years out from my diagnosis of Multiple Sclerosis (MS), and I had a new lesion in my spine (I had thought it was just shingles without the rash). I was escalating my treatment to an immunosuppressive agent, while facing burnout from COVID-19 pandemic. I had gained financial independence by paying off my student loans and mortgage. It is bittersweet being back in Tallahassee. COVID-19, influenza, and RSV were raging in New Zealand when we left, and now we’ve gone through a triple-demic here this winter in the US. New Zealand had been successful keeping COVID-19 out of the country until March 2022, but then the Omicron subvariant knocked down the borders like the big bad wolf. It’s ironic that I went to New Zealand to avoid the pandemic, but, of course, it arrived eventually and I was infected twice, that I know of. The first time I was asymptomatic and only found due to surveillance monitoring required by my employer. Then my son brought it home from preschool and we both ended up with a secondary worsening requiring antibiotics but overall mild cases. I did come over with a new prescription of Pulmicort ($12 in New Zealand vs. $300 out-of-pocket in the US) that I continued for over a month to help with new bronchospasm that has since resolved.

When we left New Zealand, masks were mandated indoors and the opposite was in the US! We saw a handful of other people wearing masks in the Orlando airport on our way out, but I had been keeping up with the CDC COVID-19 maps as well as Facebook posts by Dr. Steven Currieo. I knew that cases were up, not down, which made the lack of masks concerning and I was quite angry at the laissez faire approach by the public. For my first few weeks, I focused on readjusting to the time change, exercising, and keeping up doctor appointments so I could resume year two of Mavenclad for my MS.

I have since started practicing telemedicine urgent care with three telemedicine agencies, Amwell, MDLive, and Teladoc. This allows me to practice part time telemedicine at home in order to keep an eye on my health, especially my energy levels. I was surprised to learn there are metrics these companies look at concerning antibiotic and prednisone prescriptions, so it’s not just a pill mill as I (and likely most of you) had previously thought. It was quite easy to transition to telemedicine since I had done quite a bit prior to moving to New Zealand. I was surprised how much I enjoy telemedicine, even though there are limitations in what can be done during a visit. There are quite a few workarounds to rule out red flags without having to touch or even be in the same room as patients. Plus, I get to stay in sweatpants and take plenty of breaks during my day.

I have been asked multiple times if I would return to New Zealand, and my answer is mixed. I enjoyed my time, but cannot imagine living there permanently as my friends, family, and home are here in the States. Some days I long for the slower pace of life and daily hikes in the beautiful nature around the nicest people. Then I remember the long queues for my patients to see specialists or have testing done. Additionally, a specialist must sign off for testing that I have ordered here in the States without supervision.

My family is very grateful for our time away but are glad to be back home now. If you see me around, please ask me how my travels were. I may share some photos with you as well as talk about the barefoot culture of New Zealand.