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  1. #1
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    Default Incompetent Physicians, Coming to Terms with Mental Disorders, and Frustration!

    Ok, this might be a bit long-winded, but a lot has been going on and a lot is on my mind, so please bear with me.

    Most of you know that my back/spine problems have been pretty bad, and at times unbearable, since my accident. Four months of physical therapy, chiropractic, and drug after drug have not solved it. So Thursday I went up to the OHSU spine center to try to figure things out, but only came home more frustrated than when I walked in. My doctor (who is an anesthesiologist who specializes in pain management) was a bit too blunt for my taste - almost to the point of rudeness. Told me never to take tramadol again because it can cause seizures in the general public, not to mention an epileptic, yet wouldn't give me any other options for pain control. And then when I told him I can't work (training horses) because of the the pain, he told me I need to find "another applicable life skill, because you only get so many chances before you're a vegetable. Riding calm horses in an enclosed space might be acceptable, but I cannot let you leave this office without strongly warning you against it."

    Then things really got fun. He poked around on me a bit, and then tried to tell me I have Fibromyalgia. Um, excuse me? I have Fibromyalgia because I am sore on at least 11 of 18 trigger points, because I have reported cognitive problems (weren't you just talking about my TBI?), and I have a history of anxiety (which he took to be truth from the mouth of my mother, even when I specifically told him I do NOT have anxiety problems)? There's one part missing here: I have had pain ever since a very specific date: September 11, 2010 -the day of my accident. The pain is NOT WIDESPREAD, like it is in true Fibromyalgia, it is very specific to my back and muscle groups that are involved in my seizures, which are still not 100% controlled (and I even told him that my last seizure was only four days prior to that office visit...didn't seem to matter to him). I might not be an expert, but that doesn't really sound like Fibromyalgia to me. AND THEN, he told me that I have a "pain disorder related to psychological factors" and that he wanted me to start physical therapy and consult with a pain management psychologist. This is AFTER he ordered an MRI of my lumbar spine...thank heavens I have the radiologist's report on it, because he told me it was "normal"

    This is what the report said:
    Lumbar spine MRI without contrast 3/3/2011
    Clinical history: Low-back pain radiating down right leg.
    Technique: Sagittal and axial noncontrast T1 and T2 weighted images were obtained of the lumbar spine without IV contrast. Sagittal stir sequence was additionally obtained.
    Findings: There are 5 non-rib bearing lumbar type vertebra. There is minimal retrolisthesis of L5 on S1. Alignment of the lumbar spine at other levels appears anatomic. The vertebral body heights are normal. There is focal disk height loss and desiccation at L5-S1. There is a tiny focal central posterior disk protrusion at L5-S1 which rests within the epidural space and causes minimal central spinal canal stenosis. There is mild bilateral facet arthropathy at L4-5 and L5-S1. Disc spaces at other levels are relatively preserved. The conus terminates at a normal level. Paraspinal soft tissues are within normal limits.
    Impression: A small central posterior disk protrusion at L5-S1 causes minimal central spinal canal stenosis. No significant neural stenosis or compression is seen at any level.

    Like I said, I'm no expert, and the key word to me here is that all of the findings are "mild" or "minimal", but I still don't think you can call that a "normal" MRI. His only solution to the problem is PT (which already failed once) and pain management psychotherapy....Long story short, I really didn't appreciate being told that my problems are all in my head (of course I am not saying that I think Fibromyalgia is a mental disorder, I know enough to know that it is a very real physical problem, but I still just can't believe that it is something I have).

    My mom and I both left very frustrated, so we are getting a second opinion with the physician at OHSU who first saw me for Post-Concussion Syndrome. He is a sports medicine/ortho doctor, so maybe he will be able to provide some additional insight...but my appointment is not until the 15th - thank heavens my TENS unit will be here Wednesday, because I am almost out of narcotics!

    But, this whole finagle brought something to my mind that I've honestly been keeping buried for a very long time....

    It took me many months to be aware of and accept the fact that I have a traumatic brain injury and a seizure disorder, but I have finally done it over the past few weeks. I know that it is not going away, it has a real effect on my life and on my functioning (it's the #1 reason I chose med school over vet school), and I can look at myself in the mirror and say "Megan, you have a brain injury. You have a seizure disorder." I can do that now and genuinely like the person I see in the mirror.

