Posts Tagged ‘FTD’

Fresh spoor

2011-11-20

I follow as closely as I can the tracks of my silkee as she wends her way along the strand.  The call of the sea has been strong of late, as she is suffering most grievously here on the shore.

Shortly after the previous post, some nine months ago, she began to have painful spasms in her throat.  Soon she could not eat normal gluten-free food.  She had to go to a soft food diet.  I took her for an EGD.  A few days before the procedure, she began having a different kind of chest pain.  We told the anesthesiologist, and he demanded a cardiac workup.

Off to find a cardiologist, who found low to moderate blockage of one cardiac artery, and prescribed a vasodialator that kicked off abdominal migraines (twelve to eighteen hours of non-stop, uncontrollable vomiting).  Then another med, and a third, all triggering abdominal migraines, before she dropped her as a patient.  The GP refused to prescribe her abdominal migraine meds, because of the heart condition.   She was having ten  to twenty episodes of cardiac pain a day, sometimes passing out, popping nitroglycerine pills and enduring the resultant headaches.  Off to find a second heart doc.  Insurance refused to pay for an arteriogram, we waited to get one done as part of a research project.

By this time she was barely holding on, the cardiac pain and fatigue were so severe, she was unable to do anything:  write, read, watch TV.  Her depression worsened.  Her FTD was getting worse.  Before, she had a wall up to keep out the unwanted thoughts generated by the dying neurons in her brain.  She has practiced for fifteen years a Theravada Buddhist mental culture, anna-panna-sati, mindfulness of in-and-out breathing, the Burmese Forest School version, brought to the United States by G. V. Desani.  She has also her japam, and ishta as a bhakti yogini.  These kept up the wall for years.  Now the wall came crashing down.  Nightmares happened while awake as well as in sleep.  Hallucinations occurred, quickly recognized as such, but disturbing, nonetheless.  She sometimes feels abandoned by God, and has to fight through her own dark night of the soul.

She began falling, and re-injured her knee, repeatedly.  This kicked off pain crises involving her RSD.  Her pain  has been out of control for months.  She now must use a chair-side toilet, as the bathroom is too far away for her to walk.  Other, new pains appeared.  Intense, sharp, deep joint and bone pain; greatly worsened fibromyalgia-like pain.

Cardiologist number two had no clue about how to treat cardiac angiospasms.  I did the research and recommended a treatment plan for him, which he prescribed.  At least he finally gave the approval for the EGD.

The EGD found no pathology other than mild irritation of the lining of the esophagus and stomach.  Smooth muscle spasms again.  Again, GI had no clue of how to treat it.  Referred her to other, useless specialists (we could do some tests, but we couldn’t do anything to treat you, regardless of the outcome of the tests).  Twenty minutes on the internet yielded therapies apparently beyond their ken.  Now off to find a doctor smart enough to prescribe them.

Her heart pain is now fairly well controlled, using the beta-blocker, metoprolol.  This med also eased the nightmares that she has suffered for years.

Her throat spasms are worse, she cannot have even soft food.  She’s on a liquid diet, and sometimes has problems even with that.  Cooking was a way to show her love, now that is gone, too.

Typing is more difficult for her, neurologically.  So we adapt.  She will tell me what she wants to write.  I draft, she comments, and we repeat until she’s ready.  This is the first product.

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Posted in Bhakti, Chronic Pain, FTD, Living with Illness | 3 Comments »

Words

2010-12-26

I am thinking about the importance of words.  I think most people take words for granted.

A friend of mine sent me an article by Tony Judt.  He wrote about the importance of words in this family when he was growing up, about the times in the beginning of the 1950s when speaking proper English was very important.  In college he was a master with words, but he didn’t really understand the importance of silence.

Over many years and during my illness I have learned the importance of silence.

A few weeks ago I went to see a play based on The Screwtape Letters by C. S. Lewis.  C. S. Lewis is one of my favorite authors and I will be talking more about his work in future.   In one passage Screwtape is advising his nephew Wormwood, a fledgling demonic tempter on Earth.  He suggests that Wormwood try to fill the human’s head that he is trying to corrupt with noise.  For if our heads are constantly filled with noise of people speaking, trains running, babies crying and dogs barking, we will never know the peace of silence and the knowledge that may come from within.

Tony says for him rhetorical flexibility allows for a certain feigned closeness, conveying proximity while maintaining distance. I see this in people who don’t walk the talk. I also agree in matters of language, outsiders are frequently deceived.

I remember that when I was the director of a health information department in a hospital, the director of human relations often sent down recruits who he believed were just right for the position I had requested.  He often based his decision on the person’s flair for words, what we call in Texas a bullshit artist.

I have always thought of language as a gift. When I was young I was too shy to speak so I wrote down my thoughts.   As I became older, I realized that many times people only listened to part of what I was saying to them because they felt like they needed to think about what they were going to say in reply. First to test this theory, then out of frustration that I was not being listened to, I would often stop in mid sentence.  Most people did not notice.  Has a pause/silence become so uncomfortable?

When Selch and I started dating, I would stop in mid-sentence and he would say “Yes, continue?”  I was somewhat flabbergasted realizing I had fallen into this rather lazy way of speaking.  Fortunately, I received enough prompting from him and was even able to finish my sentence even though it might mean talking over someone’s premature response.

As Tony wrote in his article many people talk the abbreviated language of Facebook and Twitter and texting.  It is still confusing to me because words used different ways can have so many ambiguous meanings.  I communicate on Second Life quite a bit.  Everyone has forgotten how to spell or they just don’t care about spelling anymore.  I will be texting with someone and am later shocked that I am talking to a philosophy teacher with a PhD.

We have voice on Second Life now which adds an interesting depth to conversations on Second Life.  If a person is speaking in text, it is easy to hide whether you are male or female.  Voice morphing software is available but they do sound like a male trying to impersonate a female or a female trying to impersonate a male

What I love about voice on Second Life is I have the opportunity to really speak with people from other countries.  Yes, there are some language barriers perhaps made worse by not being able to actually see the person but we usually seem to work it out and are for the better for having the experience.

I, like Tony when he wrote this article, am in the grip of a neurological disorder.  He says what I think so well that “the view from inside is as rich as ever.”  Fortunately, I am still able to speak fluently at times.  What you do not know is often it is a struggle to capture the words in my head and speak them out of my mouth or type them onto paper.

So many of my characters are suffering from locked-in syndrome.  For awhile they were all yelling at me, wanting me to tell their stories.  That is the way it has always worked.  I dictate the drama they play in my head.

In most people there is a control mechanism in their heads that they take for granted.  It is like a gate you walk through to get to the subway.  It helps order tasks and projects so that you aren’t constantly overwhelmed.

The reason it is hard for me to say or write my stories is the same reason I am unable to do activities of daily living even though I appear to be capable of doing these tasks which I’ve done all of my life.

I feel like there are so many tasks and I can’t do all of them at once, so I become paralyzed with fear and eventually I just give up.  The doctors term this apathy because that is what appears to be to them.  It is a much more complicated than that.

Now, my characters and ideas aren’t screaming at me.  They haven’t left me.  I spend much more time in silence now, contemplating, using Theeravada Buddhist mindfulness practices and saying  prayers.  This has opened up a world to me that many people cannot see because they are so busy living their lives and caught up in mortality, and noise.

I am not through using my words.  Selch is by my side, my life partner, helping me to pull expressions out that use to flow freely.

As Tony wrote, especially now in this world today, good honest communication is how we sustain and grow and solve the problems we are having in this country and in the world.  We were given the freedom of speech by God.  It is a gift that can be taken away.  Please use it wisely for ourselves and our future generations.

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Posted in communicating, FTD, Living with Illness, Second Life | 2 Comments »

Since I’ve been away…

2010-12-05

I am very happy to be here once again posting to my blog.   I have missed being able to share my thoughts, feelings and information with you.

Unfortunately I have been unable to do even a little writing because of health problems.  First, I had a deep venous thrombosis (DVT) in my left leg. I was admitted to the hospital and put on a higher dose of anticoagulant medication.  I am still having pain sometimes and that leg.  We’ve switched insurance companies lately (my husband had to change his job to get better insurance that would pay for my meds) and it is been a struggle to get them to pay for some of my expensive medications.  I will talk more about that in an upcoming blog.

