Derm told me I don't need a rhuemy- I need a psychiatrist!

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Regular Member

Date Joined May 2009
Total Posts : 99
   Posted 7/2/2009 2:14 PM (GMT -6)   
Oh gosh- I go to a derm that's part of a group of 6 men (no ladies).  Anywho- the first time I saw one of them for the rashes on my face and body he prescribed me an antihistamine and a topical for my scalp (its a mess) and a steroid for my face and body.  He told me to come back in 2 weeks.  So I did- yesterday.  I got a different doc and he asked me some questions and basically told me that it was in my head.  That I didn't get rashes for any other reason than stress.  That the stress brought on the sun sensitivity and that since it had been happening since I was young I should look to a family stressor.  Problems with parents or siblings.  Emotional or physical abuse.  Um no.  I didn't have any of that- I just get red and rashy when I get hot, sweat or go into the sun.  But he told me to get a psychiatrist and reccommended Paxil.  He also told me that I didn't need to see a rhuemy because even though my family doc did all the tests- the derm didn't think that the results warranted a specialist because they weren't "that off the charts".  Strike two-(don't say bad things about Dr.Great Guy- it pisses me off).  Sorry about the profanity I am just really frustrated.  Derm told me that I have rosacea on my face, that my scalp issues were stress and OCD, gave me another script for another antihistamine, a script for finacea, added to my first antihistamine (quadrupled the dose) and told me to come back in a month.  So bascially he told me everything is in my head, get a psychiatrist go on more antianxiety meds (I am on Zoloft and ithas been very good to me) and everything will be fine. 
I left so confused and doubting myself and my possible illness (since I haven't been dx'd and I am waiting on my first rheumy visit).    So here is what I am asking:
Is it possible that he's right?
Is everything just in my head?
Is that why it took me so long to get an appt with my rhuemy- cause they don't think that I am really sick?
Should I just stop taking the pain meds and toughen up?
Now I feel stress!  Can anyone help?  Has anyone had a silimilar experience?  How did you handle it?
Please help!

Veteran Member

Date Joined Mar 2006
Total Posts : 2608
   Posted 7/2/2009 3:02 PM (GMT -6)   

Its possible that he's WRONG. It's certain that he has a lousy bedside manner. Don't let him convince you that's it's all in your head. Get a second opinion.

Hang in there,

SLE, fibro, renauds, restless leg, hiatal hernia, double vision, migraines, costocondritis.

prednisone, plaquenil, leflunomide, neurontin, synthroid, triamterene, actonel, niaspan, tri-est, cymbalta, tricor, acifex

Veteran Member

Date Joined May 2005
Total Posts : 7725
   Posted 7/2/2009 3:02 PM (GMT -6)   
Is it possible that he's right? == Well, anything is possible, but I strongly doubt his theories.

Is everything just in my head? == I doubt it, unless you have high blood pressure from stress that makes your face red, rashes don't usually appear for "just stress".

Is that why it took me so long to get an appt with my rhuemy- cause they don't think that I am really sick? == "THEM?" mean a recommendation? Sometimes they just can't see the forest for the trees, and they aren't specialists like a lupus-aware rheumy would be. Depending on insurance, you may not need a recommendation to see a rhuemy. If you're talking about how long it takes to see the rheumy, it's just cause s/he is busy, not about you.

Should I just stop taking the pain meds and toughen up? == What are the pain meds for? DO they help? Might be best to wait till you see rheumy for deciding to change.

"I just get red and rashy when I get hot, sweat or go into the sun." -- that seems fairly normal for most sun/heat sensitive people -- or sweat sensitive ppl. (I consider myself allergic to my own sweat.) I stay out of sun/heat as much as possible, and make sure to keep troublesome areas clean, use baby power as needed, and wipe off sweat with a clean cool washcloth as needed.

Ain't life grand?
Lynnwood, Lupus & Sjogren's Moderator
Life is far too important to be taken seriously. - Oscar Wilde, 1882

Veteran Member

Date Joined Jun 2008
Total Posts : 675
   Posted 7/2/2009 5:04 PM (GMT -6)   

Oh boy, do I know just how you feel!  In my case it was a hematologist - who still managed to make me feel bad and stressed and quite indignant even AFTER having seen a rheumy, being dx'd w/ UCTD and treated with Plaquenil, and being sent to him by my pcp to rule out a specific and genetic blood disorder my mother has and I am beginning to display symptoms of.    This doctor told me I knew too much (because I am a former medical transcriptionist) and therefore was imagining my symptoms and should see a psychiatrist so he could Rx the proper med.  Oh and I should take Xanax ALL the time!  How exactly do you "imagine" to have  polycythemia? 

