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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 75 to 99 of 262. Go back in thread:
Posted by blah on January 28, 2003, at 20:21:32
In reply to Re: I'm Sorry, posted by androog on January 28, 2003, at 11:15:15
Thanks, I do appreciate your words, but I do know this diagnosis is correct. I also have depression, dysthymia, anxiety, and probably avoidant personality disorder traits, but I am primarily schizotypal. In a way it's what I've been telling thearapists and doctors ever since I was a child. I just didn't have the right words to explain it, and they were too arragant to both sift through what I was saying, and in some cases to believe me in the first place. No one would believe the trouble I had with physical activities like homework, housework, and exercize were real. I was too inteligent for it to be a learning dissorder. My eccentricity, or as it was usually called, "being weird" was cause for daily torture by my peers at very young ages, and on some level I am avoided, teased, or judged by most people I know to this day. When I was young the teachers and most adults accused me of just trying to get attention, but I was just interacting to only ways I knew how. Now, even after changing my behavior considerably (if only on an intellectual level) people, especially women know there is something fundamentaly wrong. They don't know what it is, they just don't want to be around it. So often I feel like I'm speaking a different language than the people around me. The more I'm alone, and the more my depression builds the more my mind drifts, even when I'm around people now, and all pdocs care about is addiction, and all friends can talk about is selfesteam. Selfesteem doesn't cure disorganized thoughts. Unless some drug works (and it won't be anything conventional) there really isn't any hope for me. I don't have the effort I once had, and ecconomic survival will soon be an omnipresant problem.
I made an appointment with that other pdoc I was talking about. She won't be able to rx opioids right away but maybe in a month or two, and maybe we'll be able to find another source like a pain doctor. I'm just having trouble holding on everything hurts so much, and there is no hope anywhere.
Posted by Luka62 on January 28, 2003, at 22:43:27
In reply to Re: licensed physicians, posted by androog on January 25, 2003, at 11:53:22
I couldn't believe when I read that meds such as valium, ativan, vicodin and ultram could be purchased online. I checked out some of the sites and was astounded! I know the situation some people are in, feeling they have no choice, they can't get their docs to prescribe for them...I may consider the same if I had to, but fortunately I have docs who do prescribe what I need, including pain med.
The prices they charge are outrageous! Sounds like you're paying a price to get the drug off the street. I take the pain med Ultram, which costs about $1.00 a pill for the BrandName, less for generic. Most online pharmacies charge from 3 to 5 times its retail cost.!
I suppose you'd consider you're paying more for "online physician consultation", but who's to say who is really authorizing the requests?
Posted by Luka62 on January 28, 2003, at 23:01:53
In reply to Re: opiates and major depression, posted by androog on January 27, 2003, at 1:49:04
> Watch out for that Nardil! It put me in the hospital hooked up to an EKG, sucking on nitroglycerin. They didn't tell me I couldn't use OTC nasal spray while on Nardil, just that I couldn't eat certain things.
>
> And they think opiates are dangerous!
>
> Glad to hear the Ultram is working for you.
>
Thanks!
I hear you! You should have been informed better about the nasal spray. What sounds benign can be deadly!
In the past I've taken prescribed narcotics not just for pain, but to make life a little more tolerable. However my pdoc doesn't prescribe narcotics for me.(Matter of fact, he lost his position as a superintendant of a state hospital when years back he prescribed a Schedule II drug to a patient who was having trouble kicking a habit.) I think it'll be a long time if ever opiates are used for depression giving the high potential for abuse.
Posted by bozeman on January 28, 2003, at 23:38:56
In reply to Re: I'm Sorry » androog, posted by blah on January 28, 2003, at 20:21:32
Wow . . . Reading your last three or so posts, I am absolutely floored by the similarity between your "stream of consciousness" and that of a dear friend of mine. He too is incredibly intelligent but painfully stymied. Like you, he feels like Stranger in a Strange Land (if you've never read it, the title says enough for you to get the picture.) His entire life he felt like the world was on one sheet of music and he was on another (he's right), that everyone talked about him (actually, they do), and that no one understood him (for a long time, that was true.) Dating women was a disaster. They all expected to one day find out he was an escaped ax murderer, he thinks, and that's probably not far from the truth. That is, until he found the one woman who looked past his "weirdness" and found the shining soul underneath. Yes, he's still different, still doesn't connect with the rest of the world most of the time, but he connects with her when he's able to "come out", and she patiently does her own thing the rest of the time. Most people look at them and wonder what she sees in him, but if you ever really watch the two of them together you know what it is. He treasures and appreciates her for really seeing who he is, and she treasures and appreciates him for letting her be who she is (most men find her intimidating, and I see why they would -- she's tenderhearted but tough as nails.) Often he is on medication, with mixed results at best, often apparently with only side effects and no positive benefit. No matter what side effects or disturbed moods he gets, she just gives him space and supports him from a distance until he lands again. They are actually better together than either is apart, because each gives the other something no on else ever has.
