• N&PD Moderators: Skorpio

Need Help Please

Ok I know all you guys are trying to help me and I apreciate it <3 , I really really do, and your all welcome to post including Murphy and Hammilton, this is not just about what I want to hear but more so about uncovering the facts. I know I must come across one stubborm mofo but guys believe me I am an open minded person and the only reasons I've been against a psychosamtic diagnosis is beacuse everytime Ive considered it there have been so many factors that have indicated to me otherwise, so many reasons at play that all prove against it. I've considered a psyhosamtic possibilty throughout the years and particualrly at the start when I first developed Dysautonomia after seeng many shrinks I have moved beyond it, talking to you guys I'm revisting that all over again. I would love to make a list of all the reasons why I know its not psychosamatic and have each one adressed if you guys can be bothered helping me but only if yous are willing to help with it and in the end if my reasons are disproven then I will accept it and be thankful to you guys for helping me find the real disagnosis.

As suggested here I can request a doctor to administer drugs once I fall asleep but if I happen to wake up with an adverse reactions then most likely you guys would say the mind is a powerful thing and I woke up because subconciously my sleep was restless sleep due to being on high alert or something like that, its a lose lose situation for me, as for the placebo I've already done that when I actually made mistake by taking oxynorm for 1 week everyday thinking I was taking 5mg oxy when in fact I was only taking 1 mg due to the confusion I had with the instructions on the box that stated 5mg/5mg, I know it was a dumb mistake to make but only because I had previously tried hydromorphone which was 1mg/1mg so I thought if the oxy was also 1mg per 1mg they would have listed it the same way. But despite previosuly having had severe adverse reactions to 5mg oxy in hopital I didnt get any reactions whatsoever when I actually thought I was using the same dose at home, eventually I went to my doctor and complained that the oxy he had given me was useless and did NOTHING and I began to think he had tricked me witha placebo until he questioned what dose I was taking which soon become apparent that I had made a mistake and only been taking 1 mg thinking it was 5mg. So you see guys been there done that with the placebo.

There is nothing wrong with psychosamtic illneses they are also very real, there is no shame in them and they dont make you any less as a person, and if there was the slightest reason I thought I had a psychosamtic issue I would accept it and focus on recovering rather than wasting 8 years looking elsewhere, but please keep an open mind here too I understand in this world we compare everything to our understanding of common occurances and past experiences but I do have a RARE proven diagnosed neurological illnes called "Postural Orthastatic Tachycardia Syndrome" where it sufferers have heat intolerance due to dysfunction of the sudomotor function in the brain along with damage to nerves and pathways between the brain and the sweat glands but additionally in me I actually generate excessive heat compared to other Dysautonomia patients and this has been narrowed down to the fact that my Autonomic Dyfunction started right after an OD on party drugs which is extremely uncommon yet possible as one of the causes for Dysautonomia is toxic exposure, so you see when something as uncommon as this happens due to uncommon circumstances then the uncommon symptoms I have are to be expected.

Furthermore the hyperthermia thats contributed to the damage in my temperature control is everyday, day and night, during sleep and awake, whilst im watching tv, focused, concentrated, out shopping, eating etc etc. and has been constant for 8 long years. Now why my daily overheating actually worsens during adverse reactions is anyones guess. I also have been diagnosed with Autonomic Neuropathy but what sets me apart from the rest of the flock is the fact that whilst most Dysautonomia patients have chemical sensitivities anfd whilst all familial dysautonomia patients are unable to be anethetised due to complications they still are able to tolerate alternative anelgesics where as in me it seems to be very widespread and more generalised, so how can it be that others with Dysautonomia have partial chemical sensitivity and with them its accepted as a physical part of their illness but just because I have it worse than them it makes me psychosamatic considering the uncommon circumstances that my condition did develop due to drugs.

The fact that the very fisrt thing I noticed following my overdose was that I was no longer able to take ecstacy and meth due to an allergic type reaction is very significant and has a major hand in all this although most of you would rather believe that too is psychosamatic, but how can we accept that a large part of my condition and symptoms are due to proven diagnosed neurological condition and dismiss the other uncommon symtoms that cant be explained as being pysychosamtic when the whole thing spawned from a the very same uncommon circumstance of developing Dysautonomia after an OD? The fact that the first few weeks after my OD I was constantly ending up in hospital with fevers and documented high temperatures mainly after every sexual activity where they would find there was no other causes for my fevers other than the autonomic dyfunction as the temperatures the hospital documented is well above anything anxiety is capable of inducing, that to me is a great indication that I have something abnormal going on.

