Why Can't Medical Professionals See Past The Ptsd

[JEKBreatheandBelieve]

I have been struggling with low blood pressure and light-headedness for awhile now. Last night it was particularly bad and accompanied by chest pain, so I went to the ER. Unfortunately, I have been there many times because of mental health reasons.

Once the ER doctor (who I believe did my stitches the last time I was there), read/remembered that, he started asking if I was going through another bout of depression. Another bout? Um, yeah, cause it magically went away. Anyway, I clammed up because I didn't know how to say that yes, earlier today I was in really bad shape and I have been struggling a lot lately, but right now my problems are physical. And I have been working a lot of separating out somatic versus psychosomatic pain lately.

Anyway, I couldn't say it. He brought in the crisis worker. They did the obligatory blood tests and then sent me on my way home. Today I have spent the day sleeping. I've gotten up a few times to walk around and get food, but I still have low blood pressure and light-headedness and have found it hard to stay awake.

I wish that I could have spoken up for myself last night and actually gotten the care I went there for. It makes me so mad that I can't get help for physical problems. Just because I have mental health issues doesn't mean I can't have real physical problems, too. I am so angry, but have no idea what to do about it.

 

[Changing4Best]

I get low blood pressure also, but it is caused by low blood sodium (which was so bad that one time I passed out in Walmart and was taken to the ER for it). They could not even get a pulse on me that day, it was so bad. My MD told me to drink Gatorade, but I hate that stuff, so I take a half a salt tab now and then along with a half a pottassium tab to approximate the ratio of Gatorade electrolytes and all goes reasonably well. Possibly one of your medicines is causing the low blood pressure? Look up all your meds on WebMD and see if any of them causes low blood pressure or low blood sodium which is called hyponatremia and then speak to your Dr. about it, if you find out any of them do. Another way to handle this is to call your pharmacist and ask him or her if any of your meds could be causing the low blood pressure. The med that is causing my problem is called Oxcarbazepine. Don't go ahead on your own and lower any doses, make sure to speak with your Dr.(s) first!

 

[JEKBreatheandBelieve]

Thanks, @SheilaKathy . I have two medications that can lower my blood pressure. One is a blood pressure medication that I take at night at a really low dose to help with the nightmares. I've been trying to figure out if it's worth the blood pressure struggles to stay on that one, because it can't really be lowered. It shouldn't have that much of an effect on me, but then I am sensitive to meds. Usually the low blood pressure from that med. is gone by mid-day. My anti-depressant says it might lower blood pressure so I don't know if that is playing into this at all. I have talked to my doctor a little about it, but so far we didn't change anything. I have been drinking Gatorade at least once a day- I did 2 today since I was still feeling so awful and my blood pressure was still pretty low. I don't like the stuff either, but it helps.

 

[EveHarrington]

I think it's irresponsible of your doctor to not tweak your meds or remove them completely if you're having such drastic side effects (potentially). Honestly, removing those meds first makes the most sense instead of doing a lot of tests to find another cause. If the low blood pressure continues once those meds are out of your system (which may take weeks), then it's time to look into other causes of the low blood pressure.

We are the only advocates we've got. If we don't stand up for ourselves then we won't necessarily get our needs met.

Do you have someone who can advocate for you right now? A loved one or partner?

 

[JEKBreatheandBelieve]

@EveHarrington , I started these meds in an inpatient program and they were monitoring it and at the time we opted to stay on the meds. Now that I am at home, I only have my primary care doctor whom I've only had a chance to meet with once. She recommended an at home blood pressure monitor so I could tell better what my blood pressure was. I am in the process of looking for a psychiatrist, but no one around here that deals with trauma patients is taking new patients. I am more upset with the ER doctors for not treating me or considering helping me. When I follow up with my primary care doctor, she will listen and help me. I am thinking I need to bring an advocate with me when I got to the ER, but that is usually not possible. My husband has to be with the kids.