How do I know so much about them? Because she's my sister. And in my opinion, he's better for her than the attorneys and other high-powered types she's dated in the past. I love him for what he does for her -- lets her just be herself, and lets himself need her just the way she is. He doesn't use her, he just needs her strength and calm. And she thrives on that.
My point is the same as androogs: don't give up! There is no way for any of us to tell what tomorrow will bring, even when we are *completely* sure that we know everything there is to know about all the possibilities. There really are good and caring doctors out there, who can help, though I agree you sometimes have to go through three dozen (or more) "know-it-all" ones before you find one who understands that you live in your body, no one else does (we hope :-) and you know what's going on in there better than anyone else could. There are new drugs and new treatments being developed that really do help many people. Unfortunately, you haven't found what works well for you, and a doctor who will support and work with you in finding what works for you, yet. And you may not for a long while. But don't give up, others are here to support you, who know you're suffering terribly. We can't stop the pain or the injustice of it, but we do care.
I'm not trying to give you the glib "everything's going to be alright" speech, because we both know it may not be. But you're smart, articulate (at least in your writing), you're strong, you obviously know a lot about your condition and your own life, and you gotta keep trying.
Sometimes when I felt the absolute, crappiest, scumsucking worst, the only thing I could hold out to myself was, "I'm not gonna give *anyone* the satisfaction of seeing me quit. Not my enemies who think I'm a loser, not the doctors who think I'm a hypochondriac (haven't we all heard that one!), not the damn devil, either. I will go on fighting until the day I die -- of old age -- or get hit by a truck, whichever comes first." You quit, they win!! Don't let them win by forfeit. Sometimes anger was all I could muster, and sometimes I couldn't even manage that. But I couldn't just let them be right about me. I knew my condition was real, not "mental", and if I could just find someone who knew enough to help, I could make it.
I wasted about fifteen years of my life I could have felt like a person instead of a blob of nothing, before I agreed to try medication. You've tried the medication, but not felt the relief. You're understandably frustrated and at your wits end. But please, don't give up. There is hope, however small it seems. You can come here to vent and talk whenever you need to.
I pray that you find some relief and some peace soon, and that your new pdoc will be able to help you get what you need. But even if you have to go through another dozen docs, don't stop trying. I and others here need to hear what you have to say (thoughtful and pointed comments, even if they do come at light speed. We'll keep up. Just you keep talking.)
Sincerely wishing you a better day than you've had --
bozeman
Posted by Mattkit on January 30, 2003, at 20:40:39
In reply to Re: I'm Sorry » blah, posted by bozeman on January 28, 2003, at 23:38:56
Hey Blah
Keep writing, I like reading it and I am learning
from it. I know about the suffering and damn I wished I had the answer. I know about the feeling of desperation and being in a pdocs office that just doesnt get it. I always thought if I was a heroin junky I would want to go to help from someone who has done heroin cause they would have experienced the "feel"' I feel the same way about pdocs, I think alot of them have never had a bad day in their life and their trying to help me.
Dont waste too much time with the bad ones. Ive been there where the only thing keeping me from suicide is my heart,it keeps beating and I have to wake up (if Icould sleep) and go thru the whole shit again. My father is a schizophrenic
my mother the most beautiful person ever in my life died when I was 21. And I am left with a mind that is really screwed up. Im 36 now and have had alot of bad days the few good ones are worth it though. If you ever feel "the rest of the world" is normal dont believe it, the rest of the world is never (very few) happy either they
just deny it and live like shit (the9to5hell).
Be proud of who you are cause from what I have found the "strange people" and the alcoholics, and the drug addicts are the true nice people of this world they just havent figured out how to
get what is due to them while taking care of themselves along the way. Im not a women but I bet
there are a million girls that would rather be with you then their boring boyfriends or husbands
they have now. One thing else I have learned that
its up to me with my screwed up mind to find the answerand so far its a lifelong journey, I make alot of mistakes and I have alot of work to do
but will keep going. I just hope they come out with a I DONT GIVE A FUCK PILL SOON cause when you feel that way you live forever.
Posted by Dr. Bob on January 31, 2003, at 0:42:02
In reply to Re: I'm Sorry, posted by Mattkit on January 30, 2003, at 20:40:39
> I just hope they come out with a I DONT GIVE A xxx PILL SOON cause when you feel that way you live forever.
I'd like as many people as possible to feel supported here, so please don't use language that could offend others:
http://www.dr-bob.org/babble/faq.html#civil
Thanks,
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration; otherwise, they may be deleted.
Posted by McPac on January 31, 2003, at 20:32:17
In reply to Crossroads., posted by Blah on January 27, 2003, at 23:18:12
Please send me an e-mail at
Imupacrk@msn.com
Posted by bee happy on February 17, 2003, at 21:25:18
In reply to Re: Buprenorphine-- bee happy, posted by Mattkit on January 27, 2003, at 23:09:58
Hi Matt I am just checking back to see if you had any luck with Buprenorphine trial. I am still doing very well with it and am curious if any others who expressed interest were able to a) find a doctor willin to try it and b) benefit from the trial. I hope you are well. Bee
Posted by SLS on February 18, 2003, at 16:04:13
In reply to Re: Buprenorphine-- bee happy » Mattkit, posted by bee happy on February 17, 2003, at 21:25:18
> Hi Matt I am just checking back to see if you had any luck with Buprenorphine trial. I am still doing very well with it and am curious if any others who expressed interest were able to a) find a doctor willin to try it and b) benefit from the trial. I hope you are well. Bee
Hi Bee.