What about when in hospital they gave me morphine very cautiously in a very small dose and when it didnt help with the pain they increased it and again it did nothing for the pain and I asked for more and on the 4th increase in dosage I had adverse reaction, why is it that it took 4 goes when I was equally cautious on the first 3 times yet I had no bad reaction and why did the hopital staff find it odd that I would have temperatures increased to a level where anxiety sufferers dont experience once I had the adverse reaction?

Why is it that I actually dont develop the symptoms like respiratory depression, digestive issues, increased pressure in the head and increased blood pressure and hyperthermia evfen when I am actually anxious, even real anxiety itself does not proveke the same symptoms as supposed adverse reactions do.

I can give you guys so many examples of occurances that set my symptoms apart from anything psychosamatic but for the sake of you guys helping me im going to try very hard to keep an open mind here and work with you guys about what yous tell me, but what if in the end, just what if everything Ive said is true, what if I am a freak whos damaged certain receptors in the brain after that drug overdose and as a result of neurotoxicity developed Dysautonomia and stumbled upon a formula whereby the hyperthermia during the od whilst engaged in sexual activity damaged my hypothalamus and my sexual responses leading to this daily overheating and left me with a chemical sensitivity towards the very drugs that caused the damage..then what? whats my next step? lol I know how far fetched that sounds when I say it like, now I understand why its so hard to belive and I dont blame any of you guys for it its just my luck though :)
 
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Ok I know all you guys are trying to help me and I apreciate it , I really really do, and your all welcome to post including Murphy and Hammilton, this is not just about what I want to hear but more so about uncovering the facts. I know I must come across one stubborm mofo but guys believe me I am an open minded person and the only reasons I've been against a psychosamtic diagnosis is beacuse everytime Ive considered it there have been so many factors that have indicated to me otherwise, so many reasons at play that all prove against it.

Then why haven't you presented even one of them? Not one single thing indicates something other than psychosomatic. Actually, everything screams psychosomatic. Nothing you mention here even indicates this.

Psychogenic fevers have been documented of reaching almost 106F (41C). You don't mention numbers, but this should easily show that psychogenic fevers may reach any level.

I was equally cautious on the first 3 times yet I had no bad reaction and why did the hopital staff find it odd that I would have temperatures increased to a level where anxiety sufferers dont experience once I had the adverse reaction?

You're not familiar with an active placebo, are you? The point is that you didn't experience any negative reactions earlier because you either hadn't felt the morphine at all, because it wasn't sufficiently felt, or the anxiety took longer to develop.

Why is it that I actually dont develop the symptoms like respiratory depression, digestive issues, increased pressure in the head and increased blood pressure and hyperthermia evfen when I am actually anxious, even real anxiety itself does not proveke the same symptoms as supposed adverse reactions do.

This is so obvious I really cannot believe you're asking it. "Digestive issues," high blood pressure, and hyperthermia are common symptoms of anxiety. Increased pressure in the head is an amorphous, vague symptom. If you actually had increased intracranial pressure, you'd have be experiencing severe headache, nausea and vomiting, lethargy, etc. Even pychogenic respiratory depression has been reported.

So far nothing you have given has provided any sort of indication that this is not psychogenic in nature.
 
OK, a different approach; I think Monkey Mantra's suggestion already pointed in this direction: Are there any viable test with which one can exclude a psychosomatic cause for some kind of illness?
One idea was to administer the resp. substances while the patient is sleeping. Could work and doesn't sound too dangerous to me, as long as we speak about a clinical environment. Any else ideas...

I agree that it doesn't help a lot that we are constantly giving the same explanation while Unlucky is convinced that it is something else. So, instead of telling him than we think it's some psychological problem, I would welcome some ideas to determine resp. to exclude this alternative... Are there established tests for this?

- Murphy
 
an approach like the above is certainly feasible, but there are no real pre-existing settings that I can see where this is anywhere near a norm and thus would have to be a very open-minded MD to host this investigation, if to be done in the safest clinical manner
 
Agreed! I think most physicians would risk their license, as well as serious judicial consequences, and thus would refuse to participate if any signs of health risks arise. Such studies would be suited best for an academic background, but the difficulty of raising the necessary funding for such excludes this option IMO.

(For the sake of discussion I will consider Unlucky's problem as something with, at least in some part, physically caused maledy. Please note that personally I still vote for a psychological origin. But I'm willing to see the whole issue in a different light, as soon as further evidence against this theory shows up. I do not claim to know 'everything'. :) )

Again: How can a psychosomatic cause be excluded experimentally?

Murphy
 
by administering an active placebo?

I don't see any other option, except perhaps administering the drug under aneasthesia.
 
wow, I thought I would have lost you guys after my rather lengthy comment which unintentionally ended up more like a long essay, wasn't sure if anyone would read it but im grateful that yous did, thanks :D especially to Murphy and Hammilton for their willingness to meet me halfway on this.