The most difficult thing that I’ve had to deal with is that my FTD is becoming worse and is affecting my ability to write.  I have so many stories in my head and so much that I want to share with people. My characters are screaming to have their stories told.  In the literature for FTD and one of the symptoms that doctors explain that may happen with FTD is apathy.

Before we knew I was diagnosed with FTD, Selch began to notice that I would not take my pain medicine even though I was in a tremendous amount of pain.  I did not seem to care about bathing even though I used to take two  showers a day, and that I would no longer pay the bills.

I think for me being labeled apathetic is not exactly the right term.  The problem is that when I am faced with the task, I become overwhelmed.  My mind becomes flooded with each detail of the task that I must do and I become paralyzed with fear to the point I am unable to take any action.  Then as a coping mechanism, I try to put out of my mind doing the task at all.

Now I am devastated that my FTD has started affecting my writing again.  I have so much information and so many stories that I want to share with everyone, but right now I feel like most of it is locked in my brain.  It is as if there were a large crowd of people who are trapped in a room but the control mechanism that used to be there to let them  file out in an orderly fashion is not working anymore.

Selch, as always my knight in shining armor, is working with me to help me to be able to write again.  Right now I’m using Dragon Naturally Speaking.  It is hard for the thoughts that come from my brain to go to my mouth instead of my fingers on the keyboard.

In the near future, I hope to once again be sharing my thoughts and feelings with you. Take care everyone, until you hear from me again.

Soulfulsilkee

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Posted in FTD, Health care issues, Living with Illness | 2 Comments »

Gifts from a terrible disease

2010-08-17

Sorry I haven’t been able to post lately.  I’ve been skirmishing with my cornucopia of miasms and the time I’ve had left has been spent resting between rounds of the battle.

I have talked before about gifts that come from illness, such as strength and compassion, but these two gifts that I want to mention are not happenings usually associated with FTD.

The first is unexpectedly increased creativity in some people who have FTD.  A passage from a University of California website says “In our clinic at the Memory and Aging Center, we see people who lose certain abilities, like language, while gaining new ones, like musicality and artistic expression. We have met individuals, particularly those with semantic dementia, who never created art before becoming ill and are now making wonderful, intriguing artwork. One explanation for this phenomenon is that healthier parts of the brain compensate for the areas that are no longer working. Therefore, visual expressions such as a drawing, painting or sculpture bloom as the person loses their capability for verbal language.”

I am a writer and I had a big problem with writer’s block that lasted for years.  A few years ago the dam burst and my mind was filled with many stories.  My characters have always “talked” to me since then.   I am the person who dictates what they tell me, and I do a bit of maintenance work on their pages.

Now, my characters constantly cut in line to try to be the first to tell their story.  They are a rowdy crowd and sometimes I have to blow the whistle and say, “Let’s have some order here. I will get to all of you eventually.”  I don’t think they believe me.  They know my time is limited so they continue their bad behavior.  When I am able, I try to dictate some of their words and I also have a “talk box” for each character who wants to tell me their story.  I can type or use Dragon Speak to get their words out.  Of course, it is only a temporary measure.  When I am too ill to keep up the system, the mob is back.  As of late, I think they have become more understanding.  During this last spell of illness, they entertained me by telling stories one by one.

The other gift  that I have recently received from FTD  I discovered recently.  I have no idea if others with FTD have experienced this with the illness.  Recently, we went to the Smithsonian Museum of Natural History.

Selch wheeled me into the room of stones and quartz.  I began to feel vibrations on different levels.  I told him about my experiences and he positioned me so I could touch different stones.  Each stone had different vibrations and the vibrations sounded like music.  As he pushed my chair further into the rooms, I could hear a symphony of different vibrations.  The colors, the “music” and the vibrations together were an amazing experience.

I wished that I could  touch all the different stones that were behind the glass.  Of all the stones I believe Amethyst was most pleasing to my senses.

Unfortunately, when we came into the room where diamonds were exhibited, there was a crowd of people.  My experience was somewhat muted.  Perhaps too many people block the flow of energy.  This experience is so new to me.

The last stones I encountered were meteors from space, mars, etc.  They also had their own vibrations and tones.  Generally their vibrations had a deeper resonance.

I had read about the power of stones and crystals but never really paid much attention to it.  We have a friend who is a jeweler and the last time I went to his house and he brought out different stones and gems, I did notice an attraction to some of them and I was also delighted to spend a few hours digging through different pieces of gold looking for real treasure (meaning higher quality gold.)  By the end of the day, I found myself really interested in gemology and he gave me a book to take home.

I tried to read the book but after I was away from the stones I lost interest.  Also my spiritual teacher had a collection of different stones and gems.  He talked about their life force and healing properties.

If any of you that have FTD (or another neurodegenerative disorder) and you have experienced an experience of increased creativity or this phenomena with stones and gems, please share your story with me.   Or if you are a loved one of someone with these disorders and have witnessed it.

Also maybe you or your caregiver might want to try or assist you with many creative activities to see if they appeal to you.  I read about a man who had no creative talent who has FTD.  He is now creating beautiful sculptures.  I am not saying that we all will be able to do that but perhaps you or your loved one might gain some pleasure by trying different creative things.

I wrote in a past note that I had lost my ability to play the piano with my left hand or recognize notes on the bass cleft.  We went to the music store recently and I did remember where to place my left hand on the keys.  It is a start and after we are more settled, I am going to purchase a keyboard and see if I am able to resurrect some of my musical ability.

Never give up. We are traveling through the dark woods right now, but on the other side we will continue our journey to a better place.

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Posted in FTD, Living with Illness, Uncategorized | 3 Comments »

For Those Who Are Not Heard, Part 2

2010-07-04

Doctors often do not listen to patients who have FTD, and will tell them that they do not have FTD.  They know so little about the wide variety of symptoms associated with FTD disorders, and how these symptoms and underlying diseases overlap.  This same phenomenon extends to the rest of the medical community:  those of us with illnesses, and even our caregivers, are not heard.

There is still much unknown about FTD and related disorders.  It is only this year that the leading researchers are starting to agree on which signs to look at and the basic measurements that they need to take, to enable them to start sharing and comparing the knowledge and data that they have each been collecting separately.

Further down the research food chain, doctors grab the more common stereotypes, and apply those typical symptoms as inflexible requirements for a diagnosis.  Many people who have FTD do not show “typical symptoms”, and so these doctors refuse to order MRI’s and PET scans, or the neuropsychological testing, that could confirm these presenile neurodegenative diseases in the early stages.  I was told by one self-proclaimed expert that if you don’t have emotional blunting, you can’t have FTD, despite physical evidence on an MRI of unilateral frontotemporal atrophy.

There is no cure for FTD and related disorders but neuroprotective medications do help to slow the damage from these diseases.  There are certain medications that people with these disorders that should not be on, certain medications that make their symptoms worse.

I understand that doctors are taught to sound confident and authoritative in talking to patients.  The idea is that the patient will be comforted to feel that the doctor knows his stuff.  The problem is that a doctor’s confidence in his knowledge needs to be based on fact, not fancy.  Missing a diagnosis of FTD adds years of uncertainty and unnecessary misery to patients and their families, over and above the depredations of the diseases.  And there are few things as disheartening to me as the aggressive ignorance of a doctor confidently and authoritatively asserting falsehoods.

Would it really be so hard just to listen?  To preserve some modicum of scientific humility?

Or maybe this humility is the means by which we can distinguish between the truly knowledgeable researchers and the lesser lights.

My words about this disease that is taking my life — robbing me of my grandchildren, and the world of the art that I want to create — come straight from my heart.  But there are so few who have the heart to listen.

A long time ago in December, I went to a bar, to listen to the words of a poet who was blind and hard of hearing.  He had another poet recite his poems.  All of his friends had promised to be there to listen to him.  This was a major event in his life.  He had never before revealed his poetry, what was in his heart, to anyone.

So the lights were dimmed and a blue light enveloped an attractive woman who sat next to the poet.  Her voice was like velvet and his simple poems about love flowed out of her mouth.   I was drawn into the poetry, my heart beating with the rhythm of his verse.

Then I felt a cold breeze periodically slip past my shoulders.  I looked around the room.  People were quietly getting up from their seats, stealing out like thieves into the night, slowing robbing the room of its humanity.  Then I remembered that another friend of ours, a poet who read his poetry every week at this time was reading his work  just down the street.  This section of town was known for the bars where poets read and people listened to live music.

