Falling out during session.

[FauxLiz]

@Deanna's Gap you are right that a therapist doesn't over-ride a doctor, however I don't I see my doctor twice a week like I do my therapist and that could sway my doctor to consider his opinion and act upon it. However, he has not breached any contract. He didn't build his practice by riding my issues for three plus years either. Yes, he has built his practice while I have been seeing him but it is not as if he overcharged me, overcharged my insurance or took advantage of me in any way. There is not a legal claim that could be filed. As for why I have continued to see him, because he has helped me, I trust him (and that is a rarity), because he listens to what I am saying and helps me to see the cognitive distortions in my beliefs and I am better for the work that we have done in those three years than I was in the three years I worked with my previous therapist before moving 800 miles to where I am now and that therapist is a known expert in ptsd, routinely testifies before Congress on the issue, splits his time between the VA and private practice solely focused on ptsd. Yes my current t and I have our challenges and right now is one of them. Yes I admit that my trust issues can be frustrating including not trusting what he would say to my doctor but I am not going to throw away all this hard work two weeks before I go inpatient when like it or not I don't know if this rift we are having currently is because of my ptsd or real issues.

 

[FauxLiz]

@scout86 To answer your questions. Yes he has expressed concern about that one medication. He has been clear that he believes having access to a narcotic with my history of self-medicating with alcohol, cutting, and other self-injury coping strategies that there is too much potential for abuse with my having access to this medication. He hasn't specifically said that if he spoke to my doctor that he would attempt to convince the doctor to take me off the meds but he has indicated that in several ways including asking for me to sign consent in conjunction with our discussions around my use of the meds. Lastly, does he know the severity of my migraines. I can tell him, I can cancel appointments because I can't go out but I will be honest even my own doctors have a difficult time understanding the severity until they see it in action. There are too many indicators that I am not exaggerating including cold sweats, significantly increased blood pressure and involuntary physical reactions including placing pressure on the eye socket and neck when asleep but still experiencing pain.

 

[EveHarrington]

I think this is an issue of you not being able to set and enforce boundaries. It’s not a therapist issue.

 

[scout86]

He hasn't specifically said that if he spoke to my doctor that he would attempt to convince the doctor to take me off the meds but he has indicated that in several ways including asking for me to sign consent in conjunction with our discussions around my use of the meds.

I can kind of see where both of you are coming from on this. So, basically, he might be concerned that you could kill yourself? (Which, it seems to me, any of us could, any time, in an assortment of ways...) And if THAT is what he's concerned about, maybe there's a way to reassure him somehow? You might ask him what it would take to make him comfortable & see what he says.

 

[whiteraven]

@anonymous the medication is a nasal spray called Stadol (butorphanol tartrate). It...

Just wanted to chime in to say that I also have/had a Chiari I Malformation and chronic migraine. I actually had a suboccipital decompression to correct the Chiari in 2006, which got rid of the explosive headaches I was having with it, but I do still have chronic migraines (along with other chronic pain).

I understand and agree with your concerns. It's difficult when you've been on meds that work - and they are the ONLY meds that work - (whether they are narcotics or not, but esp. when they are narcotics) feeling comfortable or safe sharing that info with other doctors. Then, when one comes along and indicates he thinks you should stop taking them (for whatever reason), it can be terrifying.

I'm sorry you are dealing with this. I wish I had some advice. I've been there, but mostly have just had to drag myself through it each time.

 

[FauxLiz]

@EveHarrington i have never thought of this as a boundary struggle but that makes sense there is significant transference in our interactions that make it difficult to set and keep my own boundaries.

@scout86 yes he is concerned that I could use this medication to kill myself but at some point he needs to understand that my need for the med to do it’s job when necessary is more important than I would risk with a suicide attempt.

@whiteraven I had the posterior decompression in 2014. However I consider it a failure as I did not get any relief the surgeon swears it was a beautiful textbook surgery and there is nothing more to do so now I just live with life post-op being the same as pre-op except everyone tells me I am supposed to be fixed.

 

[lostforgottensoul]

He has been clear that he believes having access to a narcotic with my history of self-medicating with alcohol, cutting, and other self-injury coping strategies that there is too much potential for abuse with my having access to this medication.

So, basically, he might be concerned that you could kill yourself?

It sounds like he maybe concerned about addiction/abuse of a narcotic to cope with mental/trauma related issues which is different then just trying to kill yourself though that's part of it as well.

I think this is an issue of you not being able to set and enforce boundaries.

Agreed. Personally I was clear to each doctor what the other doctor was for and that it was a non-negoatiable thing. I was seeing a pain dr/therapist/MD no matter what because of chronic pain/mental & trauma reasons/medical reasons and the meds I take are to help me stand up & function just a tiny bit (like being able to take a shower. Walk a small bit, etc. Its not like I can do much physically)/bringing emotions to a more normal level, helping the extreme anxiety (though I don't tell my other doctors much about why a see a therapist, only that I do and that itself isn't negotiatiable)/to help an array of medical issues.

Basically they know that I see the other and what the other is for, what meds the other is giving me and a bit about why but none of it is up for debate. Thats been clear to each from the get go. If they didn't like it then I can move on and find another Dr/therapist that would be ok with it.

yes he is concerned that I could use this medication to kill myself [or possibly could become addicted to it and use it as a coping mechisim because of my past with alcohol] but at some point he needs to understand that my need for the med to do it’s job when necessary is more important than I would risk with a suicide attempt [or possibility of becoming addicted].

