have you ever been told you have "functional overlay"?

Question

Hi guys.  

I am perplexed with this "functional overlay" thing.  It was written up in a report to my Dr. by the opthamologist. 

They did quite a few MS checks, ( which I did not understand) , they are eye people not MS people.  That being said, they laughed when I told them that I have LOTS of lesions, and even a black hole in the brain.  He for some reason, I guess, thought this was funny. 

So, to prove to myself that I did remember reading that..... I for sure did.  It actually was highlighted way back in 2009.

I'm trying to figure out why people say and concentrate on certain things.   It is just to confuse us, I think. 

I have been off the Aubagio for about 10 days now, and I still have not heard from the MS clinic  or my neuro !  I don't really know what to do about that. 

But, we are concentrating on the new grand baby that is coming in a couple of weeks, and that is what I choose to do right now, the other stuff in my life is just to much right now. 

HUGS to all, 
Candy

candy158 · Answer

wow, you guys are the best !!!!!!!!  Thank you so very much.  I have been calling my MS clinic nurse, and it does not get me anywhere.  I only see my GP when there is something other than MS ..... he sends me my repeats on my regular med's, but he doesn't do anything with a DMD , and does not seem to know that much about MS.  That is why I research things, and try and go into an appt. with notes and questions.  Hubby always goes with me, and sometimes he does more talking than I do, because he sees the disfunction of memory and walking etc. that we all seem to suffer from .... 

I was taken back with an Opthomologists report considering he is not an MS specialist, he just looks for things in your eyes.  His report was not really about my eyes, but , the Optometrist did change my perscription  on my glasses quite drastically.  They seem to be ok .... have had them now for about 1 month. 

The Dr's seem to have such a way to belittle me, I don't know if it because I am a sap,and take things really to heart, or not... but , they seem to need a verification .... from either another Dr, or tests, but they don't really seem to be nice people.   I don't know !!! 

Did anyone on the site turn into the Wedenair today on MS and how to fight it with Vitamins and such ???  Dr. Cartwright was the Dr.   ... I found it so scientific that I actually lost some of what he was talking about, it was 1 1/2 hours this morning....?

Thanks again guys, and I am trying to persist with this DMD , and see where we go with it...... but, so much is happening in my life right now, actually DMD is not #1 on my list.   Our son/wife and 4 grandkids left Victoria last Monday in a UHAUL to move to Dawson Creek.  We were NOT told  due to the wife.  I'm really worried, so you can see how I am really stressed now.  Our daughter is due for her 2nd baby is 3 weeks, have a big test on Friday, and I'm going, and we are hoping she does not need to be manipulated, but they think that maybe. 

See what I mean, lots going on..... just trying to keep my head above water... and my stomach to be able to hold things down, Could use some prayers if there are those that could..... much appreciated. 

((HUGS))
Candy

MrsAristotle · Answer

I spoke to my neurologist several years ago about this. Functional Disorder. He laughed, literally. He said they used to call PARKINSONS a FUNCTIONAL DISORDER.

He told me some neuros use this FND label when there is nothing showing on the tests, BUT there is something going on and they should treat it with respect.  He said it doesnt mean the person is not without real neurological issues, just that at the time there is no evidence of what it is, but this can change constantly. Its NOT considered a physc disorder by any real modern nuero....

http://www.fndhope.org/functional-neurological-disorder-2/what-is-fnd/

SarahL2491 · Answer

this is what I found with a quick google, Candy

SOURCETaber's Cyclopedic Medical Dictionary;2005, p839
SOURCE TYPEBook
DOC. TYPEReference Entry
ABSTRACTA definition of the medical term "functional overlay" is presented. Functional overlay refers to the emotional response to physical illness. It may take the form of a conversion reaction, affective overreaction, prolonged symptoms of physical illness after signs of the illness have subsided, or combinations of these. Functional overlay may appear to be the primary disease; skill may be required to determine the actual cause of illness.
ACCESSION #21228864

doublevision1 · Answer

I agree with Ess. It pays to be persistent. It's not acceptable to not be on any treatment when there are alternatives like Tec and Gilenya. Also, 
the provinces are currently working with Genzyme to review Lemtrada in order to add to this drug to the provincial drug plans.  Keep calling! :)

essdipity · Answer

I'm on Tecfidera. After a bad start involving intestinal issues, I stopped it briefly, then started back but per my neuro, took the lower dose for 4 weeks rather than 1. Have been on the higher dose for a few weeks now with absolutely no side effects.

The reason I'd suggest Tec is that if it causes problems, these are likely to be annoying but not serious, and the big majority of those who get side effects find that these resolve after a relatively short time. Monitoring of white blood cells is needed, but after initial 3 and 6 month checks, this should become only twice a year.

I urge you to keep bugging your neuro till he actually responds with a new med. This means calls every few days or even more often. He or his staff will get tired of your calls, and that's when something will happen. Not to offend anyone, but I have to say that the meek do NOT inherit the earth. The squeaking wheel gets the oil.

This is your health here Candy, and your future. Get those elbows out and fight for what's rightfully yours.

ess

doublevision1 · Answer

Perhaps consider Gilenya. It's covered under BCs Pharmacare program. I recently switched to it and seem to be tolerating it well. It does have the possibility of cardiac side effects as well as macular edema so there is close monitoring. Perhaps your GP can push your MS clinic to get back to you? The clinic should not just be throwing in the towel with you especially when there are therapies available that you haven't had the opportunity to try.

candy158 · Answer

DV.... Hi, they did not discuss Gilenya for me.  I only see my neuro every six months, and that was about 3 months ago.  We had to stop Aubagio due to an allergic reaction.  I'm very sensitive to these drugs and antibiotics , so I am difficult to find something that will agree with my body, and I hope I can.  I'm getting ready to stop all med's soon, and see how I do.  Since no one gets back anyways, I will do it with my pharmacist and infor on the web.   

