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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 19 to 43 of 43. Go back in thread:
Posted by madeline on May 24, 2006, at 18:21:33
In reply to Re: Saw PDoc Today What Should I Do? » B2chica, posted by Crazy Horse on May 24, 2006, at 17:40:27
In my opinion, you should have never left the office if your weren't absolutely sure why he was prescribing the medication and what side effects you should expect.
Crazyhorse is exactly right, PB is not a forum filled with physicians.
Just call him and if he isn't responsive, then find another pdoc.
Posted by Phillipa on May 24, 2006, at 18:31:08
In reply to Phillipa just call your pdoc., posted by madeline on May 24, 2006, at 18:21:33
To all of you wonderful people I have been trying all day to find a new pdoc but there are a limited number of them that are taking new patients or take medicaire. And I heard that if you say you will pay out of pocket they still won't take you. A PHD wanted on for Mother and even she couldn't get one for self pay. My decision as of now. No antipsychotic. I will raise the luvox starting from the l00mg to l25mg I did this last night. And then when I am used to that add what dose blueberry suggested of the lamictal l2.5mg. And pray he keeps prescribing the valium. After 30years you just can't go off them. And I agree with most of you who ever heard of adding three things at once you wouldn't know what was causing what. And my other option not good is to try and contact my old pdoc 4 hours away and see if she will prescribe the valium for me.She knows me and said I'm not psychotic I asked her once. This doc said he's leaning toward a diagnosis of bipolar. Don't know which one as I never feel high or even good. Love Phillipa
Posted by madeline on May 24, 2006, at 18:40:27
In reply to Re: Phillipa just call your pdoc. » madeline, posted by Phillipa on May 24, 2006, at 18:31:08
Sounds like a reasonable plan, but I would still contact your current pdoc and let him know what you have decided to do.
Be well
Maddie
Posted by Phillipa on May 24, 2006, at 18:43:02
In reply to Re: Phillipa just call your pdoc., posted by madeline on May 24, 2006, at 18:40:27
Since he doesn't talk to his patients on the phone I left a voice mail with his Rn. You can't talk to a real person anymore. Love Phillipa
Posted by Jost on May 24, 2006, at 19:43:30
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
I do think PDocs sometimes prescribe anti-psychotics for people who aren't psychotic. Are you seeing a therapist? If so, perhaps this doctor sees Geodon as a temporary measure, to help for a period of sorting through issues. At least, that would make sense to me.
However, as Monte says, you need to trust your doctor's opinion, because we can't know enough to give you really informed judgments.
Maybe there's a doctor in a community near yours, if you don't feel comfortable with this one?
Is the Luvox a drug you just started? You had said you''ve had trouble with SSRI's. Has luvox caused fewer side-effects so far than others?
Jost
Posted by Phillipa on May 24, 2006, at 19:48:52
In reply to Re: Saw PDoc Today What Should I Do?, posted by Jost on May 24, 2006, at 19:43:30
Jost no I've taken low dose luvox for a long time and it's the only one I seem to be able to tolerate. l0yrs ago it worked for me at 250mg. Then it stopped so more AD's About a year since I've been back on the low from 25=50mg. Love Phillipa
Posted by Maximus on May 24, 2006, at 20:18:46
In reply to Re: Saw PDoc Today What Should I Do? » Jost, posted by Phillipa on May 24, 2006, at 19:48:52
It's a shame that Crazy horse and i have been the only ones to suggest to be compliant with her pdoc. No wonder why so much people here become resistant to treatment.
Wishing all the best to Philippa.
Posted by madeline on May 24, 2006, at 21:37:39
In reply to Re: Saw PDoc Today What Should I Do?, posted by Maximus on May 24, 2006, at 20:18:46
Personally, I cringe when I hear the phrase "Patient was non-compliant with treatment plan X"
Compliancy suggests a obediance and submission, which should not be the therapeutic model.
A physician can provide skilled advice, but it is up to the patient to ultimately decide a course of action.
As a result, the patient bears a marked responsibility when it comes to following or rejecting a doctor's advice when it comes to medication.
Taking a medication against or not in accordance with a physician's direction constitutes abuse of that drug. It may sound harsh, but it is true.
