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Dr. Bob is Robert Hsiung, MD,
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Posted by Phillipa on February 8, 2009, at 23:25:25
In reply to Re: Short-term med tactic needed » Phillipa, posted by Garnet71 on February 8, 2009, at 21:15:42
Western Blot is only a blood test can be added to the thyroid one. Good luck. Phillipa
Posted by seldomseen on February 9, 2009, at 11:12:49
In reply to Short-term med tactic needed, posted by garnet71 on February 6, 2009, at 21:18:07
Now, I am no psychiatrist, however, after reading your posts and thinking about your symptoms, I think you should give the lamictal a shot.
You indicate that you have at least a second degree relative with a so called "psychotic" disorder, and I suspect, based on your description, a first degree relative as well.
This does put you in a higher risk category for maybe not actually having the disorder, but for exhibiting tendencies.
In my opinion, there is a lot of crossover between mania, mixed state depression and generalized anxiety disorder. Currently the diagnosis du jour is Bipolar, but I think it is actually more of a Venn diagram of symptoms. I think the lamictal will help.
My mother is full-on type 1 bipolar. Lamictal has really helped her.
I would also like to comment on something you wrote:
"Could the anxiety just be from a sudden withdrawal? I didn't taper as well as I should have. I had to get them out of my body."
Well, yes, the anxiety could be from sudden cessation of meds. But most importantly, the "I had to get them out of my body" is *verbatim* what my mother says when she would decide to quit taking her meds. In this instance, the similarity may be just coincidence, I fully acknowledge, but I was just struck by the use of the exact same phrase. It may be significant.
Regarding the tiredness, hung-over feeling, that could be coming from the Ativan, but in my experience, anxiety is just simply exhausting. It is so hard to maintain that level of vigilance that your brain is telling you to maintain. If one puts an animal under constant stress, they exhibit many of the failure to thrive symptoms that chronic anxiety/mania sufferers do.
I would also suggest that the candida overbloom is something that should be considered, along with blood sugar levels in tandem with your anxiety treatment. The intense craving for sweets/carbs I do think is a symptom that should not be overlooked. Also be sure that you are eating small meals throughout the day to avoid gross fluctuations in your blood sugar.
How did you get tears in your retina? Is that the same as retinal detachment?
I wish you luck at your appointment, please do keep us posted.
Peace
Seldom.
Posted by garnet71 on February 9, 2009, at 17:21:50
In reply to Re: Short-term med tactic needed » garnet71, posted by seldomseen on February 9, 2009, at 11:12:49
Thanks for offering your opinions, Seldomseen. I totally agree about total body exhaustion from maintaining anxiety and panic. I haven't ruled out all my options, so I'll think about what you said. SS, the retinal tears are just from the shape of a very nearsighted eye--your cornea shape is distorted, more oval instead of round. THis puts strain on the retina, stretches it. People as nearsighted as me all have a considerable chance of retinal detachment someday, and the tears are a sort of slow, protracted detachment.
I wanted to let you all know about my appointment with the endocronologist today.
I don't even know what all of these mean, but the tests ordered were:
Lyme-both enzymes
Iron & Ferritin
Follicle Stim. Hormone (FSH)
Luteinzing Hormone (LH)
Vitamin D
Comp. Metabolic Panel
Basic Metabolic Panel
Iron
TSH/Thyroid Stim. Horm.
Free T4
Thyroid Antibodies
Cortisol
Adrenocorticotripic Hormone
Urine Metanephrines - part of cortisol, i think
24-Hr urine catecholamine
Creatine Battery 24 hour urine
Cortisol (oo)One of these tests is Cushings related; 2 neurotransmitters are included in the test above -she said one is neuroephrinine, I think. I don't remember the techical name of the other one.
She was very reluctant to order the cortisol and Lyme tests, but I pushed for them. She said Lyme would be in area of infectuous disease, outside her expertise, and that I did not seem to have any cortisol-related issues. Because I have no digestive problems, they always seem to immediately rule things certain things out. I honestly cannot wait weeks upon weeks, if the other tests were negative, then follow up appointments, more testing, etc. to get back to normal. The vision problems will be addressed by my opthamologist this month, so we didn't talk about that.
