Ritalin to help with lack of sleep. Mdoc wants me to check with current pdoc
 

Hi,


At the mdoc's office today I explained that I am extra-ordinarily sleep deprived. I told her that I was unable to fill out a simple form at Human Resources earlier in the day due to probable low brain function. I begged the girl in the office to fill out the form and date it for me.

Mdoc asked about meds that would help with staying alert in the daytime.
I told her that I used to be on Ritalin and found it very helpful except for the humungous hassle the state gov puts me through to get the med because it is a "controlled substance."

She thought I should be motivated to go through the hassle to take medication (ritalin) that helps me.
I told her I cannot deal with very much.

She is willing to write the prescriptions for me if I check with my pdoc (or her suggested neruo/ psych).

M

This would be good.

I have a interesting story for my son.

He was my hopper to the top of the wall and back down.

And now my headache guy. He would stay up all night, till a
dose of ritalin after 6pm. And then he could sleep at night.

It was a mistake that I gave that first dose after 6pm.

I wasn't supposed to. But homework was late that night.

Donna:hug::grouphug:

well this is exciting to see if this helps you again, glad that you are willing to give it a try. I will be anxious to see updates about this.
This is huge!
((((HUGS)))
bizi

Donna,

I found Ritalin to be an amazing med!


Bizi,

I am optimistic. We'll see what happens. I wonder if it will help with depression without causing agitation.


M

Cardiac results were good
 

Hi,


The results of the Cardiac CT for Calcium Scoring were good. My score was 0 (Zero).
I guess being on the Verapmil for 20 yrs works. Duh


Anyway, I asked her to ask me how I can tell the difference between chest pains due to heart issues and those due to anxiety.
She gave me a b.s. answer . . . . 'kept talking around in circles . . . . she said she can never guarantee, . . . asked for another heart test

Then we spent almost 40 mins going 'round and 'round about meds for sleep and then for staying awake in the day. She almost got upset it seemed and then at one point I started to cry. Spending time with her is exasperating.

In the future I should tell her to take a deep breath and get to the point so I can get out and go home.
M

ritalin, mood south, poor bedside manner
 

Dear Mari

Happy your cardiac CT was good, and that Ritalin might help you with sleep and alertness issues. :)
I hope that pdoc is on board with that.

Sorry your mdoc was so exasperating. :( One expects to feel better - or at least not worse - when seeking medical counsel! :rolleyes: It never ceases to amaze me just how unperceptive or even downright insensitive doctors can be to our state of being, when they get all wrapped up in their science. I am so sorry you ended up crying due to her carrying on. :(:heartthrob:

You mentioned a few days ago that your mood had gone south. I am wondering, did that lift or... ?
How are you doing now, moodwise?

I send you lots of hugs and warm thoughts. :circlelove:
Let us know what happens with the Ritalin.

~ waves ~

Waves,

My mood was good enough yesterday and today. It is better than it was the day I said my mood had gone south but maybe it is still not all that good. I cannot account for the mood changes. They do not seem tied to my sleep.

I have felt that this mdoc is good --- better than any other doctor I have had. Also, I like that she is conveniently located.
I do feel that she is not taking into account the bipolar --- cognition, mood, and the whole thing about how very very hard it is to deal with being bipolar. My pdoc, tdoc are gentle. My sleep doc is very gentle.

Mdoc wants to write 'scripts for me and I tell her I have already tried them or others in their family and will not take them (Sleep meds for example).
We seem to have the same discussion every time. I tell her that 25 years ago my psychologist said that the sleep is a medical probablem and the psychiatrist I was seeing said sleep is a psychological problem. I tell her that the care givers I have now say the same thing.
Then she she wants me to see different psych care givers. Then she wants me to ask my pdoc better questions. I told her I value the relationship I have with the pdoc and cannot ask too much of him because I need to keep his trust.
She asks if I tell my pdoc the truth about my sleep and low ability to function. (I do.)
She gets frustrated that the sleep problem cannot be fixed.

When she recommends expensive drugs like Lyrica or Provigil, I tell her insurance will not cover them. She asked about the coupon for Lyrica she gave me. I told her activating the coupon involved too many steps that I could not manage.
She seemed to feel that I was not motivated to improve my situation.

I wish she would accept the sleep condition and move on to take care of my other needs.


M

Mari

I have to tell you, The last phrase of your post gave me a laugh.