After fifteen minutes, there were only five people there, the audience was the manager of the bar, a new female friend of the poet’s and me.  The female poet kept reading his poems and occasionally, she would address “the crowd.”  My poet friend continued to grin from ear to ear.  I wondered if he had known that anyone had left.  Then I thought perhaps he was better off not knowing.

I knew that if I walked down the street, most of the missing audience would be there.  I imagined myself chiding them for their transgression.  But, I decided, why waste my time in a verbal attack on fools, when a man was sharing his soul with us here.

About ten minutes before the session ended, his “friends” began to file back in as quietly as they had left.  Then she of the velvet voice said, “Before I read a final poem, I want to thank all of Bill’s friends for coming here tonight to listen to Bill’s poetry.  She rattled off their names one by one and they each squirmed a little in their seats or made some facial gesture, to acknowledged in a social way that they had been caught.

Then the poem was over and they all gathered around him to tell him how his poetry had touched their hearts.  I parted quickly not wanting to hear their gushing lies.

Alas for us who suffer these deadly diseases, there is no narrator in this life to name the names of those who will not hear.

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Posted in Bhakti, FTD, Living with Illness, Medical Mistakes, Physicians, Treatment | 2 Comments »

LIVING WITH FTD: People spreading the word about FTD.

2010-04-26

In this post, I want to talk about people and groups who are spreading the word about FTD.  FTD is still a relatively unknown disease and it is people on the front lines and in the trenches who are doing good work to spread the word about FTD.  Many people believe FTD patients have little insight into their disease.  I am here to tell you there are a growing number of people with FTD who are well aware of their disease and going to great efforts to spread the word about FTD.

For those of you who don’t know, there is a wonderful chat group at The FTD Support Forum. We meet on Tuesdays and Fridays at 2:00 p.m. central.  My user name on the support forum is Mermaid.  Any of you who have FTD and are able to communicate or have a loved one who can help you communicate, I encourage you to join the FTD Forum.  There is a lot of support and good information at the forum.  Our chat group has many friendly folks who are waiting to welcome you with “open arms.”

If you want more information about the chat group, join the FTD Forum and send a private message to Mermaid.

Also, many people who have FTD  are doing wonderful things to spread the word about FTD.  John who has FTD   is very involved with the Alzheimer’s Organization.  He has been working with his local chapter and has recently been to Washington to speak to Congress about pre- senile dementia and FTD.

Tracy Mobley  has written an article as a guest blogger this month on  AlzheimerSpouse.com about what it is like to live with FTD.

Susan Grant has finished her film Planning for Hope.  I really encourage everyone to go to her website, FTD-The Other Dementia.  She needs volunteers in all areas to help her with film distribution.

In addition, there are several people with FTD who have blogs and websites.   If anyone has an FTD/Neurodengerative Brain Diseases blog or website and I haven’t put you on my blogroll, please let me know.

In the next six months, I am planning to have a place on the virtual world, Second Life, for people with FTD, other Neurodegenerative diseases, chronic pain and those who are terminally ill.  More news on that later.

There is a Webinar on Thursday, April 29th.  It is Free Webinar Cognitive and Behavioral Issues in PSP. CBD and FTD with Dr. Brad Boeve. It is from 8 to 10 pm EDT and you can register at this link.  Some of the members of our chat group are patients of Dr. Boeve’s and I’m sure he has some valuable information to share.

Anyone who is doing projects to let people know what it is like to live with FTD or focusing on the lives of FTD patients please contact me.

I will keep you posted with updates about what is going on in the FTD world.

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Posted in FTD, Physicians, Second Life, Treatment | 3 Comments »

Chronic pain- Recent Updates

2010-03-04

Hi everyone,

Recently, I’ve been having a difficult time with various illnesses  so I am a little behind on posting.  I have found multiple articles that may be helpful to those of you with chronic pain.

First let’s discuss slow breathing might help pain.  I first learned about this practice in prenatal classes prior to the birth of my first-born.  Imagine the scene on of Alien when Sigourney Weaver’s guts were being ripped apart by the alien.  Slow breathing did little to help 13 hours of Pitocin induced hard labor.

Fortunately, I have found tha slow breathing can be affective for chronic pain as well as anxiety attacks related to my FTD.  The author also mentions mindfulness exercises which I do incorporate with slow breathing.

Try to sit in a relaxed position.  Breathe slowly and concentrate on each breath and how it feels as it goes in and out .

Regarding mindfulness exercises, the mind is a wild horse and it takes awhile to “break it in.”  If you continue practicing mindfulness exercises which can be something as simple as repeating one syllable phrases over and over again, the results you will gain in helping to control your pain will be well worth the time.

The next article is Tattletale Pills Remind You to Take Your Medication.  Two topics are discussed.

Companies are using wireless technology to develop devices that monitor whether you take your pills.  One way people may be doing this in the future is swallowing a microchip about as thin as a few human hairs.

Over a two-year period, it became increasingly difficult for me to remember to take my medicines and take the correct dosage.  Fortunately, Selch has worked out a system that makes it easier to make sure I receive correct dosages at the correct times.  He bought a large square pillbox that has little boxes for each day of the week and boxes for morning, lunch, afternoon and bedtime.

He or my aide have to pour my meds which also include pouring  liquid pain medicine  into small plastic bottles for each time I need to take a dose.  Even though we have an organized system, someone still has to remind me to take my meds.

The author of the article writes about  a pill that, once ingested, wirelessly transmits information about side effects and how well it’s working. 

Information is sent it back in a readable form to a cell phone or e-mail account.

I wonder if it also tracks any information about side effects that may occur?  The author writes it might be available as soon as the end of 2011 but I imagine that it will be first  for the kind of medication that gets the most attention and research funding such as cardiac meds.  Still, if it works, it may be able to benefit those of us who take medication for chronic pain and FTD within the next five years.

The other invention discussed in the article is the GlowCap that helps people remember to take their medication.

If I was still taking my meds from a bottle,  I don’t think I would see the glowing orange light.  Also what “melody” are they talking about?  Have you ever seen the movei, “Little Shop Around the Corner?”  Jimmy Stewart plays the head clerk.  The manager bought a large amount of cigar or cigarette boxes that play a melody when the person opens the box.  No one wants to buy them and Margaret Sullivan ends up getting a job as a clerk in the store because she convinces a woman to buy the box by telling her that it is a candy box.  When you open the box to take a piece of candy, the melody plays so it reminds you not to eat too much chocolate.

The next article is New Extended Hydromorphone approved.  Hydromorphone is also known is Dilaudid which is one of the medications I take in liquid form for breakthrough pain.

Dilaudid, in past research, is known to be a short acting medication so an extended release version I think is definitely a plus for chronic pain sufferers because Dilaudid can be very affective in helping pain.  It works by making the person feel like the pain is not as bad as it is.

As Karen says, Exaglo is being released under the REMS program which we in the chronic pain have been welcoming like the plague.

The company that developed Exaglo is CombinatoRx, Incorporated (CRXX) which develops novel drug candidates with a focus on the treatment of pain and inflammation.

An article in Bioworld says Exalgo’s REMS  includes “safe-use tools” for prescribers, patients and pharmacists to ensure the “right patients” get the drug and at the appropriate dosages, he said.

Neuman noted that Exalgo’s REMS is less restrictive than the one Covidien initially had recommended to the FDA, which currently is working on developing a classwide opioid REMS.

As I have explained in previous articles, REMS for other specific long acting narcotics as they stand now are very restrictive and will certainly cause many physicians to stop prescribing these narcotics and many pharmacies to stop dispensing these narcotics.

In Pain Topics.org, they outline the REM requirements for Exalgo.  They sound much like the REM plans for other narcotics.  I am concerned that even if a doctor agrees to enroll in the Alliance program and patients agree to enroll in the program that pharmacists will not enroll in the program.

Let me give you a personal example.

We have recently moved and Sech went to the local CVS to get my pain meds. filled.  We had no problem in obtaining the medication at the pharmacy in the previous state  where we lived . All CVS stores order from the same distributors.  Selch spent three weeks getting the run around from our new local CVS pharmacist before he finally agreed to order my medication.  When Selch brought the meds home, he opened the sack up to discover that the pharmacist had given me the Mylan Fentanyl patches although Selch had specifically ordered the Sandoz patches.  Mylan do not work as well for me.  I am not putting them down, to each his/her own and I bless what ever works for you.

