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my FAKE appt went like garbage today


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So we're in the car on the way to my appt today (FINALLY) after being jerked around for a week and a half between the base, hotlines, civilians, just begging for an appt to see ANYONE. The phone rings when we're about halfway there, and it's the civilian place I finally got in at calling to say my tdoc had a family emergency and I would have to be rescheduled. The first appt they had was a week. I just wanted to collapse. I had been just hanging on praying to make it to this appt, with my mind set that if I could just make it to today finally someone could help me. Suddenly in my head it was like a box or an empty room (the walls were green for whatever reason--isn't it weird the details I choose to create), with me frantically clawing at the walls trying to climb the walls just trying to get out get out get out. I made dh stop the car, stop touching me, stop talking to me because every thing that required my brain to process anything made the need to get out of the box crazier.

Dh kept trying to comfort me and said something like "we can make it just one more day" and I snapped. Then I tried to scratch my face off. I was already freaking out, dh saw the blood and started freaking out--my car was a little bubble of utter chaos. It would have been funny if I hadn't been busy losing my mind.

So I called the hotline back and they told me I needed to go to the ER, so I did. I got to go up and see the pdoc for the base (yes the single pdoc on staff for the entire base) who stayed late to see me, which was nice I guess. They doctored up my face as best they could but I look like a horror movie. I think I'll probably have scars.

Anyway, he talked to me for about 45 mins and told me he couldn't diagnose anything, but he was going to begin treating for a tentative BPII diagnosis. He wants to see me next week, and to expect an hour to an hour and a half at that appt, before he can make a formal diagnosis. He said he basically wants to get me stabilized then he'll begin MEB procedures, so I guess that's coming whether I want it or not now. Does it sound reasonable to you guys for him to be able to talk to me for 45 min, then an hour and a half and make the formal diganosis from that? Do pdocs normally "talk" for that long anyway? What else might I expect at that hour long appt?

He is starting me today on Zyprexa, 5mg. He says it won't interact adversely with the 240mg of Inderal LA that I'm on for migraines. Any advice on the start of drugs--what to expect, watch out for, (other than what's on the label)?

anonymous

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From my experience, he won't be talking for that long. You will be doing a lot of the talking, with him asking questions. He might go into a bit of family history, a bit of your history growing up, what your family structure was like, when you first started noticing something was wrong, etc. He will want to know what medications you have taken, if any, and what reactions you had from them and what effects you noticed, good or bad.

When I was started on Zyprexa, I noticed a difference in my mood within just a few days, so hang in there.

Incidentally, Inderal can have a huge, negative effect on mood. Many people with a diagnosis of depression or bipolar (especially BP-II)CANNOT take Inderal for that reason. This may be playing a big part in what is going on, or maybe not. Might be worth bringing up. For those of us with BP, even seemingly innocent medications can spin us out of control.

For migraine control, I use Verapamil, which is another blood pressure medication that works well without the adverse effects on moods.

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When I was diagnosed bp (2, but possibly 1), it was actually this board that helped me with the diagnosis. I was miserable, anxious, giddy, and depressed at the same time, sometimes just ridiculously manic, raging, stupid decisions, etc. I read this board daily and came to the idea that I may be bp. I brought it up at my next pdoc appt and he said "Okay Let's treat you for it and see how you respond." He started me on Lamictal as a mood stabilizer and abilify an anti-psychotic like zyprexa. As far as the mania/hypomania (who really knows?) goes, I'm a little better. I know how to bring myself back down to earth when I start getting giddy. But the mixed states of depression/mania/anxiety are still getting me down. I still have self injury issues too. Guess that's just part of the deal.

At your appointment, your pdoc will most likely spend all that time going over your history and family history. Everything Jenni said.

Sorry if I haven't really answered your questions. I just wanted you to know you're not alone.

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From my experience, he won't be talking for that long. You will be doing a lot of the talking, with him asking questions. He might go into a bit of family history, a bit of your history growing up, what your family structure was like, when you first started noticing something was wrong, etc. He will want to know what medications you have taken, if any, and what reactions you had from them and what effects you noticed, good or bad.

When I was started on Zyprexa, I noticed a difference in my mood within just a few days, so hang in there.

Incidentally, Inderal can have a huge, negative effect on mood. Many people with a diagnosis of depression or bipolar (especially BP-II)CANNOT take Inderal for that reason. This may be playing a big part in what is going on, or maybe not. Might be worth bringing up. For those of us with BP, even seemingly innocent medications can spin us out of control.

