Posted by medlib on May 23, 2003, at 18:10:53
In reply to Drug that could change my life...if I can get it, posted by Snoozy on May 22, 2003, at 12:39:25
Hi Snoozy--
I'm sorry that the medical community is giving you such a hard time; wish I thought that your experience is at all unusual. If your difficulty in getting Ritalin seems a tad illogical, it may be because 1 or more of your docs don't have licenses to prescribe Schedule II meds. Most GPs don't, and a surprising number of specialists, including pdocs and cardiologists, decline to pony up the extra cost or bother with the triplicate forms hassle if their practices don't include many likely candidates for stims. Often, this state of affairs is presented as "conservative medical judgement", when "conservative" is just a euphemism for "more convenient" or "cheaper".
From what you've described, it does sound like you may be vasovagaling. If that's the case, it's important to determine if, when you stand, your heart rate rises sharply before it drops. As Mitch suggested, take your pulse lying down, sitting and standing. It's a good idea to wait 10+ seconds after changing positions before beginning the count. People with low bp sometimes have some difficulty finding and "holding onto" their pulse long enough to count it. Some of us who've taken a lot of vital signs may be able to offer a tip or 2 on technique, if needed.
A stray factoid escaped from my Swiss cheese memory when I read your posts. I recalled scenes from GI labs and tilt table tests and a drug often prescribed that begins and ends with an "f". When my mental efforts to retrieve the med name produced only more familiar "f" words, like "futile" and f..., I got irritated enough to go look it up--it's Floricef. In the process, I found a web site you may find useful. I admit that I'm a sucker for flow charts (often termed algorithms in medicalese); but, if I were you, I'd print it out and take it to your cardiologist. It will probably irritate him to be presented with it, since it's a four year old article from the American Journal of Cardiology which he's presumably read. But, it *may* convince him that you (and your condition) are too serious to just brush off. If so, you may find that Floricef or midodrine works better than Ritalin (and is easier to obtain).
http://www.aafp.org/afp/20000401/tips/9.html
BTW, when you say you feel "sick", do you possibly mean that you feel slightly nauseated? Do you crave salty snacks? This notion is no doubt worth even less than my usual 2 cents, but have you been checked for adrenal insufficiency? It occurred to me when I noticed "depression, no appetite (under weight?), fatigue, and low bp/orthostatic hypotension" mentioned together.
Being on the receiving end of crummy medical care when you're feeling too crummy to do anything about it is the pits. I wish for you better help and health.---medlib
poster:medlib
thread:228336
URL: http://www.dr-bob.org/babble/20030520/msgs/228680.html