The pharmacists said that Sandoz patches were not available.  CVS stores nationwide order from same distributor.  This does not compute.  If this is the attitude of pharmacists now will they be willing to enroll in this Alliance Program?

Notice in the Pain Topics commentary that” FDA Briefing Material for the meeting  provides no data indicating exceptional abuse liability for hydromorphone and  a clinical study conducted in only 9 subjects that found hydromorphone was no different in abuse potential than hydrocodone or oxycodone.”

Also, “hydromorphone products accounted for less than 1% of nonmedical use of all pharmaceuticals, less than 3% of such cases involving opioid agents, and it was implicated in less than 1% of all drug-related suicide attempts.”

I agree that data does not call for such a restrictive program for this new drug.  Lack of data has never stopped the feds from involving themselves in the practice of medicine and trying to persuade physicians not to prescribe narcotics.  Remember the  DEA practice ofraiding of doctor’s offices a few years ago?

The author of Pain Topics asks, “Will there eventually be separate REMS programs for every opioid analgesic, each with its own registration requirements and prescribing procedures?”

Unfortunately, I say yes there will be if they have their way about things.  I don’t know what drives the DEA and the FDA to practices that are and will keep more and more chronic pain patients from receiving their pain medications.

They consider those of us who need narcotics to have any quality of life an acceptable sacrifice for their stated agenda which is  to keep people from abusing prescribed pain medication.  Even their own studies and data do not show that there is significant abuse in people who take prescribed pain medication.

Taking pain medication away from people who need in it in hopes that it will keep people from abusing drugs(who are taking their relative’s and friend’s pain meds)  is not realistic.  When you cut off one source, people who abuse narcotics will just find another source for their habit. Despite the “War on Drugs,” narcotics are plentiful.  So what have they accomplished?

Are these agencies that naive or is this a power agenda?

I have no idea, but we as chronic pain patients need to tell everyone we know what is going onand  we or our loved ones who understand what is going on need to write our congressmen.  I understand that we are all victims.  We are victims of our illness and victims of the medical and governmental system.  But, the only way I  see that we can make a difference is if we ban together and tell anyone who might be able to help us in our cause for the right to have adequate pain relief.

There are some rays of hope in this darkness of denial such as the MayDay Pain Project.  John Stossel recently did a program about the plight of chronic pain patients, War on Pain.  It was on the Fox Business Channel so most of us were unable to see it.   To watch the program go here.

One of the physicians in the practice where I go for pain management is involved in the MayDay project.

Let’s all pray that someday soon this world will WAKE UP.  Until then, remember we are all brothers and sisters united by our souls.  Whether you believe it or not the thoughts that we think may affect our reality so try to think positive thoughts.  I’ll be thinking positive thoughts for all of you and know that you are always in my prayers.

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Posted in Chronic Pain, consumer driven health care movemnet, DEA, FDA, FTD, governmental regulations, Health care issues, Medical System, Opioid therapy, Pain Management, Physicians, REMS, Treatment, WarOnDrugs | 1 Comment »

Anti-depressants may not work

2010-02-02

I just read an article in Newsweek that says antidepressants may be no more effective than placebos. I have been on several antidepressants.  My relationship with antidepressants started when I was having moderate situational depression.  The doctor tried putting me on three or four antidepressants but none of them helped and I had the additional burden of side effects along with depression.

The only thing that helped my depression was getting out of the situation.  But, I have talked to many people who swear that antidepressants help them so I’ve always thought if they work for them and they suffer no side effects then I wish them the best of luck.

After I developed symptoms that could not be explained, physicians that I saw always pushed antidepressants.  They told me they weren’t saying that everything was in my head and that anti-depressants actually had been shown to help my symptoms.

I gave them another go round.  Again, nothing but side effects.  So, I started refusing antidepressants.

Then, my doctor diagnosed me with complex regional pain syndrome.  He has a very scientific way of thinking and explained to me in a scientific manner why antidepressants work.  So once again I hopped on the horse.  This time my companion was Cymbalta.  For the first two weeks, I actually felt better.  I happened to be on vacation in No Where’s Ville, Pennsylvania when I had a severe anxiety reaction due to Cymbalta.  My physician advised that I immediately stopped taking it.

After that, I started doing some research of my own regarding side effects of antidepressants, reading some studies and reading  lots of testimony from other patients that  made me realize that antidepressants can have some major side effects, even suicidal ideation.

Since then, the only thing I have let my doctor prescribe in the anti-depressant category is Trazadone in a very small dose to help me sleep at bedtime.

I have been mostly focused on side effects of anti-depressants in recent years and haven’t paid that much attention as to whether they worked or not.  Many people said that they really work for them and who am I to judge?

I do remember reading a study that said the body adjusts quickly to change in serotonin levels.  I also read recently that serotonin levels are not the hallmark for depression that everyone has been thinking they are.

The article in Newsweek says that studies show that anti-depressants are no better than placebos.  I believe we all have the ability for self healing if we are able to have faith.  Perhaps there is something to the placebo effect and no one should be concerned or ashamed if it truly is a placebo effect.

I am  concerned  that when everyone starts reading this article , they might discount the placebo affect and perhaps not feel as well.  I suggest reading the writings of Edgar Cayce if you are open minded.  His abilities are an example of how the mind does have the power to heal.

I grew up in church where they told us that healing only came through Jesus.  Now I do believe that healing does come from God but the power to heal has been given to all of us.

Remember the passage in the Bible that said if you have the faith of a mustard seed you could move mountains.  I think so.

I once knew a man who had the “gift” of healing.  He knew this gift came from God and everyone has the potential ability to “heal.”  It is one of God’s gifts to humanity.

I cannot say whether antidepressants work for others or not.  In the article someone asked why would the FDA would approve antidepressants if they didn’t work?  The FDA has a huge political agenda and they are not always looking out for the best interest of the people.  See FDA REMS and the fact that they have blocked two new pain medications that might help chronic pain patients.

Please if you are on an anti-depressant, talk to your doctor before you decide to stop taking your medication.  If you get off antidepressants suddenly it can cause serious withdrawal symptoms that could be life threatening.

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Posted in Chronic Pain, errors in medical treatment, FDA, Health care issues, Living with Illness, Medical System, Opioid therapy, Pain Management, pain management specialist, Physicians, REMS, Treatment | Leave a Comment »

New Marker for Cell Death might someday be used in neurogenerative disease

2010-02-02

I just read an article called Monitoring Cell Death Could Help Cancer Treatment.  While now they are studying these monitors for cells that have been attacked by tumors there is a potential that it may be able to be used in neurology to target cells that have been damaged by stroke and neurogenerative diseases.

An Israeli company called Aposense has developed an imaging marker that, when used with PET scans, indicates the presence of dying cells.

“Apoptosis, the process by which cells commit suicide, is a vital mechanism in the body that weeds out damaged, infected, or otherwise unhealthy cells. No matter what the disease or the tissue, cells undergoing apoptosis have very distinct characteristics–the electrical profile of their membrane changes, the cells become more acidic, and lipids in the membrane lose their rigid order and become jumbled. Aposense believes it has found a way to target a trace marker to this combination of traits, which would let doctors image cell death.”

They  have designed small molecules with very high specificity for the apoptotic cell.  A small molecule recognizes the set of alterations in the apoptotic membrane of a cell and it binds to the cell, goes through the cell membrane, and accumulates.

The reason that this tracer might be able to be used to target cells damaged by storke and neurogenerative diseases is because the characteristics of apoptotic cells are universal.

Perhaps someday it may be used to detect dying neurons in someone who is in the very early stages of FTD.

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Posted in FTD, Treatment | Leave a Comment »

What is missing in this picture?

2010-02-01

I felt like I just had to say something.  It has been annoying for the past few months.  In the last two days I have read an article providing information about FTD and information about a conference.  Both of them stated that the information/conference would be helpful for physicians, nurses, and caregivers.  Do you see something missing there? HELLO, I’m here.  I am a person who has FTD that can reason, communicate and has a great deal of insight into my illness.

Guess what?  There are others in this world like me.  It is frustrating to live in a world where most people don’t understand what you have and the people that do assume that everyone who has it is aggressive, apathetic to others, has extreme personality changes, etc.

Perhaps that will happen to me but there are variants of FTD which exist in which the person who has it does not become aggressive, apathetic to others and has extreme personality changes.

