I know i'm probably not dying but I'm neurotic about my health.
June 15, 2012 12:32 PM   Subscribe

How does a hypochondriac know he really should go see the Dr.? How should he talk to him about his anxieties?

I’m 35 with a history of GAD, IBS, ADHD, high blood pressure, and a family history of Bipolar disorder and high blood pressure.

One and a half years ago, due to stress at work and a horrible relationship with my supervisor I started showing signs of depression. I didn’t sleep well, lost my appetite only in the mornings, slight apathy (especially regarding my job which was a very toxic workplace). The most significant symptom was I became very irritable. After screaming at another employee I decided to see my general practitioner. I went to the doctor on a morning in which my supervisor did something to really anger me. At his office when the assistant took my blood pressure she thought the machine was broke my blood pressure was so high. (I don’t have the BP levels at this moment). The doctor was very concerned and put me on Metoprolol for two weeks. In addition, I had been taking Adderall for several years and the Dr, ordered my off of it immediately. It had been noted once before that my blood pressure was high in the past but it was never discussed as a immediate concern by my Dr. After two weeks off the Adderall and on the beta-blockers I returned to the Dr. and she said my BP was normal for me. I then saw my psychiatrist who thought that I may have some low-level bipolar disorder explaining the irritability and low-level depression and he put me on Lamictal I took some time off work and my mood improved dramatically. I’ve been on the Lamictal since.

However, I have become neurotic about my health since that incident. I know I don’t take the greatest care of myself. My diet is horrible. I don’t exercise. I’m in decent shape regardless of what has been stated previously in this post, but I know this will eventually catch up to me.

Now I have this recent tendency to see Dr. Google starting about 6 months ago when I thought I caught an STD. (Some advice, DO NOT research STD’s online!!!!!) I saw the Dr. and it was fine. (There was one time several years ago that I was very concerned about oral cancer. It was my saliva glands but I feel my Dr.’s assistant overreacted and gave me the scare).

I just got back from three month’s abroad in Europe. About two weeks into the trip I noticed my stool was pale, very loose, and my urine a bit dark. I went to Dr. scared myself and called my Dr. He told me through his receptionist that I should go to a local Dr. if I had a concern. I waited a week or so and it improved. I didn’t take into account that I was eating new foods, drinking different water, I was dehydrated, and have suffered from various bowel problems in the past.

Still a little concerned I continued to monitor my bathroom outputs and 6 weeks ago noticed my urine was very foamy. At the same time I started getting persistent muscle twitches during the day and muscle jerks when falling asleep. With my history of high blood pressure it is of course kidney disease I’m concerned about.

I watch myself for other vague symptoms. I understand that if they are vague they are probably nothing to worry about.

I know the muscle issues a symptoms of about 1000 different illnesses and the most common would be anxiety. I know my actions and concerns also fit hypochondriasis and it is unlikely that I have a one serious illness back to back with another imagined serious illness. I know this intellectually but I’m still concerned and embarrassed to visit my physician, cry wolf, and pick up the reputation of a hypochondriac.

I am going to speak with my psychiatrist about this in a few weeks when I have my medication check for the Lamictal. I will also get a physical from my general practitioner in a few weeks when that can be scheduled by his office. I think it is most likely prudent to be seen but I think a good compromise between my embarrassment and concerns would be to visit a different Dr. just to be safe. (also, I don’t like to see his assistant due to her previously mentioned overreaction. I’ve heard another patient make similar comments about her).

In the future how can I know when I should really see the Dr.? What would be the best way to discuss this with him?

I appreciate all of your thoughts.
posted by anonymous to Health & Fitness (6 answers total) 5 users marked this as a favorite
My doctor knows I'm a hypochondriac, because I told him on my first visit. It's important information for your doctor know, IF they are a good doctor. If they are a jerk, they could hold it against you, yes. A few have held it against me in the past, but my current doctor is understanding (saintly, even). He listens to my worries, and is firm and no-nonsense with me.

