[chaotic13]

Ever have one of those days where you know you are going to end up being a jackass and despite you best efforts not to be... you still end up being one anyway?

This week Sunrise posted about her experience with her new PNP. I have been wining over the past year about the quality of my ADHD treatment. So today I had a follow-up with my family physician. I've only been with this guy for 8 months, but he is an excellent GP and is genuinely interested in serving his patients. When I asked about being evaluated for possible ADHD, he did not feel he had the appropriate background to treat me so he referred me to a neurologist in his practice. Even though he referred me he still inquires about how my treatment is going, even politely asks me how therapy is going and if there is anything else that he might be able to help me with. All around nice competent caring doctor.

During today's appointment he asks.. "So how are your ADHD symptoms, is the medication still working for you, do you have any concerns?" My response: "OK I guess, It's not a cure all, Nope I'm doing well."


Here is another thing I did today during the appointment. I've lost a lot of weight this year. My H is getting on me because he says I am not eating and exercising too much. I know this is not true. I am eating appropriately and I am not over doing it with the exercise. My weight loss has been very gradual and deliberate. He is just using this as another one of his psychological attacks on me. Even though I am aware of what he is doing my head starts to crank out doubts... Am I doing too much, do I really have ADHD or am I just wanting to misuse a stimulant, ????? When I get to the doctors office, the nurse takes me back to the room and stops briefly at the scale, then changes her mind, leads me past the scale saying.. "You don't need to do that." I walked right by that scale knowing damn well having my GP assess and render my weight loss acceptable would have made me feel more confident about how I am progressing. GP: "How is your exercising and weight loss going?" Me: "Fine, slow and steady."

I have so many questions yet when given the opportunity to ask them and get answers, I don’t. Instead I remain aloof, withhold information, dismiss my concerns and act like everything is great. I don't get it.

Why am I still a jackass? I'm only hurting myself. It is not because I am unaware. Its not because I don't TRUST him. I simply don't open my mouth and say what is bothering me.

[Perna]

I was a little confused about what is bothering you!

If it were me, it would be your husband's comments? But it sounds like you have doubts about yourself? One moment you say you're doing things well but then you say the doctor's confirmation would make you feel better.

I'm losing weight deliberately to "show" my doctor and if the nurse tries to pass the scale, I'm making her stop :-) It sounds like you're trying to hide something from yourself or others but not take responsibility for it? If you close your eyes no one will see?

[chaotic13]

I don't know what's bothering me either. The weight issue is a problem, but it not a health problem. When I went to that appointment, I planned on getting on the scale and having an independent 3rd party support what I've been saying. Then the next time my H starts in on me I could simply say, "I know what I am doing, my doctor and I have discussed it, leave me alone about it." I could have easily said to the nurse, "No, I think I'd like to weigh in because I want to ask the doctor what he thinks about my weight loss." But, I didn't. Its the same thing with the ADHD medication. There was no evaluation done, the neurologist just basically asked me a few questions and gave me an Rx. My second appointment with him he recommended that I double my dose which would have put me well above what is recommended in the literature. I declined to follow his instructions and stayed within the recommended dosage. I don't really trust the neurologist's judgment, I just go to him for the Rx. It helps me but I have no idea if I really have ADHD or if I am just getting off on the stimulant. Again, I wanted to raise this issue with my GP, but I didn't! When it came to the actual conversation, I didn't want to draw attention to this issue. I didn't want to be mentally ill. I just wanted to hear that I was fit as a fiddle and doing great. I'M bothering me.

[Perna]

Yeah, and one thing with the ADHD stimulants, one of the side effects is weight loss so you could have a combo thing going there that might not be a good idea?

I think there's always a lot going on when we see doctors/therapists and it's hard to get it straight and say what we want. That's too bad about the neurologist not being very good, I'd maybe get another appointment with the GP and discuss the neurologist and your weight loss and everything? You could use the neurologist's lackadaisical style as the reasons you want to talk to the GP and then maybe discuss your weight loss, whether you're really ADHD and should be taking the meds, etc. and what he thinks you should do?

[sunrise]

</font><blockquote><div id="quote"><font class="small">Quote:</font>
chaotic13 said:
So today I had a follow-up with my family physician.

</div></font></blockquote><font class="post">What was this a follow-up to? Was it a follow up to discuss the status of your ADHD treatment? If so, your doc must have thought it quite strange that you scheduled an appointment only to say, "OK I guess, It's not a cure all, Nope I'm doing well." I think if I scheduled an appointment for a specific reason and that's all I had to say, my doc would think it was kind of strange. If this appointment wasn't to follow up on ADHD but some other reason (an infection or something), then I can see how it would have been hard to talk at length about the ADHD topic. I find when I schedule a doctor's appointment, they want to know what it is for, and then they budget the time accordingly. It is hard to try to pack too many topics into one appointment.

I suggest you make an appointment specifically to discuss your ADHD treatment and progress. Then there will be no "escaping" the topic when you meet with your doc. As part of the ADHD topic, I would think the weight issue would naturally arise.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
Its the same thing with the ADHD medication. There was no evaluation done, the neurologist just basically asked me a few questions and gave me an Rx....