As I said in my last post.  FTD is underdiagnosed even in patients who have “typical” symptoms.  Most physicians who see patients don’t see people like me until they are in a later stage if at all because we do not have the “typical symptoms.”

It is a frustrating situation for every one.  I just want to let people know that there are people who have FTD that are actually posting messages, blogging, chatting, researching information about FTD and getting information from conferences.

One of them made a film, another one wrote and published a book.  Some of us are still here and making a difference in this world.

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Posted in FTD, Living with Illness, Physicians | Leave a Comment »

Living with FTD-Frustration of Diagnosis and Support for FTD Patients

2010-01-29

I am going to be writing more posts on what it is like living with FTD in the near future.  This morning, I want to talk about a particular frustration that I share with some other people who have FTD as well as people whose loved ones have FTD.

The “typical” FTD patient according to most medical literature exhibits personality changes, “acting out behaviors”, denial and lack of insight about their illness.

In reality, symptoms of FTD can wildly vary among people who have the disease.  FTD is hard to diagnose because a person with FTD can show symptoms before actual brain damage shows up on an MRI or brain scan.

Even people who have typical symptoms often will be misdiagnosed as having psychiatric problems and spend valuable early years under the treatment of a psychiatrist and taking psych. meds that actually may make their FTD worse.

Most neurologists do not have the training to diagnose FTD.  People with FTD usually “pass” typical neurological examinations.  Thus, the neurologist tells the patient that he or she cannot find any neurological abnormality that explains their symptoms.

I have many FTD symptoms but as I mentioned above, I do not have the typical symptoms that doctors use to screen for FTD.  I’ve had unexplained neurological symptoms, anxiety, depression and increasing apathy towards activities of daily living for the last five years.

My husband and I went through Dante’s Medical Inferno trying to obtain diagnoses for my other illnesses (RSD, abdominal migraines, Celiac Sprue, Meniere’s Syndrome, etc.) I’ve met some physicians who belong on the inner rings of hell but after years of struggle I finally met a few doctors who are good Samaritans.  You will know when doctors get their angel wings every time that hell freezes over.  Okay I’m joking, sort of.

I was admitted to the hospital for unexplained neurological symptoms.  The neurologist came in with a gaggle of baby docs, did the usual neurological examination and said what so many have said before, “I don’t know what is wrong with you.”

My husband, a battle worn veteran of diagnostic warfare and physician retreat, requested that the neurologist order an MRI of my brain.  The neurologist complied.  Most doctors are willing to order an expensive test.  Why not, if the insurance company pays for it and they can be rid of a difficult case that could potential cost them time, money and liability by using  the authority of  The Test that will certainly show something if there is actually something wrong.

My MRI was consistent with FTD/shrinkage in the frontal and temporal lobes on the left side.  The neurologist had his own opinion.  Although he knew nothing about FTD, he told me that FTD was rare and I did not exhibit the symptoms so he was sure that I did not have FTD but I should follow up with another neurologist.

If, I had not been a professional patient then I probably would have gone to another neurologist who knew nothing about FTD.  I would have continued having greater difficulties with anxiety, depression, loss of speech.  When I started having auditory hallucinations then I would have probably been referred to a psychiatrist and  put on psychiatric medication that might make my FTD even worse.  My family totally baffled by these developments as I became incontinent and unable to speak would be advised by friends and the family physician that it was probably time to put me in a nursing home.  I might have died not ever knowing I had FTD.

As I mentioned, I belong to an FTD support group.  They are a really nice group of people almost all caregivers that provide a lot of good information and are very supportive to whoever joins the forum.

I am glad I found this group.  I can’t go out to a support group and there aren’t really any other FTD support groups online.  As the months passed, I discovered as many people do who have chronic, serious or terminal illnesses that I really wanted to talk to others who also had FTD.  It is great to have supportive friends but sometimes when your in this sort of situation you really want to talk to someone who is  down there in the trenches sinking in the same mud.

Fortunately, I met a very brave and compassionate woman who has FTD.  She’s made a documentary about families coping with FTD.  She invited me to a weekly chat group where I eventually met six other people with FTD.

Most medical literature says that the hallmark signs of FTD are acting out, personality changes, denial and lack of insight into illness.  Another FTD “researcher” told me despite my solid proof that I did indeed have FTD diagnosed at Johns Hopkins that I could not have FTD because of did not have these “hallmark” symptoms.  He told me he had reviewed 2000 cases (I later found out not actual people but autopsy slides of people) and all of them had the “hallmark” symptoms.

It is a fact that I have met a total of seven other people who have FTD, are able to communicate and have insight into their illness.  I realized if there are eight people who have FTD who did not have the classic early symptoms of FTD that neurologists use to screen for FTD then there are probably many people living their lives that are progressively becoming more difficult that don’t realize they have a terminal degenerative brain disease and they might have only a few more years to live.

This possibility really bothers me.  Most people who have terminal diseases have some forewarning even if it is a short period of time to say what they want to say to their loved ones and get their affairs in order.

No one knows when they are going to die and many people die in accidents.  Still it bugs me with all our modern medical technology that there may be thousands of people out there who don’t know that they have a devastating terminal illness.

Since most recognized FTD patients are unable to express their needs in a functional manner there is not the kind of support for FTD patients that there is for people with other terminal diseases.  Support for FTD on the Internet is primarily focused on caregivers.  I certainly agree that they need much  support but I think there should be more support in the medical community for FTD patients including those that are unable to communicate their needs.

Since FTD ,until recently, has been considered a rare disease even by FTD specialists, there are very few programs set up for FTD patients.  I wished that FTD patients were able to receive the same kind of support that Alzheimer’s patients are now receiving and that there were  more clinics that had programs and interaction for FTD patients.

New research in Alzheimer’s has also lead to new research in other neurogenerative diseases such as ALS, Parkinson’s and FTD.  I hope in the near future that there will be more programs for FTD patients.

Currently, FTD patients are treated with medications for symptoms.  Most FTD patients before they are diagnosed have been progressively having  increasing problems at their jobs and not long after they are diagnosed they end up having to go on leave or disability.  They remain at home with their families until their loved ones can no longer take care of them and then they are placed in nursing homes where they usually rapidly decline.

I have read about a lot of families that are wonderfully supportive and do everything they can to help their loved ones with FTD.  Also the Alzheimer’s Association has support groups for people with presenile dementia that people with FTD can attend.  Unfortunately, I am too disabled by my other illnesses to be able to attend a meeting.

Still, the burden of care and support remains with the families of loved ones.  If people with FTD don’t have loved ones that are able to take care of them and support them, they end up living alone until they cannot take care of themselves and then they are put into the nursing home.

I have not seen one article that addresses the possibility that there may be thousands of people who have FTD who do not know they have FTD because even FTD specialists rarely see “atypical” patients such as myself and the others who I have met who are “atypical” patients so they may not even know “atypical” patients exist.

It is a fact that there are people that have FTD who are able to communicate and have insight into our disease.  There must be others like us  who are probably falling through the cracks because they do not have the “hallmark” symptoms of FTD which are used as a screening tool for FTD.  Perhaps when FTD no longer is labeled as rare by most neurologist, this will occur to some physicians.

I read an article recently in which an FTD researcher speculated due to the new research breakthroughs they are making in discoveries about neurodegenrative diseases that the diagnosis of FTD may end up accounting for 65% of people who have presenile dementia.

I do not wish for anyone to have FTD but the more number of people who can be found that have FTD means larger amount of funding for further research and programs for people with FTD.

If people with FTD were like stars that scatter the universe and I was an angel, I would scoop them all up in my magical net and protect them under my wings.

I am one spiritual being who is having a human experience.  Part of my experience is living with FTD.  I do the only thing I am able which is  to tell people about what it is like living with FTD and giving support over the phone, the internet and always in my prayers.

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Posted in Autopsy, Dying, FTD, Health care issues, Living with Illness, Medical System, Neuropsychiatric evaluation, Physicians, Uncategorized | 18 Comments »

Giving your symptoms names

2009-12-18

Any one with chronic pain or chronic illnesses knows that to get by it is best to maintain some sense of humor, no matter if anyone else “gets” it, you know what you mean, that is all that matters.