I have a feeling that many of the tests will be normal or close to normal, that I have wasted a lot of money I do not have. If anything stood out to her, it was only the potential of thyroid imbalance. For adrenal exhaustion or Cushings, she said weight loss is a major symptom for adrenal, and that I don't appear to have Cushings, but I told her my body feel so completely out of whack, what if the possiblilty exists that I have another imblance that mitigates the weight loss, so she agreed to the tests. I'm really tired of only be considered for "one diagnosis". I was absolutely shocked to find I had gained 30 pounds in only 2 months!!!! I have been eating so many healthy foods, although I crave sugar and carbs which I'm sure have contributed to this gain, I honestly cannot see where it all came from.
I also (briefly) asked her about long-term xxRI use that results in hormonal imbalance, and she said she had never heard of any such research. She was very young and very sharp, and I feel comfortable with the outcome of the appointment, though it was very rushed. They really don't have time to think about all of the stuff we find on the internet.
I gave 6 vials of blood today; the 24 hour tests I start tomorrow, and one involves getting a script filled, then getting my blood drawn 24 hours later. My head hurts so bad. I haven't taken any Ativan since about 1 pm yesterday, have none left, stayed up all night last night, but just slept 4 hours and woke up with a headache and burnt feeling in my brain. Piece of mind, though, is closer now.
The strangest thing is that I found out today I was only 37 years old; I have been thinking for months that I was 38. Good sign of being a basket case...lol.
So when the tests come back, I'll update you all if in doing so, it will help another.
Thanks for all the advice and I'll post another update in a couple of weeks when she calls me with all the results!!
Posted by garnet71 on February 9, 2009, at 19:15:33
In reply to Update and thanks, posted by garnet71 on February 9, 2009, at 17:21:50
Correction: one test was for norepinephrine.
Posted by Phillipa on February 9, 2009, at 22:54:43
In reply to Re: Update and thanks, posted by garnet71 on February 9, 2009, at 19:15:33
Garnet you did it!!!! Got an endo to do the lymes testing fantastic. Weight gain could be low thyroid? Good a lot of testing. Two for for hormones LH & FSH to see if in perimenopause. The panels routine cover the electrolylets and blood counts. Cortisol that is great especially the urine one. Sounds like an excellent endo. Don't forget to update. Love Phillipa
Posted by garnet71 on February 10, 2009, at 14:30:59
In reply to Update and thanks, posted by garnet71 on February 9, 2009, at 17:21:50
I have not had any of the scary symptoms since the day before yesterday--after I had a healing dream. Not to be mistaken as part of a delusion; I had an emotionally healing dream when I was 14 years old and it has positively affected my life every since. I've also had other profound dreams I won't get into here...This was more of a physical healing dream rather than emotional...Could be the former was my mind's way of coping with somewhat hellish experiences, this time more of just a crisis, which I guess the psych world would explain as a coping mechanism, maybe transference, or it is something spiritual.
It could also be that I had a bad reaction from taking melatonin or magnesium citrate - even eating lots of cilantro and kale, and that this was a temporary reaction.
I'll never know. Or, the symptoms could very well come back.
My question about the tests - if I am not experiencing the symptoms I've had recently (panic attacks that led to racing thoughts and even severely distorted vision), wouldn't that skew the test results? I'm concerned about the cortisol since my panic attacks and other symptoms are no longer present and I have to do the 24 hour urine tests. I can't do it until the end of the week because my schedule is full of appointments and meetings and I can't carry around the damn bottle...or maybe I can but don't want to. Wouldn't you know though that the testing facility gave me a plastic container full of ACID that goes with the test that is meant for the processing lab! Thankfully I am thinking clear enough to have realized this is not a bottle I am to fill and called them.
Anyway, 3 tests will be drawn from this particular 24 hour urine test and am wondering if it will be as accurate if I lack symptoms at the time of the collection. Any opinions?
Posted by Garnet71 on February 10, 2009, at 21:03:59
In reply to about tests, posted by garnet71 on February 10, 2009, at 14:30:59
Not that anyone is listening, but I'm still concerned - esp. having a 2 day headache.
Over the past week, although I've had some dizziness and fuzzy head feeling symptoms, along with the cogntivive problems---but in the pas week, first my brain was really fuzzy, feeling like cotton stuffed inside my skull, then vision problems; major distortions, then a 'burnt' feeling in my brain-and headache that won't go away. STill haveing some distorted vision, but not as dramatic as the other day.
