Posted by Snoozy on May 23, 2003, at 19:20:40
In reply to Re: Drug that could change my life...if I can get it » Snoozy, posted by medlib on May 23, 2003, at 18:10:53
Hi medlib -
I had no idea that a doc needs a license to prescribe Schedule II drugs. I just assumed if you were an M.D. you could prescribe anything, with the DEA watching everything. That's very interesting, and good to know. Part of what's so frustrating now is that I've had Ritalin before, from 2 different pdocs. And those 2 were judicious in their prescribing overall.
I did have a tilt table test some years ago. I didn't pass out, but I did have an abnormal response. I don't remember if the heart rate was abnormal, but I can check it out at home. I tried propranolol, Florninef, and midodrine, and they either didn't work enough or the side effects were too bad. I've also tried non-drug treatments: support hose, drinking extra fluids, increasing salt, sleeping with head elevated.
I do get nauseated when I'm standing and my bp drops. I also get very hot and sweaty. I become nearly oblivious to what's going on around me, my mind is just so intently focused on not passing out. I've always unconsciously done all of the shifting around and sitting positions that they recommend. I can clearly remember many episodes of this in childhood.
I do love pretzels, which I discovered generally have a much larger sodium content than potato chips. And I am underweight (I haven't had a huge weight loss though - I've always been thin. At least I got one socially desirable gene!)
Would the adrenal function be tested by bloodwork? I'm scheduled for a complete physical next month, and I'm supposed to come in for labs a week before. I'm thinking perhaps I should call and make sure they do adrenal testing.
Thanks so much for the info!!
> Hi Snoozy--
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> 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".
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> 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.
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> 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).
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> http://www.aafp.org/afp/20000401/tips/9.html
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> 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.
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> 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
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poster:Snoozy
thread:228336
URL: http://www.dr-bob.org/babble/20030520/msgs/228698.html