too quick to diagnose?

Penguin129

For the past two weeks I've had really bad insomnia. Abby's sleep hasn't been the greatest (due to teething or a sleep regression) which hasn't been helping. The last time this happened to me was almost 4 years ago when I had depression. I decided to go to the doctor.

I went to the conveinient care place in town and saw a physician's assistant. She basically asked me what was going on and what I thought was wrong and diagnosed depression, just like that. She prescribed pills and told me to start taking them right away before I even get blood work done to rule out other things like anemia or a problem with my thyroid.

I forgot to tell her I had anemia in the past after major blood loss and had to go on iron supplements, how I had vertigo, and just a month ago a big bout of dizziness. She didn't ask me if I was feeling sad, helpless, had thoughts of suicide, etc (syptoms of depression) which I don't. I feel she was to quick to diagnose the problem because I self diagnosed. I am not a doctor and didn't know isomnia could be caused by other things.

I am getting blood work done tomorrow and have to have an appointment later in the week to go over the results. I really want see a different doctor and get another opinion (still at the same place). I am worried the new doctor or PA are going to tell me that I already have a diagnosis and not listen to me.

How should I address the new doctor or PA I see? Please help me figure this out. Thanks!

jjbmstinco

I would do a couple things.  Start keeping a journal about your stress level, eating habits, sleeping patterns, and general mood. This will give you long term data rather than basing it off one day.

2. Tell your new person exactly your concerns.  Tell them about the depression, the anemia, the dizziness ect.  Write down all the stuff you want to tell them so you don't forget.  Let them know that you aren't against the depression Dx (diagnosis) but that you feel that other things need to be ruled out first.  

3. I would ask about what are the most common side effects of your Rx.  My H went through several medications before finding on that works for him.  He has been on it now for close to 6 years. Not all of them are the same.  

4. I would also ask you why you were thinking that you can't sleep. Are you worrying about something while you are trying to sleep? What are you doing beforehand? If you can't sleep, do you get up and do something?  Looking at a bedtime routine might be very beneficial. It essentially prepares your body for sleep.  

While I am not a doctor,but I have a good idea on how to Dx and treat depression.  I am very familiar with the brain chemistry, but I will say that I am a big believer in natural medicines before moving to Rx. That is just mean and it doesn't fit everyone.  Let me know if you have any questions.

Penguin129

@‌jjbmstinco
Thank you so much for taking the time to read my book of a post and responding so quickly. You asked me more questions and gave me more suggestions than the PA did. 1-3 are all great ideas and I love the way you said to word #2 when I see a new person. Exactly the wording I was looking for, but didn't know how to express.

As far as #4 I think the main reason I have trouble falling asleep is because Abby usually wakes up every two hours, sometimes every hour. This has happened for a couple of weeks now and we are trying to fix it, it is a natural regression and I think she's been teething off an on. She goes to bed at 9:30 and usually is up by midnight for a diaper change. If I go to bed at 10 most of the time I can't fall asleep because I know I'll be up with her soon. This continues the rest of the night. So I am worrying about when she'll be up. Before bed I usually check fb, pinterest, and here. Sometimes I'll watch a show. I have a small snack and some milk before getting ready for bed. If I can't sleep I just toss and turn all night. I try really hard to not look at the clock because that makes it worse.

We feel the same way as far as natural medicine or changes to diet/routine before medicine. I was medicated for a year 4 years ago, but there was no doubt about the diagnosis and I needed the meds.

Thanks again for all your input:

jjbmstinco

A few things that are just my opinion...

It seems to me that you know why you aren't sleeping.  It is the fact that you are afraid once you fall asleep, Abby will wake up.  Therefore you aren't getting a restful sleep.  I would also say that if you are up every 2 hours, you are not entering REM sleep (the sleep you need the most).  Now that doesn't mean very  much when you have a child, but eventually it will catch up with you. She needs her needs met and therefore you take care of that like you should  Hypothetically, if she slept for 8 hours, would you sleep for 7-8 hours?  If the answer is yes, then I don't think its medically wrong. Its you brain being on alert. If you took care of her problem of not sleeping through the night, then you should be able to sleep. 

I have read quite a few studies that say TV/internet before bed stimulates the brain, so when we go to bed, it can't whined down. Having a small snack and reading has been testing to help our bodies prepare for sleep. Maybe that is something you can try. 

I am not a mother so I have no idea on this one, but I feel like 9:30 is really late for a child her age to go to bed.  I was 8 when this was my bedtime.  I don't know your schedule, but I wonder if you pushed back her bedtime to like 8. Then that is extra hours, you could be sleeping/resting/preparing for bed.  Plus, if she got up at 10, then you would already be up. Again, not a mom so IDK how anything like that works. 