He also put me on an SSRI, and my dosage was raised by a psychiatrist. You can wait for your next appointment with your psychiatrist if you want.... but if your anxiety is as overwhelming as you are implying, you are allowed to ask for an emergency appointment. And I would, if I were you. Don't feel embarrassed; that's what they do. Additionally, if your doctor has a nurse line, use it. Call and ask for advice. I've found this very helpful in triaging my bullshit.

Do not research disease online, ever. You are not equipped to deal with what you will read, and you will make yourself insane. My doctors have all forbidden me to look up diseases on the internet.

I can't speak to your current physical symptoms, except to say that muscle twitches are rife in the highly anxious. And I wouldn't say I'm good at calming down fellow hypochondriacs, but here is one thing I do when I' starting to freak: I ask myself, "If I went to a doctor and told them exactly what I was thinking, would they want to put their head in their hands and cry with frustration over how nonsensical this is?" That's helped me just buckle down and deal many, many times.
posted by Coatlicue at 1:39 PM on June 15, 2012 [2 favorites]

Speaking from experience, the very best thing you can do to put your mind at ease is to GET RELIGIOUS about improving your diet and exercise regimen. If you know you're doing everything you can, when something goes wrong you'll trust yourself more. Proper nutrition and exercise makes everything better, including depression and anxiety. At the very least, take a good multivitamin, B-complex and omega-3 oil supplement. In my case, cutting out red meat, empty carbs, and fried foods wasn't that difficult when I developed healthier habits.

That said, here's a little advice from the dark side...

Instead of fighting your hypochondria ineffectually, give in by becoming a paid subject for research studies at medical universities. With the right uni, you can get every test under the sun: endless free MRIs, functional MRIs, CAT scans, colonoscopies, bronchoscopies, cardiac stress tests, overnight metabolism tests, sleep studies, bone density scans, and every blood panel and psych inventory known to mankind. You name it, I've had it! As someone who didn't have health insurance, it was quite reassuring.

Not only are you getting paid to undergo hundreds of thousands of dollars of medical tests, you're doing it all as a "healthy normal". You're not neurotically wasting anybody's time, you're helping science! How sweet is that?

If there is anything wrong with you, research studies are a great way to find out: I actually had a tiny colon polyp removed which I never would have found so early, and was able to keep an eye on my osteopenia without paying a dime. I haven't done a study in years--my advice in the first paragraph has kept me on a fairly even keel-- but for a certain stressful time in my life, it was a godsend. Something to think about!
posted by doreur at 2:05 PM on June 15, 2012 [3 favorites]

"Do not research disease online, ever."

That's a bit extreme, isn't it? Data points: my father diagnosed his own adult-onset acromegaly and pituitary brain tumor by reading the Merck Manual. It wasn't a "silly overreaction", he was genuinely fucked and basically saved his own life. As an adult, I went to the ER and was told I would have died if I hadn't come in-- good thing my nursing student mother drilled into me the warning signs of septicemia when I was a kid. I also enjoy knowing my friends and the people around me can count on me for quality first aid (which I've delivered more times than I care to remember). Oh well.

In sum, knowledge isn't the enemy. The more you actually know, the less you're prone to overreact and go off on wild flights of fantasy. I think everyone could benefit from being Red Cross certified in First Aid, CPR, and AED: it's just part of being a responsible citizen. In fact, here's the link for anyone who's interested:

posted by doreur at 2:31 PM on June 15, 2012

It seems to me like someone with your known medical conditions should be getting regular checkups anyway. Could you maybe arrange to see your doctor regularly every few months? When you notice a symptom that concerns you, you could make a note to ask your doctor about it at the next routine appointment.
posted by Perodicticus potto at 2:32 PM on June 15, 2012 [1 favorite]

doreur: No, it's not extreme if you're a specifc type of hypochondriac, although I knew someone would cite the time they self-diagnosed and it went fine. I've self-diagnosed accurately, too, but it doesn't change the fact that looking up medical information is far more triggering for me than it is helpful. My doctors are all extremely competent, and they told me to ask THEM about any medical concerns rather than researching it myself and working myself up.

