new pdoc
 

You mean he pretended to know but you could tell he didn't? Hmmm. Verapamil is unusual as a mood stabilizer, sure enough - it is understandable someone might not know of it. It is a good sign that he seemed to accept it. I would have preferred his showing thoughtful interest over feigning knowledge but many people in many walks of life - not just doctors - might have behaved the same way, in comparable situations.

My reply is an acronym, so I get away with it! ;)
O! M! G!
No doubt! :eek::Noooo:
That sounds pretty scrupulous - a decent first interview.
I hope the Lamictal is helpful. Are you allowed to get brand name Lamictal, or do you have to get generic lamotrigine?

T6? Are you sure it doesn't say T4?

I am glad he is checking your B12 and your folic acid. I would advise you to suspend any supplements, until you do the labs.

Awesome! :):):) Did he also write scripts for your other meds or did you tell him you were ok for a month?

----------------------------------------

This sounds hopeful.

How do you feel about this pdoc and the whole situation?

Did he say if the med students would be there every time? I am concerned for you there, mostly because it I personally would be uncomfortable if they were always present.

waves

about the thyroid tests - T6
 

I haven't found much to go on thus far but, from what I can glean, T6 would be an uncommon thyroid hormone variant. It might be measured to assess hypothyroidism. I am still confused as to why he wouldn't check T4 too - in fact, FT4 (Free T4) is usually preferred as it measures only "usable" T4. Typically, thyroid function testing measures TSH and FT4; FT3 is sometimes included also. More extensive thyroid or endo panels would include all of these, plus other things.

Not saying he did something wrong - just am very, very curious indeed as to what he is looking for, assuming your test does indeed say T6.

waves

Waves,


Thank you. You are helpful.

I will look at the script for the lab and get back to you on the thyroid test.

Mari

Mari

If you have to get a generic, please try to make sure its always the
same one. They don't work the same. And even at the small
dosage of 25mg, it would make a difference.

Derrick took lamictal many years ago, so I hope its helpful for you.

Donna :hug::grouphug::grouphug:

I had a med student sit in on one of my pdocs visits.....not a new one though I have been with her for years.my pdoc got all authoritative on me...I had been drinking a lot and she made me feel bad. anyway. I think you probably could have refused their presence...not sure about that.

Yes, you can refuse to have them present.

They are supposed to request that they be allowed to sit in.

I have had many request that they be allowed to either sit in on Derrick's
case when we were with Riley, or as when I was doing my Cancer treatment
I was asked that two students be allowed to observe the treatment for the
radiation.

I allowed it because how else are they going to learn to use the equipment.

I have had them sit in on my doctor's appts. also. But they have always
been nice.

Donna :hug::grouphug:

Residents in the room
 

Hi, Waves, Donna, Bizi,

They were probably residents and he named the hospital program but the name went past me.
We have a shortage of spots for medical residents in the U.S. and I was pretending that they were two of the lucky ones to be there to listen to me. :D
Maybe they learned something.
I found myself talking to them a little --pointing out things that I might not have needed to emphasize to him.

It was more like when I first said "Verapamil," he had a very brief blank look as if he had never heard of it and then in less than a second his face changed and showed that he remembered that he had heard of it.
He recovered quickly and he seemed to accept Verapamil. I can tell because he was not asking dumb questions like the GP's and other specialists do. He accepted it.

Regarding the two residents:
Twenty plus years ago, my then pdoc asked if the medical school could pay me $100.00 to be the patient while he was giving a test to a student who was completing her program.
The student asked me normal pdoc questions for 40 mins and I made sure that I told her things that she seemed to forget to ask.
After I left, she was supposed to talk to him: dx me, come up with a possible treatment plan . . .. things like that.
I left there after my 40 mins crying hard and the pdoc apologized that it had been difficult and thanked me.
The pdoc saw me in a different light and from that point on the two of us made headway in establishing good meds.

====
Today, the pdoc asked questions from my childhood and about who else in my family has gotten help for psychiatric issues.
Near the end of the session, after we had covered work and family, he asked how I am doing with my husband.
I said, "We have been together long enough that we are used to each other and stay in our own space" --- or something pretty close to that. :cool:

Upon double checking, the handwriting still looks like T3 andn T6 but I suppose that the people doing the paperwork for the blood draw at the lab could / will read it as T4.

I probably have to take the generic.
I do remember reading things about the generic Lamictal being lousy for some people. I hope it works for me.
He instructed me not to put any new creams on my skin.-- apparently so that we would know if the Lamictal is the cause of anything going on.

I dropped off the scripts (Tuesday) and was told that they do not have Gabapentin in 200 mgs capsules and that they would try to call the pdoc the next day. DUH. I do not care. I will pick up the other meds Wed whether the Gabapentin is ready or not.

