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Author Topic: Does my uBPD wife's MD know?  (Read 709 times)
Mike_confused
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« on: November 06, 2014, 10:58:24 AM »

My uBPD wife is a cornucopia of health problems, real or perceived.   I never know what to believe.   In fact, I truly no longer believe most of her health complaints.   That said, I have often suspected that her primary MD herself suspects that my BPDw in fact has BPD. 

My BPD wife has changed MD's many times because "they don't care".  She found her current primary MD four years ago and has stuck with her.  Initially she ideallized this MD, but my BPDw's opinion of her MD has slowly declined.   She has stated that the MD acts as if she does not believe her complaints of pain and illness. Now to my question:

My wife has taken topomax for several years (she likes it because it keeps her weight down, although she DENIES this fervently).   She has also been prescribed Neurontin, which she will now longer take.  I just read that these anticonvulsants are also occassionally prescribed for BPD.


Coincidence or an awareness on the part of my wife's MD?  As far as I know, the MD has made no statement to my wife re: BPD.
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Mike_confused
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« Reply #1 on: November 06, 2014, 11:05:42 AM »

If I remember my BPDw's statements correctly, she stopped using neurontin because of the potential for weight gain.   She claims that she continues her use of topomax because it helps her migranes.   Of course I do not believe her.  The topomax clearly keeps her weight about 15 pounds below her natural weight.   As for her migranes, she still gets severe ones a few days EVERY month.

Her primary care MD MUST suspect BPD.  MD's must see a fair number of people with BPD, and therefore, be able to recognize the signs.
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jedimaster
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« Reply #2 on: November 06, 2014, 11:35:47 AM »

Unfortunately, your wife is right about Topamax.  Dear Lord, I only wish it worked for BPD!  My uBPDw is on Topamax for migraines, but if it works for BPD it must be a higher dosage.  Two of our children used to have seizures and the dosage for epilepsy is massive compared to the dosage for migraines.

I have an appointment tomorrow for a checkup with our mutual family doc.  I am going to tell her everything I can about our situation and see if she can help.  My wife used to be on Cymbalta for fibromyalgia and she came off about a year ago.  During the years she was on it she was just about as normal as anyone could be.  She has steadily declined over the past year and it is getting unbearable.  I am going to beg the doc to come up with some reason to get her back on Cymbalta if at all possible.

If your wife's doc is a GP and will take you as a patient, my suggestion is get an appointment and talk to him/her.  They may not be able to talk back to you, but HIPPA can't prevent them from listening.  I am so hoping/praying that my appointment goes well.  I am determined to survive this one way or the other, but it would be so much better if she would get back on the meds.  Good luck!
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Mike_confused
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« Reply #3 on: November 06, 2014, 12:02:41 PM »

jedimaster,

wow.  My wife is diagnosed with Fibromyalgia and was on Cymbalta for about a year.  The drug made her wildly out of control.
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« Reply #4 on: November 06, 2014, 12:17:32 PM »

Wildly out of control would just about describe the situation here now.  Just goes to show how different drugs affect people differently.  I believe I would try to get in to see her doc, either as a patient, a consult, or however she will see you.  I would like to think our doc suspects something, but I just don't know.  My wife is so good at being normal in public that it's very likely the doc has no clue.  Yours may be the same, I don't know.  One reason I am anxious to talk to her is because my wife insists that she came off of Cymbalta under the doctor's supervision.  I'm very curious to find out if that is true.  We have a good relationship with her and because she also treats my elderly mother-in-law and our adult son with disabilities, we are able to talk pretty openly about each other.  She may feel she can't in this case, but like I said, HIPPA can't stop her from listening. 
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"Do.  Or do not.  There is no try."  | "Train yourself to let go of everything you fear to lose.”  |  "Anger, fear, aggression; the dark side of the Force are they. Easily they flow, quick to join you in a fight. If once you start down the dark path, forever will it dominate your destiny." ~ Yoda
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« Reply #5 on: November 06, 2014, 12:38:55 PM »

The withdrawal symptoms from Cymbalta that I witnessed were horrible for her.    When she was on Cymbalta, she would try to beat the hell out of me when she didn't get her way.  That is the main reason I moved to our second home which is my ancestral family home - in the woods where she refuses to tread.  Thank God.
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Mike_confused
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« Reply #6 on: November 06, 2014, 01:03:44 PM »

I also read recently that a low serotonin level has been linked to BPD.   Strangely, my BPDw's primary care MD prescribed a serotonin supplement for her.
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« Reply #7 on: November 06, 2014, 01:28:52 PM »

It sounds like your wife's MD is suspecting something other than what she complains about, but BPD?  Who knows. 

