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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by zeugma on October 23, 2003, at 16:42:34
I'm still in a state of disbelief about this one.
I was at work feeling not great, not awful, just tired. I do some administrative work before classes start (I teach at a supllemental ed school) and if I finish the administrative work in time, I get to take a break. I was starving and was thinking that was why I was feeling kind of low. I went to the pizza place across the street and ordered a slice with pepperoni, sausage, peppers, everything- i didn't care what i ate as long as it was food. I usually don't eat there, i usually take the food back to the school, but as I had finsihed fairly early and i wanted to get a cup of coffee before starting my class. I ate the food quickly, gulped down some root beer, walked over to starbuck's and got a tall cup. Sipped it as i walked back past the homeless denizen of the neighborhood, who was engaging in some florid EPS-type activities at the entrance to a bank. I was just sipping the coffee, thankful that I had time to caffeinate myself before teaching- these days i normally get decaf but i was feeling out of it.
I see one of my students in the waiting area outside the classroom, i say hi to him and comment that it felt like winter out there. as i walk past him he says "there's something on your back." I took my jacket off and examined it. "No- on your pants." I said, "oh, it must be pizza" as i waslk past him towards the bathroom. "Pizza? he repeats bemused. It wasn't pizza on my pants.
There was smeared fecal matter all over the right pants leg. It was unmistakably feces- i wswabbed at it with some toilet paper and water, and i threw the soiled paper into the toilet, feeling as if this were unreal. I had been reading a book, "THe Paradoxes of Delusion," about Wittgenstein and the schizophrenic mind, which describes the unreality of the delusions schizophrenics experience. I can't say anything about the thesis of the book, but it felt absolutely unreal standing there in the bathroom with my pants spread out on the floor and me swabbing at them with toilet paper and water. Tghere was nothing to do, I obviously didn't have a spare pair of pants at the school, and compounding the disaster all the other teachers had called out sick today. There was no way I was gonna teach. Finally I put them back on, having cleaned them off as best I could, I told my supervisor i had to go home and explained briefly what happened. She looked incredulous at me and muttered "bizarre."It was embarrassing as hell, I had a 45-minute ride home on the subway, when i got home i closed the door, stffed the pants into a plastic bag, threw on shorts and stuffed them down the garbage chute. A nauseating, humiliating experience. A few years ago on my birthday, while waiting for the bus home, a bird pooped all over me as i got on the bus. I spent the entire ride home (45 mins. or so) pulling out one tissue after another wiping the bird poop from my hair. More recently, in April, I had what my therapist called a "saturation" experience in a pizza place: I took a bite of my peeperoni pizza and was washing it down with Deer Park water when I felt something moving in my mouth. I pulled some baby roaches out of my mouth- disgusted, i BOLTED out of the pizza joint and never looked back.
This latest thing though was really worse. Worse than the sewage that came up from my shower drain in September. (I wonder- amI really delusional? How caould all t hese things happen to me?)I am sitting at home now instead of teaching, feeling awful, embarrassed, kind of nauseous too. Never walking into a pizza place again.
Posted by zeugma on October 23, 2003, at 18:08:10
In reply to another nauseating problem, posted by zeugma on October 23, 2003, at 16:42:34
what I'm really worried about now is my tendency to panic in these kind of situations. I do not seem able to think clearly- all i could feel were feelings of shame and humiliation (I have avoidant personality disorder) and i'm really worried that this will cost me badly in the workplace at some point (if not now). Does it seem like my responce was a panic-type response? Please reply- I go to my pdoc tomorrow morning and i need to discuss panic/anxiety issues with him.
Posted by Dinah on October 23, 2003, at 19:46:07
In reply to Re: another nauseating problem, posted by zeugma on October 23, 2003, at 18:08:10
Actually, I think you were quite moderate in your response. My husband or I would have probably stripped down where we were and walked home in a newspaper or something, then boiled ourselves for the rest of the day.
I think that was a yucky situation that no one could have possibly handled extremely well unless maybe they were in the medical profession.
Posted by KellyD on October 23, 2003, at 20:03:02
In reply to Re: another nauseating problem, posted by Dinah on October 23, 2003, at 19:46:07
I think you had an approiate reaction to such, well, an almost no words to describe, situation. The fact you were able to carry on to the best of your ability, despite wretched circumstances, is commendable, at the very least.