My type of hypochondria means that I cannot tolerate looking up my symptoms of anything on the internet. I call the nurse line. I tell the medical professional what I'm worried about. I let them make the call, because I cannot trust my own mind on this issue. Glad that you're able to reason yourself out of your hypochondria, but that is simply not possible for many people, and to pretend otherwise is kind of insulting to people with this psychiatric issue who haven't managed to logic themselves out of it.

My hypochondria has never been helped by getting scores of medical tests. It just makes me afraid that there's yet another test I should get, or that the test was screwed up someone, or that the results were mixed up with someone else's, or any number of improbable things. That is the nature of hypochondria for many, many people. At the very least, I do not see the point in a hypochondriac making themselves feel worse at a moment of crisis. They can try the cognitive-behavior-exposure-logic stuff AFTER they're stabilized a bit.

OP, determine which brand of hypochondria you have and proceed accordingly.
posted by Coatlicue at 2:52 PM on June 15, 2012 [2 favorites]

It's not clear to me if you were only on the beta blockers for a few weeks -- if you've had normal blood pressure since that short time period without it being corrected with drugs, maybe it wasn't such a serious condition after all, and there would be no reason to be concerned over having had a "serious condition" in the past.

Blood pressure gets higher if you are under a lot of stress, you may well have had a lower reading if you had spent the morning in a relaxed way. Even if you still have high BP, you probably would not have had that highest number in other situations.

Frankly I'm not sure why you feel embarrassed to see your doctor. It sounds like you feel that you have been seeing them too often, but you should be getting a general checkup every year or so anyhow. So, 1.5 years ago you went (no issue there), doctor wanted to see you again in 2 weeks and you went (following Dr's orders), a year goes by and you decide it would be prudent to make sure you don't have an STD (safeguarding your own health as well as that of others), and you asked a question over the phone. These seem like perfectly reasonable interactions with your doctor.

If you are uncomfortable with either this doctor or their staff, the doctor made any sort of unprofessional comments about getting checked for STDs, or even if you simply feel that a different doctor would be a better choice for you, those would be reasons to try seeing someone else for your health care.

I have become neurotic about my health since that incident. I know I don’t take the greatest care of myself. My diet is horrible. I don’t exercise.

You haven't gotten neurotic about your health, you've gotten neurotic about looking things up online. Use this to your advantage and start researching "easy ways to improve your diet" and "starting an exercise program". While you are at it you can search for "health screening recommendations for 35 year old men" (or "for 35 year old women" if that is more appropriate for your situation.)

I've noticed some people (more commonly men, occasionally but rarely women) seem very reluctant to see a doctor at all unless they are unconscious, have blood running onto the floor, can see a bone sticking through their skin, or something like that. If you are interested in living a long and healthy life it is prudent to go to a doctor periodically as they are trained to notice signs of disease early on and can do health screenings for various things.

In the future how can I know when I should really see the Dr.? What would be the best way to discuss this with him?

A good way to prepare for your doctor's appointment is to write down your main questions and to bring some paper to put down the answers. Some questions you might ask: "How often should I get a general checkup?", "What screening tests should I be getting?", and "I'm concerned about kidney disease, what signs should I watch for?"

(There's a "he" in the third-person phrased frontpage question, but in the expanded area you makes no reference to your sex or gender, so one last thing.) If you are female you might consider seeing a gynecologist as well as a GP. There are some health screens that you should be getting that a gynecologist will be much more experienced with. Like anyone else, doctors are much more comfortable with tasks they are experienced with, and that makes it easier for you to feel more comfortable and not feel embarrassed.
posted by yohko at 4:53 PM on June 15, 2012

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