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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 14 of 14. This is the beginning of the thread.
Posted by floatingbridge on April 29, 2011, at 15:13:39
Well, I am w/o a psychiatrist now. Great. My choice.
My gp says just keep tapering the norco. Yeah, super. Down to 5mg. Am I throwing a party? No. Because my pain is pretty high. I also am so fatigued. I want to lie in bed with my face to the wall. She said xanax was next, after norco. Super.
It's been about eight weeks plus since my
last AD. Yes, I feel better without an ssri/snri. Hard to explain it. However, the initial euphoria of getting off of them and getting a mind back for myself is
threadbare. I'm not functioning, though I can at least laugh about it. And have an orgasm. My moods are not nearly so
crazy. Only intense. And I can track
them back to thoughts or sensations. For instance, pain will register as anxiety. When pain creeps up, I will have negative thoughts; left unchecked, I will chase the thought while the pain goes unacknowledged until it's louder. I
wasn't able to make that connection very well on the snri's I have experienced. (I'm talking here of my own experience. I am not applying this to anyone else's situation and am not extrapolating, "Snri. Baaaad!!!!" You know, like Frankenstein and fire.)The long and short of the situation with my pdoc is that I receive incredibly mixed messages about medication. Now
I pay to sit in the office and cry.I feel like I need treatment of some sort. Am I insane for considering an maoi for
example? Stanford said yes once. But my docs here are totally scared. My pdoc is reluctant to prescribe anything but xanax, which he happily enough (I thought) prescribed one visit, only to chide me the next. I think I wore him out :(My gp seems to think getting off everything is good. Eight to ten weeks in, and no plan in sight except removing xanax next. (Right now I take about 1.0 mg. the majority of that is for sleep. Yes, by my pdoc's approval, since sonata no longer works, that is what I'm given. I'm
teaching myself to ride through most of
my panic w/o xanax.)I don't really care what medicine I take right now. There is no sexy new med waiting for me. Norco? I am better off w/o it. Xanax? Good lord, if I didn't need something, I'd happily leave it.
I'm depressed again, yes, most certainly physically.
I see my gp on Monday. She won't do
psych meds beyond your basic snri.I've been reading the archives here. I must need a second opinion, but can't
even get up the nerve to cold call or call
my pdoc for a referral. Guess I'll do that. Great. More scrutiny.People in my life seem happy to see me drug free. Like quitting my relatively
small dose of xanax is going to heal me and somehow I will feel *so much
better*. I don't have the luxury of waiting it out a year to see if my brain resets, or reboots, as if I were experiencing a computer malfunction.I feel very raw and starting from scratch. However, I am still committed to positive
solutions and tell any suicidal ideation to take a hike! Right now, I'm wondering if April really the is the cruellest month, as Elliott said.Here's to May.
Posted by mtdewcmu on April 29, 2011, at 17:00:16
In reply to May Day, posted by floatingbridge on April 29, 2011, at 15:13:39
> It's been about eight weeks plus since my
> last AD. Yes, I feel better without an ssri/snri. Hard to explain it. However, the initial euphoria of getting off of them and getting a mind back for myself is
> threadbare. I'm not functioning, though I can at least laugh about it. And have an orgasm. My moods are not nearly so
> crazy. Only intense. And I can track
> them back to thoughts or sensations. For instance, pain will register as anxiety. When pain creeps up, I will have negative thoughts; left unchecked, I will chase the thought while the pain goes unacknowledged until it's louder. I
> wasn't able to make that connection very well on the snri's I have experienced. (I'm talking here of my own experience. I am not applying this to anyone else's situation and am not extrapolating, "Snri. Baaaad!!!!" You know, like Frankenstein and fire.)
>What about an AD from a different class? Have you tried Wellbutrin or a TCA like nortiptyline? Sorry if you have and I forgot. TCAs are sometimes used for chronic pain as well.
Posted by Phillipa on April 29, 2011, at 20:44:33
In reply to Re: May Day » floatingbridge, posted by mtdewcmu on April 29, 2011, at 17:00:16
FB you wrote you feel better off the SSRI's and SNRI's so why take anymore? And life is better it seems. Just my 2 cents. Phillipa
Posted by floatingbridge on April 30, 2011, at 12:34:16
In reply to May Day, posted by floatingbridge on April 29, 2011, at 15:13:39
Hey Phillipa & MT Dew,
Life really isn't better. I am in bed 3/4 time. I don't go out unless absolutely necessary. I don't call people. I feel depressed again, certainly physically, but when I notice my avoidant behaviours, well, I just don't muster anything to counter. My relationship with my pdoc had dissolved, and that's that.
I feel like something isn't right. And I don't know how to get treatment, if I want treatment, what to treat.
I hate meds. I've tried doxepin (so awful. I was supposed to keep taking it, I know.). For some reason the gp & pdoc nixed amitriptyline ('harsh' sides? ).
I did call the/my pdoc and ask for a referral. The doc left a long message that we don't know yet what we are treating (after 3 years), that maoi's aren't out of the question but seem premature.
