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Medical Forum / Diseases and Disorders / Lupus / April 2004

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Heart trouble & stress.

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Wesley - 08 Apr 2004 05:06 GMT
Hello Everyone,

I went to Transplant clinic on Tuesday, where it was confirmed that I
did indeed have a small droop on the right side of my face.  A small
strke?  Probably something, I forget the name, between a TIA and a
*frank* stroke.  There is some damage, but hopefully it will be
temporary.  The cranial angiogram I had this winter showed some
narrowing of vessels on the left side of my brain, which explains the
damage on the right side of my body.  The arrhythmia probably caused a
small clot to form in one of the chambers of my heart, where it was
then moved on and lodged itself in one of those narroed vessels.

The arrhythmia is still there, so I will be seeing a cardiologist at
the end of the month.  They referred me to a neurologist as well.

My transplant coordinator wants me to see a psychiatrist.  She said
that my poor tired body is just not dealing well with all the stress
that has built up.  Stress from all the illness and pain, and stress
from life, kids, moving is building up, and my body is not sending out
the normal chemicals to deal with it.  One of those chemicals is
cortisol, and I just don't make any of that on my own.  That's a
problem for the endocrinologist.  The psychiatrist would be able to
prescribe something like Xanax (sp?) to help with the rest of the
problem.  Why can't a PCP prescribe something?  Talking to someone is
not going to help.  I need action.  Lord knows, If I could have talked
my problems away, I would have done so here.
Grace Casselman - 08 Apr 2004 05:24 GMT
I'm sorry for your problems, Wes. And yeah, don't just let the system
carry you along... you've been in it long enough to stand up and say
"yeah, I'll try this, but I'm not going to do that."

G.
JDWAT@webtv.net - 08 Apr 2004 07:47 GMT
Oh Wes,

It's just so much to deal with.  I hope they can figure out why you had
this possible mini-stroke type episode & fix it soon.  I agree with you.
The doctor should be able to prescribe anything you need & that includes
Xanax.  Doctor's prescribe anti depressants all the time & at a record
pace, so don't let them bully you.  

If you think a psychiatrist may be able to teach you how to deal with
stress, that's one thing, but the fact that your body isn't producing
cortisol is _not_ a mental problem!  And don't let them tell you
otherwise, k?  

Who wouldn't have stress?!  My goodness!  Now, I don't know you well,
but I know you have a wonderful friendship with the people at your
church.  Do you ever talk to your
minister/pastor/reverend/rabbi--clergyman?!  LOL!  (yes, I'm going to
bed soon)   If not, maybe you can see if you can.  Then you can honestly
tell your doctor that you have your own counselor, who sees to all of
your stress-related needs.  He's there at anytime night or day, weekends
or holidays, for one _60_ minute hour or 4, whichever you need.  But he
can't write you a prescription, so they can do it themselves if they
want you on Xanax.

If worse comes to worse, maybe you could do one appt & tell the
psychiatrist your needs are being met.  Be sure they are though, okay.
There's truly no shame in it, Wes.  We're on your side either way &
maybe there's things you can say to the doctor that you wouldn't say to
us or anyone else, even Kip--for fear of upsetting her.    

Just don't let them _tell_ you that you have to do it.  They work for
you & it's your decision to make.  

Big Hugs & Prayers Too,
Maggie
JDWAT@webtv.net - 08 Apr 2004 19:31 GMT
You know....the more I think about this, the more I believe that your
stress problems are coming more from your doctors & less from your
illness.  The fact that they refuse to schedule one lousy golf game per
quarter with each other so that they can monitor your needs just rubs me
royally!

You didn't have to go through the stress of feeling so rotten because
one doctor refused you the cortisol test.  Nor did you have to go
through the stress of excruciating pain because one doc refused to take
you off of the meds that was causing the pancreatitis!  