    But my first impression when the doctor mentioned pain related to psychological factors was anger. Lots and lots of anger. He was questioning my mental health and I just got MAD. And I don't know why, because it's perfectly legitimate to question it. I've had an on-and-off history of anxiety and depression, but it's something that I've always personally struggled to deal with emotionally. My mom has been severely bipolar since many years before my birth, and as terrible as this might sound, my greatest fear in life is becoming like her. I've tried dealing with the problem through therapy which helped some, and I even tried SSRIs - they kept the depression and anxiety problems away, but they also unwound me so much that I felt like my emotional rheostat, which normally flipped between "EEEEFFFFFFF my life!" and "YYAAAAAAAAAAAAYYYYY!!!!!" was now stuck just on the "yay" side of "meh". I didn't like it and I felt like I didn't have *enough* anxiety to get done all that I needed to get done in my crazy absolutely insane life, if that makes any sense. I stopped drugs and therapy and I got very, very good at lying to myself and really, truly believing that I was superhuman and I could do everything I wanted. So I did. And for the most part, I was successful. Then, only about two months before the accident I really started getting burned out on life and I felt like the mansion of cards I had built was crashing down, but I just couldn't muster up out of the burn-out to do much about it until things were at the breaking point. I met with a counselor at school only about three weeks before the accident.

    Then that happened. And everything was turned upside down. I went through the depression, anger, denial, grief, and anxiety that always accompany something so life-changing as that, and I fought with it and I deal with it and I overcame it. As I said, I'm at a point now where I am really, really okay with the brain injury and consequences of that because it has taught me so much and it really has made me a better person. There is a silver lining that I can use to help me and help other people.

    But now, just as I have finally reached this point, that monster is back. He's clawing at his cage and he can't be kept in it anymore. But I just can't seem to admit that to myself. I cannot look at myself and say "you have an anxiety disorder". It's a little easier to say that about the depression, because I can blame it on the brain injury (depression is so very common after TBI). And the denial has gotten to the point where I will even deny my entire past history of anxiety and depression. I will deny it to myself, to my mother, to doctors, to anyone. And I don't know why. I think I just look at it as a sign of weakness and failure, which is absolutely ridiculous! I would NEVER think that on ANYONE who is suffering from these terrible diseases, I know it's a physical, chemical problem of the brain, but I will think that about myself. I've spent so long lying to myself and convincing myself that I am a superhuman uberwoman that such a problem cannot possibly affect me. Do I have episodes of anxiety? Yes, everyone does. I might have a little more than other people because I am a pre-med major in my senior year taking insane numbers of credits while trying to juggle thirty other things all while coming back from a devastating injury with my token high-strung personality. Who wouldn't have a bit of occasional anxiety? It's all part of the game.

    At least, that's what I try to tell myself. I try to convince myself that if I do have a bit of anxiety, that it helps me to perform at my peak functionality, but it's not true. There are times, usually during midterms or finals or other off-the-charts-stress times, that it gets to the point where I nearly can't function. Then the depression sets in because my life now is so different than it was six months ago and I am not succeeding and I am not superhuman anymore, then I get more stressed about how I am going to redeem myself from the lack of success that I lose more functionality and I get more depressed...it's a very vicious cycle.

    And yet I still won't admit it to myself. I just can't do it. I can't bring myself to accept that there is one more piece of me that's not what I want it to be. Not after the brain injury, not after the back injury, not after losing so much. Then when the doctor at the spine center told me my pain is a psychological disorder, I went into even greater denial, but ironically, a piece of me believes him. Maybe it is all in my head. Maybe there is nothing physically wrong with me and my problems are all just manifesting as physical symptoms.

    Anyway I cut it, I'm confused and frustrated. I want to solve the anxiety and depression, but my time-tested method of "deny it and bury it deep until it fixes itself" really isn't working anymore. But I'm paralyzed by the fear that if I do admit it, then it really will become real and I it will eat me up and I will end up like my mother - depressed and completely nonfunctional for 20+ years. I know I need to do something, but I don't know what. I want to go back to my new life that I had figured out after the TBI and before this. I want to be able to ride and train (myself and my horses) again. I want that feeling of control again, because right now there is no control.

    I think the first thing I need to do is accept it and figure out exactly which areas of my life it's affecting the most, but I don't even know how to do that anymore.
    "The FEI is often in error, but never in doubt." - Jim Wofford

    "You do not find the happy life. You make it." - Camilla Eyring Kimball



  2. #2
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    I am sorry you've been having such a rough time. Seeing an Ortho Doctor makes a lot of sense to me. Have you tried finding a practioner who does acupuncture? I seem to recall that is supposed to be beneficial for pain of various types. Good luck, and definitely do not go back to the idiot whose chairside manner is so abominable! Good luck and keep us posted.
    Jeanie
    RIP Sasha, best dog ever, pictured shortly before she died, Death either by euthanasia or natural causes is only the end of the animal inhabiting its body; I believe the spirit lives on.