I'm really upset about not having health care;I think the endo appt. yesterday cost me about $1500.00, and then I have PDoc appt. this week, eye doctor appt. later this month--who will probably refer me to a neurologist in addition to expensive retinal scans I had to get last year. It wouldn't be so bad if I could pay thousands, couldn't complain about that. But what to do? It is sooo hard to qualify for medicaid anymore, and what kind of neurologist or retinal specialist or endo will take on people who can't afford health insurance and can't pay the bills?
Posted by Phillipa on February 10, 2009, at 21:07:00
In reply to Re: about tests » garnet71, posted by Garnet71 on February 10, 2009, at 21:03:59
Garnet have had a two week long headache, and my vision is blurry and have had PRK lasix surgery. But I paid out of pocket for it. Love Phillipa ps motrin doesn't touch the headache.
Posted by Garnet71 on February 10, 2009, at 21:15:56
In reply to Re: about tests » Garnet71, posted by Phillipa on February 10, 2009, at 21:07:00
Are you saying you had the headache as a result of the surgery, or just after the surgery?
I can't even take an over-the-counter pill. I am honestly scared to take anything at this point.
Posted by JadeKelly on February 10, 2009, at 22:33:38
In reply to about tests, posted by garnet71 on February 10, 2009, at 14:30:59
Hi Garnet,
I'm sure this has been covered but *just in case* Have you been tested for diabetes or Hypoglycemia, or some other blood sugar related disorder? Whenever I am as stressed as you seem, wieght literally drops off of me. The fact that you gained 30lbs with out time to even notice makes me suspicious of something to do with blood sugar OR a disorder that fast weight gain for unknown reason is a symptom. Can you just call your GP and ask, or do you have a book that lists symptoms? Do this AFTER you get your results.
I think at this point its best for you to relax if you can knowing you are about to either rule out a lot of things, or its time to do some more tests.
Stay calm, you're doing all the right things. If you get to the point where you can't function, like one or more of your symptoms becomes out of control, you can always call emergency # where you are.
Good luck, hoping you find out something on tests that can be easily treated.
~Jade
Posted by Phillipa on February 11, 2009, at 0:18:53
In reply to Re: about tests » Phillipa, posted by Garnet71 on February 10, 2009, at 21:15:56
Garnet no have the headache past two weeks. And afraid to take any more meds also although have to take the synthroid and can't just stop the benzos but can cut down on luvox. Lost my taste and smell after the lasix though. No one knows why????? Love Phillipa
Posted by garnet71 on February 12, 2009, at 17:12:37
In reply to Short-term med tactic needed, posted by garnet71 on February 6, 2009, at 21:18:07
It's been about a year since i went to this psychiatry practice, and after spending 40 mins. talking with the PDoc today, I feel very comfortable with his assessment. (The first thing I said to him, jokingly but half serious, was 'I better get more than 5 minutes'...lol.
I wish I had never left this place, but the last I had gone there, I saw the nurse for a year at a time, who was very intelligent and good at the job, but since I was not at my best, I guess I just loss confidence with the practice. I felt inclined to tell the PDoc about trying another doctor for 2nd opinion (which turned out to be a disaster), to let him know what I've done as far as meds lately, and felt kind of bad.
So for the symptoms I listed in my initial post--he doesn't think I'm Bipolar. He said I am ADHD, after doing the screening that was never done because I had depression/PTSD, and he told me that ADD/anxiety coincide quite often. He also listened for along time. He said even the recently emerging racing thoughts and distorted vision were most likely severe anxiety, but said it was good to see my opthamologist next week. I told him everything I vent about here, and how the ADs have made me worse, in terms of depression and motivation, etc.
So for the scripts:
Buspar 15 mg
Ritalin 20 mg x 2
Xanax .25 mg as neededHopefully I'll only have to take the Xanax for a month or less. I have concerns about the Buspar being strong enough for my level of anxiety, and am scared of the Ritalin since I've never taken a drug like that before. I might wait on the Ritalin pending medical tests, but at the same time, am anxious to see if it will help.