Maybe it's time to let them know just where your stress is coming from &
maybe a psychiatrist can help in this area.  S/he may just be able to
_do_ something about their incompetence.  Maybe it'll turn out to be one
of the best things to ever happen.  If you go, you can spend the entire
hour telling them everything that your doctors have put you through &
then tell them that your first session should be billed to them! : )

Hugs,
Maggie
BJ - 08 Apr 2004 22:03 GMT
Hi Wes,
I have to agree with Maggie. It seems to me that you have been given the run
around by all of these doctors. One says something. Another says something
else. They don't seem to be following through as they should. Talk about
stress! I have always found that dealing with doctors is one of the most
difficult things for me. A family doctor could certainly prescribe an
antidepressant. You don't need to add another doc into the mix, unless that
is what you want. I hope things will start to come together for you soon. I
think this is too much for anyone.
Hugs,
BJ

> You know....the more I think about this, the more I believe that your
> stress problems are coming more from your doctors & less from your
[quoted text clipped - 16 lines]
> Hugs,
> Maggie
Wesley - 09 Apr 2004 04:45 GMT
Thank you Maggie, and everyone.  This is a great group of people!  The
most important person in my life, my wife Kip, has told me that I do
not need a psychiatrist.  She has been with me for 25 years now, and
she has seen me depressed, such as back in 1996, just after Gabi was
born, when my retina detached and I lost my vision for 9 months, as
well as my business.  That was prozac time, and it did help.  And
there have been times when I have had panic attacks, such as when I
started dialysis for the first time in 1984, and the patient next to
me crashed and died.  Tough times, I have seen them, and Kip has been
right there with me.

However, this is not one of those times.  It is tough, yes, but I am
not having panic attacks.  I am not hyperventilating.  The arrhythmia
hits at any time.  For instance, we just came home from Home Depot
where we shopped for light fixtures and wall paper.  We went out to
eat first, and we had a great time.  We were looking at wallpaper for
my son Liam, and having a great, relaxing time, when all of a sudden
they hit.  I became dizzy, and they took my breath away.  My cheek
began to "pull", for lack of a better term, my arm and leg began to
tingle, and I felt horrible.  After a few minutes, it was gone.  My
heart rhythm returned to normal.  My cheek was still numb, but the
pulling sensation was gone.  I was under absolutely no stress at that
time.

While in transplant clinic on Tuesday, while the surgeon was standing
there feeling my pulse for what seemed like half an hour, and the
nephrologist was listening to my heart with his stethascope, neither
of them mentioned panic attacks or depression.  They only let me out
of there because I promised to walk over to Cardiology and make an
appointment.  They wanted me to get one for this week, but the first
opening for the chief of electrophysiology was for the 27th.  You see,
there's the problem.  There's the stress!  If they wanted me to be
seen this week, why in the heck didn't they call over to Cardiology
themselves and use whatever pull they have?  My only other option, if
I want to be seen more quickly, is to go back to the ER.  No thanks.

No. No psychiatrist for me, not right now.  I'm not saying never,
though.  If the cardiologist, or my new PCP (takes over May 1st)
thinks I need Xanax, then I will take it.  One good thing.  The
nephrologist changed my blood pressure meds around, and the .2 mg of
clonidine three times a day has really helped to lessen the number of
attacks of arrythmia, as well as the duration of each attack.

Thank you everyone.  God bless you.  You are right, Bruce, my dear
friend.  We do need to talk sometimes, and this is such a wonderful
place to unload.

> You know....the more I think about this, the more I believe that your
> stress problems are coming more from your doctors & less from your
[quoted text clipped - 16 lines]
> Hugs,
> Maggie
BJ - 09 Apr 2004 16:56 GMT
Hi Wes,
I am sure Kip would know if you were depressed. Sometimes the patient can't
see if themselves, but those around them can. I am glad you have decided not
to see a psychiatrist now. I think, after reading your posts, that your
problems are physically based. Things will improve once all that is sorted
out. Besides, you have a bunch of amateur shrinks right here, if you need to
talk. <g> God bless you too. Happy Easter to you and your family.
BJ-Sk. Canada
> Thank you Maggie, and everyone.  This is a great group of people!  The
> most important person in my life, my wife Kip, has told me that I do
[quoted text clipped - 63 lines]
> > Hugs,
> > Maggie
JDWAT@webtv.net - 09 Apr 2004 18:02 GMT
I don't blame you a bit, Wes.  I really think that most of your stress
comes straight from those that have vowed to never harm you.  Alls that
doc had to do was make a phone call & you could've seen the cardiologist
right then & there. They could've given you a monitor & by the next
appt. they'd have a good idea as to what was wrong.

