Ralph/All: Could this GI doc be so off base?!!!!

Discussion in 'Fibromyalgia Main Forum' started by CAAnnieB, Aug 29, 2005.

  1. CAAnnieB

    CAAnnieB New Member

    Hi Ralph,

    I'm SO glad you have decided to stick around! I've been hoping you would as I always find your posts & responses to be informative.

    Well, I sure had a doozy of an appt. with a GI specialist at UCSF the other day!...First, he had a Medical student examine me & get some history. Then when the MD/PHD came in; he lectured me on the relationship between my Gastritis, Fibro & chronic stress. He interogated me about my childhood...looking for abuse, neglect, rape, mugging, etc, etc...Thankfully; my childhood was a very happy one. Then he asked me about when my pain symptoms started, when my stomach problems began...trying to connect it to a traumatic event in my life.

    This Gastro specialist did not examine me or ask very many GI questions. Instead, he gave me the "fight or flight" speech about my FM bod being in a constant state of stress. He recommended longterm psychotherapy (at least one year!) to get to the root of whatever deep-seated fear is causing me stress & thus my Gastritis.

    All he offerred me was a RX for Amitriptyline or Nortriptyline. He said he could put me in touch with a colleague's study using Celexa for FM/ Gastro problems.

    I kept waiting for him to get beyond the psychological approach, but he never did!

    He also told me not to worry about having too low of stomach acid because we don't really need the acid! It's only useful if we eat spoiled food? This sounded really weird to me!

    I told him that I was not feeling comfortable taking Prevacid long-term as it might be lowering my acid TOO much. He said, "If it (Prevacid) helps, take it...If not; stop."

    In summary, he told me that our FM bodies are producing too much stress hormones & are in a constant state of stress. This stress is the cause of my chronic Gastritis. It won't improve until I get help in dealing with whatever is at the root of my stress.

    I didn't feel like I was stressed out very much until AFTER I went to see this guy! Is what he said valid? I DO understand the whole concept of FM being a CNS disorder...And the ANS falls under that category, thus the stomach can be disregulated. But I refuse to put antidepressants into my body when 1) I'm not depressed 2) they aggravate my stomach pain & 3) I have weird reactions to most drugs.

    It is SO discouraging to go to these supposed experts...just to have them lump me into their typical Fibro patient profile...And to receive the same recommendations they give all FMers! Eeeeek!

    Thanks for "listening". I AM trying to do natural remedies to heal my stomach & intestines...Not having success yet, but I'll keep at it!

    Blessings,

    Annie B
    [This Message was Edited on 08/30/2005]
  2. bpmwriter

    bpmwriter New Member

    "I DO understand the whole concept of FM being a CNS disorder...And the ANS falls under that category, thus the stomach can be disregulated. But I refuse to put antidepressants into my body when 1) I'm not depressed 2) they aggravate my stomach pain & 3) I have weird reactions to most drugs."

    this sounds exactly like a conversation i've been having with myself lately. i took lexapro for about 6 months b4 moving on to other approaches. during the time i was on it, i noticed that gi symptoms improved greatly. in fact, things i thought i was "allergic" to, i was able to eat. i also slept better and pain was more manageable. but i've been wrestling with going back on an antidepressants because i found myself unmotivated to do anything, they gave me tinnitus and daytime sleepiness became an issue. major cost/benefit analaysis!

    in any case, some of what your doctor said may be correct, but he shouldn't be selling you on the idea that stress is the sole perpetuating factor and antidepressants are the cure. my massage therapist told me yesterday, "all fibro patients are different" - your doc ought to offer them as a tool and discuss the options with you.

    eddie
  3. CAAnnieB

    CAAnnieB New Member

    Doxygirl,

    I really appreciate your support! At least this Dr. told me I didn't seem depressed! Yeah! I was in such shock during his "lecture" that I was speechless! Plus he never gave me an opportunity to ask questions. I finally asked him about taking Prevacid long-term...And how I had read that FMers have low stomach acid (in general) & what if I was making things worse by lowering the acid even more with the Prevacid. That's when he told me there is no such thing as having too little stomach acid as it's not really needed.

    There were so many strange things about this appointment...I could go on & on, but I won't!

    Again, thanks for the support. I need that support this week big time.This visit was just so disappointing to me...