I saw this cute post today:

Have you named your illness symptoms? That may sound like an odd question, but there are some very good reasons for giving your symptoms names. One of them is this: when you give one of your symptoms a name, such as Gertrude or Elmer, you separate yourself from it. When you do that, you are much less likely to identify with it, which makes it possible to step back and see ways for dealing with it and managing its effects on your life that you otherwise couldn’t.

Here’s an example of what I mean: if you have a severe migraine, you may say to a friend or to yourself that you’ve been having awful migraine pain. But when you do this, you can easily feel like a victim. If instead, you tell your friend or yourself that “Sylvester” has been acting up and making himself felt, you don’t make it personal, so you are much less likely to feel like a victim.

A related benefit of naming your symptoms is that it allows you to communicate with them. You can write to them and tell them how they’ve affected your life, and you can tell them how you have felt, and continue to feel, with them. When you do that, you will probably find that you feel a sense of relief and even freedom.

You can also talk to and even have a conversation with “Sherlock” or “Agnes” (or whatever you’ve named your symptoms). When you do, besides telling them how you feel about them, you can ask them if there is anything they want you to know. You can ask them what are the things you do and the situations that make them worse and you can ask them what changes you can make to lessen their severity and minimize their impact on your life.

End of Post.

If people with multiple personality disorders can do it, we should be able to be as equally creative or more.   Illness may narrow your abilities to do certain things but it gives you an opportunity (when you are not trapped in a whirlwind of pain and unwanted thoughts) of time to reflect and open your mind to possibilities like when you were a child looking at the stars or the clouds.

I read recently that physicians are finding some people who have FTD while they lose their ability to process numbers etc. are becoming more creative and are more able to express  themselves artistically.  There are many ways to be artistic: painting, drawing, writing, collaging, making jewelry, etc.  I participate in something I call creative television watching.

I love to watch Turner Classic Movies.  Sometimes when I am watching a movie for the second, third, fourth time, I imagine what it would be like if they re-arranged the furniture, if the guy hadn’t gotten on the train, or if he had gotten on the wrong train or maybe the train didn’t show up at all.  After a good movie often I think about the movie and the characters, imagining what might have happened  after the end of the story, an entirely different story perhaps.

I think about possible future inventions and one gadget I would really like would be something that connects to your brain patterns and to my favorite movie so that I am able to take the characters and create additional scenes and plotlines.

You might think I have too much time, but my time like everyone else’s time is limited.  I just know that my curtain call for this life character is sooner than I use to believe.  I wonder when you  leave off stage does someone direct you to the right or the left or do you just stumble out into the audience?

Back to the naming illnesses.  I think I’ll give the name game a try.  My father use to call me Myrtlerayleenajane.  There’s a few names to start.

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Posted in FTD, Living with Illness, Uncategorized | 1 Comment »

Visit with FTD Research Specialist

2009-12-04

Monday, at 8 a.m. sharp I arrived at the office of a physician who does research in FTD.  Selchietracker as always my faithful companion accompanied me.  The physician’s office is affiliated with a local medical school.  I had been to other clinics in this medical school for various reasons and not been satisfied with the physician’s diagnosis and/or treatment.

I was willing to give this physician a chance.  He had been recommended by a person at National Conference for FTD which Selchietracker attended a few months ago.

After we were escorted to his office and we met the doctor, the first thing I realized was that I had met him before.  I had worked in the local medical community for several years dealing with many physicians so I assume that I have met him somehow in that capacity.

Unfortunately, because we are in transition and about to move again, Selchietracker could not locate the disc which contained my MRI film at the last-minute when we were walking out the door.  He did bring documentation from a doctor who diagnosed me at Johns Hopkins as well as the results of the MRI and other tests as well as her conclusion and findings.

He asked us what we wanted from him, confirmation of diagnosis? Did we seek  treatment options-he quickly answered there was no treatment, or  he asked, did we need further information?

Selch explained that we would like to identify what strain of FTD I might have and find out further information about research trials, etc.

First the doctor bragged about  their extensive collection of autopsy slides for FTD patients.  Apparently they have the largest number of autopsy slides for FTD in the country.  Well that was okay but not very helpful to me since I am still the walking wounded.

Next, he put me through a battery of neuropsychiatric evaluations.  Any of you who have had to do these tests or watch your loved one with FTD complete these tests know that it is no fun to not remember simple words.  I especially fear the dreaded count back in 7’s from 100.  I can never get past the first few, major mental block.  Or the pictures you are required to draw of the connecting shapes and a three dimensional square.  My pathetic attempt looked like the work of a three-year old and to add insult to injury, he told me he was labeling my work with my name.  Come on, enough of kindergarten.

Then he did the usual neuro exam.  I know the drill well.  I could probably perform the exam blindfolded without the assistance of the doctor.  Of course, nothing wrong there except his breath.  I do wish doctors would check their breath before approaching a patient.  There is nothing like being poked and prodded and having to hold your nose.

After the exam, we discussed my history of symptoms.  He asked a few appropriate questions.  Then came the true test. What about my behavior?  Selch proudly proclaimed that despite my other symptoms commonly associated with FTD including apathy towards activities of daily living , that I was still a compassionate person who understood the affects of my illness.

Despite the fact that the physician had not reviewed my MRI and did have ample evidence from a doctor from Johns Hopkins who specializes in FTD that I did have FTD,  he proclaimed I did not have FTD because my behavior was not appropriate.

Because of my problems and reactions to nightmares, he conceded that I did probably have Lewy bodies.

For a brief description about Lewy bodies see: http://en.wikipedia.org/wiki/Lewy_body

For more information about Lewy bodies and FTD see:  http://ftdtheotherdementia.com/whatisftd.html

Selch explained to the doctor that there is a variant of FTD that has Lewy bodies.

The doctor stubbornly remarked that he had seen thousands of FTD patients (FTD is supposed to be still considered rare and it isn’t as if he is attached to a major FTD clinic, so did he mean thousands of live people or thousands of autopsy slides that he mentioned previously) and every single one of them male and female had a history of acting out and not understanding anything about their illness.

I told him that I could produce six people diagnosed with FTD who are able to attend a weekly chat and discuss their disease process.

He gave no response.

So, he wished us luck and suggested we send  him a copy of my MRI.  I think we will be heading to greener pastures.  We are moving closer to a well-known clinic for FTD patients so I think we will continue down the yellow brick road to meet Oz.

Because, because of the wonderful things a good physician does, like PET scans, etc.

I realize the best way to get a functional MRI,more complex scans  or trial treatment is to be enrolled in a study.  Am I willing to be a guinea pig?  I’ve been poked, prodded, scanned, panned, scoped, doped and have never lost hope since I was a small child.

I still firmly believe that there are many others like me that are out there but they haven’t been diagnosed.  Most neurologists don’t know much about FTD.  If depression and anxiety are the first features, then the patient is likely to do a lot of couch time.  I went to many doctors for many years before a doctor discovered that I had a complex regional pain syndrome, with a domino effect other diagnoses fell into line .

I was diagnosed with FTD because of Selch’s practice of smoothly prodding doctors to order tests needed to evaluate my condition.  Also, we have learned when presented with an abnormal lab result or other abnormal finding that cannot quickly be explained away, we will seek multiple consultations until we are satisfied with a diagnosis or have reached a temporary point where we have to stop until other doors open up in the future.

I love when we go to Manhattan to see one of my doctors.  While we are on the streets and Selch is rolling my wheelchair down the uneven sidewalks ,I always see someone with a poster that proclaims one thing or another.  I also think of those comedians who say, “Here’s Your Sign” and “You might be a redneck if…”.  I imagine rolling around holding a poster that says IF YOU HAVE THE FOLLOWING SYMPTOMS YOU MIGHT HAVE FTD SO GET HELP NOW WHILE YOU STILL HAVE A LIFE TO LIVE.

Instead I remain in my “sick” recliner, preaching to the choir.  Maybe, someday, somewhere, someone will find me.

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Posted in Chronic Pain, Dying, FTD, Medical System, Physicians, Treatment, Uncategorized | Leave a Comment »

Should Physicians tell Patients about Medical Mistakes?

2009-12-04

Today I read an article in Medscape regarding the issue of whether or not a physician should tell their patients if they make a mistake in the medical care of the patient.  You can read the article here.

I have suffered greatly because of physicians’ medical errors.