That's why communication (and I CAN'T stress this enough!) between the patient and the physician is absolutely essential.
That way the patient won't feel pushed and ordered around and the doctor won't have a patient abusing a drug under their care.
If you can't talk to your physician, the find another one. It may be your choice, but it is also your health.
Posted by Racer on May 24, 2006, at 22:26:24
In reply to Re: Saw PDoc Today What Should I Do?, posted by Maximus on May 24, 2006, at 20:18:46
> It's a shame that Crazy horse and i have been the only ones to suggest to be compliant with her pdoc. No wonder why so much people here become resistant to treatment.
>
>I've been watching this thread, and purposefully leaving it alone, but I want you to know that I agree. And I wanted to say something. And I even babblemailed Crazy Horse to thank him for saying it.
The last time I said such a thing, though, I felt very much attacked by others who disagreed with my advice. I was the only one in a thread suggesting compliance with the doctor's orders, and the experience left me with a bad taste in my mouth. I also felt attacked on other threads afterwards by a few of the same people.
So, I didn't chime in because I am either a coward, or learning self-protection. Up to you which you think fits better.
Posted by yxibow on May 25, 2006, at 2:21:46
In reply to Compliancy versus abuse, posted by madeline on May 24, 2006, at 21:37:39
> Personally, I cringe when I hear the phrase "Patient was non-compliant with treatment plan X"
>
> Compliancy suggests a obediance and submission, which should not be the therapeutic model.To a tee it may sound so, but it really just means that a patient, paying money for advice, goes to a doctor, who suggests from their knowledge, treatment plan X as you say, and the patient tosses the pills down the garbage disposal. That is what the statement means.
It has nothing to do with submission. It has to do with the saying, you hire a dog to bark, but then you bark yourself.
Sure, a doctor patient relationship should be one of equal communication.I think my doctor summed up our relation with regards to medication once that he, as the one who holds a DEA license and could be in jeopardy of losing it if we went with some bizarre plan that I suggested that he never had skill with, may be in charge with driving the bus, but there's nothing wrong with me, the patient glancing over to make sure he's not making a wrong curve on the steering wheel.
> Taking a medication against or not in accordance with a physician's direction constitutes abuse of that drug. It may sound harsh, but it is true.Completely agreed. And sometimes some of us stray here and there, and I've owned up to taking medication from prior plans.
> That's why communication (and I CAN'T stress this enough!) between the patient and the physician is absolutely essential.
Most assuredly.
> That way the patient won't feel pushed and ordered around and the doctor won't have a patient abusing a drug under their care.Agreed.
> If you can't talk to your physician, the find another one. It may be your choice, but it is also your health.
And its easy to say -- but some people have limited resources to be able to find one. Here in this case, she needs one that accepts Medicaire. In the most sophisticated urban places in this country you may find a handful of doctors who will take it, but its a hard thing to find. If its something she wants to do, its something she will do under her own right.I think that discussing with the nurse practicioner is the right thing and I do hope you hear back from her or your doctor, Jan.
Antipsychotics are not just used for psychosis. However I understand your trepidation. That's why I think I will just finish this thread by saying that you and him are in the same office together. Say something for the time that he gives you. I know you have the power in you to speak up and inquire.
Best wishes
-- Jay
Posted by cecilia on May 25, 2006, at 2:35:38
In reply to Re: Saw PDoc Today What Should I Do?, posted by Maximus on May 24, 2006, at 20:18:46
I also cringe when I hear the word compliance. We're paying the doctor for advice, not to be told what to do like a child. The phrase doctors "orders" also makes me cringe. It's my body, I'm not going to unquestionably follow orders. Philippa's doctor has made it clear that he's an idiot, only a fool would make 3 med changes at the same time. Wasn't he also the one who told her to go from an SSRI to Emsam without a washout period? If Philippa isn't able to get another doctor, she's smart to question the one she's stuck with. Cecilia
Posted by TJO on May 25, 2006, at 5:56:30
In reply to Re: Saw PDoc Today What Should I Do?, posted by cecilia on May 25, 2006, at 2:35:38
Hi,
Does your local hospital have an out patient program? They will usually take medicare or hospital charity care. Think you need a new pdoc asap OR if you really need 3 med changes at the same time should sign into the hospital or stay close to home as a precaution as to how they all might interact. You don't want to fall asleep driving or something that would just make a bigger mess. Does your current pdoc have any partners in practice? Maybe one of them would take you on. Or maybe your pharmacist could give you some advice on the med interaction and might even know of a good doc? Hope this helps.Tam
Posted by valene on May 25, 2006, at 8:01:26
In reply to Saw PDoc Today What Should I Do?, posted by Phillipa on May 23, 2006, at 17:14:38
I know Phillipa for a short time, but have really enjoyed corresponding with her and she is a delightful person. I have only her interest in mind.