The thing about the medications and BPD - I've noticed that not only what works for one person may have opposite effects on another, but the effects on one person may change with time.  So what may be the "miracle" for a few weeks turns into the source of all her problems a few months later.

The BPD brain is like this:  "I feel uncomfortable as if something isn't right or is missing.  I need something or someone to fix it."  The pwBPD has thought that way since childhood.  So, over the course of their lives they have sought out one thing after another to fix what they feel is missing, yet are incapable of digging deep enough to understand what may be missing is really their perception.  Here is how it plays out:

Regarding doctors:  They will get diagnosed with one thing, take medication, and after a while when they still feel crappy, blame the doctor, find a new doctor, a new diagnosis, new medications, and on and on until they eventually mistrust all doctors as quacks.  Then they may turn to alternative medicines.

Regarding dating partners:   Things don't feel right so they blame their partner, break up, and quickly move on to someone new.  The same thing repeats itself, and before long they have a list of failed relationships, always blaming their partners.  Eventually, they may conclude that the problem is them, but falsely conclude their problem is that they only know how to attract jerks (as opposed to the correct conclusion that their partners weren't the jerk, it was their behavior that ruined the relationship).   

Regarding employment:  Their bosses are always jerks and their places of employment always have policies designed to cause stress and piss them off.  So they quit one job, take another, and so on and so forth until they have had dozens of jobs and the same problem every time.  Eventually they conclude they are in the wrong career, and may eventually decide to work for themselves.  And then they conclude that working for themselves is just as stressful, and decide instead to go back to school.

I think this is why so many of them turn to illegal drugs - not to solve the problem, but to shut the whole thing down so that they no longer think about their problem.  We all have various things that bug us, aches, pains, emotions.  I think the pwBPD tends to find one of those normal life stresses and accuse it as the source of all their problems.   
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jcarter4856
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« Reply #8 on: November 06, 2014, 01:54:51 PM »

Regarding doctors:  They will get diagnosed with one thing, take medication, and after a while when they still feel crappy, blame the doctor, find a new doctor, a new diagnosis, new medications, and on and on until they eventually mistrust all doctors as quacks.  Then they may turn to alternative medicines.

I've observed similar with my wife. However, I have a profound counterexample too:

For years uBPDw had suffered from periodic episodes of extreme abdominal pain leading to almost complete inability to function (had to stay in bed). These would last a few days and occur every few months. Many many doctors had failed to find any cause. On most occasions the symptoms would pass before she felt she wanted to go see the Dr. She herself would often ascribe the symptoms to some specific stress event in her life at the time.

This continued for nearly 20 years. Until one day I put my foot down and forced her to go see a real Dr. I said I'd take her to the ER if she didn't go see someone right away. Then, pure chance there was only one Dr. available that day with a free slot, not her regular Dr. That Dr. instead of the usual "take some Tylenol for a couple days and come back if you're not better" decided to get abdominal MRI done. This found a very real, very serious actual medical condition (that was causing the recurrent episodic pain). All ended well, after a few months of treatment she is fine and has had no recurrence of the original problem.

I felt I needed to share this lest you not take your pwBPD's medical complaints seriously. 99% of the time they are likely psychological in basis, but it ain't necessarily so...


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MaybeSo
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« Reply #9 on: November 06, 2014, 11:04:01 PM »

There is something called the ACES (Adverse Childhood Experiences) study that is big in the medical field these days, and should be garnering even more attention than it has so far. It is a huge, longitudinal study that started years ago with a Kaiser Physician that shows that childhood neglect and abuse directly contributes to a marked increase in actual serious health issues like heart disease, obesity, etc.  and now that the study has been going on so long and has such huge numbers, it also points to a direct increase in mental health issues and somatic illness (based on adverse childhood experiences) like fybromyalgia, eating disorders, etc.  A savvy doctor these days who has a patient with this kind of presentation is thinking Borderline, or Complex PTSD or trauma, and associated disorders, like depression, anxiety, etc.

Re fibromyalgia, Lots of folks with childhood trauma or chronic stress have these kinds of symptoms. It’s being linked to an overload of stress hormones over a long period of time that seem to affect or damage or inflame nerve endings.  Basically, the body/mind connection is very real and most docs realize this today.  If you are not at ease emotionally and it goes on too long,  it is going to show-up with actual physical symptoms eventually. Our bodies are not meant to be bathed in stress hormones 24/7.  It will do a number on you eventually.