The first time, was in 1991. I had a D&C for a miscarriage.  After the procedure I continued to have bleeding and began to develop severe abdominal pain.  I informed my physician and the office said to make a follow up appointment.  I had the D&C where I lived and it was far away from my work place, so a secretary at my office got me in to see her doctor at the medical school clinic.  Over a course of three weeks, I saw five physicians.  None of them could figure out what was wrong with me. One of the doctors, did a pregnancy test.  She asked me if my stools were dark and I told her they were.  My pregnancy test was still highly positive.  She brought up the possibility of a tubal pregnancy but after consulting with the head of surgery she told me that wasn’t a possibility.

My last clinic appointment was with the head of surgery.  He examined me and reviewed my case and concluded that I was a post-partum neurotic.  He gave me a Demerol shot and advised me to go home.  Fortunately, a urologist I had seen was there and he said he thought something was wrong with me.  He said he was going to admit me to the hospital and he sent me down to GYN for a sonogram.

After they performed the sono, the doctor pulled out a huge, long needle.  I asked what they were going to do.  I was informed that they saw pus on my sono so they were going to extract it via my vaginal canal.

After they began the procedure, the physician turned towards the intern and told him to page the surgeon stat for emergency surgery.  He told me I had massive bleeding in my abdominal cavity.

They rushed me into emergency surgery.  I remember the doctors running down the halls pushing my gurney to the OR, all in slow motion.  A nurse told me I might not survive.  Fortunately, a top specialist in fallopian tube repair was on call.  I had a ruptured tubal pregnancy, not post-partum neurosis.  The specialist successfully repaired the tube.

After surgery, the urologist came in to apologize to me.  He told me that I had a tubal pregnancy.  All the doctors assumed because I had a D&C that I couldn’t have a tubal pregnancy.  The surgeon who repaired my tube had been a professor of the doctor who did my D&C.  He called the doctor and asked him the results of the D&C pathology report.  It showed no fetal cells.  Physicians are routinely supposed to read pathology reports after surgery, but the physician said it had been misfiled.  The doctor who repaired my fallopian tube told my original physician to call me immediately and apologize to me, which he did.

Fortunately, everything turned out okay.  I had a baby boy two years later.  Obviously this happened because of slightly unusual circumstances, tubal pregnancy, but there was gross physician error involved.

Did I feel better that the physician apologized.  Yes I did.  I still was angry that none of the other physicians, especially the head of surgery, did not come to see me after surgery and apologize.  Did I consider suing?  It crossed my mind but since I was in the medical profession I knew that there was no case because there was no loss of organs.

The second incident occurred in 1997.  I was having right sided abdominal pain.  I consulted a GYN and she told she would do surgery to remove abdominal adhesions.  She did a laprascopy but found massive adhesions. Without informing me or my husband or obtaining a surgical consult, she converted the surgery to a laparotomy. When she was trying to remove adhesions, she accidentally injured three nerves in my abdominal area.

After surgery I had trouble walking and severe abdominal pain.  She told me both symptoms would pass and sent me home.  For two weeks I difficulty walking and severe pain.  I saw her for a follow up visit.  She told me the surgery went well and that she thought I had a psychosomatic disorder that caused my pain.  She explained to me stress can do things to the body and put me on antidepressants.

I tried to see her again but she refused to see me.

I suffered with this pain for years and over the years it got much worse.  No one could figure out what was wrong with me.  I ended up seeing a pain management doctor for treatment of my symptoms.

In 2003, we moved and I saw a pain specialist who was a neurologist. He did some testing and told me I had reflex sympathetic dystrophy which is a chronic pain syndrome. He said after reviewing my records, my disorder had likely developed after a complication in the abdominal adhesion surgery.  I obtained my medical records. We discovered what she had done. Did I file a lawsuit? It was too late to pursue any legal recourse.  Was I upset?  Tremendously so.  It has affected my whole life.  I am tortured every day by severe pain.

Do I think that physicians should tell patients when they made an error in their treatment?  Of course. When you as a customer pay for services you expect to be informed if any errors occurred in the performance of your service.  What do you do when your accountant makes an error in your tax return, your mechanic doesn’t fix your car as he or see promised, or an appliance you were sold doesn’t work?  You complain to the appropriate people and expect an apology and an assurance that the problem with be fixed if possible.  If the service provider is unable to fix the problem, you expect some compensation.

So why do so many physicians not tell their patient about medical mistakes?  I think because as medical students, physicians come to understand that telling patients about your mistakes just isn’t the thing that doctors should do.  They should be seen by their patients as a person with superior knowledge in the medical field so the patient will be able to trust them.   Also, their medical malpractice insurance is ridiculously high and they are afraid that they will be taken to the cleaners in court.

First of all, almost all medical malpractice claims are settled out of court.  I have done quality peer review of patient cases with physicians.  Most people who find out that a medical mistake in their care end up not suing.  They may threaten to sue but often change their mind when they find out how difficult the process to recover any damages may be.

The attitude of the physician as the great healer, keeper of medical knowledge, and the condescending “protective” relationship of the doctor to the patient should have been thrown out years ago.  Today’s medical consumer is much more likely to want to know what is going on with their care and they also have more tools to research their illness via the Internet.  Doctors say that medical information on the Internet is incomplete and full of errors.  That is true, but a large part of the population of people are educated, especially the baby boomer generation.  They are use to obtaining and receiving information where and when they want it.  And half of the doctors look up medical information on Wikipedia!

So, as the baby boomers mature into their elder years, I believe the consumer movement in health care will explode with thousands of people seeking information about their medical histories and care.  It will probably change the practice of medicine.

I think the role of the doctor today should be that of patient advocate.  The doctor should be a team member in providing good medical care for the patient. He or she should encourage their patients to become informed and welcome their efforts to find out information regarding their condition.  If the doctor is able to communicate with the patient about their knowledge and continues to encourage good communication between the patient and the doctor, it is reasonable to assume that misunderstandings that lead to threats of lawsuits will decrease tremendously.

Many physicians say that they will not tell their patient about any mistakes they may have made in their patients medical care.  Consumer trends and new governmental reform may force them to reveal more information. They should get used to providing information to their patients.

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Posted in Chronic Pain, errors in medical treatment, Medical Mistakes, Medical System, Physicians, Treatment | 2 Comments »

Flupirtine: New Help for Fibromyalgia, FTD?

2009-11-22

As I mentioned in an earlier post, I bought a small quantity of flupirtine tablets from Germany. I wanted to see if it would help some of my pain that my usual opiates (fentanyl, methadone, hydromorphone) do not touch.  One type of intractable pain resembles Fibromyalgia (FM), an all-over achy pain, particularly deep in the joints, that comes and goes.  When it comes, it stays for hours or sometimes days.  It never just starts and then goes away.  I don’t know if it’s actually FM, or just another facet of my RSD.

Flupirtine maleate is a centrally acting, non-opioid analgesic that has been available in Europe for years.  It was used for lower back pain and post-surgical pain, and then for pain, generally.

Here’s the really important thing.  It also has CNS neuroprotective properties.   This is leading to its possible use for treating CNS neurodegenerative syndromes such as Alzheimer’s Disease, Multiple Sclerosis, Parkinson’s, Huntington’s and Creutzfeldt-Jakob disease, including cognition in CJD.  It might be useful for FTD treatment, too.  Flupirtine is currently undergoing FDA trials for treating Fibromyalgia.  It is also known in Europe as Katadolon and Trancolong.  It is not available in the USA, as it is not FDA approved.

Typical dosage for adults is 100mg three or four times a day, half that for children.  I’m not sure about long-term use or side-effects, yet.  Most of the information is hidden behind registration walls, and I haven’t had time to do all the registrations.

Here is what happened with my first dose:

  • 3:00 pm — fibromyalgia-like pain starts
  • 3:25 pm — took 100mg flupirtine by mouth
  • 4:45 pm — I realize the fibromyalgia-like pain is gone
  • 4:55 pm — bad headache in upper right forehead
  • 5:30 pm — took 1500mg acetaminophen and a short nap, and the headache’s gone

I think the headache is a side-effect of the flupirtine.  The location is exactly where I get a headache and feel electric sensations when I have flare-ups of FTD symptoms.  I doubt that’s a coincidence.  And headaches were reported as side-effects in a good article on flupirtine’s half-life for young, elderly, and renally-impaired patients.

PS.

