PT-LawMom

I’m back from the doctor’s office. A quick summary:

1) She totally agreed that I need a new neurologist and gave me a few names, but also suggested that I talk to other gastric bypass patients who are suffering from neuropathy and find out if any live near me and have a specialist they would recommend. She said that because these effects typically come up 5-10 years after surgery, most people have stopped seeing their surgeon by then. It used to be that surgeons would do all the follow-up but these days, due in part to insurance reimbursement (or lack thereof), the surgeons tend to cut and run and have no idea what is happening to their post-ops. So I’m off to the “WLS Gone Wrong” boards to see if I can find some people to speak with.

2) She was just as shocked as the pharmacist that the neurologist put me on such a rapid dose of the Neurontin. I told her I called and was told that it was right. She said she typically makes patients do a week of one pill at night, followed by a week of two pills, then finally up to thre per day. Now that I’ve done four pills per day, she said I can either slow down and try to work my way up or just push through. With exams coming up in a few weeks, I think it’s better to push through.

3) She said she would have just upped my Cymbalta and not put me on the Neurontin, but I told her about the unpleasant Bow Chicka Bow Wow side effects and that changed her mind (apparently there’s nothing she would prescribe for women in that category). She agreed that Neurontin was a good choice over the super-weight-gaining Amitryptelene. She did NOT, however, agree with the neurologist’s decision for me to stop Cymbalta cold turkey and told me my one day off/one day one approach was good and that I should do that for a total of two weeks and then do another two weeks at every three days and so on. I love my PCP.

4) My Thiamine level has never been tested. Ever. According to various studies, this could be the answer to why I’m having the neuropathy. That and the low Vitamin D. So she tested my Thiamine and my D and my B12. She also told me to start weekly B12 instead of monthly.

4) In terms of stopping future nerve damage, she said that maintaining my vitamin levels is the most important thing. She wants to do bloodwork every three months and I may need to do some more IV therapy. If they cannot control things that way, she wants to send me to an Endocrinologist because apparently they are better at dealing with these things than a hematologist. Interesting stuff.

So all in all a good visit. I was a bit (okay a lot!) weepy (damn medication side effects!), but she toook about 30 minutes with me and made me feel so much better. Big difference from the neurologist who made me feel like this was all my fault and that she could care less about the potential for future problems as long as she could control my pain now with whatever medication she had on hand.

The bloodwork took like 15 minutes because my blood is just NOT flowing fast (darn hypotension. Now I’m back at work and, even though my appointment took FOREVER, I still have to take lunch because… the labor and employment partner I’ve been wanting to lunch with since July called up yesterday to see if I’m free today! So here I am in my suit and lots of makeup to make me look like I feel better hoping my brain will cooperate and I’ll sound somewhat intelligent. Wish me luck!