Well, I went to the pdoc (1st time)...
Find a Conversation
| Fri, 07-14-2006 - 4:17pm |
Caution, some mention of SI further down, possible triggers.
Sorry, it's long, too.
Ok, well, I went. I did what I was supposed to do. Whoopie. Sorry, I'm a little bitter right now. I was there about 10 minutes early for the noon appt. I got taken back with the doctor at 12:25, fuming inside, but of course not saying anything. He never apologized for being 25 minutes late for the appt. You've all been there: first question, why are you here. My answer: because my tdoc told me to come. Next question: tell me about your moods (or something along those lines). I told him all the stuff I could as he kept changing the subject or not letting me finish. I was out of there within 30 minutes. He told me tdoc sent some information over stating she thought I was bp. He totally agreed, no questions asked. He mentioned bpII, he felt that was what the dx was. It didn't make sense to me, as my most recent episode was mixed, and if you have a mixed episode, you automatically get bpI dx. Of course, I didn't question him.
He was surprised that I was just on an a/d and was very sure that I should also be on a mood stabilizer. He wants to up the bupropion (wellbutrin) but refuses to do it until I have a mood stabilizer in me and he is sure it is working. He thinks the bupropion is a good choice for me but again, not alone. He discussed the three main bp meds and told me there was no way he was going to give them to me because since I am so against meds, he figured the side effects would make me stop taking them very quickly and he would never see me again. He had a smirk on his face when he said that. I appreciated his trying to get me to put my guard down. He wants me to take topomax and said he will start me out at 25mg and very slowly work me up to a theraputic dose. Once I am there, he will increase my bupropion to help me out, but not until then. He was not pushy about the meds but did tell me he was "going to twist my arm to take it" as he was really concerned the a/d alone was causing me some of my current problems and that I could get worse if I continue on this path. He went through a lot of information about other meds but really wanted to be careful with my lupus. He would not give me lamictal because of the potential of a serious rash and he wanted to make sure that we could distinguish a lupus rash vs. a med reaction. He really wanted me to take the lamictal; he thought it would be best for my symptoms, but he was very considerate of my underlying medical condition. I was very appreciative that he listened to me about that and was sensitive about my med anxiety.
Before I left, I asked when I should call regarding side effects. He said he wants me to call about anything. He wants me to feel comfortable with the meds and if anything bothers me, I should call, even if it is something that seems trivial. He understands my anxiety and wants to decrease that as much as possible.
I was very annoyed with the visit, as it started out pretty crappy, but by the time I left, I felt pretty good about it overall. I'm still upset about some parts, but the things that were really important (my lupus and my med anxiety) he really listened to me and tried to help me feel better about it all.
When I left, my head was spinning. I was clenching my teeth and I had major thoughts of SI. I was on the verge of tears and slipped pretty quickly into a minor depression. I was feeling very mad at my tdoc for "making" me go and felt like calling her and leaving a very ticked off message on her voice mail. But, I didn't. I filled my rx and came home. I'm still not real comfortable with everything, but I've resigned to the fact that I really need to deal with this, as it is definitely getting worse as time goes on (dh said it's been noticable for almost 2 years, but he still thinks I have a very "mild" case of bp).
The bill I got from pdoc actually stated the dx as bpI, most recent episode mixed, which was what I was expecting it to be. I don't know where the bpII statement came in during the session, but that is not what he dx'd me with. He also said I had many traits of borderline personality disorder because of the SI and the experiences I had as a child (being abused) also made that dx possible. He did not put that as a dx though, he just mentioned it in passing.
So, I guess it's all officail. I'm starting the topomax tonight. If anyone has any input about topomax, good or bad, I'd appreciate the information.
If you read this far, thanks for listening. I needed to vent a little, as I'm still not feeling real good about this yet.

Pages
Hi Morgaine,
Thanks for your response. I think all doctors are late for appointments. I guess I just thought people working in the mental health field would try to create as little stress as possible for their clients. My tdoc is always 10-15 minutes late, even when I was the first appointment.
I now agree that the a/ds alone are not the best of ideas for me, either. I didn't notice a whole lot of benefit from them. I actually started taking them for a very bad reason: I was hoping to send myself into a hypomanic or manic state. I was tired of feeling like crap and I love being hypo- 98% of it is positive for me. I also made myself believe that if I did take an a/d and it did make me hypo or manic, it would prove to me that I was bp. I was a little messed up, eh? I already knew that a/d's caused hypo in me- I took prozac in college and I was way wound up- started having a drinking problem (looking back, it was to self-medicate and bring myself back down, although I would never have seen that then) and almost failed out of college- and I was a dean's list student. So, I don't know what I was thinking by asking for an a/d. I had been hypo for a while and came off of that and I just wanted it back. I guess that is part of the reason I don't want a mood stabilizer...I love the highs and don't really want to give them up. I've never gotten myself into much trouble while high, but I know that may not always be the case. I also see myself cycling a lot more frequently now. The a/d alone caused me my first mixed state. I have to say, those suck. I've had that happen at least twice in the last two months and man, they are hard to deal with. I also experienced a lot of dysphoric mania (anger, irritability, not happy, enjoyable). So, my wish of being hypo got a little distorted.
Wow, that got a little long winded...sorry!
Pdoc wanted me on lamictal, too, but he was concerned about that Steven's-Johnson (I think that's the name) rash that can happen. He didn't want to be confused about med reactions vs. lupus symptoms. I've been relatively rash free (well, not really, but I know my lupus rashes very well and have only had one new one in the past year) so I feel confident I would be able to distinguish between the two. But, he is the professional and I have to trust his judgement. I will give the topamax a try and see what happens. If that doesn't work, maybe he will switch to the lamictal. I guess we will cross that bridge when and if we get there.
Oh, and I heard about the topamax making you dumber than a brick or causing memory problems. I read some people call it dope-a-max. I already have word finding problems and short term memory problems with the lupus at times, so this will be nothing new for me. It's frustrating, but people are used to me struggling. I just tell them about the lupus and they are cool with my stupidity LOL!
Hugs!
Peg
Pages