Posted by JohnX2 on March 6, 2002, at 12:58:03
In reply to Re: Medication Swizzle game vs. good docs, posted by JohnX2 on March 6, 2002, at 12:46:21
PS irony: the swizzle game makes some pdocs more
money.-John
>
> Hi,
>
> I don't know what happened with your good
> medicines. I think this is a common problem
> though that I ran into: find a few good meds
> that have one or 2 snags.
>
> I believe it may be possible to find happiness on
> those medicines if you have a good pdoc/better
> information. Too many people blame the problem
> (not you necessarily) on the medicine instead
> of the process of getting to the medicine and
> the follow ups.
>
> I'll throw out examples, maybe a lot of
> people do well on certain SSRIs but have unbearable
> bruxism (teeth grinding). What to do?
>
> Crummy doctors find it easiest to use the most
> simple scientific trial and error method on
> planet earth which is process of elimination.
>
> Therefore, if you don't like a medicine, let's
> just swizzle the patient to another one. Never
> mind doing a little investigation to see if I
> (doctor) can treat the little nuiance to make
> the medication that is mostly working solvable.
>
> Ok, now onto the good doctors. Maybe there are
> some with some good DEDUCTIVE thinking skills that
> can identify trends in your good and bad responses
> and focus on addressing those trends instead of
> putting you through the swizzle game. Back to
> bruxism, a lot of people complain about this problem
> but how many pdocs know how to fix it (god knows
> there are so many little anti-dotes to try) and
> how many would just find it easier to swizzle the
> patient onto another medicine where enevitably
> the patient will encounter some OTHER problem
> that makes medication unbearable.
>
> I'm sorry but my take is that good physicians
> should have some sort of training in the past
> that required them to solve really tough scientific
> problems using analytical deduction. A lot of
> doctors don't have scientific backgrounds, go
> to medical school , learn what they do via
> memorization , solve problems with simple
> process of elimination, and turn into what I call
> "walking flowcharts". If the flowcharts on
> giving medicines don't give out all these little
> "secrets" on how to make medicines valuable,bearable
> or how to put 2 and 2 together from YOUR
> history to maybe get a better dx on you,etc , then
> the doctor may never find a good treatment for you.
>
> Another good example is the starting dx. This
> is more important than the medicine. How many
> people do I know that don't get the right dx and
> then take the wrong meds? Bipolars treated with
> unipolar meds, etc. Again, its not always obvious
> from an initial exam if you are sly bipolar II.
> But maybe after taking 5 anti-depressants, getting
> 2 hypomanic responses that petered out, instead
> of continuing to use process of elimination along
> the major depression medicine path the good doc
> should look at the trend, use some deduction, and
> say, hey maybe this patient is bipolar.
>
> Unfortunately I think I am being too idealistic
> about finding these docs. They are overbooked.
>
> So sometimes people come here, and I give suggestions
> as well as others on how to make a medicine more
> bearable to improve the odds of making through
> the trial to get a response or stay on a medicine
> with 1 or 2 snags, or get a better dx. My suggestions
> or "secrets" maybe they are, are usually known by at least
> a few other people here, (a lot of time we learned
> these by BEING BURNT), but the person posting
> came here with the question leading me to believe
> that his attending physician isn't up on the
> "secrets" and using a little deductive thinking.
>
> -John
>
>
> > I have to put this in, because I am getting to a point of despair about ever recovering from my depression.
> >
> > I have been seriously depressed since I was 18 (although I have had symptoms of depression from a very young age) and have tried Prozac, Efexor and Celexa. Each one of these has affected my life in such a way as to make it worse rather than better. Although ADs have lifted me out of the darkest moods, they have also made me so tired I have had to sleep 15 hours a day, changed my appetite so that I have been scared and incapacitated by my compulsive eating, made me lethargic and numb, made me not care about my life enough to try and change it.
> >
> > I am sick of being in this mess, which is that I can't cope without ADs and can't cope with them. I am trying to do a university course and am failing miserably because I can't get myself together enough to do any work, talk to anyone or go to any classes.
> >
> > I have an NHS doctor who is not interested in combining drugs or trying anything unusual (eg. MAOIs) - he isn't even interested in the fact that my depression is different from the "classic" type (it's atypical). I feel like in order to get any real help I will have to do something desperate, and I have no wish to do that. I just want my life back.
> >
> > I apologise for being very negative, but I would really appreciate some advice.
> >
> > AL
poster:JohnX2
thread:96683
URL: http://www.dr-bob.org/babble/20020301/msgs/96723.html