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    Psychiatrist for FM?
    Krissy6 posted:
    My rheumatologist diagnosed me with FM several years ago. It was vry mild and I didn't think much about it. Then I went through some mild and severe stressful events and it flared up to the point where I couldn't work. The stess is gone but the flare isn't. My GP referred me to a pain specialist (PS) in the same practice group and the PS has bounced me all over the palce with different meds. I know that this is necessary sometimes to see what works and what doesn't, but after 10 months of this, I'm wondering what to do next. I applied for SSI and because I mentioned depression in my claim, they insisted that I go to a psychiatris for evaluation. Did that and she says I should be treated by a psychiatrist. Since depression and FM both have brain involvement, I wonder if this is true? My rheumy, GP and PS all say that its not necessary. Are any of you seeing a psych. for FM treatment? Thanks
    purplediane responded:
    i've been seeing psychs for years. always thought i just had depression but now wonder how long i had fibro too as i had many symptoms and thought them due to depression, maybe was the other way around. i currently see a psych and he manages my meds for depression as well as fibro, although there aren't really any good fibro meds i've found so far. i have applied for ssi in the past and am again, for depression. fibro and depression go together i think. sometimes you feel so awful in your body you can't feel good in your head. if you want any chance of getting ssi for depression, and it's hard and takes a long time, you absolutely must be seeing a psych, and one that believes that working is too much for you. you need him on your side. his medical records and statements are what the ssi doctors will use to determine your disability. and having someone to talk to about everything is not a bad thing.
    bette_kaffitz responded:

    Most of the fibro meds are antidepressants, antiseizures, muscle relaxants, and the like. They are pretty powerful compounds. Unfortunately, most of us need more than one medication to do the trick. Mixing these psychotropic (works on the mind) drugs can be tricky at times. Hence the referral to a psychiatrist. Those guys and girls prescribe that type of drug all the time. They know the ins and outs of the drugs and their possibly dangerous interactions.

    Some rheumys or GP's feel comfortable doing this type of prescribing. Some don't.

    Several years ago, my pain doctor asked me to see a psychiatrist because my meds were just not working well together. I mentioned to the shrink that I had been gaining a lot of weight on those meds. Turns out, one of the meds (that he didn't think I needed anyway) was notorious for packing on the pounds.

    Most of us get depressed with our fibro. For some of us this depression is a major component of our illness. If you feel that your mood is driving your pain--as opposed to your pain driving your mood--then you SHOULD see the psychiatrist.

    Hope this helps.

    Krissy6 replied to bette_kaffitz's response:
    Thanks to Bette and purplediane for your prompt responses. The SSI doc recommended a doc, but she won't see me without a referral. I'll talk to my PS when I see him on Friday.
    dollbug responded:
    Hello Krissy and welcome. MiMi in NC...I think we FMers are all different and of course the doctors who treat us are different as well. I know that when I first got sick my doctor was treating me for depression (only)....the bad part of my treatment is the fact that I was trying different kinds of medicine but was NOT getting any better. At the time I did not realize that perhaps I did have something other than what the doctor thought I had. Over time though this was beginning to get very clear to me....since nothing was improving how I felt. That is when I decided to do my own research. Computers are wonderful tools for those of us who want to find out more about what is going on with us.

    As I did my research things were pointing to parathyroid the time I did NOT even know what the word meant. But the more I read about it the more I understood it and I truly thought that I just might have this. So I spoke to my doctor about what I thought. He disagreed with me and continued to say that I was *just depressed*. Well, for a while I went along with what he wanted me to do. Finally, I decided one day that I was *sick and tired* of not getting any better.

    I went in and actually spoke to him again about my health. I knew at the time that I was getting sicker instead of getting better. So I then brought up the *parathyroid problem again. Again he assured me that I did NOT have this. So I made a point to him that I wanted him to PROVE to me that I did not have it. I knew that there was a *scan* that would or should show if indeed it was a problem. The doctor again tried to talk me out of this, as he said it was a really *expensive scan*. I then told him that I wanted him to order it so I would know for sure.

    Well, this was the first test that I ever had where my doctor did NOT contact me with the *results* of the scan. His office nurse called to tell me that he was making me an appointment with a surgeon. Now here is the interesting part about what happened next. When I went in to speak to the surgeon about what was going on, he reviewed my medical records and decided that he thought my health problems were due to low Vitamin D. Well, this did NOT sit well with me either. I looked at this man and told him that I was really sick and needed help and that IF he could NOT help me then he needed to point me in the direction of someone who could.

    He then leaned back in his chair and scratched his head and I could tell he was *thinking*. He then said that he would like to be sure and run an *ultrasound* on me, if I was willing. I told him whatever it took. And he ran it in his office that day.

    I think he was as shocked as anyone about the results. I did indeed have a parathyroid issue which needed to be addressed as soon as possible. My surgery was scheduled and the bad gland was removed. He told me that it was actually larger than he expected it to be and that on the day of my surgery my blood calcium level was almost 10 times what is considered normal. It was 88. Normal is 9.2. He told me that I could have had a heart attack or a stroke.

    So as you can see there are doctors who sometimes do NOT always know what is going on with us.

    I had multiple health issues at the time which might have been a *reason* that I was a hard person to figure out.

    I do want to say to you though....I do NOT take medicines now. I do have a muscle relaxer to take as needed. But I have learn how to *control my FM pain by taking vitamins and supplements and doing other things as well*. I never found any medications which truly made a difference in how I felt.

    It took me a long time before I figured out exactly what I needed. I also have chronic fatigue which I battle almost every day. I have found nothing to help and the doctors have told me there is nothing on the market that will make a difference.

    Hang in there and good luck.


    franr responded:
    Hi Krissy
    Sometimes a psychartrist is not only for depression problems they can be used for medication management of all these different drugs that most of us are take .These MD's are trained to mix and match medications,And they know what drugs interact with each other and what meds we can take or not take,So a psychartrist is not a bad idea, Actually my psychartrist will not put me on Savella,or lyrica because of the side effects with hypertension which I have.So they know what chemical cominations to mix, Hope this helps. Fran
    bette_kaffitz replied to dollbug's response:

    My sister's DH had his parathyroid removed too. He has to consume some calcium every day. They discovered the problem when BIL had repeated kidney stones. Ouch!

    (He's the same BIL who had the kidney transplant (donated by DS), a second transplant, and finally a kidney and liver transplant that corrected the reason he had kidney problems in the first place. The good news is he's doing great. (4 of his siblings had the same liver problem and died from it!)

    Sometimes I wonder what God was thinking when he put us together. It's one of His miracles that things work out as well as they do as often as they do.

    dollbug replied to bette_kaffitz's response:
    Hello Bette. I also had to consume calcium for a while, right after surgery. Something about the surgery and calcium level causes was much more than I would have normally taken. Weird.

    Interesting about the kidney stones as well. I also have them in both kidneys. (even after my surgery, which was several years ago) doctor ever told me there was a connection between stones and parathyroid.

    I think it is odd just how much we can learn from what others share.

    Take care.


    bette_kaffitz replied to dollbug's response:

    The parathyroid governs how we use several substances including calcium and oxalates (found in foods like spinach and many others. Without the parathyroid, calcium cannot get into the blood--and then throughout the body where it is needed for many cellular tasks.

    Both calcium and oxalates can build up in the kidneys causing stones and other problems. I'm not sure about calcium, but oxalates can damage both the kidneys and liver. Hence the B-in-L's kidney/liver transplant. His problem was genetic and most often found in northern European populations--like his folks' Germany.

    It might be worthwhile to have your oxalate levels checked next time you are due for a routine blood test. Just a thought.


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