  3. #3
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    Please, please find a decent therapist. no one could be expected to go thru all you have been thru without professional help. You need someone to help you sort thru this.. A friend just started going to a psychiatrist who specializes in pain management, perhaps thats a place to start?
    "Kindness is free" ~ Eurofoal
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    The CoTH CYA - please consult w/your veterinarian under any and all circumstances.



  4. #4
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    Quote Originally Posted by Vegas Sky View Post

    But my first impression when the doctor mentioned pain related to psychological factors was anger. Lots and lots of anger. He was questioning my mental health and I just got MAD.
    Ditto on the suggestion that you seek therapy, not because you are making up your symptoms or because your pain is psychosomatic, but because you've been through a lot!

    I do understand completely where you are coming from. My 4 year old daughter has been very seriously ill and throughout her recovery she has had some pretty intense behavioral issues. (ie: crying uncontrollably for hours on end, sleeping 18+ hours a day, things like that.) I had a pediatrician suggest that she was playing up her symptoms, that she had an underlying behavioral problem, that it was all in her head. Not kidding. (Dude, she's 4! How could she make this stuff up?!?)

    I remember how angry it made me and I have no doubt that is just how you are feeling now.

    After a lengthy analysis the psychologist determined she has been reacting to chronic physical pain. She's an intense individual to start with, but the constant and diffuse pain has just sent her poor little psyche over the edge.

    My point being, you may well have some serious lingering pain issues that are greatly interfering with your mental and emotional state. The mind-body connection is a strong one and when one half is off kilter, the other is sure to follow.

    So definitely seek out therapy, please, and also continue to push your physicians to help you manage your pain. I think once the pain is controlled you will be better able to sort through some of the anxiety and other stuff you have going on.

    Hang in there, and good luck!
    We couldn't all be cowboys, so some of us are clowns.



  5. #5
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    The fact that your able to write out and explain what has been going on with you is a big BIG step. You now need to find a specialist in treating mental health disorders. They will help you sort this out and give you the tools you need to help you work this through!!! You've come so far!!!



  6. #6
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    Quote Originally Posted by EqTrainer View Post
    Please, please find a decent therapist. no one could be expected to go thru all you have been thru without professional help. You need someone to help you sort thru this.. A friend just started going to a psychiatrist who specializes in pain management, perhaps thats a place to start?
    This. Plus, even if the pain does have a physical cause, supposedly there are things you can do 'mentally' to help improve your experience of the pain. (Obviously, it does not make the pain go away, but for example relaxation techniques help reduce any increase in the pain caused by muscles being tense, or the levels of inflammation in your body being raised due to stress.) (Or so I am told. I have an inflammatory arthritis and haven't actually tried it myself yet. One More Thing on the To Do list.)

    If nothing else, someone who is a therapist who is trained in helping people with chronic pain should be able to help you develop skills to more clearly explain to other people (doctors, other people in your life who need to know, whatever) what your condition is/has been.

    (My dad totally and completely failed to understand how exhausting the pain of inflammatory arthritis can be, no matter how many times I tried explaining it to him, until he got osteoarthritis in one finger. Now, suddenly, he's on my side and hassling me about getting proper treatment because "how can you live like that?!?!" - hah. I TOLD him.)

    Btw, if you go to anyone who does want to put you on SSRIs or the like MAKE SURE they know you have family history of bipolar disorder. It's possible to have what amounts to very mild bipolar disorder that presents primarily as depression (because the manic episodes aren't particularly 'high') and some of the SSRIs are a Very. Bad. Idea. if you have that, because they can make it worse instead of better.

    (Don't get me wrong, they're fantastic drugs, but so many people really don't give enough medical history and then don't really get the treatment they need, and so many nurses and techs doing the intake paperwork don't really properly interview any more - my mom was just talking about this today, actually. When she was a nursing student in the 60s they had required classes on interview technique because they really would sit down and properly INTERVIEW a patient, not just tick off boxes on a form and try to get it done in 5 seconds or less - I know a big element of it is just down to them no longer having the TIME to sit down with a patient, but it means that you have to take responsibility for it yourself, as a patient.)

    Anyway. I agree with going to talk to someone, and see what they can help with. Also, don't give up on the physical front - sometimes you have to be quite persistent. It's very annoying.

    (Interesting the thing about seizures and tramadol though. I'd never heard that. It is my Drug Of Choice for when the arthritis pain gets crippling. Codine drugs - Vicodin, etc. give me headaches or knock me out and THEN give me a headache, so. Fingers crossed I can keep my tramadol, because I don't really want to start moving up the pain-control ladder just yet.)