That being said, this PSYCHiatrist she is seeing is quite new to her. Of course none of us claim to be doctors, but we all know there are *idiot* doctors out there.
Would YOU want to begin taking 3 new psych drugs at ONCE? Not me. Yikes! What will this do to brain chemistry? Sorry, I disagree and I am not trying to play doctor.
Posted by gardenergirl on May 25, 2006, at 9:13:38
In reply to Re: Phillipa just call your pdoc. » madeline, posted by Phillipa on May 24, 2006, at 18:31:08
> My decision as of now. No antipsychotic. I will raise the luvox starting from the l00mg to l25mg I did this last night. And then when I am used to that add what dose blueberry suggested of the lamictal l2.5mg.
I'm glad you talked to the nurse and let the office know what you decided. And I hope you find some relief in this new regimen.
>She knows me and said I'm not psychotic I asked her once. This doc said he's leaning toward a diagnosis of bipolar.
Others have said this, but I want to reiterate that anti-psychotics are not prescribed just for psychosis. From what I understand, the older ones at least work somewhat like really strong anxiolytics. For whatever reason, taking something that is capable of reducing great anxiety helps to reduce psychosis. That's why you sometimes see Haldol given when someone is extremely agitated.
So it might be that a low dose of an AP might be helpful for your anxiety symptoms. That would be my guess as to why your pdoc prescribed it, but I'm only speculating.
Good luck.
gg
Posted by Sobriquet Style on May 25, 2006, at 10:12:04
In reply to Re: Saw PDoc Today What Should I Do? » Jost, posted by Phillipa on May 24, 2006, at 19:48:52
Phillipa, when you ask "What Should I Do?", if for example everyone on this thread gave you advice which was against your psychiatrists instructions, would you do it?
I think some of us know you as much as we can from this forum, but in some ways, firstly we're not psychiatrists and secondly we know you through a kind of emotional online induced friendship. You know the way doctors who know people personally and have emotional attachment can't treat those people as patients because their professional judgement is somewhat clouded.
I've read your posts and I know you're somewhat dependant on how other people respond to drugs - the specific drug you're thinking of trying. At the end of the day though they're only giving their experience. You will have your own unique experience, whether good or bad. You can read 200 reports of how people resonded to a drug, but it'll never be a 100% indicator of how you resond to it. Sure, you may be able to know you'll get sedation or headaches or something. That is also on the leaflet you get with the drug.
IMO, when I go to see a doctor in the past, his exact words have been "May I suggest xxx drug" The thing is, right in front of him is my medical notes and full medical history, he's asscessing my state of mind and we're having real life face to face contact. Plus his got a medical degree, and specialization in psychiatry, is licensed to not only *suggest* meds but legally issue them.
Then you have babble where people say "May I suggest xxx drug" from screen names and people that barely know you.
So, to answer "what should I do" IMO follow what your doctor says. I remember a while back a poster who didn't want to take antipsychotics, and for a while she didn't and in that time she said, I don't them etc etc. then she started taking tham and everyone on babble noticed how much her health *dramtically* improved. Conversely, I bet they've been people who took tham and thought "man I feel like sh*t" - went to the doctor, told him/her and was took off them. Then they know that drug isn't the one. Its a process of elimination, of what doesn't and *does* work for *you*
~
Posted by Maximus on May 25, 2006, at 14:29:22
In reply to Saw PDoc Today What Should I Do?..what he said? » Phillipa, posted by Sobriquet Style on May 25, 2006, at 10:12:04
Hi Sobriquet,
What you wrote is very clever et very well put, indeed. I could not agree more with you.
