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Suggest Treatment For Persistent Thyroidectomy, Depression, Bipolar Disorder And Back Pain
Question: my wife has many health issues, Thyroidectomy, bi polar 2, depression, back problems, stomach problems etc. However for her mental health issues NO ONE can find the right formula to make her feel well. She takes 11 medications daily all prescribed by different physicians... What kind of Doctor can we visit that will look at all of these to see if one counteracts with another
Brief Answer:
Internist
Detailed Answer:
I am sorry to learn about the medical challenges regarding your wife's health.
Typically it is the Internal Medicine specialist who carefully registers potential drug-drug interactions.
Often times, a family physician does the job too.
These are times of sub-specialty doctors who attend to problems in their area of expertise and defer to other specialists for problems unconnected to their domain of work. However, Internists will coordinate all care plans and ensure redundant or counter-productive treatments.
I hope you are able to find one nearby who can assist with her complex medical conditions and try to simplify the treatments, and possibly even reduce the number of medications she needs.
Internist
Detailed Answer:
I am sorry to learn about the medical challenges regarding your wife's health.
Typically it is the Internal Medicine specialist who carefully registers potential drug-drug interactions.
Often times, a family physician does the job too.
These are times of sub-specialty doctors who attend to problems in their area of expertise and defer to other specialists for problems unconnected to their domain of work. However, Internists will coordinate all care plans and ensure redundant or counter-productive treatments.
I hope you are able to find one nearby who can assist with her complex medical conditions and try to simplify the treatments, and possibly even reduce the number of medications she needs.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I am submitting her medication regiment...can you and your colleagues shed any input or suggestions based on what she is taking as far as improvements or recommendations. As I stated right now her depression is very severe and quality of life is very bad. A brief history...since adolescence she has always had hormonal issues, diagnosed with thyroid cancer in 2006 and she had her thyroid removed. After a few years, keeping her TSH in check became a real challenge with her levels going from hypo to hyperthyroidism and depression worsened. She has endured 1 suicide attempt, 2 admissions of inpatient from not wanting to live anymore, 3 outpatient programs, many counseling and coping sessions. XXXXXXX 2013 she was diagnosed as Bi-polar and put on Lithium, for two yrs she progressively worsened leading to her last hospitalization in XXXXXXX 2015. They took her off Lithium and changed her medications. This was AMAZING, she felt so much better than she has ever felt in over 2 years. We believe it was the Lithium that caused her downfall. She felt good for about 2 months and then constant tweaking of meds has led us back to a dead end street and she is absolutely horrible again not wanting to live feeling like this anymore. We are desperate and in need of help. (is there a real Dr. House out there anywhere). This medicine regiment was added to yesterday with Depakote.
Synthroid 137 mcg 1 x in am
Clonazepam 1 mg 1 x in am
Probiotic OTC 1 x in am
Amitiza 24 mcg 1 x in am and 1 x in pm
Divalproex tab 250 mg DR 1 x in am and 1 x in pm (started 9-28-15)
Myrbetriq 25 mg 1 x in pm
Fenofibrate 160 mg 1 x in pm
Latuda 60 mg 1 x in pm
Lamotrigine 100 mg 1 x in pm
Alprazolam ER 2 mg 1 x at bedtime
Nexium 40 mg taken 3 or 4 times a week
Tramadol 50 mg as needed no more than 2 x day
Can you give any helpful recommendations to this regiment or any advice at all that we would of course discuss with her Doctors before making any changes. As I said we have had many Psychiatrists and are currently with one at Sheppard Pratt Hospital in XXXXXXX He came highly recommended and accredited but we still haven't found the right formula for her as of yet. We are running out of time as she just can't tolerate not having any quality of life at all.
Synthroid 137 mcg 1 x in am
Clonazepam 1 mg 1 x in am
Probiotic OTC 1 x in am
Amitiza 24 mcg 1 x in am and 1 x in pm
Divalproex tab 250 mg DR 1 x in am and 1 x in pm (started 9-28-15)
Myrbetriq 25 mg 1 x in pm
Fenofibrate 160 mg 1 x in pm
Latuda 60 mg 1 x in pm
Lamotrigine 100 mg 1 x in pm
Alprazolam ER 2 mg 1 x at bedtime
Nexium 40 mg taken 3 or 4 times a week
Tramadol 50 mg as needed no more than 2 x day
Can you give any helpful recommendations to this regiment or any advice at all that we would of course discuss with her Doctors before making any changes. As I said we have had many Psychiatrists and are currently with one at Sheppard Pratt Hospital in XXXXXXX He came highly recommended and accredited but we still haven't found the right formula for her as of yet. We are running out of time as she just can't tolerate not having any quality of life at all.
Brief Answer:
Follow up
Detailed Answer:
I can understand how difficult it must be for you both.
It is hard to pinpoint medications that can be eliminated without the opportunity to examine the patient and have regular follow up opportunities.
But the only two medications in the above list that fall in endocrine domain are
Synthroid and Fenofibrate.
Regarding synthroid, if the cancer is presumed cured based on a through evaluation , then doses need to be adjusted in such a way that TSH stays around 1 to 2 with Free T4 levels closer to higher range of normal.
And with regards to fenofibrate if the Triglyceride levels are under 500, then that too can be considered to be discontinued, but only with due consultation of your physician , with close monitoring of levels overtime.
If acidity is not a problem anymore then Nexium is not required.
The others are psych tropic medication which require a psychiatrist only to modify during continued long term follow ups.
I am sure your doctors will always try to reduce the number of pills she is on. You can also state this explicitly at your appointments with her doctors.
Follow up
Detailed Answer:
I can understand how difficult it must be for you both.
It is hard to pinpoint medications that can be eliminated without the opportunity to examine the patient and have regular follow up opportunities.
But the only two medications in the above list that fall in endocrine domain are
Synthroid and Fenofibrate.
Regarding synthroid, if the cancer is presumed cured based on a through evaluation , then doses need to be adjusted in such a way that TSH stays around 1 to 2 with Free T4 levels closer to higher range of normal.
And with regards to fenofibrate if the Triglyceride levels are under 500, then that too can be considered to be discontinued, but only with due consultation of your physician , with close monitoring of levels overtime.
If acidity is not a problem anymore then Nexium is not required.
The others are psych tropic medication which require a psychiatrist only to modify during continued long term follow ups.
I am sure your doctors will always try to reduce the number of pills she is on. You can also state this explicitly at your appointments with her doctors.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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