I'm finding myself not caring and staying in bed. I don't think my pdoc gets this. He gets angryish, like that will motivate me. Maybe it's his frustration. He used to think I was more capable than I am, and I can't carry that weight anymore. He dismisses any personality disorder out of hand, and says I could sell anything to get the treatment I think I need. This really hurts because I take that as that I'm manipulating him. I don't want him to be able to be manipulated. I don't want to 'sell' or manipulate. I want to feel reasonably better.
So all the meds piled on me didn't really help. There were too many. But now I face total abstinence, and I'm afraid that I'm overshooting the wash time and now just falling backwards. Then some people who know me here probably know I can handle distress poorly.
I have a kid, and this is the first time I can't whip myself out of bed. This really scares me.
And while I refuse to entertain SI on principal, there is a rock bottom hopeless ness that is becoming clearer. I don't like that. Aren't these warning signals? Or should I wait like I'm being told to by all three doctors, gp, pdoc, osteo?
Ironically, my pdoc says I am too dependent on doctors. But I can't write a scrip? I don't want to be my own diagnostician. I can only present my symptoms to the best of my ability. Big pictures were never my strong point.
Posted by mtdewcmu on April 30, 2011, at 13:45:36
In reply to Re: May Day, posted by floatingbridge on April 30, 2011, at 12:34:16
> I feel like something isn't right. And I don't know how to get treatment, if I want treatment, what to treat.
>It sounds like you are showing classical signs of major depression. No need to make it more complicated.
> I hate meds. I've tried doxepin (so awful. I was supposed to keep taking it, I know.). For some reason the gp & pdoc nixed amitriptyline ('harsh' sides? ).
>What were you taking doxepin for? Sleep? As an AD, I would think doxepin is much more side effect-prone than amitriptyline. Have you tried nortriptyline or the odder ones like desipramine? If you don't do well on SSRI/SNRIs, that still leaves a lot of options. If an AD makes you go to sleep, take it at bedtime. If it wakes you up, take it in the morning.
> I did call the/my pdoc and ask for a referral. The doc left a long message that we don't know yet what we are treating (after 3 years), that maoi's aren't out of the question but seem premature.
>
> I'm finding myself not caring and staying in bed. I don't think my pdoc gets this. He gets angryish, like that will motivate me. Maybe it's his frustration. He used to think I was more capable than I am, and I can't carry that weight anymore. He dismisses any personality disorderWhat personality disorder are you thinking? Avoidant PD? If you are suffering major depression, personality disorders are further down the list in importance.
> out of hand, and says I could sell anything to get the treatment I think I need. This really hurts because I take that as that I'm manipulating him. I don't want him to be able to be manipulated. I don't want to 'sell' or manipulate. I want to feel reasonably better.
>If there is no longer trust between you and your pdoc, then I would get a different pdoc. It's not worth the effort to try to win him back. Plus, I think suspicious docs can not be changed. It's about him, not you.
> So all the meds piled on me didn't really help. There were too many. But now I face total abstinence, and I'm afraid that I'm overshooting the wash time and now just falling backwards. Then some people who know me here probably know I can handle distress poorly.
>
> I have a kid, and this is the first time I can't whip myself out of bed. This really scares me.
>
> And while I refuse to entertain SI on principal, there is a rock bottom hopeless ness that is becoming clearer. I don't like that. Aren't these warning signals? Or should I wait like I'm being told to by all three doctors, gp, pdoc, osteo?
>Wait for what?
> Ironically, my pdoc says I am too dependent on doctors. But I can't write a scrip? I don't want to be my own diagnostician. I can only present my symptoms to the best of my ability. Big pictures were never my strong point.
I would focus on treating the depression, since that is the gravest threat right now. Correcting depression will probably benefit pain and other subjective symptoms anyway.
Posted by floatingbridge on April 30, 2011, at 18:55:45
In reply to Re: May Day » floatingbridge, posted by mtdewcmu on April 30, 2011, at 13:45:36
> It sounds like you are showing classical signs of major depression. No need to make it more complicated.
Yes. I suppose you are right. It's up to me if I want to treat it medically. My husband is opposed. My pdoc says I just feel things intensely. After everyone went out this glorious afternoon, I had a good cry in the tub. That activity has gone on for centuries and it hasn't been medicated. Of course, there was medicinal bleeding, cupping. Good lord though, I might not be so lonely if I lived in a village. Unless it was decided I was a witch.
>> What were you taking doxepin for? Sleep? As an AD, I would think doxepin is much more side effect-prone than amitriptyline. Have you tried nortriptyline or the odder ones like desipramine? If you don't do well on SSRI/SNRIs, that still leaves a lot of options. If an AD makes you go to sleep, take it at bedtime. If it wakes you up, take it in the morning.
>Thanks MT Dew. I thought emsam would be easier. I do have trouble with sides unfortunately. For instance, as much as the idea of irreversible damage is contested, something went pop! during a strattera trial and that's when I trace the onset of pain episodes--up and down the spine events and a thing called raynaud's turned my feet purple. Things have calmed down but not 100%.
