She was a 33 year old raven-haired exhausted woman who had probably been a beauty before she bore children, now aged 9, 6, and 4. She wanted a renewal on her sleeping pills. She did not want the antidepressant or anything else, just sleeping pills. She said that since the children all slept through the night, now she could, too. She had not only a tubal ligation at her final pregnancy, but an ex-boyfriend who was no more than a distant memory.
Her last doctor, apparently a rarity, had actually started by prescribing the sleeping pills every third night. That had not lasted more than four weeks or so. She wanted, and felt she “deserved,” sleep every night. She was convinced that was what the insurance doctors gave the rich people, so she was not going to let anybody skimp on her. Sleeping pills every night. She would not have to think about anything other than keeping a bottle by her bed and getting it into her mouth. Sleep would be automatic and life would be sweet.
The last doctor had been, to his credit, assertive enough to tell her that if this was what she wanted, she would be coming in every three months for the rest of her natural life on planet earth, to get sleeping pills. She thought that was just fine; that it was what everyone did and should do, since we had something as wonderful as sleeping pills in the world. Read more on Pharmaceutical Companies Are Stealing Our Dreams…
Filed under prescription drugs, Sleep, Substance Abuse by on Jul 1st, 2010. Comment. 
She was nearly thirty, dark haired and round-faced and ambitious, and wanted to be a drug and alcohol counselor, maybe. Maybe not. She had only three months of sobriety from alcohol; probably wanted to be one of those people in power. So many programs dry people out and let them “stay on” a bit. So many people use their own exaggerated stories to “help” other people stay sober. A closet industry of subjective touchy feely, trampling, as many do on my long years of difficult, mind boggling training with cheap feel-good.
Her drug and alcohol counselor had told her that she would feel rotten for a while, so she had accepted that. But she felt obligated to tell me that she had felt rotten, so I let her talk and tried to listen.
People coming off alcohol may take as much as a year to get their sleep cycle back (alcohol represses Rapid Eye Movement sleep) and to stop feeling a little bit nervous. But this was not that. Read more on Serotonin Syndrome: Less Is More…
Filed under prescription drugs, Substance Abuse by on Jun 24th, 2010. Comment.
People who have panic disorder go to doctors to take care of it. I have had maybe hundreds of patients, more than I can count over my years of practice, who have come to me with this. Most of them do well. Usually the panic disorder runs its course.
That is not to say that panic disorder is not terrifying. Often people believe that their first panic attack is a heart attack. Often they have come to me already addicted to benzodiazepines by emergency room physicians who (understandably) worry a lot more about the immediate comfort of the patient than about the long term situation. Here is the official government take on panic disorder. Yes, find a psychiatrist you can trust. Yes, they recommend family and support groups. Good stuff, but free and easy to recommend. Yes, there is some exciting new research but as long as insurance companies and HMOs determine how people get treated, it is unlikely that research will be quickly translated into treatment.
Most people who go with the mainstream treatment do pretty well. Here is another description of mainstream treatment, a little more complete. Read more on A Real Doctor — Like House MD…
Filed under medicine, prescription drugs, Stimulants, Substance Abuse by on Jun 17th, 2010. Comment.
She was exactly my age, with a birthday only two days before mine. Same year. I know that there are more people born under the sign of Aquarius than any other astrological sign, so I am no longer surprised at the number of people who have birthdays in February. (Especially since, if you count back nine months, you end up with June, which is when everyone’s thoughts turn to love and their thyroids and probably other glands are hyper-secreting.) But this was one of those people who makes me think I look awfully good my age. Probably a function of middle class privilege and doing more intellectual than physical work.
This woman had a son who cared about her. The fact that she came to the clinic with him made her fairly special among those I was serving at the time. He had been worried when she seemed too sleepy and too angry and not herself.
Like most patients, she really did not want to tell me much about the other doctors she saw or what medications they gave her. I told her that I could check for interactions, and that her failure to tell me would increase her risk of having problems. I know that a lot of people get “pain killers” and don’t think that they count for “real medicine.” Read more on The Shrink As Sherlock — Detecting Opioid Addiction…
Filed under Addictions by on May 20th, 2010. Comment.
People told me I would have troubles in France because it was a “Catholic” country. I do not think any trouble I can remember came from the few people who actually attended church regularly. But back to politics. The parties were grouped into “left,” “right,” and “center.” The left included the commies, whom I had to reassure that even though I was an American I did not hate them. I found “rightists” fearing change as obsessively as any conservative (read “ultra-republican” American ever could. Read more on Psychology of Politics (and Politicians)…
Filed under Addictions, politics by on May 19th, 2010. Comment.
Thanks to modern technology and “time-shifting” I was able to watch the brief apology speech Tiger Woods gave to his wife and children, his fans, the employees of his charitable foundation and – probably most importantly – his sponsors.
Some critics question the sincerity of the greatest golfer ever – noticing his lack of emotion or even passion when apologizing, his unfamiliarity with the text he was reading from and his lengthy wait to even appear and give such an apology.
My concern was the total lack of mentioning a very serious aspect of the whole Tiger Woods fiasco – driving while intoxicated. The whole incident erupted on the world news scene when Tiger smashed his luxury SUV into a fire hydrant and a neighbor’s tree and was dragged unconscious from the vehicle by his wife.
Filed under Substance Abuse by on Feb 23rd, 2010. Comment.
There are actually people in southern California who complain about the winter. You have to get your jacket out of storage. It gets dark too early, but luckily some people start their night lives earlier.
There are flus and there are coughs.
There is cough syrup.
When I was in grade school, the only cough syrup our kindly family practitioner could give was something with codeine. I was a sick little girl who seemed to be allergic to everything she touched, so I got a little of some kind of precious substance when the winter snows hit New England, and my respiratory system remained intact with that little bit of codeine.
Filed under Substance Abuse by on Dec 21st, 2009. Comment.