I added in the brackets as I think that that's part of it. But take this into session with you and tell him exactly that. That would be setting a boundry. You are 100% correct in my opinion but I think he needs to be told that and I think its important for you to tell him that. Its basically standing up for yourself and your right to be on medication that helps a medical issue, even with your past with alcohol. Just because I am a (now clean) addict does not mean I cannot be or shouldn't be on pain meds so as long as I am not abusing said pain meds. Just my opinion on the matter.

 

[anonymous]

This is a big one, I have to be anonymous here (i think i always have on this subject?) because I gave certain people access to my posts here but this is not for anyone else.

I had been AA for over 20 years when I went back on meds (self-meds). My whole drinking drugging experience (I now know) was about self-medication only. When I got those painkillers a miracle happened in my life. The pain was gone. I read in the literature that PTSD CSA survivors are in constant pain and then I knew for sure what that meant for me and I also knew I would probably always be on some kind of drug. Drugs work for me. It has a downside. I know what I'm like. I also know what I have to do for me and no therapist or doctor in their right mind is going to tell anyone with mental health issues they should be medicating themselves with drugs or alcohol. They will, however, put you on the psych meds that in my opinion make you want to kill yourself or have other equally unpleasant side effects.

So, I don't mention it to avoid these stupid arguments. I know how to sound my professionals out on the subject and it's just better for the most part not to mention it. If you are like me, you are going to do it anyway. So I use a little pot and I use a little alcohol and I keep it at a level I can manage and that's it. When the doctor asks me if I drink I say no. When the doctor asks me if I use drugs I say no. That way, I don't have to listen to them. They work for me after all. It is a boundary issue I think as was mentioned and to the credit of one of my former therapists, when I told him I was going to start drinking again he said "you're a big girl, I just don't want to find you in the gutter with a bottle hanging out of your mouth." He hasn't and I'm not and I'm happy with the way things are going. My anxiety is manageable and without the self-medication, I doubt I'd be able to leave the house. Is it ideal? No, but what is?

 

[whiteraven]

@whiteraven I had the posterior decompression in 2014. However I consider it a failure as I did not get any relief the surgeon swears it was a beautiful textbook surgery and there is nothing more to do so now I just live with life post-op being the same as pre-op except everyone tells me I am supposed to be fixed.

I'm really sorry to hear that. Sounds like you've had much the same experience with doctors that I have. If I may ask, prior to the surgery, what symptoms were you having? I was having neck pain (which has continued, but I also have degenerative disc disease so it is likely caused by that) and tussive headaches. I couldn't do anything strenuous (like picking up anything heavy, walking up and down steps, or walking around for long periods of time), had to take stool softeners (because straining caused a massive headache), had to take care not to get a cold (because coughing was intensely painful), etc..., or I would get these explosive headaches. They'd only last for a minute maybe, but then I'd have a dull, persistent headache for at least the rest of the day. And, of course, my cerebellar tonsils were descended into the spinal canal and the cerebral spinal flow was limited.

After the surgery, these headaches (the tussive), my tonsils are back to normal, as is my flow. So generally, my surgery was successful. I'm wondering how all that compares with your surgery?

Now, I still have migraines. I was having 15-20 a month for about a year. I also was taking a narcotic, which only one doctor wanted to prescribe. I wasn't abusing it - I had a Rx for 30 that it took me 2 years to get through. I was very, very careful to try everything else first. And mostly, I just suffered the pain. Finally, a brain scan showed I had inflammation (one reader said it was normal - well, you know - so I had to have it reread by another facility), so my doc put me on anti-inflammatories and I had to change my diet drastically. It broke the headaches. I still have them occasionally, but they are much, much better.

I did develop occipital neuralgia (many years later), which I think is because of the surgery, but I'm dealing with it.

Anyway, I just wanted to share my experience, as someone who has had the surgery and also has dealt with chronic migraine.

 

[lostforgottensoul]

self-medication

That, in my humble opinion, is NEVER the answer. Coming from an addict and someone that self medicated for about 13 yrs, it is not good and where these things can get very dangerous. Pain medication is for pain. Psyc meds for mental issues (like anxiety), alchohol, for an an acholohlic is something to stay away from, and illegal drugs are illegal (unless prescribed).

And telling a doctor you are an addict is accountability. For me anyway.

 

[FauxLiz]

@anonymous and @lostforgottensoul when I say self-medicate it is alcohol and has been since jr. high. I didn't know that was what I was doing but I learned as I have gotten older. Because of my migraines I am very careful with pain meds because losing access due to addiction is not a risk I am willing to take. Illegal drugs, never done too prim and proper when I was younger and now not worth my job. I live in a medical marijuana state and had the prescription but I tried it and marijuana did not help my ptsd or my migraines.

@whiteraven prior to my surgery I had the normal sneeze, cough turn your head wrong instant headaches but they would stay with me and its hard to explain how you can have two types of headaches at once but that is the only way that I can describe the combination. In addition to that I had tingling in my hands and feet, I would struggle with balance and for a long time I had no idea why. The last weeks before they finally decided to do emergency surgery I was constantly falling, was losing feeling in one leg and the tingling was starting to move up my arms. My doctor ordered a new MRI as I had a headache, light sensitivity and confusion greater than I could imagine. I had the MRI on Thursday after two more days I had friend drive me to the ER as I was dehydrated, hadn't had food in 5 days and just wanted to die. They pulled up the images in the ER (test was at the same hospital) and called for a neurosurgeon as I had developed hydrocephalus. It wasn't fun in any way.