Seeing a new Doc - psychiatric questions asked

[BEG]

I am seeing a new doc and will be tested for XMRV. However, his preliminary paperwork (that I need to fill out) has several pages relating to psychiatric issues. What to do? Write N/A on the psych. pages, answer them, or what? My feeling is that CFS is a disease. If one is a cancer patient, you don't get those questions to answer. I am turned off by this line of questioning.

 

[Esther12]

If he doesn't know you, it probably makes sense for him to examine psychiatric causes for your fatigue.

So long as he doesn't presume that because you have CFS it must be a psychiatric problem I think it's fair enough for him to examine the possibility, especially because if there is a psychiatric cause then there are better treatment options.

It is a difficult one when so many doctors treat CFS patients unfairly, but I'd start off by giving him the benefit of the doubt and answering the questions as clearly as possible. Sadly there is a danger he will then use this against you, but if he that sort of doctor then I expect he'd use a collection of N/As in the same way.

Good luck with it all.

 

[BEG]

Thanks, Esther12. I can provide him with documented test results and office notes from a CFS specialist who diagnosed me with CFS. However, you're right. This doc will treat with the antiretrovirals if XMRV positive. I should be cooperative at this first consultation.

 

[Otis]

I see a psychiatrist because he's the best doc around with sleep meds.

I actually got a letter from him indicating that I don't suffer from primary depression or any other psychiatric disorder. I keep it handy for such occasions.

So if you have/do go, for whatever, to a psychiatrist and it's a positive situation you might considering asking for such a letter. Some docs just believe what they want to believe but this has helped me more than once.

Best wishes BEG. I hope this will lead to a positive outcome.

 

[BEG]

Thanks, Otis.

 

[SickOfSickness]

Yes, even the good understanding docs usually need written answers to those questions. Just to have it on file and protect themselves. It shows they checked for those things. It's a pain I know. I hate it too. I hate when they ask once they come in the room. Sometimes it's the first line of questioning. I would rather it be on paper so maybe when they walk in they can skip that part. In my case I think I have psych diagnoses too. They just want to know what they are. So just get through it as you know...

 

[JAXintheCity]

If he doesn't know you, it probably makes sense for him to examine psychiatric causes for your fatigue.

So long as he doesn't presume that because you have CFS it must be a psychiatric problem I think it's fair enough for him to examine the possibility, especially because if there is a psychiatric cause then there are better treatment options.

It is a difficult one when so many doctors treat CFS patients unfairly, but I'd start off by giving him the benefit of the doubt and answering the questions as clearly as possible. Sadly there is a danger he will then use this against you, but if he that sort of doctor then I expect he'd use a collection of N/As in the same way.

Good luck with it all.

This is absolutely brilliant! I can't believe I've never thought of it!

You know...it made me realize that I have never been to a Psychologist/Psychiatrist who thought my disease was "all in my head." But I've been to plenty of MD's who treat it like it was such! What a joke?!?

EDIT - I realized after I posted this I responded to the wrong quote. I meant to respond to Otis who said that she gets her doctor to give her a note that says she does not have depression, etc. SORRY FOR THE CONFUSION! CFS brain...

 

[*GG*]

I see a psychiatrist because he's the best doc around with sleep meds.

I actually got a letter from him indicating that I don't suffer from primary depression or any other psychiatric disorder. I keep it handy for such occasions.

So if you have/do go, for whatever, to a psychiatrist and it's a positive situation you might considering asking for such a letter. Some docs just believe what they want to believe but this has helped me more than once.

Best wishes BEG. I hope this will lead to a positive outcome.

Yeah, I actually saw one because of work issues drew me into depression, because they did not want to accommodate me!

I guess I was lucky, he believed in my illness and was very supportive and thought I was very intelligent, he chalked up my depression due to my illness!

BEG, perhaps you should find out what his/her viewpoint is on ME/CFIDS/CFS first?

Best of luck!

Interesting that people get "medical" care from these Docs. They have gone thru medical school, right?

So I guess they just have more of an interest in the brain, without actually operating on it.

PS So sad that some Drs still think of this disease as phsychological!

PSS My PCP office called today and about when I went to see another Dr (in Boston) and my blood pressure was high. They wanted me to come into the office to due a follow up, at the PCPs, but I don't want to pay the $30 Copay, I just blew them off, and said I would have it checked somewhere else, but have no intention. (My PCP copay used to be $10, but now she is a Tier 3!)

Perhaps I should not be so quick to dismiss this? I have had high readings in the past. I just feel that the medical community has done so little to help us out, that I don't really care if I die of something like this. Perhaps I should have asked if there would be a charge for this?

I have a Dr appt, my primary for CFS, in mid October, but they never do blood pressure, I think I will request!

 

[IntuneJune]

Otis....


Bravo, bravo!!!!

 

[BEG]

Thanks all for responses. I wish I could say that the psychological paperwork turned out to be a non-issue, but it didn't. He summed up my numbers to one questionaire and diagnosed me with a psychological term (not depression). As far as the psychological term, I believe it is only partially true and related to having CFS. I will respond with a letter asking him to put it into his office notes.