Posted by zeugma on October 23, 2003, at 20:14:33
In reply to Re: another nauseating problem, posted by KellyD on October 23, 2003, at 20:03:02
Thanks so much for your responses. I am feeling like anxiety is coming close to making me fall apart right now. I thought about the newspaper ploy- believe me if I'd had any lying around i would have wrapped myself in it and gotten home like that. What I'm upset about is that I am in a very responsible position where I work, and there was an already bad situation there (the other teachers calling out). I feel very validated though by what you say.
it's also upsetting the kind of feelings I had from the soiled pants - I felt like I was back in kindergarten and had had an *accident*. The essence of avoidant personality disorder is that kind of terrible embarassment. Especially awful to feel that way when you're surrounded by children and you're a teacher!
To say the least I am going to have a lot of material for my next CBT session. I also see my pdoc at 10:30 tomorrow morning and I plan to ask him about a benzodiazepine for this kind of self-consciousness and agitation. I feel very close to meltdown right now.
Posted by KellyD on October 23, 2003, at 21:40:06
In reply to Re: another nauseating problem, posted by zeugma on October 23, 2003, at 20:14:33
Take care of you. I'm very glad you have an appointment for tomorrow. I have found that sometimes the responsibilities we are tied to can be a "saving grace" and move us to have to keep plugging along, difficult, but sometimes the diversion is a blessing.
I have stated before, I'm a Klonopin poster child. Makes it possible for me to have a functional life. We have to do what gives us the ability to live our lives as well as we can.
I hope you work this out. I can understand how difficult this is. Hang in there.
Posted by fallsfall on October 24, 2003, at 7:31:14
In reply to Re: another nauseating problem, posted by Dinah on October 23, 2003, at 19:46:07
Medical professionals would be more likely to have a change of clothes with them. Maybe that's why they handle it better.
Posted by fallsfall on October 24, 2003, at 7:34:21
In reply to another nauseating problem, posted by zeugma on October 23, 2003, at 16:42:34
I think you handled it extrememly well. When we have a particular emotional soft spot, I think that we tend to blame it for many reactions that we have. I think that a "healthy" individual (Is there such a thing?) would have reacted much the way you did.
Stay away from that Pizza place, for sure!
Posted by Dinah on October 24, 2003, at 19:20:11
In reply to Re: another nauseating problem » Dinah, posted by fallsfall on October 24, 2003, at 7:31:14
Posted by Katt on October 26, 2003, at 13:06:14
In reply to another nauseating problem, posted by zeugma on October 23, 2003, at 16:42:34
man, that sounds shi##y
Posted by zeugma on October 26, 2003, at 15:42:49
In reply to Re: another nauseating problem, posted by Katt on October 26, 2003, at 13:06:14
Thanks to everyone who was supportive. Unfortunately, there's a predictable pattern that occurs with me in response to stress. No matter how well I deal with it, no matter how many relaxation exercises I do (my CBT therapist's solution for everything) even in the best of times I feel tense, jittery, and have a difficult time staying calm. When something stressful occurs the bottom falls out. I've had terrible IBS this weekend, severe stomach pain, terrible sleep last night, overall feeling completely rancid.
I saw my pdoc on Friday and he told me point blank that he doesn't want to put me on any more drugs. It's easy for him to say that because he doesn't have to deal with the consequences of my anxiety. Right now it's not the episode itself that's upsetting me, it's the aftermath (terrible jitteriness, physical anxiety symptoms). And doing the cognitive strategies my CBT therapist also relies on mean nothing when my gut is feeling so AWFUL. The anxiety is so bad that I don;'t think I will be able to properly explain it to her when I see her tomorrow (just being the presence of someone makes me too self-conscious to want to explain). I think the best i will be able to do is print this out and let her read it. It is so frustrating feeling so anxious that even talking to your own therapist is too intimidating to fully explain what is going on. And the MOST frustrating part is that the cycle is totally predictable: Anxiety-provoking event occurs; I become anxious in response; then I calm myself down; then the sh*t hits the fan (how appropriate for this situation) as the physical consequences of the increased anxiety levels hit me. I am hanging in there but feeling awfully rancid, upset with my doctor, and worried that this will also impact me at work. Thanks again for your support.
