Posted by yxibow on September 20, 2008, at 1:56:56
In reply to Can't really see a psych, but Want to talk to PCP, posted by WaterSapphire on September 17, 2008, at 14:39:49
> Due to financial issues and need for other medical appointments that I have to get in first, I am planning on giving my internist a call.
> I am really afraid to go back on meds at all because I feel my body is not filtering them right. It is such a hard thing to explain, but some examples would be...
>
> 1. Feeling sicker after eating certain foods
> 2. I had to go off pain management because even the lowest dose of medicine got to be too strong it affected my breathing last fall
> 3. If I limit my fluid intake I feel better than when I drink even normal amounts of water.
> 4. One test showing I was wasting things, which needs to be rerun
> 5. Magnesium helps in large quantities and does not even affect my gut, but seems to cause an increase in flank pain which supposedly has no cause and supposedly my kidneys are fine...I don't want to project.. but if there isn't anything organic wrong with you after testing there is a possibility that your are experiencing some form of somatoform condition -- real experiences but not organic conditions that are caused by anxiety
But its hard to say -- I mean, you could be allergic to some foods for real, that's also possible.
The fluid level issues are sort of the opposite of what one could experience if they develop diabetes -- usually its polydipsia (much more water).
> SO, the one med I was suppose to start taking before I threw all my meds away was Lamictal.
> I had been on neurontin both for mental health and for nerve pain. My understanding is that lamictal is for bipolar disorder and also for seizures. I had requested it myself because a former PCP had told me it was good for some people with bad ocd and anxiety.
>
> Any opinions on this. I am willing to try anything right now. Thanks so much...
I understand about the financial issues -- and I'm sure you trust your PCP -- some extremely rural areas completely lack psychiatrists or only visiting ones -- but there can be caveats if he or she hasn't taken CME courses on psychotropics, that drug interactions (p450, etc) could be missed somewhat if they haven't been researched first.Psychiatrists (and psychopharmacologists) have more training in these sorts of things because its their specialty, rather than internal medicine, which is the typical specialty of a primary care provider.
But I'm not saying that PCPs haven't treated patients in need of some (less complex) psychiatric care.
I guess I'm not trying to scare you and I'm sure you have as you said multiple appointments, just be open with your doctor on his/her knowledge of psychotropics and of course as always should have a ongoing dialogue and relationship about these medications.-- best wishes
Jay
poster:yxibow
thread:852492
URL: http://www.dr-bob.org/babble/20080915/msgs/853048.html