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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Insomnia And Depression After A Spinal Fusion

Hello, I recently had spinal fusion, I came home and resumed my normal work load ( we have animals, and my husband is disabled...so I had precooked meals etc for him, also we care for our grandaughters...so he sits and watches them, I put yogurt fruit boxes, snacks where they can reach them...I was dropped off at or day of surgery, saw husband only because kids could be picked up by father easier than going to our house and they got to see me...then Joe would leave...on my 3 rd day home he accused me of being stoned on pain melds . I had been up working for most of each day since getting home on 4 the post op day...I was exhausted and stumbled...I told him no...he then started cussing me...I went and got bottle counted out of 90 Norco 10 only 3 used...then he said well it was something else I took... I have insomnia...nothing has helped so about once a week it catches up with me and I will sleep 14-20 hrs. So, my daughter had weight loss surgery, I was in 4 days with spinal fusion, she stayed 4 , she is a hypocontridriact and loves attention...so we, mainly I had her kids all week...my 3 rd weeks post op, age 3&5. I do crafts with them, make treasure maps, to find treats...when my first grandaughter was 2 and my husband would be verbally abusive to me she would tell him, not to be ugly to maw maw, it wasn t nice...finally about. A yr ago my daughter saw it, ( I told them see how he treats me) ...so, he shut it down...and instead of comforting me, she goes to hug her father and her husband ( to comfort her)! I walked off, finally my SIL, came and comforted me. Now, after prelude...Sunday morning, I was exhausted, kids come over on Friday nights, now that they are in school, so they want to sleep with me, and I get no sleep...Sat we had them until 2, picking up, chores, etc, no sleep, ( I have insomnia bad...nothing has helped, been through 4 men s...went on CPCP( went down to 70 percent!). I am a retired CCU code captain, set nurse... retired due to disabled husbands and caring for grandaughters....Back to Sunday am, back killing me, I hate narcotics I have seen to many hooked on them, to trazedone, as soon as I sat down lap top in my had...after missing 14-20 hours of sleep it knocked me out, my husband just took pictures! I am hypoglycemic, have gone down to 27, have no s/ s prior, so, I have repeatedly asked him check my bag, I had been falling a lot, or drowsing off suddenenly, he took a picture, said I was overdosed...left me there until I came to I told him I had only taken my usual mess plus a trazedone ( vs Norco 10)... and it had made me sleepy, but did he check me, and IF HE DID THINK I HAD OD WHY DIDN t he call ambulance!...his. Answer was your a nurse you should know what to take...he is verbally abusive, we barely talk, live in different sides of the house...I have two full bottles each of Norco and zanaflex...he picked them up with out telling them not to get them...then I take 1/2 Valium am, noon, 10 mg HS, for depression...he said it is the reason, that I can t remember stuff, it s gonna fry my brain, I am bipolar, got off Valium with 1200 neurotoxin and Valium a day... and am decreasing dose on Valium myself, 5/5/10... he won t take his mess stays in pain, mean, verbally abusive, rarely baths, no friends dextroys nearly everything, over 35 yrs...since he can t bend over he has a tractor and instead of getting down runs over stuff so I can pick it up, he demolished a truck because a man offered his 300.00 less than he was asking, had sold it for scrap...so, after my long diatribe/epistle...he blames my Med son everything ...that Valium is frying my brain, after telling how much better I was doing for past several months...I have a great psychiatrist, he has called her, went to see my dad, ( hasn t been to my dad s house alone in 35 yrs)... went to see neighbor told them I was going to die of an Od...I function great, even post op since July 12, doing chores, sweeping, vacuuming, kill my back, breaking new burro, got a saddle on her without problems... He has told me that I will never leave him...he would hunt me down, that 99.9 0/0 time didn t want to be around me, I am not allowed to see family...if you have time to do that you can be doing more here... , see friends, take art classes, do things I use to do, I use to never miss Church, even Wednesday nights...not allowed to talk in car, or house...now, he has told me again and again I need to get off my meds, I have. Had a tia...so BBB PROTOCOL, thyroid, depression, breakdown ( I lost 40 # in one month, this psych finally helped me, had 2 l total knee, picking peas post op day 2... multiple epidurals,spinal faciotomy, now, or, I just can t please him, I told him the day I fell asleep after bring drink to table, laptop on lap, just cooked breakfast, spoke to my sister...fell asleep after taking trazedone...or maybe low BG Won t know because he just took picture and went outside...knowing if asleep I go down to 70 percent o2...also...he wants me to stop Valium... he looked it up, and won t listen to me...that I function great except for rare panic attacks...on low dose valium...what should I do? I need help....please. Seeing endocrinologist Thursday...no compassion but older man, good dr, low adrenal function due to steroids for hips/ knees/back...so, he just refers back to ordering dr...
Mon, 18 Feb 2019
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Neurologist 's  Response
Hello,

I am sorry about your obviously difficult situation. I must admit that your account is a little difficult to understand, seems to have been written under a shaky emotional state and hard to understand the complete timeline without being able to make clarifying questions.

The first advice would be to discuss the issue with your psychiatrist, perhaps together with your husband as well, because there seems to be the possibility of abuse from your husband.

I must say that your husband has a point about Diazepam (Valium). It shouldn't be used for prolonged periods as it develops tolerance and dependence as well as affecting cognitive functions.

Long term treatment of anxiety is preferably done with antidepressants. Since there are insomnia sedative antidepressants would be a good choice. Trazodone is not a bad choice, the dosage must be reseen if not producing the desired effect. Another good choice would be Amitriptyline which apart from helping with anxiety, insomnia and depression are also beneficial for the pain from your back problems.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Olsi Taka, Neurologist
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Suggest Treatment For Insomnia And Depression After A Spinal Fusion

Hello, I am sorry about your obviously difficult situation. I must admit that your account is a little difficult to understand, seems to have been written under a shaky emotional state and hard to understand the complete timeline without being able to make clarifying questions. The first advice would be to discuss the issue with your psychiatrist, perhaps together with your husband as well, because there seems to be the possibility of abuse from your husband. I must say that your husband has a point about Diazepam (Valium). It shouldn t be used for prolonged periods as it develops tolerance and dependence as well as affecting cognitive functions. Long term treatment of anxiety is preferably done with antidepressants. Since there are insomnia sedative antidepressants would be a good choice. Trazodone is not a bad choice, the dosage must be reseen if not producing the desired effect. Another good choice would be Amitriptyline which apart from helping with anxiety, insomnia and depression are also beneficial for the pain from your back problems. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Olsi Taka, Neurologist