Bizi, I am sorry that you had to deal with that. You needed her to be extra sensitive during that session and instead she put on a show for the visitor.

I do not care that much.
I can charm all three of them if I have to by G_d.

(Yes, I am cracking stupid jokes at 4:30 am).


Scripts:
He asked if I needed new scripts. I said yes.
He wrote brand new scripts for me. We sill see if the insurance covers them.
M

pdoc visit - sounds good!
 

Hi Mari!

It sounds as though it was a really positive experience for you - or at least a satisfactory one.

I am very happy about this. :):):)

I am glad that the residents were not a problem for you - that makes things easier. I do kind of hope you get to meet with him one-on-one at least sometimes though, because his behavior and, consequently, the feel you get from him would not be conditioned by these other interactions. I think it makes a difference in establishing a rapport too. But mostly, I am glad it is "ok" with you, one way or another.

Telling you not to apply new creams to your skin was very thorough. I am pleased about that, too. :)

--------------------

I hope the generic lamotrigine is ok for you. I agree with Donna that it is important to ask who the manufacturer is, then, insist your refills be ordered from that specific manufacturer. This is relevant to drug strength and can also make a difference in terms of s/e's. (Should you have minor/quirky issues, you could then try changing manufacturer.)

I took brand for a while, and was fine. I ditched the drug when I was forced to switch to generic because I got odd side effects. Since it wasn't clear whether it had been doing anything for me anyway, I ditched the drug completely. I hope whatever generic you land first is ok.

waves

Thyroid testing
 

I have looked again and I can't find much AT ALL regarding T6 in humans (lots about dogs). I cannot even find the site where I'd read it was an unusual variant implicated in hypothyroidism. I did find a post by someone who said theirs was slightly high - with no replies. That person could well have been confused.

Change of strategy: I went to the website of a private lab and searched their thyroid tests. They did not offer a "T6" test. :rolleyes::D

At this point, I must agree that the lab will almost certainly read it as T4. :cool::o

-----------
I am still perplexed as to the fact he didn't ask for FT4 (Free T4), even though T4 is most likely adequate. Some physicians would not even test anything other than TSH. As far as I know, T4 used to be used before FT4 detection was possible.

FT4 tells you the amount your body has available for use: if that is outside reference range, you have a problem. T4 gives the total amount in your bloodstream, and if it is normal, you are usually ok. Occasionally, T4 will be normal (or high) but FT4 will be inadequate. Systemic candida infection is an example where T4 can become excessively bound: even though your thyroid is producing enough hormone, your body cannot use it.

waves

I have used the generic and different manufacturers for some time, switch back and forth and have never had a problem with side effects. I wish you well and good luck from your insurance companies to cover them.
bizi

Bizi

I'm more concerned with her issues with reactions to medications. That the different generics might give her a reaction. So staying with the same generic is the easiest way to know.

Derrick also did well with this particular generic when he had to switch. But we got lucky and he wasn't made to switch to many generic brands on it.

Donna :hug::grouphug:

Yep. That's exactly my thinking, too.

hubby
 

I slept 2 hours Wed night because I had to be at work at 11:00 am. I stayed there until late afternoon/rush hour traffic and rain. When I do not get enough sleep I do not feel like I am managing.

Sometimes I ask hubby to help me and he does. Tonight I made him sit next to me while I filled out my pill minder. I talked him and myself through it -- "two of this one each day, one of this, . . . "
. . . When I was finished I took out the ones for Thursday and laid them out by color and size before taking them.

The pill minder task is completed except I only did six nights because one bottle of pills was completed at six nights and the next bottle was in another bag and I did not want to mess up my system -- such as it is.

Mari

Sounds good Mari

donna:grouphug::hug:

Lamictal
 

Today I started Lamictal: 25 mgs at 2:45 p.m.with a bowl of strawberries.

I canceled the appt with the 4 min pdoc.
M

It is 7:00 pm and I am feeling the Lamictal. I think I am getting a sort of brain fog. Or maybe it is making me sleepy.

Mari

Mari

The lamictal will make you sleepy. So because you took it so early I wouldn't be surprised if that isn't what is going on.

Donna :hug::grouphug:

Hi, Donna,

It feels weird because, as you said, I am still awake :cool:

I should have started with a half dose.
Tomorrow I will take a half pill of the 25.

Mari

That is a good idea.

Donna :hug::grouphug:

I take mine at night before bed.
bizi
glad that you canceled your 4 min pdoc appointment!

Lexapro
 

Hey I'm new but I took lexapro for 6 months and my husband said I turned into an emotionless zombie. Did you see the same in your son? I am considering getting back on it because my ADHD symtoms are worse but I'm scared of the zombie effect again.. Thanks! :)

Welcome Jelly,
 

Hi, Jelly,

Other things work for ADHD like Strattera. Talk to your psychiatrist about your concerns.

