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Ask Dr Mike. - helen-louise
Ask Dr Mike.
It's very pleasing when someone who knows far more than you about a subject comes to the same conclusion that you did, independently of your thoughts. It's happened to me a couple of times lately, most recently this evening when I saw my doctor and he agreed that I should increase the dose of carbamazepine that I'm on from 400 to 600mg per day. I think it's more sensible than going back onto a higher dose of Efexor (venlafaxine) because:

a) I spent the summer trying to reduce my venlafaxine dose, and got it from 225 to 75 mg before I started to experience symptoms again.

b) What's wrong now is mood lability and instability. I'm depressed on and off but I'm also hyper on and off, and having "attacks" of crying for an hour and a half with no trigger when I don't actually feel sad. A mood stabiliser seems like a more sensible option to try to level that out than an antidepressant, which will just make any hypomania worse.

Unfortunately as usual he was running excessively late (my appointment time was 6.50pm and I got seen at 7.35pm), and so I completely forgot to tell him about all the possible thyroid issues that I'm still having. Tired all the time, cold a lot of the time, even worse temperature regulation than usual, hair falling out so much more than usual (I'm actually alarmed by the amount of hair that's on my pillow in the mornings), putting on weight despite eating less than usual. I meant to ask whether I should have another blood test, not least of all because carbamazepine is known to affect the results of thyroid hormone screening, and it could be useful to see the results pre- and post- changing the dose. Damn. And looking at this list of possible hypothyroidism symptoms - yep, definitely having a lot more joint problems than is usual for me, and my sex drive has disappeared again. I suppose I should phone him, as he's only doing physical appointments on Tuesdays now, and I only need to talk about it. Bah!


2 comments or Leave a comment
From: kshandra Date: 18th November 2009 00:12 (UTC) (Link)
Ugh. Hope you get this settled soon.

In happier news, I got your postcard today. Bear! XD
nitoda From: nitoda Date: 18th November 2009 12:37 (UTC) (Link)
Is it possible to email him? I've sometimes had a doctor who would accept emails, especially if agreed in advance.
2 comments or Leave a comment