Went to see my physician today for some tests. I actually see a nurse practitioner, but I saw the doctor at the practice – a family doctor more than 10 years past the retirement age and a friend of my grandparents – three weeks ago to discuss the fibromyalgia diagnosis and figure out where to go from there. My CRNP (the nurse) gave me copies of my records today for the SSI paperwork. The below is the report from my meeting with the doctor.

5/20/02

Presents with quite a problem. By history she has been taking some rather heavy duty psychiatric meds i.e. Zyprexa and perhaps Respiradol1. She D/Ced the above2 because of weight gain. She now reports having bilateral carpal tunnel syndrome after one days work at a computer data facility3. Indeed she has generalized myalgia. She was seen by Dr. M***** who felt that she may indeed have a fibromylagia4. One is impressed with the psychiatric aspect.5 A conference is to be held with her parents. The presentation may be delusional6. We may be looking at a highly organized affective schizophrenic disorder related to bipolar illness7. She is to have a complete workup from an RA viewpoint8. The psychiatric considerations are very real9. Conference to be held with the psychiatrist10. All in all the prognosis is somewhat guarded. The general picture with individuals of this age range would be that of deterioration over several years11. Hopefully that process can be interrupted and she can come away from the delusional material12. One would have a gut feeling that the impression of fibromyalgia is an escape mechanism, giving her physical symptoms that she does feel but which is based on a delusion13.

1. I am still on Risperedal, which I told him.

2. I told him the the Risperedal would be continued until my psychiatrist took me off of it. My previous psychiatrist switched me from Zyprexa to Risperdal and I have not gone off any medication without approval from my doctors.

3. It clearly states in my records, and then I orally reiterated, that I have been in treatment for CTS since 1999, and also that it was not a computer data facility – a computer data facility would have had better working conditions.

4. A fibromyalgia? Is there more than one?

5. Fuck you.

6. Explain to me why it is you are the only doctor who thinks that, and why the X-rays of my deteriorating cartilage and swelling in my joints prove otherwise, not to mention the arthritis bloodwork and the shape of my tendons.

7. ROTFLMAO / [bursts into uncontrollable tears] Explain to me why no psychiatrist I have ever seen has thought I had schizoaffective disorder, and am instead being treated for bi polar II? Though many of the symptoms are similar, there is a large problem – I only get delusional when incredibly depressed or manic. To be schizoaffective, \”the occurrence of the delusions or hallucinations must be in the absence of any serious mood symptoms for at least 2 weeks. The mood disorder, however, must be present for a significant minority of the time.\” And that is most definitely not me.

8. Which I did, and he said I had fibromyalgia most likely stemming from a severe viral infection I had at the age of 13 which lasted for six months, as well as carpal tunnel syndrome and tendonitis which appears to have developed years ago, considering how bad the shape of my tendons are.

9. Well duh – just not the condition you think, you son of a bitch.

10. It has been three weeks, but you still have not called her. Would it be overly sarcastic to thank you for your services at this time?

11. Great. More fun to look forward to, if the decline of my physical condition in the past 10 years is to be an indicator.

12. Did you even look at the fucking test results, asshole? If this is a delusion then you can delude yourself into thinking that I did not just give you the finger.

13. If my friends were not almost all exclusively vegetarian, I would offer them your \’guts\’ for dinner. Maybe my family would be interested. Fuck your gut. A year and a half of extensive and vigorous head therapy, six years previous of other therapy, returning to a place I loathe to face my demons, refusing to hide and be cowardly and basically ceasing all my favorite activities because of the amount of pain they cause, and I am still escaping? This is an escape mechanism? Can I please escape from your practice and have you never come near me again? Would that be considered avoidant; another escape mechanism?

Now, this is all very well and good and somewhat amusing as well as incredibly frustrating, but there is an actual problem here, other than this guy being a total ass. To get SSI the government has to have statements and records from all my doctors. If all my specialist doctors and psych doctors all say I have bi polar II, borderline, social anxiety, fibromyalgia, carpal tunnel syndrome and tendonitis, and my supposedly \’main\’ doctor, my physician whom I do not even see, says that I am a delusional schizoaffective and that it is all in my head, there is no fucking way this side of a beautiful day in hell that I am going to be given SSI.

Unfortunately, the SSI offices determine most of their decision on what the primary care physician has to say. As the person who actually does my primary care is \’only\’ a certified nurse practitioner, the name has to be under the MD, and the referal has to come from the MD. There are no other MDs in the practice, so it is this guy or go find another practice and establish a relationship with an MD there – an MD that would be willing to recommend SSI – as soon as possible.

I am completely, totally and utterly fucking screwed. Anybody want to be my sugar daddy? I put out!