    Which reminds me - some of my friends who have pain that's a more localized sort (like one friend who messed up her knee) seem to get some kind of lidocaine patch that you apply where it hurts, and they seem to think that works really well. So that might be something to ask about, if you haven't tried it already. (Apparently it's a bit expensive, so some doctors don't like to give them out unless they HAVE to.)

    (Me, I'd end up covered in the things. )



  7. #7
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    Quote Originally Posted by ivannataoo View Post
    The fact that your able to write out and explain what has been going on with you is a big BIG step. You now need to find a specialist in treating mental health disorders. They will help you sort this out and give you the tools you need to help you work this through!!! You've come so far!!!
    Posted while I was posting but - OP, you know, you could just print out your post and take it with you once you've found a therapist you're comfortable with, and say 'this is something I wrote right after XYZ' - it might be a helpful starting point and since you've already said it (to us) you don't have to make yourself say it again. Does that make sense?

    (I'm totally one of those people who is always "fine" at the doctor, too. I had to train myself out of it. "Yesterday, my lower back hurt so much I couldn't get out of bed except when absolutely necessary" does not actually mean "fine", even if I say so. )



  8. #8
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    It sounds to me like the physician was not incompetent, just lacking in interpersonal skills. He did give you some good information, just not enough support and guidance to figure out a plan. Some physicians are lacking in tact. I work with an MD who has been sent to "Charm School" multiple times by his bosses because of his lack of interpersonal skills. It has helped him some, but he still lacks tact. Perhaps the MD you saw just needs a few more sessions of "Charm School." Who knows, perhaps he is currently enrolled and has already made a lot of progress!

    The MRI sounds pretty normal to me. That is good news. It sounds like there is hope that you will eventually recover from your back pain. Unfortunately, the MD did not have a good plan for what you need to do from here. Someone needs to help you make a plan for the back pain. I think a new PT could be helpful. You may want to look into acupuncture, massage and chiropractic to see if they have anything to offer. Some people with back pain do very well with steroid injections in the back. My farrier had them a couple of times with incredible relief of his severe back pain.

    I do think it would make sense to find a good shrink who has a lot of expertise in bipolar disorder. Your bursts of energy sound to me like you have some bipolar genes. Some people are able to use their bipolar genes to be creative and incredibly productive. If the bipolar genes get out of control, they can make a mess of your life. A shrink who truly knows bipolar disorder can help you decide if the bipolar genes are getting in the way. He or she can also help you avoid pitfalls in life. For example, some people with bipolar tendencies do not do well with SSRI antidepressants. If that is a problem for you, you need to avoid the SSRIs. You also may be someone who is best off avoiding narcotics. I don't know if the steroid injections in the back are a potential issue for you because of the bipolar genes.

    It sounds like the head injury and seizures made a lot of minor problems (e.g., anxiety) into major problems. Now, the challenge is to turn them back into minor problems. Everybody has a collection of problems. We all have anxiety, bad stomachs, headaches, back pain, bad knees or other issues. The hard part is when something else sends all of them out of control. Then, the job is to get them back under control.

    You are intelligent, hard working, and determined. You will get everything back in order again. Keep using your organizational skills to get the care you need.



  9. #9
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    Thanks everyone...really, thank you. There's just a lot to sort through.

    Now I'm stuck trying to figure out whether my pain is 100% related to the physical damage or part of it (or maybe all of it) is related to some more complicated psychological or psychosomatic factors. I don't know what to think anymore.

    On one hand, if it's purely physical, then I feel like I'll be validated and that there will be a fix for it that will make it go away. On the other, if it's related to psychological factors, then I go back to that superhuman complex - I'll feel like I've fallen into a "weakness trap"...but if I do learn that it's psychosomatic, then I'll just think that it doesn't really exist and I'll start doing everything that I'm not doing now and might get myself into trouble (you know that voice in your head...the one that says "maybe I shouldn't be doing this"? I don't have that).

    I'm just frustrated. I want the pain to go away, one way or another, but I'm afraid to discover that "my pain is disproportionate to the physical damage." I just want there to be a fix. I'm 22 years old - I can't live the rest of my life like this.

    I should also add that I have been working with a psychologist at school. He is AMAZING. He is the one who helped me come to terms with the brain injury and what it means for me and how I relate to school, family, other people, the world, etc. But I've never talked with him about my physical problems (except the seizures, but even then only briefly) and we've never really talked about the anxiety and depression disorders even though he knows that I have a history of them - the TBI issues have always just outweighed them. I've never even told him my mom is bipolar, even though that has shaped my entire relationship with her.