 

[EveHarrington]

I'm sorry, I didn't mean to discount your ER experience. I realize just how difficult it is to seek help and then be discounted and dismissed because you have a mental disorder. I wish that doctors weren't so quick to chalk things up to mental disorders when it could be something physically wrong. I've been fortunate to not experience this dismissal stuf------unless in the ER. Sometimes I flat out lie because my physical stuff has been very real and unrelated to PTSD------and while I know it's in my charts and the ER docs can see I have PTSD, it does help to throw the PTSD on the back burner.

I think you're very right to be upset at this treatment in the ER. Doctors should treat us as people and not as our disorder.

On the other hand, it can be easier to change my approach in order to get what I need than it is to make these ER doctors understand that I'm not there simply because I'm mental.

 

[JEKBreatheandBelieve]

On the other hand, it can be easier to change my approach in order to get what I need than it is to make these ER doctors understand that I'm not there simply because I'm mental.

No need to be sorry. And this is exactly what I need to figure out- how to get them to understand what I need. The crisis worker understood, but she wasn't one who will stand up to the doctors for me. I think there's only one that will do that. Which is why I liked your idea of an advocate, now I just have to figure that part out. And thanks for all of your thoughts.

 

[joeylittle]

@JEKBreatheandBelieve - while you're looking for a psych, you can definitely speak with a pharmacist. They may have ideas for you.

With the ER - oh, I just identify with your post. It's hard to advocate for yourself, and when you have mental illness on your chart, it sometimes gets harder.

I have been known to practice what I need to tell them, starting with triage nurse. Also have written myself a script that I can follow. Sometimes it's just the symptoms and timeline, sometimes it includes things about how to answer questions about my scars.

Don't be afraid to bring some tools into the conversation. And, make an appointment with your GP. You don't have to be an 'easy patient', you've got something going on and need help with it.

Random thing: I have low blood pressure, and two things really matter for me - one, I just need to stay hydrated all day long. Two, I can't eat too much magnesium. This was revealed when I went through a big almond-eating phase.

I hope you can get it diagnosed and dealt with!

 

[JEKBreatheandBelieve]

Thank you, @joeylittle . Those are good suggestions for dealing with the ER. I should call my GP tomorrow and see if I can get an appointment, you're right, I need to make sure to get help. I hate using the phone though. I definitely need to stay hydrated, but even on days when I know I have drank lots of water and even Gatorade (which I detest), I find it a struggle to stay hydrated. I will have to see what foods are high in magnesium. I don't like almonds so I know that's not it, but thanks for mentioning it. Maybe there is something else in my diet that is also messing with my blood pressure.

 

[Ed Norton]

A wise older nurse told me that one in five doctors are good and that medicine is 30%knowledge and 70% heart. She then went on to say I'm one of the one. 'Cept I'm not a real doctor and don't yet have a license to practice ..working on it...licensing school is so stupid.
:arghh;

 

[Leigh925]

FYI...I have been on several different Meds for nightmares...only mildly successful with too many side effects until two years ago when my brother who is a nurse practitioner called me and told me he found a study about a medicine used to treat spasms in the stomach. A side effect of it was less nightmares for those with PTSD. It is called librax. I take the generic form. In just a couple of months I went from 4 and 5 nightmares a night to one or two a month.....with no side effects. Actually an added benefit is that my stomach often hurts when I get stressed and it helps that as well. My
Doctor hadn't heard of it so I had to do a little convincing to have her write it but I always complained of stomach issues when I went.

Being completely honest...one time when my provider was out and I had to see another one. I asked her to write it because I often had stomach troubles when I travel and I was going on a trip (which was true but not why I wanted it). She had no problem writing it.

But back to your point...had I told her what I originally wanted it for I don't know that I would have gotten the same standard of care. Providers often can't look past the PTSD to treat the whole person...as if people with PTSD can't somehow have physical ailments. That totally sucks.

I think the advocate idea is great. My brother went with me the last time to the ER...gotta say I got way more respect. Sorry that happened and that you didn't get what you needed. I hope you can figure out a way to be heard so that you can feel better!

 

[Ed Norton]

Cyclobenzaprine?
:geek: