Venting Doctors appointment soon

[willitpass]

I have a doctors appointment soon to discuss severe health issues I've been having. I've had this appointment scheduled for a couple of months. I'm worried that they'll order blood work and test my levels of acetaminophen and salicylates (Tylenol and Aspirin). I've been trying to take levels that would be supra therapeutic but could be explained as taken out of desperation to ease pain, but I've started climbing higher and higher to the point that Im taking way more than that. I'm taking 8-9g of Tyneol a day and 3900mg of Aspirin a day at this point. I'm going to try to lower my doses the days leading up to the appointment, but I don't know if I have enough control over my mind at this point. This is so stupid. My mind makes no fucking sense. Fuck. I want to cancel the appointment, but my GP really wants me to see them and many people in my life know about it and would question if I just decide not to go. I suppose I could lie. I don't care about myself enough to bother with doctors. I should never have scheduled the appointment.

 

[Ash]

I hate it when Past Me does something sensible that Future Me will regret but can't get out of.

 

[Tesha]

It's probably not something the lab would test your blood for without being asked to.

What may happen is your blood clotting results aren't within range and they ask for another sample. You can then decide whether to go back or not, or reduce the amount you're taking at that point.

 

[willitpass]

It's probably not something the lab would test your blood for without being asked to.

What may happen is your blood clotting results aren't within range and they ask for another sample. You can then decide whether to go back or not, or reduce the amount you're taking at that point.

I know it's very possible they won't, I'm just worried because of the type of specialist I'm seeing. I've had my levels of those tested in the emergency room before just to check, I'm not sure how common it is to check outpatient in this speciality. I'm just paranoid and overthinking. They may not even want blood-work at all for all I know.

 

[mellie5]

how was the test? are you in hospital? high acetaminophen/paracetamol - you know what it does, right? and the aspirin too. I don't want to get specific and I really understand your state of mind but they are the opposite of a peaceful pill.

Even if not testing specifically for the substances you will get extremely weird results in certain standard tests and those will make anyone suspicious - maybe not of intentional poisoning right away, but of very serious disease and they will need to make further tests. And if you refuse them, then people will get very suspicious... :(

 

[willitpass]

how was the test? are you in hospital? high acetaminophen/paracetamol - you know what it does, right? and the aspirin too. I don't want to get specific and I really understand your state of mind but they are the opposite of a peaceful pill.

Even if not testing specifically for the substances you will get extremely weird results in certain standard tests and those will make anyone suspicious - maybe not of intentional poisoning right away, but of very serious disease and they will need to make further tests. And if you refuse them, then people will get very suspicious... :(

I work in healthcare, I'm well aware of the effects of what I'm doing to myself. I know what organs I'm harming and what blood tests are going to come back wrong and I'm currently awaiting results. I will cross the bridge when it comes as far as recommended treatment. I suspect elevated liver enzymes and a potential acute kidney injury, I suspect relatively severe anemia and other levels thrown off from my starvation and dehydration. However as an adult it is my right to refuse treatment, and I believe I built a decent enough story at the doctor that this was all due to progressive physical deterioration and not psychiatric issues. I've been ramping up the starvation and dehydration but scaling back on the pills due to severe nausea and vomiting, so when the results do come back then if they suspect overdoses my levels will probably be back within a therapeutic range or slightly supra therapeutic and easier to write off. Ideally they don't recommend any hospital treatments as if they send me home I can chose to not do them, that's much harder to do in the hospital without suspicion. I know what I'm doing, I have an in depth knowledge of the human body and the medical system. I know all of the tests being run and the possible treatments that will be strongly suggested to me. But currently I'm just back to living in self imposed suffering and awaiting a call from the doctor.

 

[mellie5]

Sure, patient autonomy ofc and the right to refuse treatment. So you know also how the paracetamol/acetaminophen graph looks like and what salicylate poisoning can do.

I don't want to sound "shiny-happy" but yk that p/a overdose can end up with jaundice and on a transplant list. The aspirin can, instead of AKI, have lots of other effects and since you have eaten very little and there is lots of acid in your stomach, get you a stomach ulcer too. You might have high urine ketones too by not eating. And dehydration is dehydration. I won't comment on dosages though.

I want you to be well-informed.

And idk imagine the doctor who gets a blood test with extremely elevated liver enzymes, low eGFR if you really messed up the kidneys, electrolytes all messed up too and you tell him you won't do anything, idk if he will just say "ok fine, sign here".

I am sure in health care you have seen people with symptomatic heart problems who actually "just sign" and go home with heart ischemia or BP over 240 or eGFR 2, but it depends a lot on the doctor and ofc then on the psychiatrist and the country or state you are in.

I just wish you well, whatever it means :)

 

[willitpass]

Sure, patient autonomy ofc and the right to refuse treatment. So you know also how the paracetamol/acetaminophen graph looks like and what salicylate poisoning can do.

I don't want to sound "shiny-happy" but yk that p/a overdose can end up with jaundice and on a transplant list. The aspirin can, instead of AKI, have lots of other effects and since you have eaten very little and there is lots of acid in your stomach, get you a stomach ulcer too. You might have high urine ketones too by not eating. And dehydration is dehydration. I won't comment on dosages though.

I want you to be well-informed.

And idk imagine the doctor who gets a blood test with extremely elevated liver enzymes, low eGFR if you really messed up the kidneys, electrolytes all messed up too and you tell him you won't do anything, idk if he will just say "ok fine, sign here".

