How to trudge through the medical system - my personal saga.

Wow, the past 2 weeks have been an emotional roller-coaster for my family.  My partner Ed has been suffering from depression for the last few years, which has turned into a never ending presence in our life.  Ed lost his job at a local Big Box store, and things just went down hill from there.  He has always suffered from some sort of depressive tendency, but would joke his way through things so he never seemed that bad.

We started to see a psychiatrist that used to work with me and is now over at the University Hospital.  Ed was put on various medications which only helped to some degree or another.

Several months ago Ed  started to have palpitations, which we thought were an exacerbation of his anxiety and depressive disorder.  He developed a tremor, and during this time, after he started one of the medications (Effexor), he began to have high cholesterol and diabetes, which he did not have a year ago.

Ed is a Big Boy. One would expect that he would have some of this at his age (50 years old).  However, things just came on so fast.  Neither our Primary Care nor the Endocrine doctor believed any of this was caused by the medication, so we began treating Ed with the standard oral diabetic medication. Metformin, Gemfibrizole, Glimberide, and ultimately insulin. He is on Amiltrypteline for migraine and supposedly sleep (a laugh, as he never sleeps). The only thing that has been sort of OK has been his blood pressure on Atenolol.

In between all of this, the Effexor is doing nothing, so we start a "medication wean off the Effexor" and start a new drug call Nortryptiline. The anxiety and palpitations get worse, he actually gets mean. He broke his laptop in half in frustration.  He became a more reclusive person, more depressed, more anxious, and mean!

One day when we were in the car to go for lab work Ed says to me, "don't get a bee in your bonnet, but I don't think you should leave me alone today".  Ed was feeling suicidal. We continued on to the doctors office we checked in for the lab and I politely sold the woman behind the counter that we needed to see a doctor, when asked why, I told her Ed was having some severe anxiety issue.  We saw a new young very nice 12 year old doctor. (I am being facetious). She did a depression and anxiety profile, which basically means you check of boxes to various questions on 2 little sheets of paper and viola you are severely depressed.

She recommends that we go to the Crisis ER. Which Ed declines, saying he wants to go home.  At this time he is barely moving.  He has become a big ball of anxiety and only wants to go home and to bed.  The doctor finally gives him a prescription for ativan, and calls his psychiatrist and lets us go home.

We see our psychiatrist the next day.  We begin discussion on other medication options.  We talked about MAO inhibitors and new diet restrictions.  We ultimately discussed the option of ECT, for those of you out there it is electroconvulsant therapy. I can get into an explanation of that later. None of the medications have worked for Ed's severe anxiety and there is some hope with the ECT. (I also should say, believe it or not, Ed has been turned down for Social Security Disability and the appeal.  Ed has not worked in 2 years, I have been the sole provider).  The doctor starts Ed on an anti-anxiety medication Clonazepam 1 mg 3 times a day.

The following Monday we went in for an History and Physical for the Electroconvulsant therapy. They draw labs, do an EKG. And low and behold, at this point things become more wacky.  The technician does Ed's EKG 3 times. (His previous EKG from about 6 months prior is completely fine).  This EKG, shows an elevated ST segment and a left bundle branch block. For those of you out there who are not medical, he could be in the middle of a cardiac event and he could throw a clot and have a heart attack or stroke. Mind you I said could be.

We get sent home, Ed gets even more anxious, and we get sent to go for a Cardiac CT Angiogram (I will explain all of these procedures at the end, because as I am writing this, I realize that if you are reading this you might not know what any of this is). He also goes for a swallow study because during his conversation with the doctor he told her that he is having trouble swallowing some of his pills and when he eats crunchy foods it causes him to cough.

The ECT is now on hold.

The swallow study revealed he could go through the ECT, but oh by the way there is this rod like growth in the back of your throat that needs to be worked up further (Not what a man with severe anxiety wants to hear, now he is thinking cancer, and I don't know).  I try to discuss this with my primary who says she cannot talk to me about it as it is out of her area of expertise and we need to return to the ENT. (Can we say more money out of pocket, what is the deal with not being able to get information, what is the point of having a primary care doctor). Naturally, it becomes difficult to get hold of the ENT, which I still have not spoken to.

In the mean time,  the weekend rolls around.  My son celebrated his 17th birthday.  Sunday night, Ed says, I am not feeling so well, I am having some chest pain.  My daughter and I take a begrudging Ed to Abbott NW ER, which I would recommend to anyone.  They are really great. The doctors and staff were caring and understanding. They repeat the EKG, the changes that were there before are no longer there.  It is a normal EKG.  He is given sub-lingual nitro under his tongue and the chest pain starts to resolve.   Ed really does not want to stay in the hospital. He knows our money is tight, and we have exhausted out financial resources. (I will probably be filing bankruptcy soon, I am like that commercial that says I am up to my eyeballs in debt, please help).

They draw a lab called a triponin which is a marker for a heart attack. It comes back negative which means he is not having a heart attack at this moment in time.

We are discharged home and they call us the next morning to schedule him for a cardiologist appointment the first week in November.  The ECT is still on hold. Ed is now not on any meds for his depression.

I have been home with him for 3 days now and he is getting worse. I think he only came out of our dark bedroom to get some water, and eat some food I had prepared.  He is barely talking, and I am worried.

I will call our doctor today,  maybe we can get him on something with not so many side effects like Celexa, which is a drug that we use frequently on my patients.