    Eddie,

    I thought this Dr. was totally focused on the stress factor. Of course, we all know that stress makes our conditions worse, but he was telling me that there MUST be some deep-seated fear causing me stress, thus causing the FM & Gastritis. Other than the stress of living with a chronic, painful condition (s)...I don't believe that I'm dealing with a ton of stress. I did not suffer a traumatic childhood or an adult trauma.

    Thanks for your input. I'm sure that taking some of these anti depressants may be helpful to some of us.(As they work on Neurotransmitters that may be out of whack) I am just so burned out on taking/ experimenting with drugs! I'm really trying very hard to limit my meds, not add any more into the mix!

    Ralph,

    Thanks for the response. I do work with a Holistic MD. She uses herbs & natural supplements to treat me. She has recommended MANY supplements over the past 1 1/2 years. More than I can afford! I have tried to keep using the ones I have found to be the most beneficial.

    She is the one who ordered my stool analysis (at my request) through Great Smokies lab. Those results led her to recommend me taking Similase (Digestive Enzymes), Probiotic containing Acidophilus & Bifidobacterium, DGL licorice tabs & Apple Pectin. I have used the DGL on & off for my worse periods of stomach troubles. I started to take the others daily. What I found was that the Similase seemed to make my pain (stomach, but mostly RLQ) worse. Don't know why, but I experimented several times & the Digestive Enzymes always worsened my symptoms, so I stopped it.

    I trust the Holistic Dr...The drawback with her is that her visits & supplements are not covered by insurance. I have a limited (very) income. I can't see her as often as I'd like, nor take everything she recommends. Bummer.But I do what I can.

    I like to approach my health care in a multifaceted way. My "team" consists of my Family Dr, a local GI Dr (he sent me to UCSF),a Neurologist/ Pain specialist & my Holistic MD. Obviously this visit to the Gastro specialist in S.F. was a onetime experience! He won't be on my team!

    I'm thankful for all of you & your input/ support.

    Blessings,
    Anne
  4. sofy

    sofy New Member

    my first gp suggested depression and even tho I didnt feel depressed, unhappy, I didnt discount it. I figured if Mike Wallace, 60 minutes, could get depressed why couldnt I.

    Went to see a psych for 6 months and after that he stated I was not depressed and the cause of my problems was definately organic. He sent me to a sleep doc and an endo.

    The sleep doc said I had a sleep disorder and was labled drug resistent cuz all the "keep her awake drugs" gave me health destroying side effects. I now know its because they wernt what I needed. Its stupid to try and artifically make your body go, go, go, when what it is demanding is rest, rest, rest.

    My second holistic endo tried to suggest this too but after a year he finally came around and now treats my thyroid, in spite of normal tests, low growth hormone and believes in the lyme diagnosis.

    Many docs dont want to treat the underlying cause they just want to make the symptoms go away no matter what horrible damage the treatment causes.

    I kept pushing foreword and finally found I had chronic lyme disease caused from having had the vaccine in 1999. I had had lyme several times and thought it might be a good idea to protect myself. Boy was I wrong. I will never take another vaccine for anything.

    I had the genetic markers that made this vaccine a forever mistake for me. Im still pushing foreword hoping to find out a way to a least better manage my symptoms so I can get back to living life in the main stream just a little.
  5. lbconstable

    lbconstable New Member

    Hi Annie,

    I was about 24 or 25 years old when my psychotherapist suggested that my overwhelming fatigue may have an organic cause. She suggested I speak to my MD. My MD suggested that
    I was depressed. My psychotherapist unequivocally denied that I was depressed. I figured she knew better as we had spent quite some time together and she would know what depression is.

    All in all I attended 3 years of pschotherapy and sinces then have been very involved in other self-help/motivational programs & seminars. My husband & I seek therapy together and separately as issues arise. All of it has been immensely helpful on many levels. However I'm still fatigued. The 3 years of consistent psychotherapy did not change my physical symptoms. All this internal focus as helped me navigate this illness and obtaining treatment. BTW I have both CFS & FM.

    In my late 20's I had some testing that showed my adrenals were overactive - producing extra stress hormones. Now they show the opposite, probably due to burnout. I don't think the extra stress hormones are causing the illness (I'm sure they exacerbate it), but I think the extra stress hormones are a result of the complex web of systems affected. Probably we are more sensitive to stressful situations because of the illness as opposed to the stress being the source of the illness.