Posted by KellyD on October 26, 2003, at 15:56:49
In reply to fallout, posted by zeugma on October 26, 2003, at 15:42:49
I would be quite upset, too. I don't understand when help is available, why it wasn't prescribed. But, try to hang in there - I know it's tough. You have rode out these times before and you can this time, too. I'm sorry you didn't receive more support from your Dr.
I'm thinking of you.
Posted by Dinah on October 26, 2003, at 17:13:48
In reply to fallout, posted by zeugma on October 26, 2003, at 15:42:49
Sorry to hear that. I *do* know the feeling. But as fortune would have it, there are a number of IBS drugs out there, including some that also happen to be psych drugs. (Says the person who just broke down and let a doctor prescribe one after years of only partial relief with Immodium.)
If your pdoc won't help you deal with such a common and surprisingly debilitating problem (I went to a seminar once, and it's surprising how many people are practically housebound), I'd seriously contemplate turning him in for a more empathetic model. Do you have any choice in doctors?
Sometimes, unfortunately, we have to insist on being treated properly. Doctors are too quick to dismiss certain problems as being all in your head. When we all know they're in our head, our gut, and everywhere else the nervous system operates.
Hope you feel better soon. :(
Posted by zeugma on October 26, 2003, at 20:02:59
In reply to Re: fallout, posted by KellyD on October 26, 2003, at 15:56:49
Posted by zeugma on October 26, 2003, at 20:20:47
In reply to Re: fallout » zeugma, posted by Dinah on October 26, 2003, at 17:13:48
> Sorry to hear that. I *do* know the feeling. But as fortune would have it, there are a number of IBS drugs out there, including some that also happen to be psych drugs. (Says the person who just broke down and let a doctor prescribe one after years of only partial relief with Immodium.)
>At the risk of redirect, what did your dr. prescribe for IBS?
For the most part, nortriptyline helps with the IBS, especially with the pain and nausea aspect. The problem is that anxiety aggravates it, so an anxiolytic that actually worked (unlike what my pdoc is willing to prescribe) would be prophylactic in terms of lessening the frequency of episodes. I have also heard that clonazepam can help with the actual symptoms of IBS.
Some people have a cocktail of meds- I feel like I have an unwieldy combo of mental health professionals, pdoc, CBT therapist, and neuropsychologist, all seeing various parts of the elephant of my dysfunctional psyche, but none of them getting a whole view. And I feel terribly inhibited with the pdoc, a little looser with the CBT therapist, while I see the neuropsych a lot less frequently as she's more expensive :)Maybe part of the reason I'm so anxious now is because my CBT therapist was on vacation?
> If your pdoc won't help you deal with such a common and surprisingly debilitating problem (I went to a seminar once, and it's surprising how many people are practically housebound), I'd seriously contemplate turning him in for a more empathetic model. Do you have any choice in doctors?
>
> Sometimes, unfortunately, we have to insist on being treated properly. Doctors are too quick to dismiss certain problems as being all in your head. When we all know they're in our head, our gut, and everywhere else the nervous system operates.
>
> Hope you feel better soon. :(
Thanks. I usually get more anxious on the weekend anyway, so hopefully starting a new week will help cheer me up- plus i see my CBT therapist and will have a good chance to vent.
Posted by Dinah on October 26, 2003, at 20:27:57
In reply to Re: fallout » Dinah, posted by zeugma on October 26, 2003, at 20:20:47
Klonopin didn't help a bit with the IBS for me. :( I tried nortrip, and it worked for the IBS but was too activating with the norepinephrine, so I didn't stay on it. I've got some anticholinergic now to take as needed. Haven't tried it yet.
But how about the other tricyclic, amitryptaline I think?
Mind you, I think klonopin is great and wouldn't go to a doctor who wouldn't prescribe it. It just didn't help with IBS.
And I'm getting there with the doctors myself.
Hope you feel better soon.