    I know I need to talk to him...in fact, I saw him just a couple days ago and he was so very pleased with my progress through the whole TBI thing that he said "come back when you need to." We're coming up on finals and spring break, so it might have to wait a couple weeks, but I will try to make an appointment with him. I will also know more about the actual physical problems at that time too so I will know whether this is purely a physical problem that is affecting my mentality or there are some more complex "pain disorder related to psychological factors" things going on. Ugh. I don't know why I'm so afraid of it being the latter, but I am.
    "The FEI is often in error, but never in doubt." - Jim Wofford

    "You do not find the happy life. You make it." - Camilla Eyring Kimball



  10. #10
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    I think it is very hard to sort out the percentages in terms of figuring out what percentage of the back pain is purely physical and what percent is an overreaction to the physical insult. It doesn't seem too worthwhile to sort it out. If you work on it from all angles, the back pain should go away.

    One of my family members had severe back pain last year after being beaten up at work. After a normal CT scan (the ER didn't have access to an MRI), she felt better that there was no permanent, physical, injury. It took 6 months to get her back pain resolved. A physical therapist helped her get rid of 50% of the pain. Some of it went away as her stress level/muscle tension decreased. Her friend, a DO, did some chiropractic maneuvers with her that got rid of the last 20% of the pain. It was hard to sort through what percentage of the pain came from what. Only as the pain gradually resolved did she start to sort it out. In the end, it didn't matter where it came from. It just mattered that the back pain was gone.

    Talk with your psychologist, as well as your TBI neurologist, about your plan from here. I do think you will benefit if you can find a really good shrink who is a bipolar expert. You need good information so you can keep the bipolar genes from making trouble while you are recovering from the TBI.



  11. #11
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    The MRI is pretty normal.

    I don't know if any of your doctors mentioned this about chronic pain, but sometimes basically the nerve pathway involving an area that had been injured and in pain for a while gets "confused" and the pathway will take normal signals as pain even after the area essentially heals. So you can scan and scan and see nothing, and it's not in your head (only inasmuch as the experience of pain is there, of course).

    I'm not saying that's what happened with you, but since you did have a specific accident and have localized pain and pretty normal imaging, it's just another possibility.



  12. #12
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    Quote Originally Posted by Vegas Sky View Post
    (you know that voice in your head...the one that says "maybe I shouldn't be doing this"? I don't have that).

    I'm just frustrated. I want the pain to go away, one way or another, but I'm afraid to discover that "my pain is disproportionate to the physical damage." I just want there to be a fix. I'm 22 years old - I can't live the rest of my life like this.
    That bit about not having the voice in your head that says "maybe I shouldn't be doing this"? That right there makes me think you really really need to talk to someone who has proper experience in people with bipolar spectrum disorders, because that is word-for-word what one of my friends who is bipolar has said to me about how she feels. (She actually has a list, compiled over time by other people, listing "things I am not allowed to do, or try to do, even if it seems like a good idea at the time." - It's kind of a joke, but also not, because it reminds her that her judgment is NOT always the best and sometimes she does need to check in with someone else.) (She's had some fairly severe bipolar episodes, though - it doesn't sound like you're in the same area of the spectrum that she is.)

    As far as being 22 and living the rest of your life with pain - I hope very much that you get it all sorted out, but I do promise that over time you'll adapt better to dealing with what you've got, too. (It is not always easy, and sometimes your adaptations will suck and you'll need to consciously develop new ones, but it happens.) Not that eventually it'll be all "fine, back to normal" necessarily, but there is a period of adjustment, after which it's a little easier to... I guess, still be yourself, in spite of the problems? Stop feeling so much like you're defined by what you can't do? It's hard to explain.

    (I have a type of arthritis that started developing when I was 10, very gradually, and a few years ago I totally had a moment of realizing "oh crap, I'm BROKEN!" because it'd crept up on me so much, and that was pretty difficult to deal with. I think I was reasonably mentally messed up about it - what do I do, how do I deal, how do I COPE - for maybe six months? Not constantly, but it'd pop up every so often like a jack-in-the-box and it'd just stop me in my tracks every time. These days, I still occasionally have moments like that, but it's a lot easier to recognize them AS moments of 'emotional side of brain being dumb, evaluate logically, if it makes sense, proceed' rather than getting into a tizzy about it.)

    (I think I've actually posted a bit about it here, actually - I haven't ridden lessons regularly in years - since before my little "I'm broken!" freak out, and I'm struggling getting back into lessons because of a combination of being convinced everyone will think I'm dumb if I've forgotten something, and feeling exceptionally fragile because I'm 'broken' now - except I'm NOT. I don't have reduced bone density or anything like that, the only thing, in terms of riding, that's really significant is that I'm more sensitive to improper or over-use of joints. And even then, it's likely to hurt, not make my knee, like, EXPLODE. So it's really silly, but eh. Human brains. Weird things. )



  13. #13
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    Could I suggest trying an orthopedist or neurologist outside of OHSU? Great hospital, but Rebound Orthopedics specializes in athletes who are injured (team docs for Blazers, etc.) I have been treated by them for 4 separate issues ranging from L5-S1 disc degeneration to my most recent horse-related humeral fractures. Excellent care. One surgeon even shows hunters on the A circuit, so they have a very good understanding of what it takes to do what we do.