Penguin129

Thanks again for your thoughts. It does seem late and for some it is. I space out her sleeping times based on her naps. Right now she is in her room by 8:30 and is asleep by 9:30. I could try to get her in bed 15 mins earlier and than gradually move her bedtime up. I can start this tonight. I am willing to try anything. We liked the later bedtime because dh doesn't get home til 7 pm. If it will help Abby and I get better sleep then we will have to give it a shot.

shellyamf

Before a year old, Lily slept more and was in bed by 8. Now it all depends on her nap. She goes to bed about 6 hours after her nap. So if she sleeps until 3:30 she won't go to sleep until 9:30. Even in a dark room laying in bed. We try to aim for bed time around 8:30-9:00 but there are days it doesn't happen that way.

As for you not sleeping. I get that. For me it's actually on the nights Lily sleeps the whole night thru. I'm used to her waking at least once sometimes twice. So when she sleeps all night I wake up every few hours and have a bad night. Do you nap during the day when Abby naps?? It could be a way to get more sleep in for yourself?? Do you co-sleep? Co-sleeping was my way of getting the sleep I needed so I could take care of Lily all day so P wouldn't have to get up a lot at night so he could get his sleep. I know co-sleeping isn't for everyone. Maybe you could trade off with DH on getting up at night. Or have him get up with her first wake up. Then he can sleep while you get up the rest of the night? Just suggestions.

Penguin129

@shellyamf‌
It helps to know Lily has a late bedtime too. I try to nap when Abby naps, but her naps are only 45 mins and by the time I get to sleep she's up. We coslept and had 2 close calls which is why we decided to try putting her in her own room to sleep. I am thinking about going back to cosleeping if it means I could have more sleep. Figuring this sleeping stuff out is tough. I ask my mil and mom for advice and they are completely different. My mom let me cry it out while my mil rocked dh to sleep until he was at least 2. Neither if them like cosleeping. I know I am the parent and know what is best. Are you worried about making the transition from cosleeping to not cosleeping later?

ImperiumWife

I honestly don't know what to add, it was all so well said. Jen's list is what I would have written too. I would absolutely go back, and you should push. If you think it was too fast, it was too fast. There are many other reasons, and they should explore them. If they don't, you really should go somewhere else. Just make sure you do have everything written down. Good luck with everything! 

Penguin129

Thank you all so much. You all are so helpful. I definitely feel it was too fast, especially to prescribe an antidepressant before having the blood tests come back and without asking for a more detailed medical history. I really wasn't a help with that because all I could think of was when I had depression. Now I have my list all written out so I can give a more detailed history. I am seeing a doctor on Friday instead of a physician's assistant so hopefully that combined with my list will help me get a better diagnosis.

shellyamf

I was worried about the transition to not co sleeping but now not so much. We kept putting lily in her crib after rocking her to sleep. Some nights she was in it for a few hours and other nights she'd be fine most of the night. With teething it varied a lot. Awhile back we took the front off her crib to make it a toddler bed but she rolled out a few times. Instead of spending $100 on a toddler rail we bought a toddler bed for $60. She has been doing really well in it. When she's not teething she sleeps all night in it. Teething still brings her to our bed at some point in the night. When she is done teething and nursing I don't foresee a problem with her staying in her bed. Sometimes I lay on the floor next to her bed until she goes back to sleep instead of taking her to our bed.

Neither my mom or MIl like the co sleeping but I pointed out everyone parents differently. My mom let me cry it out. Each kid is different too. I know cry it out works amazing on some kids but not others. It's just finding what works best for the parent and the kid.

I know you bought a toddler bed for Abby. Can you lay on the floor or make a pallet next to her bed instead of taking her to your bed? If you are worried about co- sleeping.

Penguin129

@shellyamf‌

My mom let me cry it out too. My mil rocked my husband to sleep until he was 2. Neither coslept. I actualy tried bringing Abby to our bed last night and she wanted no part of it. She couldn't settle between dh and I. She has a cold now with a low fever or maybe it is teething. I have a foam mattress pad I sleep on most nights in her room. I have to remember she coslept with us almost 3 months and is now in her own bed in her own room. It is going to take time for her to get used to it. I still give Abby milk at night if she can't settle which my mom says makes things worse and mil says is ok.

Yesterday I asked a good friend about what happened with the depression diagnosis (she's a Physician's Assistant) and while she agreed the lady took a short cut, she also gave me advice to let Abby cry it out or I will never sleep. She said Abby has to learn. Ugh! I was so upset. She isn't a parent yet and told me she is sure that is what she will do when she becomes a mom.

shellyamf

I know I said there were things I would or wouldn't do once I had kids. But having a kid changes your perspective on said things sometimes.

Maybe Abby is just going through a rough patch. She could be mastering a new skill or growing. I know that can affect their moods and sleeping.