>
> If there is no longer trust between you and your pdoc, then I would get a different pdoc. It's not worth the effort to try to win him back. Plus, I think suspicious docs can not be changed. It's about him, not you.I guess the trust was broken. Which is sad which makes crying in the tub an act of sanity. I've decided that going forward to have a separate therapist and a separate pdoc, if I seek psychiatric medication beyond my gp's range. And if I can't describe it in 15 minutes, and hour won't improve my diagnostic chances. I don't know why he prescribed me this huge bottle of xanax. That's a first. I have enough to see me through the next world war if need be.
>
> Wait for what?For someone to demonstrate the difference between post-snri-plus low
and depression. I really don't want to self-medicate, nor do I want to over-
medicate, nor unecessarily medicate.
What if a friendly professional said, wait
12 weeks, or 15, then you might see a positive change? Actually, you, MT Dew posted something about the norco taper. True (factual) or not, I did pass through some god awful window with that taper.
Knowing it would pass helped alot.
>
> I would focus on treating the depression, since that is the gravest threat right now. Correcting depression will probably benefit pain and other subjective symptoms anyway.Well, that's what I was thinking. That's what I've learned reading along here, and it's also what my pdoc worked to get me to see. I don't want to decide by myself, but I guess I have been all along to a certain extent.
Thanks for chatting MT Dew. How is your day going?
Posted by mtdewcmu on April 30, 2011, at 19:48:07
In reply to separation of church + state » mtdewcmu, posted by floatingbridge on April 30, 2011, at 18:55:45
I thought I was having a regular crappy day, but I decided to go outside and have a walk around the neighborhood, and I felt like I was tripping -- as per usual for starting up an SSRI -- but this time it was in a good way. Like my neighborhood actually seemed interesting today. It amazes me how much better I respond to Celexa than other drugs, and I'm grateful that it still seems to work for me. I hope the good vibes will continue, and I can still enjoy benefits from Dexedrine. Both will be essential pieces of the puzzle if my life is to get better. Thanks for asking.
Posted by floatingbridge on April 30, 2011, at 20:17:07
In reply to Re: separation of church + state » floatingbridge, posted by mtdewcmu on April 30, 2011, at 19:48:07
That is so cool that you know an AD that works for you--at least well enough.
The dex thing sounds like it's straightening out for you. That's good (!).
Enjoy :D
Posted by Phillipa on April 30, 2011, at 20:39:01
In reply to Re: separation of church + state » mtdewcmu, posted by floatingbridge on April 30, 2011, at 20:17:07
Okay this is definitely not good at all. I do know what living in a place you don't like is also like. I'm thinking if also have Renaud's that googling the autoimmune diseases timely work might yield a diganosis. Something isn't right. Depression and pain go together like a horse and carriage they say. And in bed all that time is not good. Love Phillipa
Posted by floatingbridge on May 1, 2011, at 1:54:04
In reply to Re: separation of church + state » floatingbridge, posted by Phillipa on April 30, 2011, at 20:39:01
Phillipa, there is nothing left to Google. And I'm exhausted by the whole health she-bang. Other than fatigue, and frankly whatever fibromyalgia is, I test horse-healthy. Some people might think I'm neurotic (yeah, you think?) but I'm counting my blessings no one is calling me a liar. Or an addict anymore.
Sometimes I catch myself panting the way a dog pants when in distress. My lower abdomen hurt in a real general way. That makes me pant. Wakes me in the morning and sometimes at night.
Could this be exacerbated by withdrawing from my mini-mart grocery list of meds? Maybe the norco kept the smooth GI muscle moving. Trouble swallowing at times too.
Hell in a handcart.
I see my gp Monday morning. I'll drag my med journal along.
Posted by Willful on May 1, 2011, at 9:50:39
In reply to May Day, posted by floatingbridge on April 29, 2011, at 15:13:39
PS You should tell the people in your life to take ahike on the no meds approach.
You are NOT better off with no meds, if you can find a med that helps. I was on parnate for a long time-- and it helped in a way-- to let me tolerate a very bad time in my life-- but it fogged me out-- and eventually became a huge liability. But that's my story. I do undrstand that it's better to be off a med even one that helps in some ways.
Try Emsam-- and go to a gp who understands that if you need meds, you need them. Period.
Posted by floatingbridge on May 1, 2011, at 10:53:18
In reply to Re: May Day, posted by Willful on May 1, 2011, at 9:50:39
I guess you are right. I don't know exactly how I came to this extreme place except by becoming cowed again. Working on that, though.
Thanks again, Willful.
Posted by floatingbridge on May 1, 2011, at 13:10:16
In reply to Re: May Day, posted by Willful on May 1, 2011, at 9:50:39
Willful, thanks again. I feel very sheepish posting. Besides an avoidant person, I am also pretty dependent. I loathe making decisions like this alone :-/
I did call my pdoc and left a message. What can he do? Accuse me of being crazy :D?
I said please help or refer me out. So hopefully soon.
Posted by Phillipa on May 1, 2011, at 20:56:39
In reply to Re: separation of church + state » Phillipa, posted by floatingbridge on May 1, 2011, at 1:54:04
FB I honestly don't know what to think or say?. Abd pain not good? Any irritable bowel? Could be withdrawal. What a mess!!!! Love Phillipa
This is the end of the thread.
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