Have a good day!
Posted by Phillipa on May 25, 2006, at 14:53:31
In reply to Re: Saw PDoc Today What Should I Do?..what he said? » Sobriquet Style, posted by Maximus on May 25, 2006, at 14:29:22
He doesn't have a medical record. Only the notes from the four times I've seen him for a total of less than an hour. And in the hospital once they gave me seroquel to try and get me to sleep with at the time I was on chloral hydrate, xanax , and low klonopin. The also gave me 50mg of seroquel and four hours later I was awake and they repeated the dose and in the morning I could not talk I could think the words but nothing would come out of my mouth and they had to put me back to bed as I was so dizzy and almost fainted. They discontinued it that day. So no antipschotic. Love Phillipa
Posted by B2chica on May 25, 2006, at 15:09:27
In reply to Re: Saw PDoc Today What Should I Do?..what he said?, posted by Phillipa on May 25, 2006, at 14:53:31
>>and in the morning I could not talk I could think the words but nothing would come out of my mouth and they had to put me back to bed as I was so dizzy and almost fainted. They discontinued it that day. So no antipschotic. Love Phillipa
so sorry for such a cr@ppy experience. i had a similar serious reaction to a med combo, i was luckily already in the hospital in one night they switched me from symbyax to seroquel, trileptal, wellbutrin and xanax. within 24 hours i started to loose feeling all over my body, i couldn't move, talk, three nurses had to carry me from the group room where it came on to my bed and the whole time i was trying to tell them i couldn't walk (duh) and that i was SO hot...all i wanted to say was HOT...i couldn't get it out. i was totally aware of what was going on with me but i was completely locked in. it lasted for about four hours of not being able to talk or move and took the rest of the day to dissapate completely. they said they hadn't seen it before, so they didn't know if it was coming off the zyprexa so fast or on the seroquel/trileptal so fast...or maybe some overlapping consequence.
ANYway, long story short i understand your fear.but just so you know there are other good AP out there, geodon, risperdal and zyprexa for a few.
but the decision is yours.
good luck Phillipa
b2c.
Posted by Sobriquet Style on May 26, 2006, at 9:15:34
In reply to Re: Saw PDoc Today What Should I Do?..what he said?, posted by Phillipa on May 25, 2006, at 14:53:31
Posted by Sobriquet Style on May 26, 2006, at 9:31:59
In reply to Re: Saw PDoc Today What Should I Do?..what he said? » Sobriquet Style, posted by Maximus on May 25, 2006, at 14:29:22
Most kind of you Maximus
:-)
~
Posted by Crazy Horse on May 26, 2006, at 19:34:01
In reply to Saw PDoc Today What Should I Do?..what he said? » Phillipa, posted by Sobriquet Style on May 25, 2006, at 10:12:04
> Phillipa, when you ask "What Should I Do?", if for example everyone on this thread gave you advice which was against your psychiatrists instructions, would you do it?
>
> I think some of us know you as much as we can from this forum, but in some ways, firstly we're not psychiatrists and secondly we know you through a kind of emotional online induced friendship. You know the way doctors who know people personally and have emotional attachment can't treat those people as patients because their professional judgement is somewhat clouded.
>
> I've read your posts and I know you're somewhat dependant on how other people respond to drugs - the specific drug you're thinking of trying. At the end of the day though they're only giving their experience. You will have your own unique experience, whether good or bad. You can read 200 reports of how people resonded to a drug, but it'll never be a 100% indicator of how you resond to it. Sure, you may be able to know you'll get sedation or headaches or something. That is also on the leaflet you get with the drug.
>
> IMO, when I go to see a doctor in the past, his exact words have been "May I suggest xxx drug" The thing is, right in front of him is my medical notes and full medical history, he's asscessing my state of mind and we're having real life face to face contact. Plus his got a medical degree, and specialization in psychiatry, is licensed to not only *suggest* meds but legally issue them.
>
> Then you have babble where people say "May I suggest xxx drug" from screen names and people that barely know you.