But-he told me I'm not allowed to look things up on the internet anymore, and to forget about everything I've been reading about meds, bipolar, and anything else. He said I'd be jeapordizing the plan..lol. Thank God he has a personality and sense of humor unlike the last 2 PDocs I've tried.
This plan might fall through, I don't know; what I do know, is that I feel very assured by this doctor...
For all of you that have similar symptoms as I, or are concerned about 'what is wrong with me', I hope you get another opinion before starting any potent antipsychotics and bipolar medications. I was scared he was going to suggest them, but I am relieved. I thought if I started that route, it would only be downhill from there.
I'll post another 30 days from now and let you know how it works (if anyone's listening)!
Hope everyone's having a great day!
Posted by JadeKelly on February 12, 2009, at 20:19:04
In reply to Update from PDoc, posted by garnet71 on February 12, 2009, at 17:12:37
Garnet,
Isn't it a relief? My new PDoc is excellent. My other one ought to be in jail. I like to figure things out on my own too, but when you have a competant PDoc its SUCH a relief to turn it over to them.
I have never even heard of someone getting their psychiatric care from a nurse only.You did the right thing by asking for a PDOc.
As for you dx, sounds right to me, but what do I know? Nothing!!! He does. I do think you are an over achiever (thats a complement) and that is probably the H in ADHD.
I took ritalin for 12-13 years, it was the perfect med for me. I stopped taking it when I started anti-depressants. Then I found out its an excellent augment FOR ME and my Doc has me on a dose I would never had considered before. I used to be an over achiever, everything had to be perfect. But I enjoyed my successes! I have to say, without ritalin, I don't know if I would have accomplished what I did. I had/have ADD.
So I wanted to tell you I think you will love Ritalin, but I took 5mg 3x day. One 5mg tab and I think you'll like how you feel. I'm afraid you'll take 20mg and it'll be too much and you'll quit. You can always try 5mg, see what it feels like and go from there. In fact, I'd start with that so you know what's what. Just my opinion, right after I say forget what everyone else says, do what your Doc says, haha.I just have a lot of experience with it.
Anyway, congratulations!!!
And stop saying if anyones listening!!
Most of the time you get a ton of responses!!!I'm happy for you ;-)
~Jade
Posted by Phillipa on February 12, 2009, at 20:43:28
In reply to Update from PDoc, posted by garnet71 on February 12, 2009, at 17:12:37
Garnet better log off then and no influence from me . Can't wait to hear how you are in thirty days. Love Phillipa
Posted by JadeKelly on February 14, 2009, at 16:54:23
In reply to Re: Update from PDoc » garnet71, posted by Phillipa on February 12, 2009, at 20:43:28
Oops. Wait, adding a message now and then to a fun story That YOU started can't be bad can it? Cause I just brought you back, haha. Let me know what you want to do. I could say it was a delusion or something. I just realized that by stealing the files we wrote you out of the story unless you continued on your journey on the raft with file boxes. As it stands you and I are facing each other in the cooridor. Check it out and let me know what to do!! THanks-hope things are getting better. I wish you PEACE.
~Jade PS-theres a free makeover in it for ya, I gotta find TC for that.
Posted by Phillipa on February 14, 2009, at 21:23:16
In reply to Re: Update from PDoc STORY!!!!, posted by JadeKelly on February 14, 2009, at 16:54:23
Read admin. Phillipa
Posted by SLS on February 15, 2009, at 9:37:33
In reply to Re: SLS?, posted by garnet71 on February 8, 2009, at 10:21:45
Hi Garnet.
I apologize for not seeing this post earlier.
> I hope we are still friends.
Yup.
In case you still want to investigate alternative treatments, check out anything posted on the Alternative board written by Lao Tzu. He really knows his stuff from what I can see. You might want to ask him questions. He is very generous with his time.
- Scott
Posted by garnet71 on February 15, 2009, at 20:04:27
In reply to Re: SLS? » garnet71, posted by SLS on February 15, 2009, at 9:37:33
> In case you still want to investigate alternative treatments,
No, no...I went back to psych meds, although was able to avoid the xxRIs this time (I have to admit I hate those things after being prescribed them over and over and over--only to be worse off.I didn't have much of a choice with life falling apart and all. But yeah, I've followed some of Lao's posts, and agree with you on that. For me, I think alternative treatments could have worked when I was at my best and on no drugs--If I kept up with it (esp. the routine exercise), had advice from a nutritional professional, and wasn't subject to so much stress. When I'm finished with school, alternative treatments will definitely be my plan.