If a person has a lot of chronic childhood trauma and didn’t have the protective factors that keep them resilient, it actually alters the way their body/mind works.  They aren’t just misperceiving things.  The mind/body is actually altered, their mind/body does not feel or react the way an ‘at ease’ mind/body feels and reacts. There is a high correlation to drug and alcohol abuse with these studies, too,  because those are easily available pain-killers and chronic stress and trauma is very painful both emotionally and physically and spiritually, it is painful in every way a person can experience pain.


ACES

www.cdc.gov/violenceprevention/acestudy/about.html

The initial phase of the ACE Study was conducted at Kaiser Permanente from 1995 to 1997, and more than 17,000 participants had a standardized physical examination. No further participants will be enrolled, but we are tracking the medical status of the baseline participants.

Persons who had experienced four or more categories of childhood exposure, compared to those who had experienced none, had 4- to 12-fold increased health risks for alcoholism, drug abuse, depression, and suicide attempt; a 2- to 4-fold increase in smoking, poor self-rated health, ≥50 sexual intercourse partners, and sexually transmitted disease; and a 1.4- to 1.6-fold increase in physical inactivity and severe obesity. The number of categories of adverse childhood exposures showed a graded relationship to the presence of adult diseases including ischemic heart disease, cancer, chronic lung disease, skeletal fractures, and liver disease. The seven categories of adverse childhood experiences were strongly interrelated and persons with multiple categories of childhood exposure were likely to have multiple health risk factors later in life.
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MaybeSo
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« Reply #10 on: November 06, 2014, 11:12:05 PM »

Here are the ACES questions and more about it…

www.acestoohigh.com/got-your-ace-score/

Got Your ACE Score?

What’s Your ACE Score? (and, at the end, What’s Your Resilience Score?)

There are 10 types of childhood trauma measured in the ACE Study. Five are personal — physical abuse, verbal abuse, sexual abuse, physical neglect, and emotional neglect. Five are related to other family members: a parent who’s an alcoholic, a mother who’s a victim of domestic violence, a family member in jail, a family member diagnosed with a mental illness, and the disappearance of a parent through divorce, death or abandonment. Each type of trauma counts as one. So a person who’s been physically abused, with one alcoholic parent, and a mother who was beaten up has an ACE score of three.

There are, of course, many other types of childhood trauma — watching a sibling being abused, losing a caregiver (grandmother, mother, grandfather, etc.), homelessness, surviving and recovering from a severe accident, witnessing a father being abused by a mother, witnessing a grandmother abusing a father, etc. The ACE Study included only those 10 childhood traumas because those were mentioned as most common by a group of about 300 Kaiser members; those traumas were also well studied individually in the research literature.

The most important thing to remember is that the ACE score is meant as a guideline: If you experienced other types of toxic stress over months or years, then those would likely increase your risk of health consequences.

Prior to your 18th birthday:

Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?

No___If Yes, enter 1 __

Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?

No___If Yes, enter 1 __

Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?

No___If Yes, enter 1 __

Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?

No___If Yes, enter 1 __

Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

No___If Yes, enter 1 __

Was a biological parent ever lost to you through divorce, abandonment, or other reason ?

No___If Yes, enter 1 __

Was your mother or stepmother:

Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?

No___If Yes, enter 1 __

Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?

No___If Yes, enter 1 __

Was a household member depressed or mentally ill, or did a household member attempt suicide?                        No___If Yes, enter 1 __

Did a household member go to prison?

No___If Yes, enter 1 __

Now add up your “Yes” answers: _ This is your ACE Score

__________________________

Now that you’ve got your ACE score, what does it mean?

First….a tiny bit of background to help you figure this out…... (if you want the back story about the fascinating origins of the ACE Study, read The Adverse Childhood Experiences Study — the largest, most important public health study you never heard of — began in an obesity clinic.)

The CDC’s Adverse Childhood Experiences Study (ACE Study) uncovered a stunning link between childhood trauma and the chronic diseases people develop as adults, as well as social and emotional problems. This includes heart disease, lung cancer, diabetes and many autoimmune diseases, as well as depression, violence, being a victim of violence, and suicide.
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Mike_confused
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« Reply #11 on: November 07, 2014, 08:21:22 AM »

Well that could explain everything.  She has chronic fibromyalgia.  My uBPDw constantly complains of pain - she has a low tolerance to it and an even lower tolerance to ANY stress.   What she considers stressful, I consider part of my daily life and hardly even notice it.   She does not respond well to pressure of any sort - she perceives pressure where myself and other don't intend it or sense it.

