Posted by Racer on April 27, 2004, at 20:58:28
In reply to My doctor is not listening, posted by KittenCat on April 27, 2004, at 17:06:11
Lots of comments and advice from me. I don't know if I can get up to a real Racer Rant, but I've certainly got a lot of comments:
First off, with the newer anti-depressants, there are no blood tests to check that you're in the therapeutic window. It's not like the older TCAs, but all based on whether or not you feel better. (And if your doctor asks you that, feel lucky: my last doctor TOLD me when I was feeling better -- despite me telling her that I was worse!) If you feel better, then the drug is working. So, can't really fault your doctor for not doing labs.
Secondly, though, thyroid problems can present as depression, so ask him to check your thyroid function just to rule it out. It's worth checking, since there's not a lot of reason to check it otherwise.
As for advice about the doctor, and communication, here's something I learned from organizational development: do a negative consensus. Start at the most basic level, and move to the higher points. Ask him if he does not agree with each statement, and then you'll find out where the difficulty lies.
Of course, with the depression active, that's a lot of energy to expend, but the alternative is to discuss it with him as if you weren't depressed, so ... Seriously, though, you've expressed yourself well here. The next step is to boil it all down to what you need to tell him. He already knows that you're depressed, and that you've taken anti-depressants, so that part of it isn't necessary. How about telling him that you're not sure he's hearing you; that you really need a referal to a therapist; and that you're now quite concerned about anti-depressants in general, and his ability to prescribe what YOU need after the latest difficulty with Effexor?
For what it's worth, I'm in a similar space right now myself. I don't think my pdoc has heard a word I've said about why I don't want to go back on Effexor, I'm afraid of all ADs since that experience, and I'm not doing well at all on any level. I don't think it's all that uncommon. Shameful for the medical profession, but not uncommon.
And I haven't heard of Zyprexa for depression, but that don't mean there ain't some rationale behind it. Someone here is likely to know.
Good luck to you.
poster:Racer
thread:340700
URL: http://www.dr-bob.org/babble/20040423/msgs/340777.html