Posted by Phillipa on February 15, 2009, at 21:30:00
In reply to Re: SLS? » SLS, posted by garnet71 on February 15, 2009, at 20:04:27
Garnet so what did you decide on? Phillipa
Posted by Garnet71 on February 15, 2009, at 22:22:38
In reply to Re: SLS? » garnet71, posted by Phillipa on February 15, 2009, at 21:30:00
Hi Phillipa,
I take Buspar 15 x 2 and .25 x 1 Xanax at bedtime. Just started on 20 x 2 of Ritalin (today).
No anxiety in a few days, but it had dissipated when I was on no drugs at all. Ritalin helped me today, but not sure about it yet. I was quite happy with this script; the last PDoc wanted to give me Lamictal. The Buspar was my suggestion; however, during beginning of PDoc appt. I said I needed to be screened for ADHD/ADD and he agreed. I am surprised though, I wasn't considered a drug seeker for being the one to bring it up...more lucky than anything I guess.
PDoc thought most of my symptoms were from severe anxiety, and the rest from ADD/ADHD. BUT-now I remember how well Xanax helps me sleep. I woke up feeling so refreshed unlike that hungover feeling I've had for over a year now. I really think the xxRIs screw up my sleep/autonomous nervous system--and that sleep deficiency manifests in so many areas. Xanax took me back to the sleep I used to have--like Mariott-hotel-bed-sleep..lol..You take Xanax too, right?
I honestly did not have time to experiment, with everything going on in my life. I made the decision and stuck with it.
Posted by Phillipa on February 16, 2009, at 19:18:46
In reply to Re: SLS? » Phillipa, posted by Garnet71 on February 15, 2009, at 22:22:38
Garnet yes .5 xanax with 12.5mg of valium and lowest dose of luvox for years. Seems need less of the benzos no idea why. Guess chemistry changes. Glad to see you got what you really needed. I never has much luck with any SSRI for anxiety. Thing with luvox it potentiates the valium and xanx. Wonder how fast can go even further down on them? Phillipa
Posted by seldomseen on February 16, 2009, at 20:39:14
In reply to Update from PDoc, posted by garnet71 on February 12, 2009, at 17:12:37
Oh wow! That sounds wonderful! I'm so happy that your pdoc *listened to you*, formulated a plan for you that you agree with and that you already seem to be getting some relief.
Having a good relationship with a doc will really help in your recovery (as I'm sure you already know). Since this one is actually listening to you, even if this one goes into the cr*pp*r, together you'll be able to pull together a workable regimen.
Again, I am so happy that you made this happen for yourself.
Keep us posted.
Peace to you.
Seldom.
Posted by JadeKelly on February 16, 2009, at 21:28:24
In reply to Re: Update from PDoc » garnet71, posted by seldomseen on February 16, 2009, at 20:39:14
> Oh wow! That sounds wonderful! I'm so happy that your pdoc *listened to you*, formulated a plan for you that you agree with and that you already seem to be getting some relief.
>
> Having a good relationship with a doc will really help in your recovery (as I'm sure you already know). Since this one is actually listening to you, even if this one goes into the cr*pp*r, together you'll be able to pull together a workable regimen.
>
> Again, I am so happy that you made this happen for yourself.
>
> Keep us posted.
>
> Peace to you.
>
> Seldom.
Hello Seldomseen,That was a really nice post! I don't believe we've met which seems impossible as we've been crossing paths for months! Something you wrote caught my eye. One of my twin boys is "full on bi-polar 1". Have you ever noticed that if an immediate relative is "full on" that means you automatically are bipolar 2,lol? My old PDoc could not let go of this idea. He also couldn't get me well. I think Bpolar 2 is very hard to treat, IHHO. I'm sure there are milder forms of Bi-polar 1, but it seems the diagnosis is being used as a catch-all and thats not fair to patients.
My new PDoc gave me new dx and I am happily very close to remission. Nothing like a competant PDoc I always say!
Hope you see this,if you ever want to talk BP-1 let me know.