    I would also suggest massage. Really good therapeutic massage is a lifesaver for back pain (helped me immensely).

    Pain sucks. Literally sucks the joy out of you. It is exhausting, depressing and an angry monster that sits on you, day in and day out. I hurt every day from various physical injuries accumulated over my 43 years. I really hope you find a solution. This is not in your head. After a trauma to head or body, everything hurts. You'll find odd pain that can easily be misinterpreted. Sounds like your "pain dr." is doing just that. Second opinion is good.

    Your MRI sounds kind of normal. A back specialist might be your next move, as the tiniest protrusion could hit just the right nerve and cause ungodly pain.

    Good luck, stay strong. You might have a different future ahead of you, but the future is there, waiting for you. Let us know how things progress!
    Proud member of the "Don't rush to kill wildlife" clique!



  14. #14
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    Your pain does not have to have caused by psychological issues for you to benefit from psychological counselling to make it better.

    Here is a quick blurb: Psychological assessment and counseling provides education in behavioral strategies found to be effective in the management of chronic pain. Medical professionals recognize that emotional stress can excite neuromuscular body systems, worsening any pain experienced.

    Counseling provides an opportunity to address personal issues and concerns which may complicate the medical condition. Special attention must be given to the emotional distress which can result from having a chronic or unresponsive medical condition.

    All the best.



  15. #15
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    Quote Originally Posted by AKB View Post
    I do think it would make sense to find a good shrink who has a lot of expertise in bipolar disorder. Your bursts of energy sound to me like you have some bipolar genes. Some people are able to use their bipolar genes to be creative and incredibly productive. If the bipolar genes get out of control, they can make a mess of your life. A shrink who truly knows bipolar disorder can help you decide if the bipolar genes are getting in the way. He or she can also help you avoid pitfalls in life. For example, some people with bipolar tendencies do not do well with SSRI antidepressants. If that is a problem for you, you need to avoid the SSRIs. You also may be someone who is best off avoiding narcotics. I don't know if the steroid injections in the back are a potential issue for you because of the bipolar genes.
    I cannot express how much this scares me. It just absolutely terrifies me.

    My entire life I have watched my mom struggle and fight with bipolar disorder. She's 51 years old and nowhere near winning the battle. During my teenage years there were days she couldn't get out of bed, and when I was a kid there were things going on that I didn't recognize as her suicidal periods until I was older. I love her so much, but she was never my "mom". At eight I was making all of my own meals, doing my own laundry and hers, and basically managing my own life. My brothers and my sister, who are 8, 6, and 4 years older than me stepped in and basically helped my dad to raise me. Mom's entire life has been defined by her illness. It has destroyed so many of her hopes and goals and it has ruined her physical health - destroyed it.

    I cannot be like that. I cannot. When I was about twelve I looked at my mom and promised myself I would never be like her. I would take control of my life and be strong and successful and accomplish everything that I set out to do.

    But now, the manifestation of my greatest fears is here.
    "The FEI is often in error, but never in doubt." - Jim Wofford

    "You do not find the happy life. You make it." - Camilla Eyring Kimball



  16. #16
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    Bipolar is an illness. Like cancer, like diabetes, like MS, like rheumatoid arthritis. For cancer and diabetes we have a much better understanding than we used to about the causes, and thus, treatment. For MS, and mental illness, not so much (fibromyalgia used not "not exist" because "it was all in your head").

    But just as no two cancer patients are the same, you are not your mother. Things have changed. We have - and this is critical - come a long way in the understanding that mental illness is a disease. Maybe not one we understand that well as of yet, but that doesn't negate the issues. And we do have better treatments and approaches.

    IF you do have bipolar - and you won't know this unless diagnosed - it does not mean you will follow your mother's path. And it doesn't in any way lessen you as a person. And it need not destroy you as it has your mother. ANY illness has the capacity to do that. It isn't limited to bipolar.

    Please. Take care of yourself, and see someone who can help. The sad part is, this physician could have helped you. He lacked the emotional capacity to do so - that's his problem, please don't make it yours!

    Wishing you the best down this road, wherever it takes you.
    www.specialhorses.org
    a 501(c)3 organization helping 501(c)3 equine rescues




  17. #17
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    All I can comment on is this (from your report). And I can only comment on it because I suffer from it - and it's no picnic.

