Well, this was discouraging

[Guest guest]

Hello all -

At the beginning of the year I said to myself that I would make an all-out

effort to get my pain level under control. I've been working long hours, lots

of stress, and my pain has escalated with the demands of working.

So, into the doctors' offices I go. Talked to the therapist, said I'd like to

work on accepting the pain I can't get rid of. Talked to the psychiatrist,

switched from one antidepressant to another. Went into the PCP's office wanting

a prescription for a new TENS unit, some massage, and a going-over by a PT to

make sure my stretching regimen is catching everything.

First, the doctor wanted to know why I was talking to a psychiatrist about pain.

Wasn't it really depression we were talking about? It wasn't.

When I talked about PT, I said maybe she wanted to order some imaging

beforehand, and I would be okay with that - this seemed to morph in her head

into me wanting to have surgery. She said, " You've already had back surgery,

and it didn't help, " which wasn't at all what I had said - I was becoming

paralyzed from a massive herniation into the spinal canal, and needed surgery to

save my spinal cord. I was happy with my surgery, I could move afterward, and

whatever pain I had was lots less than I had before. Not that I *want* more

surgery, what I've already had was plenty, and I don't think more is warranted.

Finally, she said that I should really talk to a psychiatrist, or a psychologist

about my problems - to which I replied that I had talked to a psychologist the

previous evening, and a psychiatrist an hour before, and I was working the

emotional/mental end of things already, thank you very much.

With that, she grabbed the forms I asked her to sign so the Flexible Spending

Account will pay for massage and some TENS pads, signed them, and stalked out of

the room to print the prescription for the TENS unit. PT was nixed because she

" didn't want to change too many things at once " - okay, I guess I can see that,

but it still felt like she was withholding it because she thought I was a nutter

who was trying to game the system somehow.

This morning I feel discouraged, insulted, belittled, and, honestly, righteously

pissed off. Not that *that* is going to stop me. I can't see a physical

therapist, fine - but I can have chiropractic and acupuncture without her okay,

so I'll do that instead. I can't have a PT assess range of motion and prescribe

exercises, but I can do that myself - not as good, but good enough. I'll do

what I need to do to get better, and if the doctor is going to stand in the way

of that, I'll go right around her and keep going.

But, dang - do they really expect that this kind of treatment would help a

depressed person feel *better*? Or is it just that they figure if they treat

you like a pathetic nutcase long enough you'll go away?

[Guest guest]

W wrote:

> Hello all - morning I feel discouraged, insulted, belittled, and, honestly,

righteously pissed off. Not that *that* is going to stop me. I can't see a

physical therapist, fine - but I can have chiropractic and acupuncture without

her okay, so I'll do that instead. I can't have a PT assess range of motion and

prescribe exercises, but I can do that myself - not as good, but good enough.

I'll do what I need to do to get better, and if the doctor is going to stand in

the way of that, I'll go right around her and keep going.

>

> But, dang - do they really expect that this kind of treatment would help a

depressed person feel *better*? Or is it just that they figure if they treat

you like a pathetic nutcase long enough you'll go away?

>

,

Just like doctors, you might have to search for the right physical therapist and

I use a physical therapists that does myofascial release and is trained in the

type. She really is on top of the problems that the lumbar spine (mine

is fused) and my SI syndrome causes and comes misaligned and causes hardened

cramps with deposits.

I would ask to be referred to another and look up a physical therapist on your

insurance directory and call them for a interview.

I go for myofascial release and have my home program and you can do self

myofascial release to keep cramping and pain down.

I also use imagery and have studies behavior modification and my pain management

doctor for five years was also a pain psychiatrist,

so it was helpful but I do not like going just to talk about pain. I like to

talk about solutions and how to cope and some pain counselors do not provide

that.

I would ask for another physical therapist that matched your personality as you

deserve it. Good Luck from another nutcase that is not going away.

Bennie

[Guest guest]

Hello ,

Why don't you go see a pain management Doctor? My pain management Doc has a pain

psychologist in his office plus he takes care of writing my scripts for PT,

massage, medications, etc.

PCP's are not versed in treating people with pain, pain management Doc's are, I

would never go see a PCP for my pain, they just don't get it and I know that I

will get the run around, so why go through the agravation?

See if you can find a good PM Doc in your area and wave good bye to this Doc.

She is not helping you, so why keep on seeing her? Take care and I hope that you

can find some relief from your pain.

Millie

>

> Hello all -

>

> At the beginning of the year I said to myself that I would make an all-out

effort to get my pain level under control. I've been working long hours, lots

of stress, and my pain has escalated with the demands of working.

