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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by LlurpsieNoodle on May 8, 2007, at 16:30:55
So... I have this little problem. I am not in touch with the connection between somatic feelings and psychological states.
For me, the somatic feelings seem to come out of nowhere, and they beg to be medicated. Bad feelings, you see?
So I send poor pdoc a goofy e-mail with a question about something which could be a real side effect, but I'm just not sure.
Response is that it could be a side effect- reduce dosage of one of my meds.
But the response didn't end there. After I read the rest of the response, I felt very upset
felt chastised that I was once again turning a psychological state into a somatic state and asking for some medication to make it all better
felt like he didn't really care about my side effect. hell, I don't know if it's serious or not. That's why I asked him
felt like I wasn't working hard enough in therapy to identify the source of my feelings. ouch
-----------------
so talked about this with T. I've always known that the way to get love (or at least affectionate attention) in my family was to be injured or sick. That since I've been in charge of myself for so long, unable to rely on an adult to notice when things aren't going well for me, that I've become more vigilant than most people about my health, or at least the somatic feelings that feel yucky.
Prior to T I had sent back a rather snotty e-mail to pdoc. Then after T I regretted it, and sent ANOTHER email apologizing for rude comments. I believe it would have passed for civil. barely.
Now I feel ashamed and abandoned. I don't know how to recognize the real side effects/symptoms of illness from those that are psychologically generated. I don't know when to seek treatment, or from whom. At least T seems to be open to talking about psychosomatic symptoms, and their sources though. But drug side effects? She's not an MD.
This is not the first time that pdoc has said something to me that made me feel like a malingering hypochondriac. I keep falling into the same trap though.
If I read too much about side effects, I get them, or at least some of them (because of strong tendency towards somatization of psychological states). If I don't read about possible side effects, I burden pdoc nonetheless about whether something like... clumsiness, lump in throat, blinky eyes, pupil dilation, weight loss/gain... all these things that are probably minor, but they cause me concern.
Sorry so long. I just feel kind of ...stuck... and anxious and maybe angry at myself. Oh what the hell. My somatic symptoms are muscle tension, and stomachache, at the moment. nothing spectacular.
I guess he only wants to hear about spectacular things. or things that he can actually help me with. how do I KNOW, though what he can help me with unless I ask.
Posted by muffled on May 8, 2007, at 18:07:26
In reply to pdockery vs Therapizing, posted by LlurpsieNoodle on May 8, 2007, at 16:30:55
I dunno llurpy.
What I tell my kid, who is sensitive and gets upset bout physical feelings. I tell him, try to just let it go, don't worry bout it. If its still bothering you next week, or if it seems to be getting much worse, then we look at it. Other than that, we all get lots of weird physical sensations and they mostly mean absolutely nothing that matters.
Eg ringing in ears, transient numbness of body part, changes in vision, twitches, pains, aches, weird gut feelings, headaches, itchiness, rashes, bowel disturbances, nausea, etc etc. There's so much weird stuff. But most of it seems to pass of its own accord. And we never know why, and it just don't matter.
Take care Llurpy, dunno if this was dumb, but its what I tell my kids.
Muffled
Posted by LlurpsieNoodle on May 8, 2007, at 18:29:33
In reply to Re: pdockery vs Therapizing » LlurpsieNoodle, posted by muffled on May 8, 2007, at 18:07:26
makes sense muffled. I think pdoc is more concerned with average functioning over spans of about 14 days. daily functioning- not so important. hourly functioning certainly not, unless I'm having a seizure or something.
But I forget that in the midst of suffering.
Apropos suffering-- I got interrupted on my way to meditate. I think I better go soon, before I lose all intention.
your dear friend,
Ll
Posted by gazo on May 8, 2007, at 23:39:42
In reply to pdockery vs Therapizing, posted by LlurpsieNoodle on May 8, 2007, at 16:30:55
maybe you could keep like a log or chart or something... make notes about body symptoms, etc.. track them.. you even include daily stuff like diet, mood and activities... then you can see trends. pdocs like trends or Wow! types of things.
and generally speaking in the ten+yrs of psych meds i've had, very few side effects are things to worry over... even when they occur or are unpleasant it's often worth waiting a few days to see if the fade. The big side effects are less common. IF you are prone to worry then you alter your body's chemistry just from that alone.
it's not a sign you're crazy doll... just find some ways to work with who you are.
much love and peace
Posted by Honore on May 9, 2007, at 9:00:47
In reply to Re: pdockery vs Therapizing » LlurpsieNoodle, posted by gazo on May 8, 2007, at 23:39:42
The idea of a log is a good one, Llurpsie. Then you can possibly make a log, of feelings and thoughts, or events perhaps that preceded or accompanied the side effect, or potential side effect.
Maybe if you do that for two or three days, you'll start to see some connections-- maybe time of day, or feeling states, or events that were upsetting, or disconcerting. It could be a way of beginning to learn how to distinguish one from the other.
But it also makes sense to ask you pdoc, if you're not clear. It's important for someone to guide you in the process of knowing if something could be one or the other, or could be either (or both)-- otherwise where will you start to catch onto it?
So I think your asking your pdoc is a good thing. And you might be misreading some of her intention-- if you're worried already about asking too much, you might hear a reproach in ambiguous, or other-meaning things that she says. I have a huge tendency to read my own fears into people's emails and comments.