I got the flupirtine from goldpharma.com, an internet pharmacy in Germany.  You have to fill out a brief medical history for a doctor to review to get the prescription.  The process was very fast, it only took a few minutes from submitting the history to get the prescription, and they shipped it the next day.  We got it in about a week.  The flupirtine came in 400mg tablets, so Selchietracker got a pill cutter, cut the tablets in half and then cut those halves in half to get the 100mg individual doses.  He thought it was kind of neat that the box of “Trancolong” also had the name in braille.  Geek.

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New FTD Symptom

2009-11-12

I had a new symptom from my FTD yesterday.  I was suddenly not able to speak.  I tried.  The words were in my mind.  They wouldn’t come out.  I tried to force them out, but the mouth wouldn’t work.  Selchietracker gave me some Nameda, which seems to help my neurological symptoms.  I was able to speak after some 30-40 minutes.  These new symptoms are very scary.  I wondered if I would ever be able to speak again.  What would my life be like if I couldn’t?

Today, I participated in the Wednesday Chat for FTD sufferers at the FTD forum.  I lost track of time and almost forgot about it.  I had some trouble signing into the chatroom, so I was only able to get in during the last of the conversation.  It is helpful to be able to talk to other people who have FTD.

If you suffer from FTD, I suggest you join us on Wednesdays at 7 p.m. Central Standard Time.  For further info see the post about FTD chat on new posts under the FTD Support Forum.

I think I’ll head back to the water for some rest and relaxation.

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Visit with the Manhattan Pain Specialist

2009-11-12

Blogging has been on hold while I went to see my pain management specialist in Manhattan.  He’s part of the team at Dr. Portenoy‘s Department of Pain Management and Palliative Care at Beth Israel Medical Center across from Union Square.

I am going to try out a couple of new medicines.  One is well known, baclofen.  It’s a GABA-B agonist, that will, hopefully, do some good via effects on endocrine levels.  We’ll see. I haven’t started it yet, as Selchietracker wants to get a handle on how exactly to manage it.  It has a lot of side effects, and many of those signs and symptoms of adverse reactions, I have already as part of my illnesses.  As one doctor said, I am a complex lady.

The other is flupirtine,  a non-opioid analgesic that works on different receptors in the brain.  It should also have some neuroprotective effect.  That may help with the effects of FTD killing off my brain neurons.  It’s not normally available in this country, although it has been available for many years in Europe.   It’s now going through the FDA’s obstacle course as a treatment for Fibromyalgia.  Selchietracker got a prescription from Germany, and bought it from an internet pharmacy, Goldpharma.com.

After we got back from the trip, I got an alert from the Reflex Sympathetic Dystrophy Syndrome Association (RSDSA).  Dr. Portenoy is helping to lead a major push to improve the medical community’s education and understanding of chronic pain, so that we pain suffers will be able to get better treatment.  The launch of this effort is a report, A Call to Revolutionize Chronic Pain Care in America, by a private NYC group, the Mayday Fund.  According to the report, chronic pain is a greater burden on the health care system “than that of diabetes, heart disease and cancer combined.”

The trip was great.  We love Manhattan.  We even found a newly reopened gluten-free Greek restaurant, Gus’s, on Bleeker St just a block east of 6th Ave.  The food is good and the seats are more comfortable than our old standby for GF, Rissotteria, which is a few blocks up Bleeker toward 7th.

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Looking for My Lost Bass Clef, on Celtic Moon

2009-10-28

I love music.  I’ve played the piano since I was seven.  The last time I tried to play, I discovered that I wasn’t able to read the bass clef on a sheet of music.  Also, my left hand had lost its musical memory for the bass clef.  I visualized playing the saxophone, which is treble clef, and my left hand remembered the notes.

I could not remember the most fundamental things:  notes. Like almost everyone who learns to play the piano when they are young, your piano teacher encourages you to make up funny lines to remember the name of each key and letters on the clef.  As I sat in front of my piano, my mind was blank.  I longed for those phrases I tossed aside long ago.  I opened the lid of my piano bench where I use to store trinkets, such as an an apple green spiral notebook with crazy white notes scattered on the cover, that contained my first six months of music theory.  Then, I remembered that I had put what was left of my beginning piano music in a file drawer.  Three rows of steel cabinets were downstairs in the basement.  There was no way I would be able to navigate the stairs.

When I was a girl, my teacher use to give me plastic busts of composers each year.  My favorite bust was given to me by my mother.  It was as larger bust of a handsome young Chopin with blue eyes and cornflower blond hair.  Once, when I was eight, I was having a difficult time playing a piece and I took the bust outside, placed in on the grass and danced around it.  I was wearing a sunny yellow dress then, in Texas.  But as I sat there at the piano that day, I pictured myself going outside in my house dress and dancing a jig with the crazy old Turkish woman who lived across the street.  No inspiration there.  No bass clef.

Now as I sit here typing, those childhood phrases are flooding my mind.  Every Good Boy Does Fine Always, FACE Good Boys, Bad Girls Eat Candy All Fall, All Funny Black Geese Eat.  My piano is in storage now.  But, down the hall in a small room there sits my childhood piano, terribly out of tune, its legs gnawed from a crazy dog and sticky keys from a gaggle of young nieces trying to play Heart and Soul.  Maybe it’s time two old friends got together.  Maybe I can find my lost bass clef.

Right now I’m listening to Live365 radio on the internet.  One of my favorite stations is Celtic Moon.  If you are a fan of Loreena McKennitt‘s style of music, then you should tune into this station.

What I love about Live365 radio, is they provide so many small radio stations that play different types of music.  My brother listens to it when he gets home from work.  He is also a fan of Celtic music.  But, his tastes have always been more eclectic.  I will never forget the timeless melody of Dead Skunk in the Middle of the Road which he played over and over again on his turntable.  He is the only person I know that has the entire musical collection of Focus, a yodeling foreign rock band founded by a classically trained flautist.

It’s time for me to go to an on-line support group meeting, so goodbye for now.

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FTD Brain Neuron Growth as well as Death?

2009-10-26

I came across this in an article in the NY Times about FTD, and the unexpected effect of the brain’s rewiring itself to adapt to the death of frontotemporal neurons:

“In 2000, she suddenly had a little trouble finding words,” her husband said. “Although she was gifted in mathematics, she could no longer add single digit numbers. She was aware of what was happening to her. She would stamp her foot in frustration.”

By then, the circuits in Dr. Adams’s brain had reorganized. Her left frontal language areas showed atrophy. Meanwhile, areas in the back of her brain on the right side, devoted to visual and spatial processing, appeared to have thickened.

When artists suffer damage to the right posterior brain, they lose the ability to be creative, Dr. Miller said. Dr. Adams’s story is the opposite. Her case and others suggest that artists in general exhibit more right posterior brain dominance. In a healthy brain, these areas help integrate multisensory perception. Colors, sounds, touch and space are intertwined in novel ways. But these posterior regions are usually inhibited by the dominant frontal cortex, he said. When they are released, creativity emerges.

Maybe this means that I may have some areas grow and increase in ability, while the other areas are deteriorating.

Does anyone out there have any experience with this phenomenon?

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The Beginning of the End

2009-10-25

I am dying.  This is a simple statement of fact.  Mature people should be able to accept this at face value, and react accordingly.  So one would think.  Instead one gets the queerest reactions.  Most deny the obvious, and say — quite without evidence or justification — that I’ll live at least ten years or more.  How convenient for them, not to have to confront anything real or unpleasant in the immediate future.

My husband set up this blog for me.  I’ll try to learn how to work it.  It will be difficult.  The interface between my spirit and my body is slowly going out.  As my brain is dying, there are episodes of “static” or storms of uncontrolled thoughts, that I have to fight hard to control.  It takes a lot of energy, just to appear normal.  I am not.  My disease is mostly invisible.  Recently, I have started to add stuttering sounds, at the end of my words, like da-da da da, or pa-pa-pa-pa-pa… for minutes on end.  Very embarrassing.   And very uncomfortable for those who want to believe the convenient lie that I’ll be around for the foreseeable future.

This won’t just be about dying.  I’m also writing a novel and consulting with an incipient start-up company to develop automated medical diagnosis software for the web.  I have opinions on politics, life, and how to improve the medical system.  I am a spiritual being, and so I don’t always have the human perspective of the world.  The spiritual view is usually quite different.   Sometimes poetry blurts out, unbidden, silly sometimes.

Selchietracker has written this to prime my blogging pump.   Channeling me.

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