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I may need help....

Posted by Adam on July 13, 2001, at 7:14:58

I spend a lot of time in the woods hiking and camping. It's been one of the few passions I have had throughout my life.

Some may have read, in 'Social a bittersweet account of my ride home with a participant of one of those camping trips. What I didn't reveal in that account was the reason for carpooling: I felt dizzy, and unsafe to drive. This is an experience I have never had, even after strenuous exercise, except with certain psychiatric drugs.

Since that time, about three weeks ago, my symptoms have progressively worsened, to the point that it is even difficult to go to work. I am extrememly tired, my joints ache, my neck is stiff, and I have a strange sensation in my face, which at first felt almost like sinus pressure, but has since spread to places as distant from my sinuses as my lower jaw. Sometimes, my face and neck around my throat feel a bit stiff.

Last night, after attempting a productive full day at work, I went to bet not so much because I wanted to but because I had to. Even though I felt terribly exhausted, I had a difficult time going to sleep because my heart was pounding so hard. It has been frightening. The worst thing is I feel so mentally cloudy. I can't think very well on my feet right now, and this is also something I'm not used to.

As these symptoms have worsened, I have made late night visits to an emergency room in Leominster, MA, and McLean Hospital. I found my symptoms to be so bizarre that I was afraid somehow it was the selegiline, or some aquired sensitivity to it. To my dismay, both the ER doc. and an internest and psychiatrist have suggested first and foremost that I am suffering from hypochondria. I am someone who, despite my troubles with depression, has prided myself on my physical health. I was once a state champion runner, and continue to be one of the strongest people, cardiovascularly, that I know. Normally, I am "healthy". I have never before been called a hypochondriac, and, lacking any other historical evidence as such, cannot understand why the diagnosis should be the first three separate physicians have initially siezed upon.

Except that I have a history of psychiatric illness. I am becoming more convinced, as I read up, that my symptoms are consistent with Lyme disease. I wonder if the odd sensation in my face is an early sign of Bell's Palsy. I live in Southern New England (only a couple hours drive from Lyme, Conn., ground zero), and, again, I spend a lot of time outdoors. I am "at risk", if you will. That I am unaware of being bitten by a tick, or lack the characteristic "bullseye rash" is not so unusual: Many who test positive for the spirochete have lacked these other indicators, anywhere from 20-40%.

A couple days ago, after spending, quite literally, three hours on the phone, I found an internest who could see me. I felt like I had to spoon feed this person a list of symptoms just to get the blood work done. More alarming, I had to deliberately steer the conversation away from my psychatric history. The doctor was completely unaware of selegiline, and seemed only vaguely familiar with MAOIs. He also seemed dismissive of my symptoms, despite my visibly exhausted state, and only met with me for a few minutes. I was simply sent to the blood lab and told to schedule an appointment for late next week. Since my preliminary vitals all appear normal, he possiblility of prescribing me antibiotics never came up.

I'm terribly afraid. The reading I have done on Lyme is somewhat reassuring, in that most who are diagnosed and treated are cured without sequellae. However, I am not confident I will be diagnosed: The blood tests themselves are not thought to be terribly reliable, and I seem to lack any other convincing diagnostic (I do not have the rash, or the tick who bit me in hand). There seems to be no consensus about the nature of what is called "chronic Lyme disease", but, as some recent articles in the NEJM seem to suggest, the very existence of a chronic illness caused by the Lyme pathogen is in doubt. That patients infected with the spirochete could experience the described sequellae, even in the absence of the microbe (and thus not respond, in the statistically significant sense, to antibiotics) seems to have occured to few. Other vague diagnoses, like hypochondriasis, or fibromyalgia, are offered as alternatives.

I'm not sure what to do. If I can't find a doctor who will treat me, what are my options? What is clear is that I'm not well. In fact, I've never been this "physically" sick in my life, despite a couple whopping cases of the flu. Or, at least, I've never been this mystifyingly sick. I certainly don't agree that I'm a hypochondriac, but it would seem my medical history has biases every physician I have met with so far towards that dx, vs. the assumption that my symptoms are legitimate. I have had my faith in medicine shaken before, but never this severly. I have never felt this clearly descriminated against, and it has come as a real shock.

As I said, I'm frightened. It seems I am my only advocate. I have yet to speak with my shrink, despite numerous phone calls, which seems to indicate she too isn't taking my fears that seriously. I don't know what to do.


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Psycho-Babble Medication | Framed

poster:Adam thread:69963
URL: http://www.dr-bob.org/babble/20010708/msgs/69963.html