I really, really, really want you to call that doc up & tell them to get
you an appt pronto.  They do have the power & those are some scarey
episodes your having, my friend.  Please consider calling them back &
seeing if they can get you in before the 27th.  I know you must be so
sick of sitting in the waiting rooms & seeing one doc after
another...not to mention all the tests.  If you decide to keep the 27th
appt, please take it easy.  As easy as you possibly can.  This means
riding one of those electric buggy's at Home Depot, but hey, the kids
would love a ride on one! : )

Hugs,
Maggie
janers - 09 Apr 2004 21:33 GMT
Gee Wes, I am a day late and dollar short.

Don't you dare let them flip your around, yet again.

I suggest, calling that surgeon and or nephrologist.  Ok, tell them that
the cardio unit could NOT get you in there asap and you need them to
intervene NOW.

It could be a number of things going on, and with all you had GOING on,
believe me, It would not surprise me in the least, that maybe the
medications are doing this and or small clots  might be the culprit.  It is
dang odd that the surgeon or who ever saw you, didn't advise you that YOU
were GOING now, to the cardiac area.  Now those "TIA" can be caused by a
number of things and sometimes, it is very difficult to determine what.
Since the angio said what it did, then that might just tell it all.
Also with your problems with other things, and medications, that might of
done it.
I think you definately need to see a cardiologist just to be safe. Heck the
neuro doc should of said something right then and there.
If they feel a psychiatrist is needed, then maybe they need to see one them
selves.  My Lord man, with all that you have been through and still keep
your sanity is amazing in itself.
Please tell them to ......  ..   :)  haha  any hooo

Hang in there.  Let's just hope something can be done to retify the
problems you are having. Oh and the numbness gone, just goes to show it
could of been a spasm of the artery as well, or clot that floated.
Please push this and get back to us.
Remember we are there for you anytime, and any where

hugs
janers
J - 10 Apr 2004 11:03 GMT
> <snip>
> While in transplant clinic on Tuesday, while the surgeon was standing
[quoted text clipped - 15 lines]
> clonidine three times a day has really helped to lessen the number of
> attacks of arrythmia, as well as the duration of each attack.

Hi Wes, I do wish they'd get started.
If they think there's clots there may be numerous imaging tests (heart area and brain) and
then there's a procedure where they go up the vein in the leg to the heart. (I forget the name
at the moment)
I sure wish they'd called over as you mention.
I'm glad the clonidine is helping somewhat.
Zinn wanted to send a message that if you do go on Xanax, her personal experience is that the
brand name is better than the generic.

Hugs to you and Kip and Gabi and Liam.
J
Gretchen - 08 Apr 2004 11:15 GMT
Wes,
You have weathered more troubles than anyone should have to bear.  I
am so sorry to hear about the latest news, but hopeful that you will
make a complete recovery.  It's amazing what they can do for strokes
(or whatever it is) these days.

I don't think a psychiatrist is going to be able to raise your
cortisol levels with anti-anxiety meds. I think most anti-depressants
raise seritonin levels, not cortisol levels.  However, they may have
suggested a psychiatrist because they are much more knowledgable about
those meds than your primary care doc.  In fact I've seen stuff in the
news about how primary care docs are handing out too many
antidepressants and antianxiety meds without really evaluating the
risks involved.  I do think counseling and meds have their place in
helping folks with chronic, debilitating illnesses cope - and it's not
a reflection on your personal strength or saying that it's all in your
head.  You do have a incredible amount to deal with, Wes.

There are new warnings being released by the FDA about most of the
commonly used antidepressants being linked to increase suicidal
ideation.  My daughter experienced that on Zoloft.  She sees a
psychiatrist once a month, not for talk therapy, but to adjust her
meds.  She sees a counselor every week to help her deal with her
depression and anxiety and helps her see how she can change her
thought processes to better cope with life. She is 14 and has a
lifethreatening allergy to peanuts, and has to deal with the
possibility of death on a daily basis. She reacts even to skin
contact, so it's not just a matter of watching what she eats.  It's
tough enough just being in high school, without the other issues.