I am sure in health care you have seen people with symptomatic heart problems who actually "just sign" and go home with heart ischemia or BP over 240 or eGFR 2, but it depends a lot on the doctor and ofc then on the psychiatrist and the country or state you are in.

I just wish you well, whatever it means :)

I'm well aware of both the dosaging and the organ damage related to Aspirin, Tylenol, and NSAIDS. I know my liver is working overtime, my kidneys are getting a triple whammy with the dehydration, starvation, and NSAIDS/aspirin. I know I'm at risk for gastric ulcers, blood thinning, stroke, etc. I'm aware of all of it. I know what starvation does to the body in all of the systems, same with dehydration. As I said, I work in healthcare and have an in depth knowledge of the human body. I've read up on medical journals related to all of this, as well as having plenty of prior knowledge. I'm not going in blind, I'm just simply not scared of hurting myself. I believe I deserve suffering.

Ideally I don't get called into the hospital, I get given treatment options to do from home. And hell, what are they going to do if I don't show up to the hospital? They aren't currently suspecting psych. Between my prior existing medical conditions and the things that I told at the appointment I'm confident I built up a good story to cover myself. I told the doctor I'd been struggling to eat and hydrate due to nausea and vomiting as well as early satiety. I told them I had been taking probably a bit too much Tylenol and Aspirin than I probably should because the pain has just been too much to handle and I haven't had anything else that helps. Any labs that come back wrong will be consistent with my story. Hopefully they are not so bad that they request urgent medical attention. And if they are, that's a problem for another day as it's the weekend and I won't be getting any results back today.

 

[mellie5]

yes, I read you work in healthcare. I understand everything you are saying and I also understand what you are doing and why. Good that you have access to journals.

I really don't know what results you have but if I were a doctor and I got some extreme tragic liver and kidney results and the patient doesn't show up I might risk and call an ambulance because - even with no psych history - to put it bluntly, I could think shit, she's unconscious and I want to cover my ass. And if not an ambulance, which is paid, I'd call the police or someone to check, and you know prior interventions will show up.

You probably also know that the lab, with extreme results, will phone the doctor directly and the doctor can ask "do you still have the blood? can we still check medication levels?". And if it's one that wants to make an autism and the lab happy, the doctor can ask for a gas chromatography, which will detect everything you have taken.

And even if the current levels of the substances are low, you know metabolites will be high. Like when people have low THC but then THC-COOH is high or BAC is 0.00% but CDT shows they have been drinking every day. And if you are stressing your heart, chances are that maybe pro-BNP will be high and a good doctor will take a good look at the medication and wonder why is it not working.

Then maybe fine, she's just not compliant and I'll wash my hands out of this.

I respect your decision and your choices and I wish you didn't have to suffer all your life. Stellate ganglion blocks (which ik are for pain) have been shown to have an influence on mental health. I don't remember the mechanism atm though.

 

[willitpass]

yes, I read you work in healthcare. I understand everything you are saying and I also understand what you are doing and why. Good that you have access to journals.

I really don't know what results you have but if I were a doctor and I got some extreme tragic liver and kidney results and the patient doesn't show up I might risk and call an ambulance because - even with no psych history - to put it bluntly, I could think shit, she's unconscious and I want to cover my ass. And if not an ambulance, which is paid, I'd call the police or someone to check, and you know prior interventions will show up.

You probably also know that the lab, with extreme results, will phone the doctor directly and the doctor can ask "do you still have the blood? can we still check medication levels?". And if it's one that wants to make an autism and the lab happy, the doctor can ask for a gas chromatography, which will detect everything you have taken.

And even if the current levels of the substances are low, you know metabolites will be high. Like when people have low THC but then THC-COOH is high or BAC is 0.00% but CDT shows they have been drinking every day. And if you are stressing your heart, chances are that maybe pro-BNP will be high and a good doctor will take a good look at the medication and wonder why is it not working.

Then maybe fine, she's just not compliant and I'll wash my hands out of this.

I respect your decision and your choices and I wish you didn't have to suffer all your life. Stellate ganglion blocks (which ik are for pain) have been shown to have an influence on mental health. I don't remember the mechanism atm though.

The only things they will find in my blood are OTC pain killers, albeit too many of them, however I already mentioned it to my doctor that I was taking more than I should. If they are truly at levels that no one would believe were unintentional then I'll see how things play out. At this point I'm trying my best to not stress about that as if that does happen there is nothing I can do to change it at this moment. The blood is already out of my hands. Currently acetaminophen and salicylate levels are not on my list of tests being processed and I know some people have taken way too much Tylenol for extended periods of time and normal-mildly off hepatic panels, so it's not even a guarantee that mine will be extremely concerning anyway. My BNP has already been tested relatively recently and was WNL, I doubt much has changed in that short of a period of time. Most anything beyond extremely bad hepatic function panels would be consistent with malnutrition and dehydration, as well as my other health conditions/symptoms, anyway, not necessarily concerning for NSAID/aspirin abuse.

 

[mellie5]

Well let's hope so. Now just don't stress too much (easy to say, right?). I am sorry you have also those physical symptoms you wrote in the other thread (but imho less paracetamol/acetaminophen and aspirin could help with the nausea).

Do you have access to the (paid) doctor version of uptodate where you work? on www.uptodate.com you can access for free the patient version. It's very useful.

Now for a crazy idea, you said you get dizzy and have nausea, did you try an Epley maneuver? you can see them on yt. I mean imagine if the nausea and dizziness are bcs you slept weirdily and an otolith fell somewhere strange. It takes 5 minutes to try :-) and you could be lucky :-)