High Anxiety

[pugmommy7]

I know this isn't a pre-e etc., related question,per se,
but "I got no where else ta go".
Actually I just trust you guys and hope someone here knows something.[:p]

I suffer from generized anxiety disorder. OCD, and some anxiety attacksand a general state of "busy-brain" when not medicated.(NO DEPRESSION)
I have been on Paxil in various dosages for about three and a half years.
During my last pregnancy my OB,though not thrilled with it, felt comfortable that I was on it. and felt that taking me off at that point was not imperitive.

Last week when I was suffering from that hellacious stomach-viral infection,I had a full blown panic attack. It was horrible. It reminded me of when I was on mag and sleep deprived.It happened in front of my mother which added much insult to injury.

I had not been able to keep my Paxil down for 3 days which was a BIG contributor. As well as a total lack of sleep and the stress of a VERY sick toddler and husband.
Anyhow, I called my OB they said it was not an OB related concern and to consult my GP. My GP was trepidatious to say the least, because I am high risk an (then)25 weeks preg.
Needless to say I felt like the proverbial "hot potato".
Ultimately My GP played it safe and prescribed me an antihystamine with some convienient side effects of anti-nausea and anti-anxiety and drowsiness. I was able to then keep down my Paxil, sleep and feel better.
(I did run it by the OB doc. too and he agreed it was a good idea, and safe, niether of them wanted to give me any catagory "D" drugs, since they are unsafe during pregnancy, I was happy about that too.)

Now my GP, (whom I trust VERY much, and is familiar with my case both now and with the first preg. since she co-managed my post partum care...)wants me to have a med. consult with my Psychiatrist.

The only time I have ever seen one, was briefly for grief councelling after my father died a few years ago, and he was a QUACK! Had me on and off meds like a stoned yo-yo.
So, now I am supposed to call my Insurance provider, get a name of some unknown Dr. to get a med consult.
Who knows this Dr. could turn out to be worse that the quack, and then run the med back by my OB.(=referral to shrink,then wait till i can get in,then try this try that,and maybe get to where I a am currently by the time the baby is born).

My question is...Why can't my OB medicate me?
That is what I plan to ask tommorrow at my 26 week check-up.
I do not understand why they would not.
Maybe they meant that the stomach stuff wasn't an OB related thing?? I do not know.I was feeling a bit out of sorts.
It seems to me, that ANYTHING going on with me right now is OB related since I am pregnant.

Any helpful input welcome,
Jennifer





Mama to Bella,1/02/03, born 33 and 5/7 weeks at 3 lbs,6oz.Pre-E and PIH,& HELLP.
Babygirl #2,EDD 6/24/04

[catherine]

This is a tricky one Jennifer. I haven't shared your experience, however my mom has suffered for over 30 years now with depression which is only controlled by MAOIs and an old fashioned one at that. She has many food restrictions and cannot under go general anesthesia without being off the drug for at least 2 weeks. Anytime something comes up with her physically, it almost invariably results in a consult with her psychiatrist and pharmacist in order not to run into problems. Most recently two knee replacements (epidural... can you believe that?!!!).

So I'm thinking that if I were you, I'd want the OB to have the final say over what he/she thinks you should take, however I would go ahead and consult with the psychiatrist. Being pregnant and all that goes with it can be a huge amount of stress and if your anxiety etc. can be better managed then that surely would be the best thing. Mom always asks her specialists (rhematologist, psychiatrist, GP, gastro guy at last count, she's done with the haematologist who treated her plumonary embolism) to call each other and consult directly, preferably while she's sitting there in the office. That way the OB should have a better understanding of your anxiety issues, and that might be important as time goes by, or if your BP starts wobbling around and they tell you not to worry about it [B)]. Pregnant babes are always a hot potato. I put my back out chasing Lucy when unbeknownst to me I was 8 weeks pregnant. When I phoned my primary care physician for some muscle relaxants, she made me take a HPT.. otherwise I might have gone another month before finding out I was pregnant. When the test was positive... she'd have nothing to do with me [:p].

Catherine
Mom to Finn, Lucy (preeclampsia and HELLP) and Chloe.
Moderator HELLP Syndrome Survivors

[laura]

I agree, totally a tricky one. I ran into the same problem with my first pregnancy- I couldn't work without medicating my ADD, I couldn't afford not to work, and couldn't find anyone that could help. What I should have done was find a doc that specialized in treating ADD. They're often better versed in dealing with pregnant women, as I know the psycs see more pregnant women than my obs see ADD! Haha[:o)]

Depending on what you see as the primary problem to be addressed (be it GAD or OCD) find a doc that knows all the ins and outs of it all, who understands that these problems don't just go away because you're pregnant. And if the psyc and the ob can confer with each other, all the better. They're professionals, let them duke it out[:)] A psyc can probably identify other means of support in addition to (or if necessary, in lieu of) meds. And I agree with Catherine, the obs get more training in the safety of drugs (and are often more likely to prescribe, to be perfectly honest) but cost/benefit input from the psyc would be invaluable.