Posted by KellyD on October 26, 2003, at 20:45:24
In reply to Re: fallout » Dinah, posted by zeugma on October 26, 2003, at 20:20:47
zeugma,
I want you to know you are not alone in the cycle that goes with your anxiety symptoms. I don't want to make this about me, but I have the same predictable pattern of behavior, too. My anxiety have always been very phyical - anywhere from a general feeling of unwellness to the biggie - a neck and shoulder discomfort that can really bring the cycle on of hyperviligence to that ONE thing that's hurting. (and makes me feel like h*ll all over, mind and body)
For me, I tried CBT, talk therapy, etc. I did not succeed in stopping the cycle. When my body started pumping the extra "spin up" chemicals around, my body responded and my mind couldn't think or change thought patterns to counteract all the body responses. Some are able to do that, I wish I could, but I can't. At first, I felt I wasn't trying hard enough, but I finally stopped feeling quilty and realized different approaches work for different folks. A benzo was my answer. I know it is not for everyone.
Ok, sorry, I did make this about me.
I just don't want you feel alone in how you cope and react. I did for a long time. Out of all the folks in the world - just me.
All that can be expected of ourselves is we do the best we are able at the time. Keep us posted.
Kelly
Posted by zeugma on October 26, 2003, at 21:33:01
In reply to Re: fallout » zeugma, posted by Dinah on October 26, 2003, at 20:27:57
I think Klonopin would help with the IBS, in my case, because it's so clearly triggered by anxiety at this point. The 'spontaneous' IBS I used to get all the time (and which DID make me housebound sometimes) is mostly under control, if still unpleasant at times. But give me an anxiety-provoking situation, and two nights later it's back in all its virulence.
Posted by zeugma on October 26, 2003, at 21:43:10
In reply to Just a bit of elaboration, posted by KellyD on October 26, 2003, at 20:45:24
Kelly,
Your message was very helpful! I know exactly what you mean about feeling "guilty" that an approach isn't working. My pdoc touted CBT for anxiety as a process with a clear endpoint- he said I could formulate definite goals and reach them in a finite amount of time. Well I think he is naive about severe anxiety disorders. Even my CBT therapist has agreed that I have to go very slowly as my anxiety takes very physical forms that very hard to mitigate using cognitive techniques. The problem is that I'm going slowly, and still getting these terrible anxiety episodes. I feel like they're destroying my quality of life, and CBT in itself can be draining- I'm spending all this energy trying to make it work instead of getting on with my life.
I really appreciate that you shared your experience. I'll let you know how it goes tomorrow with my therapist.z
Posted by KellyD on October 27, 2003, at 6:36:41
In reply to Just a bit of elaboration, posted by KellyD on October 26, 2003, at 20:45:24
Thank you, it makes me feel good I could be of some help. Hope things improve for you soon.
Kelly
Posted by Dinah on October 27, 2003, at 7:19:24
In reply to Re: fallout » Dinah, posted by zeugma on October 26, 2003, at 21:33:01
No, I meant IBS caused by emotions. Just me of course, others might respond differently.
It's a great drug though, and I'm not sure why doctors are afraid of it. It's one of the few I'm comfortable with side-effect wise and I've never increased my dose on it. It does wonders to help my promise not to self injury.
I guess that gut wise, the chain of events is already put into place though. ???
Posted by zeugma on October 27, 2003, at 21:29:30
In reply to Re: Just a bit of elaboration, posted by KellyD on October 27, 2003, at 6:36:41
I'm doing a little better now. My CB therapist encouraged me to talk, and I paraphrased what I had written above, and added another detail I haven't mentioned on this board: the self hating thoughts. Basically, feeling drained and sick made me feel worthless, and I told myself so as I struggled through the weekend. The Cognitive Behavioral therapy obviously tries to identify these thoughts and rationally respond to them so they aren't accepted as 'truth.' She took notes as I described these thoughts and gave me a photocopy to conclude the session. Painful as they are (and i did not enjoy talking about them) I am convinced that engaging them rationally is the only way to face them down.
She also wasn't surprised when i said that there was a 1- or 2- day lag between the stressful situation and the physiological symptoms. She said other patients of hers with IBS have described a similar pattern. Made me feel like less of a freak!
I'm feeling more positive now, appetite is beginning to return and hopefully I'll be able to sleep more normally tonight.
I also told her I received a lot of valuable support at this chat room I hang out at, and the support has meant a lot to me.
z
Posted by KellyD on October 27, 2003, at 21:53:48
In reply to IBS, anxiety, CBT, posted by zeugma on October 27, 2003, at 21:29:30
z,
Do what works for ya. I'm glad you're feelin' a bit better.
This is the end of the thread.
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