Advice please!

[GreenREM]

Hi,
I was prescribed propranolol last week for physical symptoms of anxiety. I made an appointment after years of struggling on when it started really effecting my work ,saw the nurse and explained my symptoms she prescribed me propranolol 10mg 3x a day. Also some tests to rule out other causes.
I started the propranolol and spent a week feeling really really low and tearful, but was sleeping better. I've started to feel better the last couple of days. Much calmer.
She phoned yesterday to see how I was getting on and I said I still feel some panic but not so bad as before but i had felt really low all week and tearful. She didn't really say much more to that, and I struggled to say what I wanted as she sounded in a rush. but she wants to book me for an 24 hour Ecg and she said I can stop the tablets as they weren't helping. I said I'm worried about stopping because I've gone from not sleeping at all to sleeping much better and I'm frightened to go back to where I was a few weeks ago- at least now i feel I'm moving forward. She said just take 1 at night but she hasn't written me a prescription when I went to pick it up.

She's phoning again later in the week with my test results but I'm out of tablets tomorrow and kicking myself for not saying I want to keep taking them more regularly as I think they were helping.

I don't know my head feels all over the place , my brain is not functioning at any level other than the basics and I have hardly any memory to think what we said accurately!

What should I do? I'm grateful she is ruling out all physical causes but it does make sense it's anxiety as it got really unmanageable after a number of really stressful things happened. Dh says phone back tomorrow and ask for more tablets as they were starting to help but this makes me feel really anxious through as I have to go through receptionists to speak to a nurse.

Does anyone know if the propranolol begin to work over time or is it immediate and so the benefits were placebo? I've also been off work,cut out caffeine and been trying to relax more so maybe that's what's helped?

I'm just really struggling and need to get back to work asap which I felt positive about this morning but now feel back to square 1 with nothing to work with other than a possible date in the future for an ecg and my test results coming back.

Any help much appreciated thank you

[Liska]

Sorry no advice just bumping and sending for while you're waiting for someone more helpful.

[GreenREM]

Thanks Liska

[GreenREM]

Shameless bump

[AnxiousCarer]

Not got any answers about the proponalol, except to ring for an urgent appointment to get your prescription sorted for you.

With view to work for me personally I found that my anxiety didn't start to improve until I gave myself permission to be off work for a substantial period of time. Whilst I was pushing myself to get back to work the anxiety just got worse. There are lots of different medications to try for anxiety, so hopefully they will get the right one soon once they have ruled out physical causes. If you're not happy with how the nurse is handling things ask to see someone else e.g GP

[GreenREM]

Thank you anxiouscarer, I think I'll speak to her again on Monday when she phones and if I'm not happy then see if I can see someone else. She seems lovely just very brisk and if the propranolol aren't working maybe change dosage or try a different med ,but she just wanted me to wait until my test results come back and then wait for an ecg.

I guess I've been struggling so long and I finally got up the courage to make an apt so I'm hoping things will change. Maybe I just need to be more direct with her though. I started to open up (which I find very hard) about how low I'd felt and I said could that be the meds and she just said maybe and moved on. Was a bit uncomfortable. I don't want to be on medication but I need some relief, even short term. I feel like I'm losing my mind I'm all over the place!

Would the care from a GP and nurse practitioner be similar? What reason would I need to give the gateway receptionists to see a gp instead of a nurse if the options are the same ? The nurse wasn't concerned about why I'm anxious or when it's at it's worst. I appreciate they are busy though. Now I feel bloody anxious about the ecg!lol

I phoned up and got another lot of tablets so that's good.

[RachelRagged]

I don't take those ones OP but please, get a new prescription sorted out.

I stopped, I thought I was better and could cope so I stopped, months ago. As of last week I have started again from square one really . Keep them going , they will kick in .

Best of Luck

[GreenREM]

Thanks Rachel, I feel much more balanced now just after a day of taking them again. I don't feel so low either I've got more energy to do things, where as before I'd put off making phone calls or going places. I'm not depressed I don't think but I definitely feel happier on the propranolol.

