bi polar, bi polar disorder, bi polar dis orders, manic depression…

I hate to say it but I love your “Mom stories.” My favorite line -
“That bird was your father’s fist,” my mother said.

You know, allergy shots never did much for me. Shrug. My allergies have just waned over time. Used to be a cat would put me in the ER about 4 hours after exposure. Now I just get a little short of breath (but I still don’t stay over night at houses with cats, no reason to go crazy and tempt fate).

I love Singulair and Flovent/Advair/Serevent. I remember when Azmacort was hot sh*t. I used to do 18puffs a day of Azmacort (an ungodly amount) and still didn’t have good control, now I take the Advair and Singulair. What a difference. Night and day.

Gosh. What a walk down memory lane. Asthma meds have come a loooong way, haven’t they? I remember when the main therapy was Theophylline (sp?) and a rescue inhaler.

Shelbi–I’m not usually manic on prednisone, but my mom gets that way. Hope you feel better and can wean off w/o any bad juju.

M

It got rid of my joint pain, but being psychotic sucks, eh? It’s good I’m non-violent by nature or I’m afraid I might have hurt someone by now.

Eesh.

Michelle, when we ask about drug allergies we mean drug allergies. Not minor stuff, which is what some of my patients call allergies.

Prednisone is rightly feared. Nasal steroids are great for folks with chronic problems (chronic rhinitis, chronic sinusitis) and have a great safety record, especially compared to the oral steroids. But no, I wouldn’t use nasal steroids chronically in a patient who was well between illnesses. One exception: in a patient with frequent recurrences, the nasal steroid can be a boon for prevention of the recurrences.

Thing is, if you rule out the nasal sprays, that only leaves me the option of oral meds (ignoring, for the moment, allergy shots, avoidance measures, or nasal saline douches). The oral meds suck. Singulair is the one exception, but singulair doesn’t work for everyone.

More and more, I try to push nasal saline douches on my patients. It really does help and the “I’m sensitive to everything” patients love ‘em, too. But the type of patient I’m talking about above will find a reason for shooting this suggestion down, too. These people have made up their mind that I’m not going to help them, and they’ll be damned if I prove them wrong. What they get out of the office visit is beyond me — some kind of weird secondary gain from being the patient no one can help, I guess.

In fact, you’ve just won a virtual hug with this post.

{{{{HUG}}}}

“The patient’s list of drug allergies fills a page. I’m sensitive to everything.”

You know, the more I get to know you docs, the more I realize I’m just pushing all your buttons.

But I _am_ sensitive to meds, well, except for the ones I’m insensitive to, but I realize when I try to explain all this that I sound a little psycho. I’m not asking for attention or trying to prove a point, I just want to survive my treatment (I live in fear of prednisone) and I’ve always been told, tell your doc everything. So I do. And then they think I’m nuts.

But I do hate nasal sprays. Hate them like Osama hates America. Sometimes docs push them on me, but I never take them and, knock on wood, have been fine without them. I’m only congested when I’m sick, if I’m not sick, I’m fine. So why the long term inhaled steroid pushing? I don’t get it.

M

The more childhood horror stories I read, the more and more I’m astounded that you grew into such a hugely likable guy.

XXX

I drifted, too, and a lot more aimlessly than you did. Still, I wound up at a pretty good place. I think that you did too.