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Which doctor has it right?

by Dr. Marie Hartwell-Walker

I have been going to a clinic to find out about some health problems that I have been having, and was seen by three different doctors with three different diagnosis. I have been having trouble concentrating, remembering things and keep zoning out when I am driving to work. I am always tired and although I always get 7 to 9 hours of sleep a night, have trouble staying awake. I get frequent headaches and dizziness accompanied by nausea. Last Saturday, I was dizzy for the entire day and had numbness and pins and needles feelings in my face. I have been going to the clinic trying to figure out what is wrong and each time I see a different doctor. I am currently on effexor and feel great with it. I have had problems like this with dizziness, headaches, nausea and zoning out while driving in the past before being on this medication, so I know it is not a side effect.

The first doctor that I saw said that either I was having trouble sleeping or that it may be neurological, put me on amnatriptaline, and said if this didn’t work she would refer me to a neurologist. I took it for a week and a half and was still zoning out while driving (45 minutes to work), and being very forgetful. I went back and another doctor saw me. She said that she was going to give me some samples of Zyprexa, that she believed that I have bipolar and was not in need of a neurologist, and she wanted to see me in two weeks. I was unable to return to the clinic that Tuesday, so didn’t have the medication for another week. It was that saturday that I had the dizziness and numbness. I went back for a third time this past Tuesday, saw a third Doctor, and told him that while the medication did help me think a little clearer, I was still having problems driving and the Saturday that the dizzy spell happened, I could barely recall getting to work. I said that I need to find out what is going on because it is not safe for me to drive this way. He told me that I have severe panic disorder and that a 24 year old should be perfectly healthy and not be afraid for her life or the life of others and gave me zanax.

Now, I have had panic attacks before, and I know the numbness that can accompany hyperventilation. I can see where he may come up with this assessment, however, I had none of the fight or flight feeling associated with panic attacks, and was acctually not upset about anything other that the physical problems that were going on. Could the dizziness and pins and needles feeling really have been anxiety and panic, even though I felt calm? And I still don’t understand what is making me fall asleep while driving. After I started taking the zanax, I slept for two days and was very irritable the moments I was awake. I cut my dose in half and am able to function a little better.

I still don’t see any of the problems I was initially seeking help for going away. Also, I don’t really have an overabundance of stress right now, so I haven’t had any feelings of panic for quite some time before the doctor put me on this. Should I go back to one of the other doctors, or does this sound like it is panic disorder? I do not want to discount any of them, however each told me the medication prescribed prior was really wrong, and this one is the one that makes me feel worse instead of better. thank you very much for reading this and any help you may have for me.

I’m sure that each of the doctors had a good reason for the diagnosis he or she made. I’d suggest you go back to doctor #1. The other two are treating your symptoms as psychological. Maybe they are. Maybe they’re not. Before I’d accept a psychiatric diagnosis, though, I’d want to positively rule out an undiagnosed medical condition. Given the symptoms you report, a referral to a neurologist as soon as possible makes sense to me. If the neurologist’s report comes back fine, I then suggest you see a psychiatrist. Psychiatrists specialize in the medications you’ve been given and are more conversant in possible side effects. If you do need psychotropic medication and particularly if you seem to be sensitive to them, you want to be seeing a doctor who is sophisticated in their use.

In the meantime — why are you driving? By risking that you may again fall asleep at the wheel, you are endangering yourself and others. Your life and the lives of others will be altered irrevocably if you cause an accident. Please find someone to take you to and from work until you get to the bottom of this.

Please write back and let me know what you find out.

I wish you well.
Dr. Marie

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