Her mother is MASSIVELY NPD.    Cares for no one but herself and appears to be shortening her husband's life - if I had to guess.  My uBPDw contends she was sexually abused at a young age and that her parents did nothing to address it.

Nevertheless, because of my uBPD wife's totally lack of tolerance for any normal stress, she reacts poorly and then punishes me.   She blames me for everything.  I have done everything to support her and bend to her wishes.  In return she points out that I cause all her stress, that I don't take care of her, and is in the process of not honoring an agreement prior to our being married (and fundamental to our very marriage).   

She is breaking my heart, and killing me slowly at the same time.
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Mike_confused
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« Reply #12 on: November 07, 2014, 08:24:54 AM »

Bringing this post back to topic however:  I do believe my wife's primary care MD suspects BPD.  I also believe my BPD wife's therapist may suspect BPD.  Her therapist has pointed out that her sister is massively BPD, explaining all the indicators of BPD to my wife. 

How could the therapist recognize the BPD symptoms in my BPDw's sister and not recognize them in my wife also?
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MaybeSo
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« Reply #13 on: November 07, 2014, 08:42:34 AM »

Excerpt
I have done everything to support her and bend to her wishes. In return she points out that I cause all her stress, that I don't take care of her, and is in the process of not honoring an agreement prior to our being married (and fundamental to our very marriage).  

She is breaking my heart, and killing me slowly at the same time.

I’m sorry.  I know.

Things can slowly improve. You start by going through the lessons on this forum and stop catering to the person. You learn over time to not take a lot of the stuff that is said personally, b/c it’s the disorder talking. You have to get very thick skin about that stuff. Pain that can’t be pinpointed or easily taken care of, gets externalized, usually to closest loved one.  It’s almost always the case, it’s all over this board. After a while you just realize, that’s how the disorder shows up, it’s not just you or something about you.  It’s typical of this disorder.   In homes where someone is ill, it’s common that the person might get catered to and enabled as everyone feels bad for them or is scared of the repercussions if they don’t and it tends to create a monster or make things worse. It’s best not to do for others what they can do for themselves or make extremely unfair accommodations.  It just just creates resentment, too.

The therapist and doc probably do suspect BPD or other similar issue. Symptoms are symptoms regardless of the label and regardless of the doc bringing it up to the client. Doc has already prescribed some things that help these folks, sometimes, to feel a bit better.  In the case of BPD it’s still a highly stigmatized label and most professional tread very carefully in terms of just saying it out loud or letting patient know.  It doesn’t prevent them from treating the symptoms which doc has already tried to do, or doing therapy to address symptoms if the client is open to do a lot of hard work.

The family members have work to do, too, to get better.  That’s what this board is all about.
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« Reply #14 on: November 07, 2014, 11:53:30 AM »

Just came from the doc's office.  It went well.  She never batted an eye.  I was telling her nothing she hadn't figured out.  Also, apparently at some point we signed a family HIPPA release, so she could talk openly, told me when my wife's next appointment is, and promised to help.  We talked about some approaches to get her back on her meds.  Hopefully (a) she will listen, and (b) Cymbalta will work for her like it did previously, and not like it does for your wife.

I would suggest getting in to see your wife's doc any way they will see you.  Hopefully you will be as pleasantly surprised as I was.  I'm finding the universal reaction to my confiding in people is "It's about time, where have you been?"

Good luck--
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« Reply #15 on: November 08, 2014, 06:56:06 AM »

 

I would recommend talking to doctors about "traits" and not about diagnosis.  Let doctors diagnose.

BPD is complex... .and the traits can also mean other things.

Stick to what you observe... .



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« Reply #16 on: November 08, 2014, 09:52:58 AM »

Excerpt
Posted on: Today at 06:56:06 AM Posted by: formflier

Insert Quote

I would recommend talking to doctors about "traits" and not about diagnosis.  Let doctors diagnose.

BPD is complex... .and the traits can also mean other things.

Stick to what you observe…

Agreed.  I believe in the future the moniker of BPD is going to go away and it will be viewed under the umbrella of a kind of complex developmental trauma that resides on a spectrum …  I think eventually a lot of the old AXIS II diagnoses will be viewed that way, and through the lens of attachment, neurobiology and developmental trauma.  In any event, stick with describing troubling symptoms when speaking with a doctor or other professionals, that’s what is most important for targeting treatment.
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