I know that feeling though of anxiety that you need to have clarified-- and also the bad feelings that come swarming out when the other person responds in a complex way-- not with a more palpable reassurance that it's okay, more than okay to ask. It's hard to know, in yourself, that it is. But it really is a sign that you're working so hard to try to understand yourself-- and you really do need to go outside to get that information that you never got as a kid.
Over time, Llurpsie will take over doing those things-- but right now you're trying to make up for things you didn't get-- which I, at least, think is very right and worthwhile to push for-- just pdocs may not be used to such serious and committed learners--
((Lurpsie))
Honore
Posted by LlurpsieNoodle on May 9, 2007, at 9:35:56
In reply to Re: pdockery vs Therapizing » LlurpsieNoodle, posted by gazo on May 8, 2007, at 23:39:42
That sounds like a good idea gazo. I think I can appropriate one of my emptier journals for that purpose. I already have a thoughts and feelings journal, but I'm kinda lazy about filling it out regularly.
however, my "physical symptoms" if we can bear to call them that... well those I'm hyperaware of, so I would be more motivated to log them.
And trends over time. I guess pdoc is interested in that. last time he asked me if my cymbalta side effects were still diminishing at the rate of about 10% a week. I said "yes, but logarithmically, not linearly, hoping they asymptote at zero" I'm such a dork.
I think he got it though.
Thank you for your reassurance that the side effects are generally nothing major. I guess I got pretty scared because I was having extrapyramidal motor symptoms on seroquel like tics and some mild tremors and things. One of my relatives had pretty severe tardive dyskinesia (old-style anti-psychotics) by the time he ... died. yeah. So, maybe I'm easily freaked out.
worrying- that's my specialty. how'd you know?
Posted by LlurpsieNoodle on May 9, 2007, at 9:41:19
In reply to Re: pdockery vs Therapizing, posted by Honore on May 9, 2007, at 9:00:47
> The idea of a log is a good one, Llurpsie. Then you can possibly make a log, of feelings and thoughts, or events perhaps that preceded or accompanied the side effect, or potential side effect.
I have a really boring meeting in an hour. I guess it's a good time to start with that.
> Maybe if you do that for two or three days, you'll start to see some connections-- maybe time of day, or feeling states, or events that were upsetting, or disconcerting. It could be a way of beginning to learn how to distinguish one from the other.
I hope so
> But it also makes sense to ask you pdoc, if you're not clear. It's important for someone to guide you in the process of knowing if something could be one or the other, or could be either (or both)-- otherwise where will you start to catch onto it?
he has been VERY accommodating in the past. once I even got my own lesson on pharmacology. and he answers emails promptly.
> So I think your asking your pdoc is a good thing. And you might be misreading some of her intention-- if you're worried already about asking too much, you might hear a reproach in ambiguous, or other-meaning things that she says. I have a huge tendency to read my own fears into people's emails and comments.
>
(me too)> I know that feeling though of anxiety that you need to have clarified-- and also the bad feelings that come swarming out when the other person responds in a complex way-- not with a more palpable reassurance that it's okay, more than okay to ask. It's hard to know, in yourself, that it is. But it really is a sign that you're working so hard to try to understand yourself-- and you really do need to go outside to get that information that you never got as a kid.
>
> Over time, Llurpsie will take over doing those things-- but right now you're trying to make up for things you didn't get-- which I, at least, think is very right and worthwhile to push for-- just pdocs may not be used to such serious and committed learners--
>
I think he's getting used to me by now... maybe that's what I'm scared of too. ugh. termination with pdoc in in my near future. I have NO idea what that entails! So, maybe I'm trying to get all I can out of him before I no longer have the opportunity.off to my dumb meeting.
> ((Lurpsie))
>hugs for you too (((((Honore))))))
-Ll
> Honore
Posted by gazo on May 9, 2007, at 11:01:29
In reply to Re: pdockery vs Therapizing » gazo, posted by LlurpsieNoodle on May 9, 2007, at 9:35:56
well, big things like tics and such are things to report if they come on suddenly when starting a med or if they persist for more than a day or too. TD is nothing to screw with. But other things, like the muscle tension can result from so many things, like worrying ironically. You could be deficient in Magnesium and get muscle spasms for example.. as i seem to remember your eating not always being so good. A magnesium supplement with a vit D one to help absorption would alleviate that if that was the cause... just examples of course.
the first thing my pdoc usually says is to try to reduce the med a bit and see if the symptom goes away, bring it back up and see if it returns.
so many things play a role in how we feel... nutrition being so key. Suppose a med works best when your B12 is good... but it isn't good so the med doesn't work right. Again, hypothetical example.
it's always bothered me that pdocs don't look more at whole person health more. i mean, i love my pdoc but he doesn't know if i eat ding dongs all day or what.
i will tell you and anyone who will listen that removing refined sugar from your diet will have a prfound affect on mood and health. Natural sugars ok..like fruit, but no refined stuff. It's amazing.
i hope the log will ease your mind and help create a better working relationship with your pdoc.
much love and peace
Posted by LlurpsieNoodle on May 9, 2007, at 11:54:06
In reply to Re: pdockery vs Therapizing » LlurpsieNoodle, posted by gazo on May 9, 2007, at 11:01:29
nutrition is not so good right now. All I can do to get a minimum of calories not to pass out. But I'm taking a lot of supplements, like multivitamin and b vitamins and fish oils, and other stuff.
I can try and drink a smoothie and eat some smoked salmon. only my favorite things. eating with friends helps. social eating is a good cue to eat. I eat more when less depressed.
I'll try a salad later on.
-Ll
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