    This is all my humble opinion, obviously. This guy has the ultimate in credentials - I'm sure. However, I respectfully disagree with him on several points. I think we need stomach acid - that's why we have it. One of the roles of stomach acid is to kill bacteria that we may ingest. Since we seem to have compromised immune systems the stomach's first line of defence is possibly even more important for us.

    There are lots of conflicting ideas about causes and modalities of treatment. That's healthy. The challenge for us is to find medical practitioners whose philosophy of health & healing is consistent with our own. When the relationship between doctor & patient becomes collaborative we can achieve a greater depth of healing.

    All this is a long winded way of saying trust your gut! It sounds to me like your desired method of treatment is inconsistent with his view of FM/gastro problems.

    Good Luck!

  6. CAAnnieB

    CAAnnieB New Member

    I SO appreciate your opinions, input & support! It means a lot to me, especially at times like this.

    This is some rollercoaster we are on, isn't it?! I think I have reached the point of total confusion...I'm afraid I don't buy in to any one particular theory about these DD's! Except that they now state that FM is a Central Nervous System disorder.This makes sense to me. It explains the pain & other body functions involved with Neurotransmitters & hormones. (ALL body functions!!) In a way; this Gastro Dr. was acknowledging that, but his take on it is that the major fear/ stress is the cause of this dysregulation. I'm sure it might be for some. We talk about triggers...Maybe that's what he was addressing, but there must be organic dysfunction happening in our bodies. Things that could be made better (cured?) by other methods than long-term psychotherapy or antidepressant drugs.

    They still have SO much to learn about the exact mechanisms of nervous system dysregulation/ sensitization. What causes it? Why does it manifest itself as FM or CFIDS in some people? And how can it be effectively treated?

    I am beginning to feel like there is way too much confusion out there in the medical (traditional AND holistic/ alternative) fields regarding these "conditions". We are one big experiment! I'm growing weary of this experimentation! (Drugs, supplements, herbs, etc,etc)

    Maybe I just need to coast in neutral for awhile...I'm not one to give up hope, but getting better is becoming emotionally draining on me. Can anyone relate?

    Thanks bunches,
    Anne
  7. jake123

    jake123 New Member

    I would write this doctor a short note telling him just what you think - that he had you diagnosed before he even saw you.
    He probably has this preconceived idea because so many doctors see stress related FM because alot of people are victims of abuse or crime.
    I was nearly murdered in 1982. Am I over it? Yes, but my subconcious chooses to scream in the middle of the night sometimes which paralyzes my husband. My doctor explains it "your serotonin went off the chart and hasn't come back". We have tried several times to wean off the med but it may not happen.
  8. CAAnnieB

    CAAnnieB New Member

    I am SO sorry to hear of your trauma. Obviously; I'm guessing that must be the trigger that began your journey with this DD. I can not even imagine living through a murder attempt. How awful & frightening. I do hope that you have found some treatments to help you. (People, faith, medications)

    You are right about this Dr. having a preconceived concept of what the typical Fibro patient is. That's EXACTLY what I told my friends & family! I said that he just saw me as a patient with a big "F" on my forehead. Fibro patient...with migraines & stomach problems...Must have deep psych issues! Most of them do...He didn't want to take time to listen to me & my individual story...Instead, he lumped me into his FM/ stress category, even tho' I gave him nothing in his interrogation to lead him down that path.

    I could tell that he had his Fibro "speech" down pat.

    I'm sure there are others like yourself who have experienced an abuse/ trauma trigger for their FM/ CFIDS. My trigger (I'm guessing) was an on-the-job severe neck strain...But I may have had mild Fibro symptoms previous to the injury. And the injury was simply a repetitive strain type injury. (Nothing traumatic) Of course, others here have brought up the possibility of the Hepatitis B vaccine being their trigger. I received that vaccine around the same time as my injury. So who knows!?

    Thanks for your reply. I'm very sorry that you are still struggling subconsciously in your sleep with what happened years ago.I hope you have found some peace during your wakeful life.

    Blessings & Gentle Hugs,
    Anne

    P.S. What med has helped you? [This Message was Edited on 08/30/2005]