Dear Abbie,

I'm sorry to hear about the Reflex Sympathetic Dystrophy... i just googled it to see what i could find medication-wise. Found a NINDS site info sheet on it - they call it CPRS - Complex regional pain syndrome. anyway it sounds just horrible. that and bipolar too. my stomach sank down into my shoes. it does state that no single medication has been found to relieve the condition but says that lots of drugs are used symptomatically... not just opiates or steroids either.

Notably i see that AEDs are mentioned and i am aware of some, including new ones, which may help with pain control. I am thinking gabapentin but more specifically its newer cousin - pregabalin. Also tricyclic ADs like amitriptyline or nortriptyline could help. the latter is often used for fibro. Amitriptyline howver is unique in pain treatment, in that it has been found, even in low doses, to help with pain of diverse origin... even psychogenic pain (i am not suggesting that yours is) but it seems to be a particularly interesting drug insofar as pain control. This i was told by my pdoc - i am not in the US.

I just thought i'd toss a few non-opiate names at you... of course i don't know what you've already tried... but anyway...

There are many meds out there. i hope your new pdoc will find something that works for you. i really hope this new pdoc is the genius kind!

let us know how things go.

~ waves ~

i get it all the time depresion is somtimes a part of beeing manic

Hi all...

I'm sorry I'm late checking back in...

Met with new Pdoc... I think he had my case file memorized... he even said he researched RSD (Reflex Sympathetic Dystrophy)... It sounded like he did because he was asking me some questions about how I am dealing with it.

I was so nervous and scared to death of this guy that I can't tell you what he looked like... I don't think I ever looked up. Tdoc told me that the office staff told her that I didn't look too good that day.... said I was shaking, rocking, and was pale white/greyish

He kept all of my meds the same for now...will see me again first week of April.

Oh well... nothing has changed...guess I will just have to keep on keeping on with the mixed feelings until I can't take it anymore.

Thank you everyone for caring!!

Abbie

hi abby, thanks for checking in.
what do you think he should have changed?
Maybe you can ask to see him sooner or talk with his nurse since you were flustered about being there. Unless you had questions written down I am not sure how you could remember the visit.

beth

Sorry he wasn't more help on the changing of medicines.

But I'm hoping that you come up with a good medicine plan.

Donna

It's the fear of being around people I don't know... and the fact that the new Pdoc is male... long story. Plus the waiting room was a bit crowded and I don't do crowds... me plus one is a crowd.

I meet with Tdoc again soon..can't remember date but I have the card somewhere. I will ask her what he said in his notes.

I was hoping he would maybe change things around a bit to help with this mixed state.


Abbie

I recently heard that abilify might be helpful in mixed states. Have you ever tried this med before?
beth

Dear Abbie,
Call that stupid pdoc's office and tell them you need SOMETHING changed because you are in a mixed state. What is he? A moron?

OK. Deep breath.
I promise to be calm.
Seriously.
Call somebody (tdoc or pdoc). Or get someone to make the call for you.
Or print out what you wrote here describing your mood and fax it to him.


Sorry that I am a bit moody tonight.
You have a pdoc. That is wonderful.
Now you have to kind of teach him to do his job. I know that that is a lot to ask of a patient, but that is what we do.

We help them understand us and we help them realize the difference between
our normal bad situation and
our very bad situation.

This guy does not know you yet and does not know the difference for you. You are going to just have to let him know what exactly is going on.

Or let the tdoc tell him.
Either way you need a med change now or later and now is better.

Here's the problem that I see. Mixed states are not stable. They don't usually stay mixed states. They can deteriorate and patients can end up in the hospital.


Abbie, I'm sorry that you are dealing with this now.

Mari

Indeed. Yes. Thank you Mari! i wish i could have pressed the Thanks button multiple times for that!

And yes, "end up in..." is right... i.e. the last resort becomes the only resort... and not a deluxe resort either. Something must be done NOW, or at least tried.

Pdoc sounds conscientious... thoughtful. Maybe he focused so much on taking on the case he missed the main point?? i.e. to stabilize you asap!

However, i dislike his waiting room situation. Usually, and preferably - partly for confidentiality and partly to maintain "safe" therapeutic boundaries, the office/appointments are set up so as to provide for minimal or NO contact between patients. (i dunno - maybe it's a clinic and they're not all his though... )

He also does not match your gender preference. i do not discount this; it is part of your comfort zone.

i am usually reluctant to "throw out" something before it has been fully tried but with the above 2 isues, i wonder if a different pdoc/situation might suit you better. However, it may be best to try to work with this for now, than to try another new person ... stressful, and seems unlikely to get you help sooner.

I like the suggestions of printing this or parts of it out... and faxing it... documents things... you don't have to deal with ppl etc. Also....

YESS.... tdoc DOES know this difference in you.... if tdoc were willing to mediate/push concepts through to pdoc for you, being another professional AND one who knows you, it oughtta carry some weight. And, having just seen you, the pdoc may not require another stressful visit but perhaps be willing to call in a script. Talk to tdoc about the whole thing, anyway.

Well, Abbie, somehow, i do hope you can find a way to get meds adjusted, asap. Good luck.

~ waves ~ ... back to formerly scheduled 'break' now...

Other mondays i recall you have had appointments so i thought you might have got to see your tdoc today... did you?

If so, was she helpful? Can she help mediate things with the new pdoc for you?

I hope so.

Looking forward to an update.

When you can.

Take care of yourself, first.



~ waves ~