>
> So, to answer "what should I do" IMO follow what your doctor says. I remember a while back a poster who didn't want to take antipsychotics, and for a while she didn't and in that time she said, I don't them etc etc. then she started taking tham and everyone on babble noticed how much her health *dramtically* improved. Conversely, I bet they've been people who took tham and thought "man I feel like sh*t" - went to the doctor, told him/her and was took off them. Then they know that drug isn't the one. Its a process of elimination, of what doesn't and *does* work for *you*
>
> ~Extremely well said Sobriquet, excellent insight and absolutely one of the very best posts i have ever read since coming to PB...seriously! I totally agree with you, and thank you for taking the time to show Jan what is going on here. She needs friends like you. :)
Monte
Posted by Phillipa on May 26, 2006, at 19:42:16
In reply to Re: Saw PDoc Today What Should I Do?..what he said? » Sobriquet Style, posted by Crazy Horse on May 26, 2006, at 19:34:01
Monte where have you been? Love Phillipa
Posted by Crazy Horse on May 27, 2006, at 10:54:58
In reply to Re: Saw PDoc Today What Should I Do?..what he said? » Crazy Horse, posted by Phillipa on May 26, 2006, at 19:42:16
> Monte where have you been? Love Phillipa
Hi Jan,
I'm going through a rough time myself (did you get my email)? I'm tapering off the Parnate, just couldn't tolerate the severe insomnia and daytime fatigue anymore. So the Parnate was great for alleviating my depression but the side effects were making me CrAZy!! I wasn't able to be productive because i was always soooo exhausted.
So the plan is to be off Parnate by Friday June 2nd, and start EMSAM a week to 10 days after that. I really think EMSAM will work well for me, i know it's not perfect, but NO drug is.
Anyway, when i feel lousy i don't feel like getting on the internet much...hopefully in 3-4 weeks i'll be feeling much better. UGH...what a life we have, huh? You're just never really sure of anything , at least i'm not.
Well, i hope you are better soon, i really do Jan...you have suffered so much. Please stay in touch, i have missed you. :)Love, Monte
Posted by Sobriquet Style on May 27, 2006, at 15:19:29
In reply to Re: Saw PDoc Today What Should I Do?..what he said? » Sobriquet Style, posted by Crazy Horse on May 26, 2006, at 19:34:01
Thank you Monte, thats a most generous complement to recieve.
Sincerely,
:-)
~
Posted by helpme on July 9, 2006, at 13:17:24
In reply to Compliancy versus abuse, posted by madeline on May 24, 2006, at 21:37:39
I once had a horrible bitch of a psychitrist who wanted me to take 11 ELEVEN drugs at once. She dismissed my complaints of bizare side effects, saying they were actually evidence of developing psychosis. Needless to say, I was "noncompliant" and devised my own desperation mix from the array. After I severly challenged her, she said I wasn't qualified to challlenge her, and to make a long story short, getting into a shouting fight with the wrong doctor will land you in the psych ward with an "anger problem" label. Once there, though it was awful, at least I can report the doctor looked at the list and was aghast. He said, "Thank god you were noncopmpliant. Use your head. NEVER take that many drugs EVER. Use your head. All this did was create side-effects and treatments for the side-effects. And a number of these are highly addictive as well. Lucky you came out alive! Keep.it.simple.please". Etc.
If i wasn't so out of my mind on drugs, I would have had the strength and brains to get a new doctor much soooner. But I was in school and...had psycho side effects, and a couple of addictions to the other drugs.
> Personally, I cringe when I hear the phrase "Patient was non-compliant with treatment plan X"
>
> Compliancy suggests a obediance and submission, which should not be the therapeutic model.
>
> A physician can provide skilled advice, but it is up to the patient to ultimately decide a course of action.
>
> As a result, the patient bears a marked responsibility when it comes to following or rejecting a doctor's advice when it comes to medication.
>
> Taking a medication against or not in accordance with a physician's direction constitutes abuse of that drug. It may sound harsh, but it is true.
>
> That's why communication (and I CAN'T stress this enough!) between the patient and the physician is absolutely essential.
>
> That way the patient won't feel pushed and ordered around and the doctor won't have a patient abusing a drug under their care.
>
> If you can't talk to your physician, the find another one. It may be your choice, but it is also your health.
>
>
This is the end of the thread.
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