I have an upcoming endescopy where I will be sedated with propofol, the GI doctor has good relations with my neurologist maybe I can convince them to administer a dose of opiod that im highly sensative to, 2 tramadols should do it or a high dose of oxycodone like 15-20mg or a 10mg intravenous dose of morphine.. but I'l have to go behind my parents back, who are also my caretakers and like to get involved with these type of choices, which will be difficult because if something happens they will persue it and wont be happy that I requsted this as they too are convinced its a pharmocological and physical adverse effect after all the times they've taken me to ER and seen me messed up due to my meds.
 
I don't know why they wouldn't be willing to, since you're already prescribed these things, I assume. However, propofol would have to be exchanged for something else, midazolam maybe. Propofol is too strong a respiratory depressant to start adding other CNS depressants.

What I would be interested in is if you respond differently to mu1 vs. mu2 selective agonists.

Anyway, if there is some other reason that you think rules out a psychogenic nature, we'd really like to know it, because so far you really haven't provided anything that does that. If, by some insane turn of chance, it would turn out to be of physical origin, I would stop looking for a single cause.
 
if there is some other reason that you think rules out a psychogenic nature, we'd really like to know it

I have now compiled together the reasons which lead me to believe why my symptoms were not of a psychogenic nature in the first place , I had to dig real deep to be able to express what I felt and why I came to the conclusions I did. It was very difficult and challanging thing to try and explain to someone else why and how one feels their perception of themselves is absoloute. I've given you and anyone else interested 19 honest reasons straight from my heart and mind. Warning though it did end up rather lengthy but I would not have made such conclusions based on a few short general ideas, If possible please comment on each one to show why my reasoning was flawed, it could be sufficiant enough to make me realise that I may have been living with a psychogenic illness all these years.....

I saved it into a basic .txt file titled "Undiagnosed.txt ready for download by right clicking and "save target as", if you like copy and paste the contents into a reader of your choice for clearer viewing....

http://www.speedyshare.com/549511780.html
 
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Let's look at it from the most important practical angle...
You require some form of pronounced analgesic effect, but have issues with most meds, therefore you need to assess if other classes that produce analgesia may be used to sub for those that you cannot tolerate well

you may need to get very creative and pro-active, but it is the only viable route to explore for practical results which is assumably the goal as as Hamm said if you are in this condition not of a psychogenic nature than it is likely not one or any simple facet that it could be pinned upon and looked to correct 'directly'
 
As much as I hate posting in ADD due to unfriendly responses from some or a lack of any comments, the scepticism when discussing my unusual symptoms and being made to feel like im intruding in an area of the forum where some think they have ownership to...yet unfortunately I'm here once again without choice simply because Im stuck with stupid uncommon symptoms to drugs and dont know anywhere else I can turn to for help...so I'm posting this in hope that the few friendly kind people who have helped me in the past would once again make an effort to help me out again....

The problem I'm having is very specicfic and a very confusing one and difficult to explain....It usually happens only with Tramadol and Oxycodone although I havent really tried it with others....My body seems to be ok when I take one single dose dose of 50 mg Tramadol at once or one dose of 10mg Oxycodone but if I attempt to redose an hour or 2 later with smaller portion of the same medication to control the pain I end up having an adverse reaction simply due to the redosing process....for example....

Single dose of 50mg tramadol = no problem =D

50mg devided into 5 parts and taken at smaller portions of 10mg per hour rate = an adverse reaction :X

10mg oxy taken at once or every 4 hours = no problem =D

10mg oxy devided into 5 parts of 2mg per part and taken at smaller portions of 2mg per hour = an adverse reaction :X

10mg oxy taken at once = no problem =D + an additional 2mg taken 2 hours after the 10mg = an adverse reaction :X

This is the very reason why Im never able to take any slow release meds and only stick to instant release...Now you may ask if this is a problem then why not just stick to one single dose rather than redosing or taking smaller portions and the answer is because often after taking a single dose of 10mg oxy it wears of quickly and the pain comes back requiring an earlier dose. Also deviding my medication up into smaller portions is what I do to desensitise myself to gain tolerance. But even if I take smaller dose like 2mg following the initial larger dose of 10mg I still end up having an adverse reaction although initially the 10mg on its own caused me no problems whatsoever.

My theory from what I can see is that my body is exteremely sensitive to metobolisation process of the medication even if it is smaller doses. It seems it has no problem metobolising one single large dose but has difficulty with frequent smaller doses due to a build up perhaps ? I've read that Cytochrome P450 enzyme system in the liveris metabolized to the very active opioid analgesic oxymorphone some people are fast metabolizers resulting in reduced analgesic effect but increased adverse effects, while others are slow metabolisers resulting in increased toxicity without improved analgesia. Does the CYP2D6 sound like the reason for my symptoms ?