Thanks for your post
Candy

doublevision1 · Answer

Hi Candy, did they discuss Gilenya as an option for you or is there a medical reason you can't take it?

How come you had to discontinue Aubagio? That is unfortunate.

candy158 · Answer

Funny story JJ, DV, I would love to change Dr's, but she is the one who is most easy to deal with, and is in the hospital in the MS Clinic, as well as nurses, and a physiatrist, therapy , and such.  in the beginning of all of this, 6+ years ago, I did try the other 3 Neuro's that help in the Clinic at the hospital, they were REALLY BAD !!!!!!!!!!!!!!!   so, I am not Scheduled to see my neuro till the new year anyways, still, it would be nice to see her, and discuss the stopping of the Aubagio, and to discuss when and if there is another DMD for me.  But, they have not called me since I stopped the Aubagio.   so, what the fk do you do ?????   

Hugs to you all, 
Candy

supermum_ms · Answer

Seriously don't give the jerk any more of your time or thoughts, he's an ophthalmologist and the last time I checked, ophthalmologists are as qualified as dentists, at diagnosing mental health conditions! 

True idiotic Dr story for kicks and giggles........my 50+ yr old brother (dx Asperger's IQ 130+) had always felt uncomfortable after seeing his GP but he really couldn't work out why, and had assumed he was just misunderstanding his GP's seemingly odd behaviour's towards him. 

Anyhooo one day my brother is having a very painful injection in his knee after a bad fall, quite a bit of teeth gritting and yelps going on and after it was over his GP say's to him in a syrupy voice........"you are such a big brave boy, your mother will be soooo proud of you!"  

My brother totally lost his usually calm self, and bellowed....I am a 50 year old man for fk sake, I've got Asperger's you fking ignorant moron and hobbled out the door, said moronic dr trailing behind apologising all the way... 

So no wonder he'd thought his dr's behaviours were odd, his dr had the mistaken impression that because he was dx with Asperger's, that meant he was mentally retarded.....er you'd think a dr would at least have a clue but apparently not! lol

Hugs.............JJ

PS sometimes it's the dr's who are the nuts! :D

doublevision1 · Answer

Hey Candy, If you're not happy with your health care providers, ask to be transferred to someone else. I had a major difference of opinion with my neurologist recently, and we mutually agreed it would be better for me to see someone else. I am much happier. As patients we do have the freedom to direct our own care, though I think many are not aware of this and assume we have no say. Thus they are resigned to being stuck with a doc that is not a good fit. It doesn't have to be that way but it does require we be assertive and press for what we need.

candy158 · Answer

Hi guys, yeah, I was so upset, I just hate reading Dr's reports, because I take them for what they say.  ( I should know better now for sure), but when the Opthomologist mentions this in HIS report to my Optometrist and Dr's, it made me feel like I was nuts. 

I tried to find an explanation, but was to upset, and so DH did look, and he tried to explain it to me, but................ it did not take away the feeling of being judged, and it makes me so not want to go to Dr's anymore. 

I will talk to my physiatrist in December as well, and see if he can explain or talk to my other Dr's ....... I know that I am not "ill" in the head, but when people say stuff and "kinda hide it" not realizing we do read our records, and I try to get my records so I can have it all at home, ................... maybe to much information... I don't know....

:(

supermum_ms · Answer

Hey babe,

If i were you, i'd seriously consider totally forgetting about this comment of "functional overlay" because it's outdated (09) and very controversial considering you do actually have an organic disease (MS) that causes visual issues!

"Conversion term comprises definitions of psychogenic disease or `hysteria. Sometimes real simulation or misdiagnosed conversion cases would be attributed to hysteria. 

On the other hand simultaneously functional visual loss and organic visual loss occur in the same case rarely and those cases are called “functional overlay”[11]. Functional overlay incidence is reported as 16.7% or even 25-53 %" 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3340730/

I was actually a tad shocked at the level of arrogance and the language used, very presumptive towards peoples nature if conversion is suspected, it's eye opening what gets published in medical article sometimes. If you do read it, remember this article is about people who do NOT have an organic cause!

Hugs...........JJ

essdipity · Answer

Hi, Candy. I gather 'functional overlay' is some kind of psychiatric diagnosis. I sure wouldn't stand for that without a very clear explanation, including examples of what is meant. The only kind of doctor really qualified to say this is a psychiatrist, though that doesn't stop other doctors from this sort of comment. Unfortunately this tends to follow us in our medical records. I have no idea to what extent, if any, this is true of you, but if I were you I'd sure make a squawk.

I know that people in Canada are very appreciative of their health care system, and I can understand that. Yet it's not true that health care there is free. Nothing is free in this world. Taxes there are extremely high. And at the same time, waits are extraordinary unless there is a real emergency, and if I understand correctly, the choice of doctors is quite limited, meaning that many people are more or less stuck. Of course not everyone and not all the time.

This is not to bash Canadian health care, far from it, and that's not even the topic here. But I am reminded of the whole issue when posters express their frustration with the care and assessments they receive, while not being able, on a practical level, to make many changes. It is awful that your neuro won't even return your calls. Keep trying, and meanwhile, do everything you can to establish a more responsive health care team.

Hang in there.

ess