Posted by Racer on November 26, 2006, at 20:41:49
In reply to Re: What Do I Do? Thyroid and Antidepressants and » Racer, posted by Phillipa on November 26, 2006, at 19:10:41
Just one word: PARAGRAPHS!!!
Sorry, can't help myself: easier to read, eh? ;-)
> Now there are a few things maybe you can help me work out.
I can try...
>I guess I will have to do the communicating between pdoc and endo as one the pdoc is 5 hours away in another city. And she's not the type to try and call him.
They can telephone from that distance... Seriously, it may be that your endo is the one who'd have to make the calls.
But they may not need to call at all. My pdoc sends his reports to my GP, my T, our marriage counselor, and the repro-endo. As soon as he's written his report, after my appointment, it goes into the mail to all of those. If there's some issue that any of them need help working out, then they can communicate about that issue -- whether via telephone, or fax, or mail. I know you're having trouble finding decent treatment where you are, but if your pdoc isn't willing to send a report to the endo, I'd ask her why not?
Aside from getting your pdoc to send on the reports to your GP and endo, I would also bring up your concerns with the endo. "Gee, Doc, I see you, I see pdoc -- I want to know that the two of you are on the same page. Will you send your information to my pdoc, and call her if you see a potential problem?"
> I've tried three here. They all three said they will only deal with now issues and not go back and examine the biggest call it blockage to taking meds. And that is the fact that the prednisone killed my Mother.
I can understand that being traumatic for you. And I can certainly understand how it became the problem it is now for you.
Here's a point, though: you're not afraid of all meds -- you take benzos, and have for years. You take thyroid medication, too, don't you? Do you think you can identify what it is about certain drugs that trigger your fear? Maybe a rational response to counter the fear would help.
> And I'm sure you've encountered this before if you take psych meds you're crazy and I always feel guilty about that too.
No, not anymore. At least out here, most doctors aren't phased by it. Yes, back in the bad old days it was a problem to show up and say you took psych meds. Now, though? Half the people on the street these days are taking an SSRI, or even an anti-psychotic for sleep. It's not nearly as stigmatizing as it once was.
And even if they do think you're crazy, SO WHAT??? As long as they do their job, who cares what they think? I know, it's not that easy, and I go through it, too. But seriously: the doctor's job is to treat your disease or symptoms. If he/she's doing that, who cares if he/she thinks, "Hm... That Jan probably thinks she's living with a six foot pink bunny rabbit..."
> what do you suggest for someone who overeracts to everything? I thought of maybe 5mg of prozac to start with the benzos as years ago the pdoc when I wasn't depressed gave me the standard 20mg pill. First day it worked ... Day 2 anxiety, day 3 panic so bad I flushed them down the toilet.
What do I suggest? I suggest a complex approach:
1. You sit yourself down and have a little talk. Tell yourself that you're going to be trying a new medication and it may feel pretty crappy for a while, but that if you can stick it out, it will help. That's the first step: prepare yourself for feeling pretty crappy for a while, because it's likely to happen with any new drug.
2. After step 1, have a cup of tea and move on to step 2 -- make a list of the side effects you can tolerate, ways to make them more tolerable, ways you can cope with them, and which side effects you absolutely positively cannot live with. (For me, for example, the three things I cannot live with are: weight gain, constipation, and fogginess/lethargy/feeling half asleep. Anything else, I can learn to live with.)
3. Talk to your pdoc about strategies to help minimize your adjustment phase anxiety. Personally, I'd ask about a low dose of propranalol, which will stop the physical symptoms of anxiety. The psychological aspects you'll have to deal with, but the racing heart, etc, won't be there.
4. Write a contract with yourself, where you agree to try the medication you're prescribed for a minimum length of time, and at the dose prescribed. This is important, I think, because I don't think you do yourself any favors by trying to start with tiny fractions of doses. That seems like a good way to prolong your agony, if you know what I mean?
5. My recommendation is to try Lexapro. Start with a low dose, generally I think they start people on 5mg, which is half a tablet. I'd plan on working up to 10mg to see how you do. The first couple of weeks, be prepared to go through some discomfort -- all SSRIs are going to take some adjustment.
If Lexapro is a no for some reason, then Zoloft. It's sort of a mid-range drug, in my experience: not as sedating/anxiolytic as Lexapro, but not nearly as agitating as Prozac. I do have a problem with fidgeting and foot tapping, and rocking, and so on -- but it's not anxiety related. It's annoying, but it's something I can live with. (Hey, it burns calories, right?) Prozac can cause agitation and anxiety at first, especially for someone who's primed to panic about drugs.
Good luck. I hope that helps somewhat.
poster:Racer
thread:707405
URL: http://www.dr-bob.org/babble/20061123/msgs/707643.html