Thanks it was a good laugh. It might help with my headache too.

Really is nice.


I hope the ritalin helps again.

Donna:hug::grouphug:

Dear Mari

sorry for the long post. i hope it is manageable.

I am glad your mood is better than a few days ago. I hope it continues to improve. There may be a bit of cycling happening.
I think your mdoc is good too - she is very thorough. I know that her location is a plus when it is already hard to juggle medical stuff. I don't know if she will ever get how hard things are for you. I don't personally think it is all about being bipolar - I think the sleep deprivation is a bigger problem in the day-to-day, and I don't think bipolar is the cause of that.

Accepting that it is psychological would mean accepting that she cannot fix it. She may not be able to accept that. Since the only way she can help is with meds, she keeps on trying to climb up all the trees that lead to meds. I do find that distressing, and I find it distressing that she cannot trust your other experts and your relationship with them. Perhaps if she saw progress on the sleep front, she would not feel so compelled to keep on trying to take it on herself.

I'm not suggesting you change her. In my last post I really only meant to express my sympathy to you for the frustration that brought you to tears in dealing with her.

Her insistence with this sleep thing is detrimental to your relationship with her, but it also shows her to be tenacious and driven to fix everything about you, two things that contribute to making her a good doctor.

Anyway, I am glad your other doctors are gentle.

I wish she would too, but she might not. You may need to find a way to deflect her on this and move her along.

There are a few ways to do this and arguing or defending your position is not one of them... you could do that til Kingdom Come and I don't think she'd change her tune.

You could start sessions with "what i need and do not need from you today" conversation - without justification... just to lay it on the line so she knows. Failing that or in alternative, when she starts on something not useful to you, blocking could work - i.e. reply with a change of subject. If you are called on it, you could tell her - once only - that you have different needs from her right now and return to a useful topic. If she requests explanations, either block again or use silence. Basically put her in the position of talking to a wall... or, say, A Mountain. ;) That will render her attempts ineffectual and it may be enough that she eventually gets it.

As to her comment on your motivation, she just does not understand the sheer energy you put into keeping up with the day-to-day. A person can be motivated but if they don't have the mental or physical energy to follow through, it doesn't help. Sometimes I have plenty motivation to do something, and at the same time feel frustrated, precisely because I don't have the necessary "juice" to follow through.

This is a difficult relationship Mari. You are dealing well all things considered. You are holding your own. I am sorry that it is difficult. Try to learn from the difficulties if you can. It may not change things but it would be a like a silver lining sort of thing. ;)

:hug::hug::hug:

~ waves ~

She does sound thorough. Are you going to try the ritalin?
bizi

Hi, Waves and Bizi,

I like that you are helping me.
In order to help mdoc, I filled out paperwork to request my files from pdoc.

Pdoc's office called today to confirm. They wanted to make sure.
I told them to send the files to mdoc because she is helping me and wants to be thorough.

M

I have no experience with stimulants, but if it has a chance of helping Mari, it might be work the hassle. I wish you the best of luck with it! So glad we're here to support you though, big hugs to you in the hopes you find some relief soon! :grouphug:

you probably had to sign a release of information from your pdocs office....not surprised they called you.
good luck in all of this....
keep us posted
bizi

I have been so so so busy.
I am going to come back here. Thank you very much you all. :heartthrob:

Mari

I am a scatterbrain and sometimes can't make simple decisions, especially when shopping. I have wondered sometimes if I need ritalin. Please let us know how it goes, if it helps, or pushes you hypomanic, etc. I hope it works well for you. :Heart:

Hello, All,

Records: I did sign the faxed request for records. Pdoc himself apparently thought it was unusual to request the complete records and asked his office people to double check that I wanted the complete records.
My “complete records” will include twenty-five plus years of records because pdoc has records from the old pdoc I started seeing around 1988.

Ritalin: My old pdoc prescribed Ritalin in the early 1990s when I complained constantly and vociferously about the cognitive dulling of lithium and other meds. I took Ritalin 10 mgs a day for two or three years. It worked great to clear my head.


Mdoc is scattered: I recognized in the last visit that mdoc jumps all over the place. For example, when she asked me to tell her my meds in order to have me confirm with her, she said for me to take Vit D3 with the ‘’scripted meds. She started to talk about how the medical community . . . . .something . . .(she trailed off) . . . then she started to look for my last Vit D3 level and never got to that because she thought of something else to say.
She also kind of interrupts herself.