[GreenREM]

I'm waiting for test results from a blood count and thyroid test and last time I had a test done I put off getting the results for weeks and was having full on panic attacks over it. I was physically shaking when I finally rang up. I have thought about them odd times and hoped their ok but my thoughts don't go any further than that. I didn't expect that,since the meds are a beta locker for physical symptoms I expected to still have to cope with the mental side.
Amazing!

[AnxiousCarer]

I often see the nurse practitioner, at my last practice he had previously been a CPN so was fab for MH. At my current practice her background is a&e and although nice I find her a bit for MH issues, she often gives me advice in direct opposition to my MH professionals. So background will be a big factor.

I think the same applies toGPs, but they are much more likely to have worked in MH either as a junior Dr. Or as part of their GP training. Nursing training is generally in physical or mental health (3 years) with a furthur year (if full time) to become a nurse practitioner (with at least 12 months, usually more working as a nurse in between) GPs have 5 years medical training, 2 years in junior Dr training posts and then 3 years GP training so will have more experience is the breadth of practice. Nurse practitioners are likely to have much narrower experience, especially as generally nurses don't rotate through different specialities once qualified in the way Drs do.

I really respect the role of the nurse practitioners , but if you are finding you are not getting anywhere it might be worth asking one of the GPs particularly if there is one who has a special interest in MH. If the receptionist quizzes you you can always say its confidential, they cant stop you having an appointment for not telling them.

I once had a Dr tear strips off a receptionist when I was on holiday as she told me to make a 500 mile trip to see my own GP for an urgent MH matter. I stood my ground and was seen by the GP who she had told me was far too busy to see me who was horrified at the receptionists response. Last thing you need when your mental health is not great is to have to fight with the receptionist!

[GreenREM]

Thank you that's interesting, I think that rings true for this nurse. She seems nice but overly concerned for my physical health rather than mental. It will be a big coincidence if I developed symptoms which mirror anxiety as I'm going through some massive stresses in my life..but I guess you never know and Inwill be grateful if it is physical! She isn't able to offer any advice on coping or the mental symptoms though. I think I'll see what she says on our next appointment and go from there.
About 10 years ago I saw a gp for anxiety/depression and came out of the appointment with a referral for cbt and anti depressants. No one ever mentioned testing my heart or bloods and I remember panicking to the cbt therapist that maybe there was a problem with my physical health and the dr is assuming anxiety/depression. Ironic really!! I guess the nurse would see that on my medical records so knows I was previously treated.
The receptionists are friendly enough and have helped me with other things ,but a couple of them can act like they are the key holder to medical help! I guess they are just trying to efficiently use the appointments and tbf you can see a dr/nurse by the next day at the latest usually so I can't complain.
There is a really good dr there who I've seen with dc who had a medical problem which wasn't being taken seriously and I went to her for a second opinion (at the receptionists advice!) she was fantastic and got my dc referred to a specialist. I asked to see her but the receptionist said I couldn't because she isn't covering my drs patients,the nurse is! Not sure if that's right really.

[Bettyspants]

Anxious carer, just thought I'd clarify something for you, nurse practitioners used to be very varying in standard (a practitice nurse is a nurse in a GP surgery ) For e X ample some may not be able to examine a patient whereas others can do the same tasks as a GP. As from a couple years ago to be called a nurse practitioner or more specifically advance nurse or clinical practitioner the college of nursing states they have to study st masters level which can take up to another 3 1/2 -4 years . This is after having worked extensively as s nurse first. They are trained to exam diagnose treat and discharge independently.patients independently , I'm a nurse consultant and am now a mentor for those in training . Hope you don't miss the hijack but lots of people could have a nurse practitioner appointment instead of GP , I'm having issues reading all your comments as my phone is refusing to let me read the full thread but I hope you got answers that helpec

[RachelRagged]

Thanks Rachel, I feel much more balanced now just after a day of taking them again. I don't feel so low either I've got more energy to do things, where as before I'd put off making phone calls or going places. I'm not depressed I don't think but I definitely feel happier on the propranolol.

Glad to hear it

Yes, when I am in the grip, I can get in awful trouble as I get scared to open mail, especially brown envelopes. Same re phone calls that need making.