I'm so sorry to hear that you've encountered "know it all" individuals. I had the same problem a few days ago. I'm new to this site and I logged on looking for some honest advise and all I got were lectures and smart asses basically telling me that my liver is going to die. Anyway, can you elaborate more and explain what type of adverse reactions you are having? Just so I can get a clearer picture on your situation. Thanks and hang in there!!! <3
 
Again: How can a psychosomatic cause be excluded experimentally?Murphy

This is an excellent question, but everyone is trying to corrupt the experimental results by suggesting that drugs be used to either sedate or dissociate the subject. This is will inevitably lead to a fallible experiment as one can always bitch about unknown, undiscovered or little-understood synergisms/interactions. Here's a better angle:

Roelofs K, Hoogduin KA, Keijsers GP, Näring GW, Moene FC, Sandijck P. "Hypnotic susceptibility in patients with conversion disorder." J Abnorm Psychol. 2002 May;111(2):390-5

Abstract:

Conversion disorder has been associated with hypnotic susceptibility for over a century and is currently still believed to be a form of autohypnosis. There is, however, little empirical evidence for the relation between hypnotic susceptibility and conversion symptoms. The authors compared 50 patients with conversion disorder with 50 matched control patients with an affective disorder on measures of hypnotic susceptibility, cognitive dissociation, and somatoform dissociation. Conversion patients were significantly more responsive to hypnotic suggestions than control patients. In addition, conversion patients showed a significant correlation between hypnotic susceptibility and the number of conversion complaints. These results provide the first evidence of a relationship between hypnotic susceptibility and the presence and number of conversion symptoms.
 
Again, nothing that you've written there excludes or even comes close to excluding a psychogenic cause.

8.01 pm = (37.8 c)
8.02 pm = (37.7c)
8.04 pm = (38c)
8.05 pm = (38.1c)
8.07pm = (37.8c)
8.08pm = (37.9c)

Nothing like this in literature has ever been seen or recorded

Did you actually look? If you had, you would have found that much higher temps have been recorded- up to 40 or 41c
 
Anyway, can you elaborate more and explain what type of adverse reactions you are having? Just so I can get a clearer picture on your situation. Thanks and hang in there!!! <3

Hi, thanks for your support, the reaction is different with every opioid but mainly changes in myblood pressure dropping either too low or going too high and causing me discomfort and other symptoms as a result, inreased compressions and pressure feeling in my head, repirataory depression, rash, acid reflux, wheazing, increased temperature ranging from low grade fevers to hyperthermia or just feeling flushed, irregular heart, muscle spasms, twitching, a sedated supression in my vitals and feeling faint to neuroexcitory symptoms that make feel wired confused and jumpy.


Again, nothing that you've written there excludes or even comes close to excluding a psychogenic cause.


In that case if my reasoning really failed to validate my symptoms as being physical then perhaps I do have a psychogenic condtition, you could be right, I may have been wrong about it all along, thanks for your help, so what do I do now then, how do I treat this or get a disgnosis for it?

PS> the temperatures there were not to show how high but to show the frequent change that occured withing a 9 minute time span which is abnormal as body temperature follows a circadian/bio rhythm and those changes occur gradually throughout the day ocassionaly spiking but not up and down as rapidly or changing by the minute as it has indicated in the listed times that I've posted there.
 
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See a psychiatrist. That's a good place to start. Not sure beyond that, surely some specialize in this sort of thing.
 
Conversion Disorder is NOT uncommon...and can manifest some very strange symptoms indeed...so you should as Hamm notes see a psychiatrist, one with expertise in this area
 
Unlucky said:
I have an upcoming endescopy where I will be sedated with propofol, the GI doctor has good relations with my neurologist maybe I can convince them to administer a dose of opiod that im highly sensative to, 2 tramadols should do it or a high dose of oxycodone like 15-20mg or a 10mg intravenous dose of morphine.. but I'l have to go behind my parents back, who are also my caretakers and like to get involved with these type of choices, which will be difficult because if something happens they will persue it and wont be happy that I requsted this as they too are convinced its a pharmocological and physical adverse effect after all the times they've taken me to ER and seen me messed up due to my meds.

As Hammilton said earlier, this approach is quite risky!! First, one could provoke a dangerous synergistic effect with respect to respiratory depression. This is potentially life threatening!
Next thing is, that if your malady turns out to be initiated by a physical cause, you will most probably see the 'expected' adverse reaction while being narcotized. Now that is of course what such an experiment is supposed to show. But I think that you could get seriously into trouble if the appropriate measures are not taken when the 'heat rush' occurs...

Anyway, the approach to provoke a response while being sedated sounds reasonable to me in the first place. I only request the necessary caution. Would be interesting to hear your docs general opinion about this experimental setup...

- Murphy
 
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