I saw this doc speak about CFS nearly 9 years ago. He really knew his stuff at the time. He is now full-time into Integrative Medicine for many diseases, autism being one, and I don't think CFS is #1 anymore.

Unfortunately, his office was out of test kits. So I am waiting on those to arrive. I found out he does the PCR test. If a patient isn't positive to that he does the serology. Note to everyone, there is a discount at VIPDX for both which I told the office. A real big disapointment is that he doesn't treat with the antiretrovirals and antivirals. I was unintentially mislead by my friend. He is looking for an infectious disease doc who will.

Has anyone heard of a DNA Adduct and Mitochondrial Studies test? This was one of the tests he recommends.

 

[helen41]

Brown-eyes

I wonder if the questionnaire indicated dysthymia? If so, that does not mean the Dr was diagnosing you with a mental illness. It's a description of a general lack of enthusiasm and joy, a low grade depression, if you will. Harvard Health Publications says that 75% of patients with dysthymia also have a chronic physical illness.
If my guess is correct, and he did say dysthymia, I don't think that him saying that should be taken as a negative. He might have been acknowledging the burden that having such a limiting illness has put on you.
Just a thought...

 

[Esther12]

Sorry to hear it has not turned out how you hoped BEG - hope I didn't advise you to be too relaxed about it when your instincts told you something was up.

Hopefully you'll be able to talk through your concerns about the diagnosis with the doctor and work out some understanding of one another. Good luck with it all.

 

[BEG]

Hi Esther,

Thanks for your comments. He fully and foremost believes I have ME/CFS. That's what he intends to treat and that's the primary diagnosis. He did not recommend a psychiatrist or therapist.

You know, I'm just fed up with this line of questioning with CFS/ME. I never filled out forms like that with my cancer diagnosis. Would someone with diabetes have to fill them out? I feel with CFS it's a way to blame the patient if the doctor's treatments fail. And of course, in most cases, treatment does fail. There are some, but not many, walking miracles out there.

At $400./hr. at least I know I'll be tested for XMRV, MLV's, or MULV's (hope I have that right) with a doc to sign off. Interestingly, there is a specialist in town who believes it's too early to treat for XMRV. I doubt then he is even testing?

This is my first foray into Integrative Medicine and it is interesting!

I wonder if the questionnaire indicated dysthymia? If so, that does not mean the Dr was diagnosing you with a mental illness. It's a description of a general lack of enthusiasm and joy, a low grade dperession, if you will. Harvard Health Publications says that 75% of patients with dysthymia also have a chronic physical illness.

This is interesting helen41, and is very close, but a different term was used. He was somewhat correct, but largely wrong. Must have been my mood when I filled out the form!

 

[Esther12]

I see.

The way psychiatric diagnosis is going I'm sure that all of us fulfil the criteria for something or other. At least he's not just presuming that your fatigue must be caused by psychological factors in the way a lot of doctors can.

Good luck with it all.

 

[*GG*]

Hi Esther,
You know, I'm just fed up with this line of questioning with CFS/ME. I never filled out forms like that with my cancer diagnosis. Would someone with diabetes have to fill them out? I feel with CFS it's a way to blame the patient if the doctor's treatments fail. And of course, in most cases, treatment does fail. There are some, but not many, walking miracles out there.
QUOTE]

Good questions and you have the background. Perhaps you should ask this at the next visit?

 

[Sallysblooms]

This is my first foray into Integrative Medicine and it is interesting!

I have had the MOST wonderful integrative doctors. They NEVER once asked questions like that. The Integrative doctor I have now is treating me with supplements that are working for my CFS and POTS. The very first one I had was great, in another state. He ordered great blood tests. The docs I have now order blood tests every four months and we can see progress. It is really the only kind of doctor I like since they usually order better blood tests, but if an integrative doc is clueless about supplements, they are no better than reg. doctors. Of course they are all different.


I do agree... with your cancer diagnosis, no one had those questions!

 

[BEG]

from ggingues:

Good questions and you have the background. Perhaps you should ask this at the next visit?

Just what I need to do, ggingues, or put it in my letter regarding the diagnosis.

from Sallysblooms:

The docs I have now order blood tests every four months and we can see progress. It is really the only kind of doctor I like since they usually order better blood tests, but if an integrative doc is clueless about supplements, they are no better than reg. doctors. Of course they are all different.

He is very into supplements, Sally, but, given the cost, I wanted to keep the visit to one hour. We just didn't get there. Maybe in a later session we will. I want the XMRV tests to rule this retrovirus and its antibodies and mutations in or out. The following is not an original idea, and I don't know whom to credit here on the forums, but if I'm negative then I can put XMRV out of my mind and move on to other modes of treatment this doc recommends.

 

[Sallysblooms]

That's good that he knows about supplements. We are working on my immune system and fighting that way. We keep checking the E.barr every few months and see progress. I know everyone is different. We all do what works for our own body. I hope this doctor will help you a lot!!!