~Jade
Posted by seldomseen on February 17, 2009, at 6:27:52
In reply to Re: Come back Seldom Seen!!! » seldomseen, posted by JadeKelly on February 16, 2009, at 21:28:24
Thank you for your post. Hello right back to you. I can talk bipolar for days. I consider bipolar to be a pyschotic disorder.
It just seems to me that everyone these days is pushing bipolar. While I don't doubt that in some cases it is the "correct" diagnosis, as I said, the symptoms all fall on a continuum. My personal opinion is that the "threshold" for what constitutes bipolar 1, bipolar 2 etc... on that continuum has gotten pushed way back.
What I do know is that, in those that do have it, it can be a refractory illness.
I think it is entirely possible (obviously) that one twin could have bipolar and the other not. I know some researchers at my university that would be very interested in your boys, as they are studying the emergence of symptoms in first degree relatives of the psychotic disorders.
My mom suffered for years with her illness, and left quite a wake behind her too. The only drug that worked for her (probably because she would actually take it) was lamictal. When she hit the therapeutic range of that drug, I literally saw her unwind, relax. She actually paints now, can read a whole book, and manages her money very well (which is a total, utter miracle). The suicide threats are just gone. She said the lamictal just felt "smoother" than the other drugs and her body just accepted it better. It didn't kill "her" just fixed her. (her words)
The other therapies just "stoned her out" which to some degree was true.
During a particularly harsh manic phase in which she lost her job of 30 years, she gave depakote a good try. It made her drool and stare. It broke my heart. I'm actually the one that suggested that she might want to consider something else.
Her mother clearly has bipolar as well, but the only drug she will accept is ativan.
I don't have it, neither does my brother. But the words "bipolar tendencies" (which IMHO, is what Bipolar 2 actually is) have come up in my therapy when the anxiety gets really cranked up. My brother deals with a fair share of anxiety as well, which curiously showed up in both of us in our mid-late 30s. He's a drinker.
As Garnet's pdoc (and mine for that matter) has indicated, severe anxiety can manifest with the similar racing thoughts and "pressure" that looks very similar to a manic bipolar. It takes a really good doc to *listen* to the patient, sort it all out, and propose an appropriate path to relief. I think sometimes that path may include the atypical anti-psychotics, but it all depends on how the patient presents, and what therapies they will accept or won't. Any regimen will only work if the patient will take it.
I do wonder sometimes what happens in the brain to "flip" that anxiety over to overt psychosis /mania in some people. I also wonder if the crash to depression is simply a protective mechanism or just simply exhaustion.
My current regimen is Prozac and Klonopin with Trazadone for sleep. I have long periods of relief, but still have bad days (who doesn't). My symptoms are quite stable and I predict they will stay that way.
Seldom.
Posted by garnet71 on February 17, 2009, at 8:31:38
In reply to Re: Update from PDoc » garnet71, posted by seldomseen on February 16, 2009, at 20:39:14
Seldomseen,
Thanks for all your kind words :)
He was the first PDoc I saw for PTSD/depression years ago, but when that was 'cured', I got really bad chronic anxiety and was given the same xxNI drugs over and over by the psych nurse. This went on for 2 years, though a break from meds in between. The doctor only comes to the office 1 day a week; he also works out of a hospital that is far from where I live. I would schedule my follows ups to see the doctor, waiting an extra month to get the appt., or scheduele when I'd miss class to see the doctor and not the nurse, but when I'd get there, I'd be seeing the nurse. I really like the nurse, but when I wasn't getting better, I gave up and quit going there.
When I quit going there, I tried 2 new PDocs--who were both terrible--one in competency and the other-I don't even know what his problem was....
I really do like this doctor. I really want to just 'trust' a doctor and do what he says without being so skeptical and doubtful. I'm honestly burnt out from making decisions all the time. Every family crisis, boyfriends, even my X/son's fathers kids (not mine), jobs w/a lot of responsibility, being a single Mom all those years...I am just tired of always being the one to make the decisions. It's nice to just let go and let someone else 'take over' for me.
I have a bit more hope now; it's too soon to tell, but I think I'm getting where I want to be for the time being.
Nice you found a great person to discuss BP with (Hi Jade!!). Your post below about BP is very interesting.
Thanks :)
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Dr. Bob is Robert Hsiung, MD,
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