I guess it's like anything else - sometimes you get an experienced plumber/lawyer/waitress/whatever and all goes well, and sometimes you get the rookie dufus who doesn't nothing but ruin your day or muck up your life/house/meal/whatever.   I think you got a dufus.  Like Lynwood said - anything is possible, but I think you need and deserve a second opinion.  And I hope you have an appt with a rheumy.  Take pictures of your rashes.  I'm assuming the steroid x 2 wks helped calm things down before this last appt.? 

Hang in there.  Some people shoudn't be doctors.


diagnoses:  mono 1972; postviral CFS 1997; fibro 1998;  UCTD (dx limbo) 2007
meds: Plaquenil 400 mg, occasional low dose xanax for sleep aid, artificial tears w/ ointment at night, Advil/aspirin prn

Regular Member

Date Joined Feb 2009
Total Posts : 108
   Posted 7/2/2009 7:08 PM (GMT -6)   
Hang in there, Trish . . . I do not think there is a single one among us who hasn't been told it was all in our heads at one time or another. I actually had a doctor decide it was all in my head and prescribe UV therapy! HA! guess where that got me? even sicker . . . and my first dermy decided that I had skin cancer, did a biopsy that read "inconclusive" for any type of skin cancer and froze all the lesions with liquid nitrogen. The scabs took about 6 months to finally fall off (I was told it would take about 2 weeks) and, dontchya know, the lesions were still there - only worse than they were before they froze them. Since then, I have gotten a different PCP (one whose pockets are not lined by the drug companies and who often "forgets" to turn in my charges to the billing department), a different dermy (she's the one who actually tipped my PCP off on lupus because of the combination of autoimmune markers in the bloodwork - I do not have a positive ANA) and have a really good rheumy in tow.

I personally have never heard of anyone having sun sensitivity caused by stress . . . illness, maybe . . . meds, maybe, but not stress . . . feel free to correct me if i am wrong, guys . . . nor have I heard of OCD causing scalp issues.

Hang in there until you can see your rheumy. Call to be put on a cancel list so that you can get in earlier if someone cancels with him/her. Don't doubt yourself - you know best how you are feeling and I think almost everyone here will agree that they have had to go through a myriad of worthless doctors before they finally found one who listened and looked at the bigger pictures. I think many of us went through a stage (I know I did) where we wondered the same things you are. Don't be afraid to fight for your health. I have told countless doctors "I'm not sick & tired because I'm depressed - I'm depressed because I am sick & tired".

My opinion is that it's probably all in your head with Paxil recommended for you by this latest guy because that is the drug company that is currently lining his pockets.

There are only two ways to live your life.
One is as though nothing is a miracle.
The other is as though everything is a miracle.
-Albert Einstein

Dx: SLE, Sjogren's, Reynaud's, Peripheral Neuropathy

Veteran Member

Date Joined Dec 2005
Total Posts : 1950
   Posted 7/2/2009 9:21 PM (GMT -6)   
Trish, it may be that the second doc you saw was "fillng in " for the first doc you saw and didn't feel comfortable changing anything. So he kind of blew you off. I would try to get an appointment with the original derm and see what he says and whether you have any improvement since he saw you untreated and really needs to be the one to follow up.

Sometimes once a doc sees you are on one antidepressant, they stigmatize you. Does Zoloft make sunsensitivity and skin problems worse? I don't know. But it might be something to look in to.

I would see the rheumie if you don't need a referral, but I wouldn't think too much until you see the original doc you first saw. A lot of docs arent comfortable or there may be notes in the chart not to change anything until he is able to see you again and maybe this doc is just not able to saythat, I don't know. Docs can be strange.

FSH follicle stimulating hormone, will make your hair fall out and I would think the derm would've checked it. Mine was out of sight on interferon and my hair fell out, but it got better after I got off the drug.
Love, Marji
Ills--Sjogrens-Lupus cond., AI polygland. dysfunction 2, hyper/hypopigment, scoliosis,kyphosis,stenosis, deg.,O.A.,spine surgeries, salivary/lymphectomies, NASH, COPD, RLS, UT/GI bleeds, hystero, brain/nerve damage,TB
Meds--INH,Plaquenil, Evoxac, Metformin, Synthroid, HCTZ, HRT and Lidocaine patchs, Voltaren gel, Klonopin, Vicodin, Restasis, Albuterol, steroids

Regular Member

Date Joined May 2009
Total Posts : 99
   Posted 7/5/2009 3:32 AM (GMT -6)   
Thanks you guys! Especially Lynnwood for putting things into perspective. Shame on me for letting this guy make me doubt years of symptoms and suffering. It just helps to hear that it happens to a lot of people along the way. You guys are the only thing keeping me sane. My first rheumy appt is only about 2 weeks away.

