Discussion in 'Fibromyalgia Main Forum' started by ldoty, Aug 23, 2008.

  1. ldoty

    ldoty New Member

    I went to see my rheumatologist because I was having pain everywhere. After the visit I got a copy of his notes. His note says "My impression and Plan: Fibromylagia - She continues to hurt and is unable to function in spite of a very aggressive regimen. I think she has significant associated depression limiting her function. She is on a Serotonin norepinephrine reuptake inhibitor - Effexor and has been on Cymbalta in the past. She has been on Neuronton and now Lyrica and doesn't feel that either has helped. She has been on Zanaflex. Today I have nothing to add. I did ask her to start withdrawing the Lyrica 1 pill/week and see if she misses it. She is asking about a functional capacity evaluation. I would favor that she be sent to Physical Therapy/Occupational Therapy for that.
    She has tenderness in her shoulders, elbows, hips, knees and right thumb MCP with bony hypertrophy and decreased range of motion.
    After reading this, I was sort of taken back by the statement that I have very aggressive depression limiting my function. FM is depressing, but I don't think my depression is limiting my function. I can't even water my flowers without my lower back hurting. Does anyone read this note the same way as I do?
  2. lurkernomore

    lurkernomore New Member

    I don't have a lot to add, except that it seems to me as if the doctor is saying that you are not able to do as much due to depression, rather than pain. And that is both insulting and misleading. I am so sorry. I would be upset and frustrated, perhaps making another appt. to have this doctor explain exactly how he meant that, and tell him how I had interpreted it.

    It is so important for the patient and doctor to be on the same page and have a good rapport. If not for having that with my own rheumy, I would be seeking another. Bless you.
  3. jasminetee

    jasminetee Member

    "associated depression limiting her function"

    No, if any depression is involved at all it should be written as: depression caused by limited function.

    Why can't they see this?

    Well, they just can't see our pain and illness Sx. That's the problem. This doctor seems knowledgeable but then goes and writes something like that. I suggest letting him know it's wrong.

    The docs Dx Depression for me when I first came down with this and I just kept correcting them and finally found better docs. But maybe this one needs just a bit more education and then he'll be ok.

    You might bring an article in about how depression is secondary in FMS.

  4. ldoty

    ldoty New Member

    I called my doctor's office and asked his nurse about the statement "I think she has significant associated depression limiting her function". I told the nurse that I don't understand why he would write a statement such as that and that it should be the other way around, FM is limiting my function. She said she would have to talk to the doctor and call me back. She called me back and said she had talked to my doctor and he said that he has tried everything he knows and according to me, nothing is helping. He doesn't know how to help me. I told her that FM is limiting my function and does cause depression and that maybe if I could do the things I use to do, I wouldn't be so depressed. I also told her that I feel this is an unfair statement. She stated the doctor said he would not change it because he doesn't know what to do for me. This pissed me off and I told her that just because he feels he can't help me, that I must be depressed which is causing my limited functions. I also told her it is doctors such as him that certainly don't help people with FM and just because something works for one person, it may not work for the next. I asked her if I could talk to him and she said he doesn't talk to patients over the phone, I would have to make an appt. I told her my insurance doesn't cover his visits so it comes out of my pocket. She finally said that she had to go and take care of other patients. I told her that I would write him a letter. She said I should do whatever makes me feel better. Then the phone call ended. I am so pissed...he is a rheumatologist and I would think he would be more understanding. I feel he is just shoving me to my psychiatrist because he doesn't know what to it must be depression.
    Does anyone else think I should write him a letter?
  5. luckyman

    luckyman New Member

    If he is refusing to listen and is not trying to help, or communicate with you, you have every right to ask for your money back. He has actually caused your condition to worsen because of his arrogance and lack of empathy. I would go to his office and nicely, but firmly ask for your records, and your money for the last office visit. Do it at a busy time and try to get the doctor to face you. You could make him look very bad if you plan it right. It will help you, and perhaps he will be more careful how he treats his patients. If he refuses, take him to small claims court. We are sick and the doctors should TRY to help us, not abuse us then victimize us by taking our money. Good luck!
  6. street129

    street129 New Member

  7. Janalynn

    Janalynn New Member

    See I read that as "significant associated depression" -
    associated to FM. Significant because there is nothing that can help you. That was MY interpretation. Obviously wrong.
    I agree to let it go. They write all sorts of stuff.
  8. luckyman

    luckyman New Member

    I wouldn't be confrontational with the doctor or the office staff. I would however pick up my records and move on to a different doctor, as your current one doesn't sound like he's supportive and is unlikely to be helpful when you really need it, as in prescribing pain medicines or writing a letter in support of disibility ... Your doctor records will paint your picture that other professionals are likely to hold in higher regard than anything you may say. They may very well "brand" you and have the potential of doing great damage. Be careful!

    Perhaps it would be over the top to ask for your money back. Personally I would have no trouble as I feel that they do not have the right to dismiss our concerns without a second thought. I feel that done properly they may actually listen. I think we should "be allowed" to keep our dignity and be treated with respect, and the doctor needs to realize this is a serious disease and not to trivialize it or us by sending us home with the latest depression prescription. It is also doing a diservice to the next patient with similar complaints. If done nicely, it may be enough to make them think about actually helping the patient, and being part of the team to do what he can, or at least out of good conscience refer us to someone that may be able to at least treat the symptoms as described, not as he chooses to perceive them.

    I'd leave with my head held high and a smile on my face. If we show credibility, all but the most hard headed and arrogant will at least have second thoughts. If he can't or won't help or refer you are definitely better off without him.
    [This Message was Edited on 09/01/2008]
  9. Well I read it as "associated depression" meaning you have fibro and therefore comes the depression. I also think with fibro pain you then get the depression living with PAIN.

    My dr. basically told me he has tried everything also, which he really hasn't. My low back and hips are my main problem.

    My questions are-

    1. how much lyrica are you taking? (since he asked you to take less.

    2. How did you get his report? I never get a copy, and it is interesting you did.

    [This Message was Edited on 09/01/2008]