>

[Guest guest]

 

The more I thought about this, it sounds like this was a intern or a resident.

or a student.  Nevertheless, if it was anyone of those listed whereas histrionic

and NPD might be listed in the notes I doubt (was it) listed with an ICD9 code

as a formal diagnosis. 

An intern/resident's notes are normally signed off by the attending physician

(in all of the teaching hospitals i have worked in).  The notation can not be

stricken from the record as it is a legal document.  However, the doc can make a

note that it was written in error.  And the diagnosis code should not be

included in your record. Good luck, let us know what happens.

I had a sort of similar experience.  Saw a specialist who spent 5-10 minutes

with me,.(after waiting 6 months for the appointment and traveling 6 hours to

see him)  I have crohns, severe as well as PUD.  

The doc asked me over and over do I take large amounts of NSAIDS or ASA.  I told

him over and over NO, NEVER.  He wrote that he believed that I had Munchhausen

dx and did drug testing for non steroidals and aspirin which both were zero.  

When my primary doc and GI read this report they were furious.  They both said

the disease is hard enough for a trained psychiatrist that has spent a lot of

time with a patient let alone a doc who spent 10 minutes with me.  I refused to

pay for any of the blood tests.  My chart clearly stated that I didn't take

NSAIDs or ASA because of multiple GI bleeds.  I understand how angry you are. 

Deb RN

>Katharine W. wrote:

>I was shocked to learn that after this last appointment, I was diagnosed with

two new Health Issues: Histrionic person, and Narcissistic Personality. 

>Now, this is ridiculous, but worse, it will affect the quality of my health

care in the future.  Who is going to take a histrionic narcissist seriously? 

[Guest guest]

, W wrote:

>

>> : Histrionic person, and Narcissistic Personality.

>

> Now, this is ridiculous, but worse, it will affect the quality of my health

care in the future. Who is going to take a histrionic narcissist seriously?

>

> I've got a call in to the supervisory doctor for the residents to see what can

be done about getting this diagnosis revised, and we'll see what happens. I'd

welcome any suggestions of what I might do at this point, aside from change

doctors. That's a given.

>

,

Get a second opinionl Also what documentation did they make the hstionic,

narcisstc diagnois? When I worked on the pscyh ward,

I saw one histionic disorder and she had a boa arand her neck, plunging

neckline, short shirt, high heels, red lipsticks, very theatrical,

true to the diagnosis and at group every sentence began with I and the stories

were like the drram of the Grapes of Wrath.

Now, I don't know if anything like this happened, I would correct it and most of

the diagnosis is subjective and you can wear things

that cover, no make up etc. Below is the diagnosis criteria and I would chack

it out , find a second opinion and get in a medical record that

you can not be anything like that. This way you have a second diagnosis.

You might find out why the doctor might have put it down by studying the

criteria and confront him.

Mnemonic

A mnemonic that can be used to remember the criteria for histrionic personality

disorder is PRAISE ME:[3][4]

• P - provocative (or seductive) behavior

• R - relationships, considered more intimate than they are

• A - attention, must be at center of

• I - influenced easily

• S - speech (style) - wants to impress, lacks detail

• E - emotional lability, shallowness

• M - make-up - physical appearance used to draw attention to self

• E - exaggerated emotions - theatrical

[edit]C

hey often fail to see their own personal situation realistically, instead

tending to dramatize and exaggerate their difficulties. They may go through

frequent job changes, as they become easily bored and have trouble dealing with

frustration. Because they tend to crave novelty and excitement, they may place

themselves in risky situations. All of these factors may lead to greater risk of

developing depression.

Additional symptoms include:

• Exhibitionist behavior.

• Constant seeking of reassurance or approval.

• Excessive dramatics with exaggerated displays of emotions.

• Excessive sensitivity to criticism or disapproval.

• Inappropriately seductive appearance or behavior.

• Excessive concern with physical appearance.

• Somatic symptoms, and using these symptoms as a means of garnering attention.

• A need to be the center of attention.

• Low tolerance for frustration or delayed gratification.

• Rapidly shifting emotional states that may appear superficial or exaggerated

to others.

• Tendency to believe that relationships are more intimate than they actually

are.

• Making rash decisions.[6]

Narcissistic personality disorder (NPD) is a personality disorder defined by the

Diagnostic and Statistical Manual of Mental Disorders, the diagnostic

classification system used in the United States, as " a pervasive pattern of

grandiosity, need for admiration, and a lack of empathy. " [1]

The narcissist is described as being excessively preoccupied with issues of

personal adequacy, power, and prestige.[2]Narcissistic personality disorder is

closely linked to self-centeredness.

Benniw

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