For migraine control, I use Verapamil, which is another blood pressure medication that works well without the adverse effects on moods.

Thanks for the info on Inderal and a possible alternative, I wasn't aware of the correlation b/w Inderal and mood. I wonder if he'll take me off it. It's good to know there's an alternative since this is the first thing to ever relieve my migraines.

He did ask me all of those things (family history, childhood, previous mood disorders, medications, etc) which I why I'm wondering what else there can be left to talk about for an hour or more. I guess I'll find out though.

Now the hard part--showing up to work tomorrow trying to explain to everybody what happened to my face. I wish people would just not ask. I really don't know what to say though, any suggestions?

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Thanks for the info on Inderal and a possible alternative, I wasn't aware of the correlation b/w Inderal and mood. I wonder if he'll take me off it. It's good to know there's an alternative since this is the first thing to ever relieve my migraines.

I take the Verapamil, like I said, and I also take Topamax. It helps with the migraines and also has some mood stabilizing effects, so double bonus. The combination works well for the migraines.

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about your face- i used to live in central illinois. the only lake there is lake bloomington, a very small, fresh water lake. i had some minor surgery on my upper arm that left me with a bandage. when people asked me what happened, i told them wtih a straight face that i had gotten bitten by a SHARK in lake bloomington. they said, with wide eyes "a SHARK?" and totally believed me! i could have told them the easter bunny did it.

so whatever you tell them, it is fine. tell them you couldn't get a cat off of your child and then the cat turned on you or something. that happened to me once and it was my arm that got mangled and i was the child, but it could have been my face. it isn't so far-fetched and if people believe there are sharks in lake bloomington, they'll believe the easter bunny bit your face. ;)

about what the pdoc does- to make a DX, in my experience, there are a number of things the pdoc could choose to do. one is the interview. it could take about an hour, maybe longer or shorter, and will include asking you (as has been previously stated) about your childhood, family environment, influential people, any abuse, what you remember liking and disliking, what early signs of disturbance there could have been in your mindset, behavior, or mood, and further up the line, like taking it up to your current life and circumstances and how you've been feeling.

the pdoc could also use diagnostic tests, like the MMPI. i hate that test. it is like 500+ questions, and they seem very concerned about your sex life for some unknown reason. i hate taking it, and have had to take it every single time i've been hospitalized. you'd think they'd agree on what is wrong iwth me by now, but they keep trying to think of something new. anyway...

that is something they may have you do.

Medications- zyprexa will change the way you think and feel almost instantly. give it a few days. they'll probably increase the dose, but start you small to see how you react to it.

as has been mentioned, be careful with inderal. i've taken it in very small doses to help wtih akasthesia, but only in small doses and with all my other meds/mood stabilizers.

i wouldn't be surprised if they don't look at how the zyprexa is going and decide to add more to it. don't be surprised if you need a change from Z to another med, or if they give you more meds, or tinker with them. mine get tinkered with every month and have for years (my requests, because i feel things aren't right yet).

it is and can be a long road, a hard process to feel like you're a normal person again. but usually feeling just like you're not going to off yourself is a great start. zyprexa should get you going towards that goal. i know things are a lot better now than when they just put me on lithium and told me that was that way back when.

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I'm sorry that you ended up freaking out. But in the end, the most important thing is that you got to see a pdoc. View it as the first step towards a calmer, happier life.

Yes, it can take weeks, months, or in truly tough cases years to reach a settled diagnosis. But what is important is not having a set in stone dx, but getting treatment and relief for the symptoms. A good doc will take action to relieved severe symptoms and the stress that they create, while working things out.

My pdoc gave me a 'tentative dx of bipolar II after 4 months and then didn't bring up the issue for another 6 or 7 months. A year and a half later she changed it to BP I.

The time the doctor spent with with you sounds appropriate. 45 minutes with you in the ER is generous and his plan for a longer follow on is excellent. Typically civilian insurances pay for a 1 hour evaluation appointment.

Getting started is the hardest part. You are nervous, you don't know the doc, you don't know what to expect, and of course you are at your worst because you have only started treatment. You will look back and be surprised how quickly you improve, and realize how much improvement you have made.

OH, you don't owe anyone an explanation of your injuries. Just tell them you were cutting branches in the garden, Thank you.

a.m.

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Someone told me this a while back, to use in response to incredibly nosey people who ask inappropriate questions.

"Why would you possibly want or need to know that?"

End of discussion

Hang in there--shit happens and you are working on fixing it. I know how hard it is to even ask the military medical establishment for any kind of help. You did that, so give yourself credit.

We're here--

china

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