Veteran Member

Date Joined Mar 2006
Total Posts : 2608
   Posted 7/5/2009 11:04 AM (GMT -6)   
Lynnwood always puts things in perspective.
SLE, fibro, renauds, restless leg, hiatal hernia, double vision, migraines, costocondritis.

prednisone, plaquenil, leflunomide, neurontin, synthroid, triamterene, actonel, niaspan, tri-est, cymbalta, tricor, acifex

Veteran Member

Date Joined Sep 2005
Total Posts : 1744
   Posted 7/6/2009 7:05 AM (GMT -6)   


You know your body better than anyone else.  If you think something is wrong, chances are it is wrong.  Go with your gut instinct.  My mother died from MCTD (complications).  She was told for years that it was "in her head" by several different military doctors.  As a result, her diagnosis was delayed unnecessarily, and she didn't receive early, aggressive treatment for her AI issues.   I recommend that you seek another opinion.  Especially, since this guy didn't even offer to run additional tests or anything.  Sounds like a real winner to me.



Current dx: Rheumatoid Arthritis
Suspected dx: UCTD/Early Lupus
Current Meds: Enbrel, Plaquenil, Methotrexate, nexium, tramadol, nasonex,Tylenol PM
Past Meds: Relafen, Vioxx, Mobic, Voltaren, Sulfasalazine, Entocort, Prednisone, Humira, Reglan, zyrtec, zegerid, aciphex

Regular Member

Date Joined Jan 2006
Total Posts : 395
   Posted 7/6/2009 8:06 AM (GMT -6)   
Hang TOUGH, I vote with Pat, get a second and third opinion. Do not give up. Get copies of all your lab work, take pictures of every rash, in good light, with a good camera, print out good quality prints or save to a disc, whether "not that off the charts or not" argh ^%*&^&^*%$#$&, sweetly walk in to the office, and politely demand copies of your progress notes, lab tests, and formal dictated consult reports, thank them and don't look back. I was seeing drs. I had worked with in a small town hospital for years!!!!!! I am a nurse and I lost count of the times I was told, you must be depressed, or maybe it's early menopause, you're just really tired, you don't look sick, or job stress? My hair was falling out in clumps in the shower and I was falling alot. I use to lay on the wet ground and look at the clouds drift by, saying to myself..... "I must be depressed, this is all in my head, ..........." but I didn't give up and saw 4 drs. over the course of 4 years. I built a notebook with a time line and documented all my symptoms. When I got to my rheumy, I wanted to hug him. He read my consult reports, labs, scanned my time line and said "what do you want me to tell you? You have lupus."

God knows, even if I don't....
CNS Lupus 2005, APS, Hashimoto's Thyroiditis
Meds: Plaquenil, Neurontin, Thyroid, Piroxicam, Aspirin, Atenolol and Norvasc, Prednisone 5mg daily and Paxil, Ambien every night.

Veteran Member

Date Joined Dec 2007
Total Posts : 2113
   Posted 7/6/2009 8:16 PM (GMT -6)   
Drop that derm and see a good rhuemy. It always takes a long time to get in to see a good rhuemy-they are busy.

A tale of two doctors (a friend of mine)

Fatigue, elevated sed rates, low vitamin D-GP sends her to a rhuemy because GP doesn't know what is going on

First Rhuemy:
Runs ANA and repeats SED,
ANA is normal SED is very elevated
Diagnosis Fibromyalgia
Treatment: Two muscle relaxants and an NSAID
Five minute appointment

Friend comes to me and says does this make sense-handing me what there was of the lab work
Consult: Where is the rest of the lab work? There isn't anymore
Did he do a trigger point exam: NO I never even got in a gown
Did he say what he thought was causing the elevated SED rates? No-he said they weren't important

My Diagnosis: Chronically bad medical advice syndrome
Treatment: See a Doctor who is not an idiot-I gave her my doctor's card-my doctor is on the Medical Advisory Commitee for the Lupus Foundation

Exam:-Over an hour of medical history, over an hour physical exam in a gown
Lab Tests: too numerous to mention, including chest X-rays, EMG, tests for lymphoma and more
Diagnosis: Not yet-but, I am really concerned with the SED rates and I don't want to treat you for Fibromyalgia until I have explained them-I want to run a few more tests-third visit in 12 weeks is scheduled soon.

Get a good doctor.
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