Depression: I told her I had drastically reduced the Gabatenin to below ttherapeutic doses to 100 mgs because of side effects. She told me to take 300.

Attempted to tell her about possible cardio reactions to Gabapentin: She said Gabapentin does not affect the heart. I told her it might and told her about the calcium channels and that calcium other mechanisms are not widely known. She said "No" and then started reading the list of side effects. I have every side effect. She seemed to say that the ones on the bottom of the list are not relevant for most people.

Gabapentin rash: See above. She said if 500 was too much, try less. I am 100 at the moment. 100 helps with anxiety but not much with depression.


Tdoc likes the mdoc: Based on what I tell her, tdoc thinks mdoc is good for me. Tdoc says that mdoc sees me as a whole person. I can trust tdoc about 90% of the time so for now, I am going with her instincts because I cannot trust my own.


Strategies: I have to work on not engaging in what ever is going on with pdoc when we sort of argue back and forth. I “shut down” other difficult people. I can do that with her. . . . doing a better job of “humoring” her and keeping better control of the discussion.

Klonopin: Waves mentioned Klonopin and other strategies/ techniques in the past for handling the office visits. I need to keep a list handy for the next visit.

Mari

Butterfly,

There are newer drugs available now.
Mdoc specicifally asked me if I considered taking medications for narcolepsy to help me stay alert in the day. Two drugs available for that are modafinil (Provigil) or armodafinil (Nuvigil).

My drug company will not pay for them but some people who suffer from depression can benefit from them as long as they are watching for hypo mania.
http://www.mayoclinic.com/health/nar...ents-and-drugs
M

Waves,
 

Waves,

I appreciate you insight and comments.

You have commented before on that before. I do not think I would know what is going on without your pointing it out.

You are right. She will not. I agree that at the moment sleep is a bigger problem than mood for me. She does not "get" either one so in a way it is all the same to me --- esp with my muddled mind. I have considered keeping a mood chart to track sleep and mood to see if the mini-cycling that I do is related to sleep or happening all by itself.

I remember that MD's write 'scripts. That is what they do. I think the two of us coming up with the ritalin compromise was a way for us to find common ground. She gets to do something for me and I find a med I might be willing to consider that worked for me in the past.

Yes. This! If I let it this could pizsxz me off to no end. I almost see this lack of trust as a personality defect that I will have to somehow manage / work around. She has talked about needing more info -- either from my pdoc or one she sends me to. Getting pdoc's records might help her OR it could open up more questions and more rabbit trails.

It is not likely that she can help me sleep more or better. As far as I know, I slept little even as an infant. If she can get me Ritalin (after I check with pdoc or her neuro/ psych guy) I might just fill it and pretend to take the ****** stuff to give her a bone.

Thank you.

Yes. I fell into the loop / trap again. I felt that I was explaining. Then I felt that I was defending myself. Perhaps I see things as very complicated and she sees them in simple terms.
I am completely overwhelmed in everything I do so I she cuts to something she thinks is clear and then I see it as too hard or not an option . . . .

Regarding motivation (perhaps about the huge hassle to get Ritalin because it is controlled):
She had a hard time understanding that I could not go through the extra steps for that med even though it could help me. She said that patients of hers are motivated to take weight loss pills but not other pills like something for heart. Looking back, I do not remember her point.
She wondered how I do my job. I do not know. I told her about one activity I do. She wondered how I could do that but not fill out simple forms for Human Resources.
I had this discussion with my sister who can do (A) some parts of her job but (B) other parts not at all. To an outsider those two would be switched.
Right. Motivation and energy do not go hand in hand.


The Sleep Thing (as I call it now) for ten years prevented me from finding a tdoc after my wonderful one and I terminated. It was pretty awful to show up barely awake and tell the new tdoc I could not talk about the sleep problems because they would take up the full session and I would not get any benefit. It was horrible trying to get any help.
I do not remember how I got past those barriers (sleep/ sleep talk/ . . . . . ) with current tdoc. I am grateful that whatever it was, I can deal with her.

M

Waves,
This will work better than what I have been doing.

M

Bump for mari

Does anyone else find old threads depressing?
 

Wow. I was taking 10mgs of Ritalin a day.


I was not on it very long because it was a hassle (a few years).



M

I have a few threads that I would definitely never want to resurrect.

You were having an extremely hard time, Mari :hug::hug::hug: