Posted by DSCH on October 6, 2003, at 7:36:59
In reply to Thanks! More advice, votes, AD algorithm? , posted by Cairo on October 6, 2003, at 5:53:08
> Thanks, DSCH. She's had a QEEG which shows hot spots just about everywhere. 60 sessions of neurofeedback didn't do anything, so we're concentrating on CBT now. MRI showed nothing,
CBT = ?
MRI will only show structural damage. fMRI and SPECT will show metabolic hypo/hyperactivity from the standpoint of perfusion, QEEG from the standpoint of electrical activity. But as with most things, you already seem to be ahead of the curve on this.
>but I agree that and fMRI and SPECT may help, but my husband says that it wouldn't show much else that we don't already know from the QEEG and observation (is this right?)
He could have a point there. "Hotspots everywhere". Where do you begin?
>We'll address the sleep issue with the Neurologist after her sleep study. I'm eagerly awaiting my own return appointment to be put on the CPAP to see how many of my symptoms improve/resolve after correcting long term sleep problems. Don't know yet if I have alpha intrusion for which Xyrem is used.
CPAP = ?
I know virtually nothing about Xyrem other than that some on the board fighting fibro are interested in it.
> I've read Amen's books and I can't get the sense that he takes this whole HPA axis dysfunction into account.
Well, I doubt many do that at all. You would need to find someone who styles themself a neuroendocrinologist. Again, what has led you to believe this is her problem?
>There are also alot of doctors out there who will put bandaids on symptoms such as using Armour thyroid wholesale. I know several locally and the patients, my friends, feel great initially, but relapse and I wonder what the feedback inhibition is doing to their thyroids. I asked about growth hormone use, but was told that that also would negatively feed back and low GH might be secondary to sleep problems.
IIRC, the typical approach with injections and hormone supplements only tends to further downregulate the system in the long run.
> I whole heartedly agree with you that HPA axis dysfunction should take priority, but the interesting drugs, CRH antagonists, will take awhile. What about aprepitant in conjunction with other meds? Any advice on an algorithm for antidepressant use?
I've never heard of aprepitant.
> Do you think the anxiety is part of the HPA axis mess? Certainly as her other symptoms increase, her anxiety does also. I think it's both primary and secondary.
For what it's worth, it is not my impression that anxiety is wrapped up in it. If this goes out on you, it's fatigue that no amount of sleep will let you fully recover from. You feel used up. You never want to wake up in the morning.
I was shocked to rediscover the male morning hormone cycle after starting on the licorice tea. I had never been a morning person. All of a sudden I was waking up as early as 4:30 on my own, feeling an itching sensation all over (histamine flush?), and then going out for my morning 3-mile walk. Basically I felt like I had reconnected with the paleolithic hunter-gatherer that we still basically all are underneath the verneer of (post)modern civilization.
For what it is worth, licorice is an old stand-by in western herbal medicine and it is considered the number one Qi tonic by Chinese herbalists.
> Also, thanks for reminding me about licorice. I need to read about it more for myself, actually, as I crash in the afternoons. My Endocrinologist simply won't consider low dose Cortisone. I've heard about pulse(?) Cortisone where you apparantly use tiny amounts only when you need it.
>
> Any other advice and votes of specialists from others?
>
> Cairo
poster:DSCH
thread:265767
URL: http://www.dr-bob.org/babble/20031004/msgs/265893.html