Saturday, October 24, 2009

Doctors, Meds, Anti-Depressants, Suicidal Urges

Probably one of the most frustrating things about my doctor's office is the multiple doctor effect. My choice of doctor has had two other doctors in her practice. One left, to be replaced by another. original doctor (Doc C) used to get very busy some days and her staff would schedule me for the other doctor. (Doc Z) Now Doc C and Doc Z used to have like minds for Fibro. "Tell me what you want to try." Not a perfect solution of course, but better than doctors who try to tell a Fibro patient what to try based on commercials.

When Doc Z left the practice to be replaced by Doc L, I was once again shifted to Doc L to build his client base and my "need an appointment the day I call" needs. So I met Doc L. A nice enough fellow who looked at my chart with confusion and of course I had to explain why I wasn't on Anti-depressants for Fibro. "I react badly. They call it chemical sensitivity. I don't tolerate many medicines at all. I can barely take half a vicodin for pain without itching myself to sores."

He nodded as if he had been listening but he just started asking me more questions: "Have you tried..."

The nodding game commenced and for the ones that I didn't nod to, I would ask "What type of medicine is that?"

"Oh it's a.... (anti-depressant, anti-seizural, muscle relaxer...etc.)" All of which we had just discussed my horrible reactions to.

Not to sound like an ungrateful wretch but...there seems to be a serious lack of communication. If I mention that I've had suicidal tendencies or apathy on anti-depressants and antiepileptics...that is NOT okay with me and I don't want to try any more of them. (I think six is my limit.) I can't speak for how these medications work for other conditions/diseases. But I am definitely NOT going to treat my Fibro symptoms of pain, exhaustion, and depression with a medication that "may enhance" these symptoms in addition to making me gain 40-60 pounds!!! So I'll be obese, apathetic, still tired/lazy, but I'll experience on average 15% less pain?

I'll take the pain and choose LIFE! (Disclaimer: Not all people react to anti-depressants/antiepileptic this way. No hate mail please. lol)

I've gone on Anti-Anti-Depressant rants before and many of my readers have vehemently disagreed. But let me point out a few tidbits that I don't believe I've publicized previously. (Although I might have. Thank you Fibro Fog. LOL)

-I was on anti-depressants before, so I'm not sitting from the sidelines talking about something I've never tried or experienced for a decent length of time. (I tried my first anti-depressant in 1999.)

-I had two moments of suicidal urges. Urges are different than the "what is it all for" depression. Urges are like random hiccups in depression switching you from general melancholy to instant despair. And the worse part is, that "instant despair" reacts like a light bulb. Bink! Suddenly you just know you have to kill yourself and you have the idea on how best to execute it. As reflexive as a rubber hammer to the knee, you're up and moving to fulfill the urge.

Obviously, I didn't succeed. Some people do succeed sadly, and others...survive the attempt often with scars, liver, kidney issues afterwards.

To be fair, only one of these episodes occurred when I was actively taking an anti-depressant. The other was after I had been "off" medication though I'm sorry to report that I don't have the exact amount of time I had been off drugs. So I'm going to say that it had been around six months in attempt to be fair.

The Urge while I was off medication lasted about a thirty seconds. The thought came to me. I sat back in my office chair and blinked dumbly, staring at my cork board. ("I want to stab myself.") I knew I could do it. The moment passed though and I was left wondering what the hell that feeling was all about.

The Urge while I was on medication lasted for over twelve hours followed by ten days of panic and horrible fear that it would return...the likes of which still haunts me! People ask me how long ago that happened. About 3-4 years ago. With my 1.5 year old daughter in the next room. My husband had a gun in the house, in the closet. Four steps from my bed. In four steps, I would have been dead. My phone was right beside me. I had the thought of calling Dan and telling him what I was going to do. That thought is all that saved me. ("Hi. I know where your gun is, and I'm going to use it.")

I can't remember if I handcuffed myself to the bedpost or just imagined I did. I remember thinking the cuffs were there and riding every second until someone could come and watch me. My daughter remained in her crib...I think. 2 hours later my MIL came and took care of the baby. She didn't look in on me. My husband showed up an hour later and came into the bedroom to find me clinging to the bed rail.

Which brings me to my next point.

-The impulse to kill oneself increases on medication. (That is NOT to say that NOT being on anti-depressants is any better. I refuse to call anyone who claims that A-Ds work for them a liar.) In my experience, discussions, interviews, and support loops I've noticed a trend. Those who have tried to commit suicide before being on A-Ds have a better chance of them working without the suicidal Urges.

-Finding a goal, and a reason to live is your BEST anti-depressant. Obviously, if this were an easy thing to do, A-Ds would be out of business. But if you're anything like me and you can't or won't try any more anti-depressants, this becomes your best defense. Talking yourself out of panic/anxiety by recognizing your symptoms, repeating why you have them and reminding yourself the feeling will pass is all some of us have.

Makes me wonder if those on A-Ds are doing the same pill form. They feel anxious or panicky...they take a pill and feel better in a few moments. Or...did they just convince themselves of it? (IMPORTANT WARNING: DO NOT DISCONTINUE ANTI-DEPRESSANTS. The medication reacts badly to this, and you can do more harm than good. Weaning is the best way, if you're considering going off your medication. and please, talk with your doctor if you are unsatisfied. I am not promoting a mass exodus here.)

-Anti-Depressants/Antiepileptic drugs. (I hope this link works. It is giving me issues.)

Knowing how I react (as well as other FibroMates...since we're prone to chemical sensitivity) should put you in my frame of mind at the time of my doctor visit.

When Doc L asks me to try another daily pill, swearing it isn't an anti-depressant...I still get the sweats. I've reacted poorly to everything including pain meds, migraine meds, anti-histamines, and muscle relaxers.

So I told Doc L that I want to either try medical cannabis (to which he actually gave a short chuckle) or Low Dose Naltrexone. To which I was told... "I don't see what Naltrexone would help". I gave him the Stanford doctors name and asked him to do the research but I'm willing to be he didn't. Doctors have their own lives of course, and I'm not sure I should expect a doctor who doesn't specialize in Fibromyalgia to care to research it. ....and then I thought about it. If a doctor is going to put me on meds for a condition...he/she better damned well care to research it or pass me off to someone who IS willing.

My doctor may feel the best course of action is anti-depressants or antieplieptic medication but when I say means no and any doctor of mine better be ready to hand me off like a hot potato or willing to try some of the more kooky approaches because if I have another 10 day migraine where I'm told "there's nothing we can do for you" only to get a shot of Demerol that makes me sick... I just might go thug.

Luckily, Doc L did give me a prescript for Physical Therapy. I'm excited by that. Exercise is good for Fibro, but motivation is hard. Having someone to push you and work with you makes exercise easier. And it is no different than "Normals" working out at a gym so don't let the term "physical therapy" bring negativity to the process.

I think that is enough anti anti-depressant and doctor speak for today.

Remember, my friends. Be in constant control of what goes in your body. Be firm but diplomatic. We're the only ones who know how Fibro feels.

All my best hopes for 98% pain free days.

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