Friday, October 19 – Dr. R

I met the psychiatrist.  After what seemed like long day of trying to be happy, smiling and keeping my tears in check while I went out to “play”, the 40 minutes spent with Dr. R were a tear filled session of him alternating from furiously writing, to long pauses where I think he had no clue how to recap what I had just spewed unintelligibly from my emotion driven mouth.

Thursday started out with an appointment at Helen’s Room, which is a completely free place to get wigs, hats, scarves and some directions on how to make yourself look better while going through cancer treatment.  Because I had no interest in wearing a wig, and knit & crochet, and I have a ton of scarves, I never felt the need to make an appointment at Helen’s Room to partake of this service.   Monica, the director of Helen’s Room, and my friend Linda convinced me that this might be fun to try, even though I am done with treatment.  I am going back to work here soon; some more hair may give a psychological boost.

Hence, I tried on wigs, and hats, and some scarves, and came away from Helen’s Room with a wig and four new hats.  Since my hair seems to have seriously slowed down on growing back in, maybe having these additions to my headwear options for winter will be a good thing.

From there I went over to Costco to pick up my newly filled Rx’s from my primary care physician.  Since I have stopped taking Gabapentin mid-day, I am really noticing more irritation and pain in my hands and feet later in the afternoons now, so I do my best to not overdue walking and standing.  Costco was not too bad, but there was a mix-up on the prescriptions, so I chose to bid my time grabbing a bowl of chili from the Costco Food Court and sitting on a bench there.  After the indicated 40 minutes to rectify the problem, I went back in and got my renewed prescriptions.

After that, I headed over to Dr. R’s office.  I checked in at the front desk and took my seat in the waiting room.  My friend Linda was taking care of her dogs at the vets but reassured me she would be there waiting for me when I was done so I wouldn’t have to do this alone.  Dr. R was running just a few minutes late.  He finally came and got me, and we went back to his office and he told me to have a seat anywhere I felt comfortable.  Of course, the chair I chose was well broken in and I sank down at least 6 inches after sitting into the cushion.  Even though I had gone in on Tuesday and filled out bazillion pages of new patient forms, answering some very personal questions as well as providing a complete medical history, he asked me why I was there.  I hate when doctors do that.  You have to fill out everything about you down to what your choice in underwear is and then they never read it.  Why?  Why do I have to spend 40 minutes or more filling out your patient history questionnaire, giving you detailed information in writing about my personal history, and then you do not even look at it.  I could not even see any of those pages I poured over on Tuesday afternoon in the file he had started for my case.

So I started at what I thought should be the beginning, I have neuropathy from chemo.  I have been taking Gabapentin, but realized a few weeks ago when I accidently missed a dose mid-afternoon, that yes it is providing me some relief from the pain/irritation, but it is also making me very tired.  When I saw my oncologist the following week I explained to her how I was now trying to decide which was worse, the irritation or being that tired.  She said we could wean me off the Gabapentin and put me on Lyrica instead.  She also said that because we were transitioning into psychotropic drugs she wanted me to go to a psychiatrist to manage these meds in conjunction with all my other medications.  She said a psychiatrist would be much better at getting me the right amount of relief with the correct medication than she would.  I explained how the insurance company has denied the Lyrica, and I am still taking the Gabapentin.  I also explained to him how I have been on Paxil for about three years now, and I am trying to lose weight, it is not coming off and Dr. Levee thinks the Paxil may be contributing to my inability to lose weight.

Dr. R kept a stern look on his face during this recitation.  He asked me if I was still taking the Gabapentin, and I acknowledge yes, I am still taking it, as I have nothing to replace it at this point.  He said I should continue to take the Gabapentin for the neuropathy.  I was all, wait, this is making me tired, this is why I want off the Gabapentin.  He said Lyrica is out it is not good.  He then asked me my medical history, again, why?  I answered all his questions, why was I put on Paxil, answered that, and then we were loath to take me off it with the cancer diagnosis last year.  In addition, I told him about the depression, and Dr. Levee thinking Wellbutrin instead, but would defer to him to manage this to get me off the Paxil.  He asked me why I thought I was depressed.  By this point, I was so frustrated the tears were already trying to escape my eyes.  I was tired and me feet were starting to hurt; I now get sharp pains that start shooting down my toes and across the arch of my foot in the afternoon.  So there I am trying to find a new way to manage my neuropathy with a doctor who is supposed to specialize in this and now I’m being drilled on my cancer, which is a huge trigger for me, I am tired and my fingers are on fire and my feet hurt.  I have lost my joy and this quack is asking me why I think I am depressed.  There was no stopping the sobbing now.  I swear he looked at me as if I was trying his patience.  He was certainly trying mine.

He made me walk him through the past year.  My diagnosis, chemo, surgery, and radiation.  Then he asked me about the pathology report from surgery – were my lymph nodes clear?  Yes, four nodes were removed and all showed clear.  He told me I should just think about that.  No shit, Sherlock!  I write a list of everything I am grateful for every night, hoping that one night, writing that list will not make me cry.  One of these nights, going over everything I am grateful for will bring me joy again instead of tears.  Then he asks me why I am so sad?  OMG?!?!?!  Really?  If I knew this I would not be sad now, would I?  Once more tears of frustration streamed down my face because this man is telling me all the things I already know.

After what felt like hours of grueling questions and statements, he finally looked up at me, smiled and said we can try Cymbalta.  I can take Cymbalta in the mornings, and start weaning myself off the Paxil.  I am to continue the Gabapentin for now, until we determine if the Cymbalta will be effective.  He said we can figure this out and I will get through this.  He made a statement that I cried enough for the next week so no more tears and only think of happy things.  Can I just roll my eyes now?  I told him I am aware of this, and I am not looking to him to medicate my sad away, but I am looking to him to help control my neuropathy symptoms so I have one less thing I have to deal with in my recovery.  He had me get on the scale so we could get a base weight to see how I react to Cymbalta and I am to go back in two weeks after I have weaned off the Paxil.  At this point, I am still not sure how I feel about Dr. R, but it can only get better from here, right?  I was emotionally exhausted after that encounter.

Linda was true to her word and was waiting for me in the lobby.  I walked into her arms and sobbed a few minutes on her shoulder.  We decided to go over to the pier and look at the water while I unwound from that first encounter with the psychiatrist.  We talked about my new wig, laughed over a few things and I was able to get my equilibrium back.  Linda headed off for a class and I headed back to Costco to fill the new Rx from Dr. R.

I was back at the gym again this morning for some weight resistance work and then a nice swim.  My waterproof MP3 player conked out 1/3 of the way into my swim.  Guess I now know how long the battery charge lasts.

I am trying to figure out what I find joyful.  I used to find joy in all sorts of simple little pleasures.  Now it all seems meh.  I am trying hard to find my joy.  I went to a lecture at CSC after the gym today and from there stopped at the store to pick up more herbs for my water.  I also stopped at AAA to get my permanent Handicap Placard.  I asked Dr. Levee to renew my temporary placard for now, but she said this needed to be permanent, not temporary.  So I did that too.  Now I am exhausted.  I think it is a holdover from yesterday’s encounter.

Life is working all the tools