I have no idea if I really have ADHD

</div></font></blockquote><font class="post">chaotic, I think I remember once you said you had been prescribed an anti-depressant. What doctor did that prescribing? Was it your GP, a pdoc, who? I'm wondering if you can see an expert for your mental health prescribing? It doesn't sound to me like the neurologist is an expert; maybe he only knows ADHD and not other mental issues? I wonder if you were very convinced that you have one specific problem--ADHD--and marched into the doc's office, armed with your journal articles and online assessments, and said "I need ADHD treatment" and then no other causes were really considered? I mention that because of my own recent experience with the psychiatric nurse practitioner who listened to my symptoms but is finding her way to her own diagnosis. She is not relying on me for evaluation and diagnosis. She has told me ADHD-like symptoms can result from anxiety or depression too. Did you ever have a full work-up, based on your symptoms, from a pdoc or a PNP?

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I have so many questions yet when given the opportunity to ask them and get answers, I don’t.

</div></font></blockquote><font class="post">Could your therapist help with this? Could she consult with your doctor and share your and her concerns? Then the "telling" would be out of your hands and she would make sure to get the job done. This could be a BIG help for you.

</font><blockquote><div id="quote"><font class="small">Quote:</font>
I didn't want to be mentally ill.

</div></font></blockquote><font class="post">chaotic, maybe you need to reframe this. I don't consider myself mentally ill. I have been severely depressed but am not anymore. I might still be depressed to a lesser extent--I don't know. I might have Anxiety. I might have ADHD. But I don't consider myself to be mentally ill. I know that there is a huge range in human variation and there is no one "right" way to be. I also know that depression is an adaptive response to stress and so my reactions to life circumstances have been completely normal and even selected for throughout millions of years of evolution. Even without what stress does to our biochemistry, there is a huge range in the natural "set" points in our levels and metabolism of neurotransmitters, etc. If a person has low serotonin, well that's a natural way to be, not an illness. They can take some meds to boost their serotonin to feel better, but it doesn't mean the person was necessarily mentally ill. He's taking a drug to alter his setpoint a bit, within the range of natural human variation. I guess my bottom line is, you don't need to be ashamed about your biochemistry!!! It's natural and within the range of human variation and perhaps due to your marriage situation, could be "worsened" by high stress. (And by saying this I'm not trying to minimize depression or other conditions we seek help with, but empower. I know firsthand how bad the symptoms are.)

[chaotic13]

Perna and Sunrise,
Thank you both for your responses. Both responses had key things that helped me start to clear the noise in my head. I just seem to let comments get to me and then my mind gets so tangled up I can’t think clearly. It’s like a computer virus that infects my thinking and sends me into cognitive overload and paranoia. I don’t have a problem with my weight loss or medication. My weight gain over the past few years was indicative of serious problems. I’m addressing those problems and my weight is simply returning to where it belongs. It is not a symptom of an illness or the result of some addiction or use of a mild stimulant. It is a sign of returning health.
I do however have a continuing problem with not taking responsibility for my own health care and communicating what I want. I withhold and hide things both from myself and my healthcare providers. I’m not sure why I behave this way but it clearly impedes my care, makes me feel guilty, and leaves me vulnerable to doubt. Sunrise, your suggestion that I ask my T to facilitate communication with my neurologist, sounds logical. However, the thought of my T exchanging information with my doctors terrifies me. I know this fear is irrational but it is deep and intense. The root of it is unclear to me at this point. Although my brain is settling down, I know I should probably talk about this in my next therapy session. I’ve put this on my T session agenda for this week.

[chaotic13]

My recent interaction with my GP (or lack thereof) along with my continuing concerns over my ADHD diagnosis and treatment resulted in me making the decision take a step back and re-assess my situation. After my appointment on Friday I decided it was a good time to discontinue taking Adderall and see how I’m really doing. I see my T this week and have set this issue on our agenda. I’m off work at the moment, have no pressing deadlines, and with the holiday was planning on just chilling out around the house with family and friends. Well the first two days off this medication went really well. I felt a little sluggish the first day, and yesterday I was busy hosting a small cookout and didn’t notice much of a change being off the medication. So since the Adderall is supposed to be a relatively short acting drug I figured most of the withdraw effects would have occurred by now. NOT! Today I was hit pretty hard and am feeling the effects of being off the medication. We attended a parade today and I found myself a totally overwhelmed at one point with all the noise, all the people, and my 11 year old is hanging on me trying to get my attention. I started to get really agitated and hyper-sensitive I had to leave. So, if you were at a parade today and your friend suddenly got on her broom and flew away, cut her some slack...Iit might have been me suffering from mild withdraw. LOL

[sunrise]

(((((chaotic)))))

I'm glad you have a plan.

Enjoy the rest of the holiday.

[chaotic13]

Thank you Sunrise.

I did have a nice holiday. I hope yours was enjoyable too. Once I recognized that I was getting agitated at the parade, I simply left and found a quiet place to chill out and settle myself. Stopping the medication hasn't been too problematic so far. I'll see how the rest of the week goes with trying to work on a few long term projects.

Regarding the weight loss concern. I haven't been eating like a pig either. I think the hype about Adderall and other stimulants and weight loss, is just that- hype. The Adderall when I first started taking it suppressed my appetite somewhat. On the few days that I did forget to eat, I later regretted it. For me the dizziness and stomach cramps that hit me when I forget to eat are hard to ignore.