Know Your Patient

I was watching a special the other day on chronic pain and one of the first things the doctor said was that it is important to know your patient. He gave an example of a woman that had been suffering from migraines for years. She was doing relief work in Africa and got to know a doctor there. He asked her all kinds of questions about her past, like where she grew up. Eventually it came to light that she had been in a car accident and the migraines were caused by untreated whiplash.

The reason I bring this up is because of my recent experience with the doctor. All he was basing the information on is a letter that he received from work. In that letter it indicated that my performance at work had been suffering... and I had numerous physical complaints. Well let's see... the fibromyalgia has been untreated for 4 years, but according to him that's just a symptom of an underlying psychatric disorder. Oh and I was potentially a threat to myself since I had an X-acto knife at work and gave it to someone so I wouldn't be tempted to use it.

Those three facts led him to the conclusion that I must be suffering from depression and needed psychiatric help. No one so far has listened to the fact that a lot of this stems from not sleeping very well. People that know me would say there is a mild depression and I would agree with them. But I wouldn't go as far as clinical depression.

And as far as the knife goes... I've never kept the cutting a secret. I've been pretty open that it is a maladaptive way of coping and one I try not to use. I haven't used self-injury since April and while I still battle with it I am not going back to it. Admitting I am tempted by it and removing myself of the temptation is not a cry for help. For as much as the doctor may have linked it to suicide I am much more likely to die of alcohol poisoning then I am with a knife.

As I said before I went to the doctor. He told me the fibromyalgia is a symptom of an underlying psychiatric disorder and referred me to the emergency assessment team for an evaluation (or basically to get the diagnosis of depression). You know it's not going to go that well when the first question is "How long have you been depressed for?" So they put me on Zoloft and yesterday I felt like I had the flu... everything hurt and I couldn't stand for more then 5 minutes. I called Telehealth and after reading the warning on the medication recommended I contact the doctor... so it was back to the ER I go. After 3 hours all the doctor would tell me is that this was normal for this type of drug. I've been on Paxil and Prozac and neither of them had the same side effects. I didn't end up feeling anxious and depressed on either of them. I also didn't wind up feeling like I had the flu. I've lost 5 pounds in the last day and a half... for most that wouldn't be a big deal... but for me that is 5% of my body weight. So I left the ER with nothing being resolved. All they recommended was that I lower the dose. I took nothing last night and have a little more energy today. It's tough though to come back from that kind of loss in body weight. I still don't have much energy as a result. I can barely eat because of the lack of energy. My roommate came home on lunch and told me I am now exhibiting the signs of clinical depression... something about me staring out the window at the trees for an hour.

At least I still have Azrael to keep me company. He's enjoying all of the attention from me being home. For now I think I'm going to go see if I can stand long enough to have a shower. Fortunately there's a handrail in the bathroom. Then maybe I'll go watch the trees some more...