Here's a find a professional link from the OCD Foundation:
http://www.ocfoundation.org/ocf1000c.htm

National Anxiety Foundation:
http://www.lexington-on-line.com/naf3.list.html


hang in there, and if you find something that ends up working for you, let us know! Even if you don't, let us know, anyway[;)]


Laura
Moderator/AK Coordinator

Mom to Alicia (severe PE) 5/98 and Camille (htn, oligo) 4/03
http://www.babiesonline.com/babies/c/camilleandallie/

[laura]

A link to an article on the meds most commonly used for Anx dis during pregnancy:
http://www.healthyplace.com/Communities/Anxiety/women_13.asp

Laura
Moderator/AK Coordinator

Mom to Alicia (severe PE) 5/98 and Camille (htn, oligo) 4/03
http://www.babiesonline.com/babies/c/camilleandallie/

[sonja]

While I was pregnant last time I got exposed to bacterial menegitis and I had a heck of a time getting my OB or GP to figure out what to do - I think that it was such a gray area that they both wanted to hand it off. After calling each office numerous times they got on the phone with one another and figured it out (along with a big book and the state health director). Maybe your doctors could work together a bit. As for going to the psycologist - I would go - it could end up being a wonderful person whom you feel great talking to, and if it is not I would ask for another name. Good luck to you.

Joy

[sandy]

Hi Jennifer, sorry you're feeling like you're being passed back and forth. ;( Did you get your answer yet?

If not, to possibly answer your question...your OB can only prescribe certain medications that you may need. A psychiatrist has the ability to prescribe any that you many need in this case. And the doctor could have liability issues to consider...like even if there was a remote chance he/she thought you might need to get your meds evaluated, and it wasn't offered, and if something bad happened, it could be trouble for that doctor.

Some psychiatrists are more into the prescribing and managing of medications; some have a background in "talk therapy", as well (whereas "therapists/counselors" do not prescribe medication, and just do "talk therapy").

Do you think this was an isolated incident due to how awful you were feeling while you were sick, or do you think you need meds. ongoing? (This might have been what your doctor was thinking.)

When you talk to your insurance company, tell them about your concerns with psychiatrists as you shared them with us. Sometimes you can get matched up with one that you might feel more comfortable with based on your concerns.

And if you do go see one, and you're not happy with your visit, call your insurance company back, tell them so, and get a referral to another one. You have the right to feel comfortable with your care. Let us know how it goes.

~Sandy/DD born via emergency C at 35 wks. June '03 due to Severe PE/class III HELLP/chronic HBP/asthma

[pugmommy7]

Well,
I spoke to my wonderful OB today about the situation. She said that many times GP's are extra cautious because it is not thier specialty. She also mentioned that in her experience such occurences have included such normally benign meds such as tylenol and sudifed.
I felt it best to consult with the OB.
She said that is was safe for me to continue the use of the Paxil. I *feel* like it was problematic because I had missed 3 doses consecutively b/c I was not able to digest them.
She reminded me that the same thing had occured while I was on the mag and had the added sleep deprivation then as well. (she didn't discount the mag's effects, she is very symapthetic to that issue-which I have not found common among OB's in general...)
So, I decide to scrap the idea of the psychiatrist for now. I feel comfortable and in very good hands with my OB.
We also disscussed that I would have to be slowly weaned from the Paxil and the play the wait and see game with a new drug/dose...by then The baby could be born.
I think best route for me is to continue the current dose, take it at the exact same time each day and get plenty of rest.
My GP also sgggested to get some alone time once per week.
Luckily, my husband is great about that, and we like to go do cheesy things like basket bingo etc, and my mom stays with Bella.

I have had similar incidents w/ the anxiety attacks, once in college when I was freaking out about exams(pre-Paxil),then while the whole induction-chaos was going on.

I secretly wished that this OB was the one on call when Bella was delivered and she was.I am saying that same prayer now. It is so great when you feel so at ease with a healthcare provider.
(the OB is spoke to on the phone on call the other night I have yet to meet in person.)

So, crisis averted.
Thanks SO much for the support.
Love, Jennifer

Mama to Bella,1/02/03, born 33 and 5/7 weeks at 3 lbs,6oz.Pre-E and PIH,& HELLP.
Babygirl #2,EDD 6/24/04