    "There is mild bilateral facet arthropathy at L4-5 and L5-S1. "

    If you are in continual pain - even mild facet joint arthritis can be
    excruciating. It's a normal part of aging but it can also be caused by trauma. It doesn't always cause pain but when it does - oh boy. Horrible and disabling. And apparently underdiagnosed. You can take all the drugs you want. They won't help. If your back pain is in fact caused by facet joint syndrome there is an easy procedure to determine that, which may provide years of relief. If the pain comes back, there is another procedure that can also provide relief, and can be repeated as needed. Facet joint problems can cause widespread pain in the lower back (or neck if those joints are affected). Doctors will often tell you it's just back strain/muscular, thinking maybe you strained the QL muscles on one or both sides of your back. But it's not - the muscle pain is a symptom. Not the cause. The cause is the facet.

    Please seek any and all help with your mental health issues. Don't fret, and don't feel anguish over it. You're not your mother. Every one is different. Really.

    And for God's sake - DON'T let ANYONE define you, who you are, or tell you what you can or cannot be. YOU decide that. OK? Except that you're not your mother. Saying that is ok. But don't let people define who you are or what you can or cannot do because of this or that injury or condition. Don't allow others to limit you, or crush your dreams and goals. This forum exists for a reason - and it's not because we're all sitting around crocheting and waiting to die of boredom because our doctors told us we're too creaky, old, sick, lame, or lazy to ride. We're here because we all want to get back in the saddle. And we can.

    If kids from Iraq and be blown half way to hell and come back to run marathons, we can overcome our infirmities to go for a ride on our horses.



  18. #18
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    Quote Originally Posted by JSwan View Post
    All I can comment on is this (from your report). And I can only comment on it because I suffer from it - and it's no picnic.

    "There is mild bilateral facet arthropathy at L4-5 and L5-S1. "

    If you are in continual pain - even mild facet joint arthritis can be
    excruciating. It's a normal part of aging but it can also be caused by trauma. It doesn't always cause pain but when it does - oh boy. Horrible and disabling. And apparently underdiagnosed. You can take all the drugs you want. They won't help. If your back pain is in fact caused by facet joint syndrome there is an easy procedure to determine that, which may provide years of relief.
    Is the procedure surgical? (Just wondering - I have arthritis in my lower spine from psoriatic arthritis, but no one's really suggested anything other than systemtic treatments to me, so I'm just curious what else they do for spinal stuff.) (Steroid injections and those sorts of approaches seem to generally work pretty poorly for PA, so there's lots that doesn't get mentioned.)

    Anyway - I will add that I totally agree that even 'mild' spinal arthritis can be agonizing depending on exactly where it is and how much inflammation there is going on - and nerve pain is, hands down, one of the WORST pains I have ever felt in my entire life. (I have never given birth, but I have been informed by someone who has that, in her opinion, there's no contest - baby was better any day of the week.) It's not how much it hurts necessarily so much as, as JSwan says, painkillers seem to barely touch it.

    (I've had far better luck with mine when it's REALLY bad using a combination of painkiller - tramadol for me - and a muscle relaxant and an anti-inflammatory. Generally, said muscle relaxant must be strong enough to basically knock me out for a few hours, but I KNOW the muscles in my lower back tighten up like crazy when my back starts getting bad, and it makes it worse, so it's like the muscle relaxant gets everything to calm the heck down so the anti-inflammatory can actually get to work without the muscles pulling at everything and causing more inflammation. And even with that I once got stuck in bed for nearly two weeks for being an idiot and doing a 16 hour car ride in an uncomfortable seat with no lower back support. My back was Not At All HAPPY.)

    Maybe see if you can get a referral to a PT who has experience with spinal arthritis, too. I saw one (well, she was a psoriatic arthritis specialist who'd started with spines in general) when I lived in the UK and she gave me some stretching and strengthening exercises to do - but the key is that she WATCHED (and sometimes poked and prodded at me) while I did them, to make sure that the exercise was doing exactly what she wanted to do, and that I understood how to do it in that way. It was very specifically customized, and it did help a lot with general pain and stiffness levels. (Still does, when I remember to do the exercises.) (Depending on exactly what's going on, this may not be appropriate, but if you do get sent for PT, make sure they're sending you to someone who isn't basically a generalist. I'm sure they're useful for many things, but sometimes you NEED specialist knowledge.)

    As far as the mental health side of things - I pretty much agree with what's already been said.