One more personal experience, then I'll shut up.  My brother got
addicted to Xanax and it was extremely hard for him to get off of it.
He was given Xanax for anxiety by a primary care physician who didn't
warn him about the risks or follow up.

Despite the stigma of seeing a psychiatrist, they do have their place
and most of their patients are not psychotic, suicidal, homicidal or
otherwise "crazy."  It's hard not to have a gut reaction to a
recommendation that you see a psychiatrist. But, they are specialists,
just like all your other doctors.  If you think meds would help you, a
psychiatrist might be the best choice.  They can also evaluate
cognitive function if you think you have may have lost some function
with your stroke.

Whew!  I guess I better go back to bed - the alarm goes off in an
hour.  I do hope you recover quickly and come to a decision that will
help you in the best possible way, Wes.

Gretchen
J - 08 Apr 2004 12:20 GMT
> Hello Everyone,
>
[quoted text clipped - 22 lines]
> not going to help.  I need action.  Lord knows, If I could have talked
> my problems away, I would have done so here.

Hi Wes, You were right about the stroke !
I see what you mean about starting the Xanax sooner rather than later.
Surely one of the doctors can prescribe a low dose while you're waiting
for an appointment with psych.
And what's (s)he going to know about your thyroid, hypothalmus, kidney,
adrenal,, goodness me !
Just thinking about all these specialists makes ME feel stressed.

I take a mild benzo (Clonazepam - for restless leg syndrome) - I forget
the dose now) and it makes me sleepy (usually)

Here's Xanax http://www.rxlist.com/cgi/generic/alpraz_ad.htm ( I don't
know why they picked that one, but Z has been on it for some time, but she
doesn't have your complications) nor the demands of kids, moving etc.

How's the moving going? I sure wish there was some way to help you.
( ( ( Wes ) ) )
J
Bruce On. - 08 Apr 2004 16:16 GMT
male hugs Wes

Maggie covered all better than I could.
All I can add is my own time with psy.time and what did help.
Learning to be aware of breathing is a big deal for your mind and bod. You
can learn quickly the signs of not breathing which elevate stress and heart
rate and in turn some bod chemistry.   How to respond will help right away .
From listening to you over time , medical is 99% you , but Wes we talk here
for it helps to not feel alone and venting is a stress reliever.
Bruce On.

> Hello Everyone,
>
[quoted text clipped - 22 lines]
> not going to help.  I need action.  Lord knows, If I could have talked
> my problems away, I would have done so here.
RhondaM - 08 Apr 2004 17:50 GMT
(((((((((((Wes)))))))))
Man, you are being dealt a handful. I am so sorry you are going through so
much.
I am not sure what else to say,  all I have to offer is a hug and
encouragement.
Keep in close contact with those drs and listen to what they say. Most
cardiologist know what they are doing. Maybe your cardiologist can give you
the xanax. The one I worked for did all the time to his patients who were
stressed.

> Hello Everyone,
>
[quoted text clipped - 22 lines]
> not going to help.  I need action.  Lord knows, If I could have talked
> my problems away, I would have done so here.
Cindy - 09 Apr 2004 02:48 GMT
Some times Wes, I think that we are stressed out when we don't even realize
it. Later we can look back on those times of our lives and wonder how we
ever made it through.
I think that the psychiatrist will understand more how the medications help
us and sometimes just give you another perspective. I saw one for the first
time on Monday.
I am not sure how I feel about it. I have been seeing a counselor since
January and I have to say that I enjoy my visits with him and I think they
are helping me...
Take it one day at a time.
Hugs Cindy
Beverley - 09 Apr 2004 04:41 GMT
OH, NO! Not more - not fair!
(((HUGS)))
Bev

> Hello Everyone,
>
[quoted text clipped - 22 lines]
> not going to help.  I need action.  Lord knows, If I could have talked
> my problems away, I would have done so here.
 
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