M

Jelly
My son did not take it for ADHD so no he didn't turn that way.

He took it for depression and anxiety.

Donna:hug:

Sore Throat
 

Hi,

I took the one half of 25 mgs at 11:-00 p.m. Saturday night.
A few hours later around 1:30 I noticed a sore throat.

I do not know if it is from the Lamictal or something else.
My friend came over here at 8:30 pm. Could I have come down from a sore throat from her 5 hours later??

Should I call the pdoc's number on Sunday? On Monday? I do not know if it is o.k. to keep taking the Lamictal.

Mari

since it is a worrisome side effect i would stop taking lamictal and see if it goes away. if it doesn't i would call the doctor.
bobby

Is a sore throat a potential side effect? I hate sore throats. Lemon is supposed to help if I recall right, honey too.
hope it goes away, did your friend have a sore throat you could call her.
bizi

Mari

I do not believe a sore throat is a side effect from Lamictal. But I would have to look it up. And I personally wouldn't stop taking it at this point.

I would wait and try some other things to get rid of the sore throat.

Donna :hug::grouphug:

The sore throat went away, but now I have a sore neck.
I called the pharmacy.

A person who identified herself as a pharmacy intern looked up Lamictal and told me that it is a common side effect of Lamitcal -- muscle soreness.

Apparently I can keep taking the med.

Mari

I am glad that you called the pharmacy.
bizi

tell pdoc I can handle tiny doses only
 

Hi,

I am going to telephone the pdoc Monday to tell him that the side effects are too overwhelming (I only took half today of what he prescribed and it was still too much).

I will try to tell him that it is too hard and three days of what he told me to take are very hard due to sleepiness, weird side effects (having a hard time talking during the evening because my tongue was big or something), feeling unable to cope with this medicine. . . . wanting to stop it.

I hope he has compassion and allows me to move the next dose by tiny increments instead of what he prescribed.
(Each step of the Lamictal DOUBLES what the last step and that is nuts and not liveable.
It is is a seven week plan that I need to stretch out to ten or eleven weeks or I am going to quit.)

Mari

Mari

How long is the big tongue lasting. Is it maybe a numb tongue. I'm just
curious. I think your plan to ask to extend the dosage to a longer time is a good one. And since you know your body he should be fine with it.

Donna :hug::grouphug:

good luck with the Lamictal and the pdoc
 

I hope that the pdoc is understanding, Mari.

I believe the ramp up time for Lamictal is more a precaution for the rash than side effects in general. 25mg is a very small dose. As far as I know, the 25s are only in the "starter kits" and would be the lowest strength available - maybe you can cut them in half or even quarters? I wonder if a liquid is available - often they make them for kids.

If you are sensitive even to half of a 25mg pill, the 7 week plan might need to be a 14 week plan or even longer. It depends - sometimes these kinds of side effects show up initially and then go away. That is my hope for you.

I wonder whether you might not have a different kind of response to higher doses - once you are used to the drug that is. Not everyone gets drowsy from Lamictal - some find it activating. I do not know if this can be dose dependent at all.

-------------
I did not notice anything with it, and was not given a titration period - they do not observe it here even though the schedule you mentioned is detailed in the drug insert. The 25's are not even available here.

I took 200mg per day in divided doses. When I got put on Depakote my doctor did not adjust the dose as he should have - so it was as though I'd suddenly been bumped up to 400 mg a day. Even then I noticed nothing.
-------------

I really hope the pdoc will work with you to find a way to make a good go of this. I hope you do not have to suffer noxious side effects for long.

Keep taking care.

waves

This is what the desk person said to me after she spoke to the pdoc about my issues regarding sleepiness:
"For the first couple of weeks it is going to be like that. Then it is going to get better."

Mari

you take it at night?
bizi

Yes, Bizi,

I took it during the day for the first dose in order to be awake to see what might happen.

The other two days I have taken it at night with the night meds.

Mari

sorry you are having side effects.....
bizi

Thank you Bizi,

Perhaps things are getting better.
It is just hard starting something new.

M

I think you are brave in starting something new knowing that you are so sensitive to meds.
bizi

Glad its getting better. I totally understand the new things being hard.

I don't usually have trouble with meds. But for some reason I did when I switched the celexa, and added two different ones.

Especially without knowing which one. Luckily its better now.

Donna :hug::grouphug:

Klonopin chaos.
 

Hi, Donna and Biz,

When I took my night meds last night/ Thursday I took the wrong Klonopin (0.5 instead of 2.0 ). :eek:
I knew something felt different but I thought that maybe the feeling was because of the Lamictal. I barely slept.
TOO MANY CHANGES! :confused:
(Late this afternoon, I figured out what had happened due to the new/ different sizes (and configureations) 4 min pdoc had given me.

Then today I was out in the sun for 30 mins and have felt weak and sleepy since then. I cannot get my head together.

Mari