    1. We're a bunch of random people on a forum, we can't properly diagnose you. (Plus, if the one commenter was right, and you might have PTSD, that can mimic some of the symptoms of bipolar disorders, so that might be what's going on instead. Or both. Or neither. Even those of us who are medical professionals can't, as far as I know, diagnose online. )

    2. There's growing recognition in the psych community that there's a SPECTRUM of bipolar disorders. So even if your brain chemistry is doing things that are a bit undesirable, like making you depressed or manic, it's not all or nothing. What you describe in your mom sounds pretty severe - there are also people with VERY mild bipolar disorders who basically manage it just through lifestyle changes, like a wake/sleep routine. There's a huge range, and a large and growing collection of treatments - not all of them pharmaceutical - that can be picked from to find the best combination for any given individual. You are not your mom. A diagnosis is not going to turn you into her. I promise.

    3. I know two people off the top of my head who are bipolar (one of them fairly bad, the other not so much) who have managed to apply the above mentioned combination of options to find solutions that worked for them as individuals, and who are living quite successful and overall happy lives. One is currently doing, I think, post-PhD work in something I don't understand even well enough to say 'oh, it's biology', and the other was very successful in a high-stress, high-responsibility job until she took time off to have a child. (And that was mainly because she wanted to be home for the first few years with her kid.) It really really doesn't mean "I'm going to be completely nonfunctional and need to give up all my goals."

    (Nor, for that matter, does PTSD - neither disease/disorder has a 'cure' yet, but we are getting better and better at letting people have really pretty good quality of life in spite of them.)



  19. #19
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    I have had a similar experience to yours.
    I have had joint pain and low back pain for 25 years and was told it was all in my mind. All the Medical tests came back normal so there was nothing Physically wrong with me. I needed to see a psychiatrist.
    Went to a neurologist who told me I was suffering from Depression and put me on a drug that blew me up like a balloon. I gained 60 pounds and my face and hands swelled up also. I went from a size 10 shoe to a 12 extra wide. Since then I have had severe weight problems. I have gone to several Dr.s and just get the run around. Now it is my Old Age. I have to expect arthritis at my age. I have been hurting for 25 years and it is no big deal with these men.
    One finally did give me tramadol. It works for me. But I still have the bone pain, joint pain, Muscle pain and low back pain with pinched nerves. But it is all in my head. I am so glad to know that. I am just Imagining I have chronic pain that makes my life miserable. But you know how women are. We do these things just to get attention.
    You might not have bi-polar disease. It can skip a generation and also you have only 1/2 the gene for it if your father did not have it. One of my friends changed her diet and is on a diabetic style diet and eats nothing with sugar or atificial colors or preservatives nor atrificial sweeteners. She is doing much better now.
    You are not alone. I would suggest you seach for another Doctor that doesn't have the bedside manner of a cobra.
    You just don't need that on top of all the rest of the things you have to endure. Yeah you will need a shrink after that kind of treatment. I used to take it meekly. Now I tell them off and tell them if they hate women then why are they in the business of treating women. One very hateful nurse I finally got enough of. I told her of she hated her job find another because sick people don't need her mean-ness on top of their ailment s they have to deal with.
    Yeah I am getting rather testy in my Old Age.
    Hang in there . There has to be someone somewhere that will help you.
    I finally got the attention about my pain after I told the Dr. I was taking 4 Extra Strength Tylenols at once for my pain. Then they gave me the Tramadol. It helps but not all the time.
    Sorry I wrote a novel too.
    It just sets me off when I hear of things like this.
    Kind regards,
    sadlmakr



  20. #20
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    The post above reminded me - I hate to sound like one of those 'this diet cured my EVERYTHING' people, because ye gods are they annoying (and anyway, it hasn't) but if you have any kind of inflammatory thing going on at all (which you probably do) then try cutting out high fructose corn syrup from your diet. Completely. Even in the sneaky hidden things. (Seriously, they put the crap in EVERYTHING.)

    I had noticed a while ago that post having something I knew had HFCS in it, like an American Coke, that my joint pain seemed worse (this after I moved back from the UK, where they don't really use it much at all) and so I'd kind of been avoiding it, but then recently my brother, who works for a pharma company, told me that sometimes to induce the effect of arthritis in rats they... Feed them high fructose corn syrup. So it was not all in my head!

    Anyway, it's kind of a pain to have to check, but it does seem to help my everyday pain to some degree. (It doesn't take it away by any means, but it does reduce it - days when I slip and have a Coke or something, the next day I am often in enough pain in my ankles or knees that taking a hammer to them seems like it would hurt LESS. Unfortunately the change in stopping it isn't as immediate - I think it takes a while for the inflammation levels in your body to drop.)

    Fairly minor change, compared to a lot of the diets out there for pain/inflammation, so maybe worth trying?



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