In what form to you take buprenorphine? How much do you take and how do you schedule your doses?
Have you ever tried Ultram (tramadol)?
Thanks.
- Scott
Posted by bee happy on February 18, 2003, at 18:30:07
In reply to Re: Buprenorphine-- bee happy, posted by SLS on February 18, 2003, at 16:04:13
Hi Scott.Yes I tried Ultram,right before going to the Buprenorphine.It did nothing for me except relieve the achiness I felt while depressed. I am taking a compounded sublingual troche 2mg 4 x's daily. The spacing usually goes something like this 8am,12noon,4pm and 8pm. Ihave gone up as high as 12mg and as low as 6mg. I think it has alot to do with how fast the troches melt under your tongue. Sometimes if my mouth is very watery they melt so fast that alot gets wasted.When that happens I take an extra one.On the other hand if my mouth is dry it seems I feel every bit of the effects. I live in a very warm climate and perhaps the heat has something to do with it. Why do you ask? Are you about to give it a try? Are you one of the very few of us who respond to opiates in such a way that it seems to be the missing link in your chemistry? If so,I wish you lots of luck.It seems that many on this board have had a hard time finding a docotor willing to try this.My doctor is pretty openminded but no pushover. I had to do alot of the research myself. And he monitors me pretty closely but also trusts when I tell him about the inexact sublingual absorbtion. Yes, I am concerned about tolerance and addiction but I am more afraid of going back to way I felt 6 months ago.So, what's your story? Any opiate history? Have you tried all the other families of antidepressants? Bee
Posted by kara lynne on February 18, 2003, at 21:12:13
In reply to Re: Buprenorphine-- bee happy » Mattkit, posted by bee happy on February 17, 2003, at 21:25:18
My doctor said there is a delay in the release of subutex in the US; suboxone has made its debut. Is it legal where you are?
Posted by SLS on February 18, 2003, at 21:16:16
In reply to Re: Buprenorphine-- bee happy » SLS, posted by bee happy on February 18, 2003, at 18:30:07
Hi Bee.
Thanks for your detailed reply.
> So, what's your story?
I suffer from a severe anergic depression that is probably a form of bipolar disorder. Dementia (general definition) is probably the most prominent symptom cluster right now. Without the partial relief I glean from Lamictal + desipramine, I cannot read more than two or three sentences before having to quit or go to sleep. My thoughts are very slow and muddied, and my memory is terrible. The few manic episodes I have had were precipitated by drug intervention. Without an effective treatment, I remain depressed continually. Since 1982 (age 22), I have never experienced a spontaneous remission. The only robust (nearly complete) response to treatment came in 1987 and lasted 9 months. I would most likely be OK today had my doctor at that time not opted to discontinue the drug combination (Parnate + desipramine) due to the emergence of mania. Once the mania was under control using lithium and Klonopin, he decided not to restart the antidepressants. I relapsed within two months. Instead of returning to the previously effective medications, he gave me the newly-approved Prozac to try. I guess it was a new toy. To make a long story short, I have not responded to anything since - not even the original MAOI + TCA combination. It is an unfortunate mistake that some people make to discontinue a particular drug, only to go on to relapse and find that their first exposure to the drug has rendered their brain less responsive to it.
I have been on most of the drugs currently available and many that remain unavailable (foreign and investigational). So, yes, I am very interested to pursue the use of opioids should the next few drug trials I attempt fail.
Among the drugs I have tried are:
Parnate
Nardil
imipramine
desipramine
nortriptyline
amitriptyline
amoxapine
protriptyline
lithium
Depakote
trazodone
Wellbutrin
indalpine
viqualine
Prozac
Paxil
Lamictal
Neurontin
Tegretol
Zyprexa
Risperdal
Effexor
clorgyline
idazoxan
nomifensine
adinazolam
bromocriptine
Cytomel
Synthroid
pemoline
Ritalin
DexedrineI have a list somewhere.
- Scott
Posted by androog on February 18, 2003, at 23:02:04
In reply to Re: Buprenorphine-- bee happy » bee happy, posted by SLS on February 18, 2003, at 21:16:16
hi scott-
i just read your latest post and i have to say that you sure have your thoughts well organized, considering your ailments. it must be tough to keep it that together when you feel as bad as you must.i'm one of the fortunate souls who has responded to tramadol. every day it amazes me how quickly it can drag me out of the hole i wake up in.
stories like yours are really inspirational, since you're still putting up a good fight after all these years. you make me realize i should stop whining so much -- that others have it even worse than i do.
hang in there and keep writing.
androog
Posted by SLS on February 19, 2003, at 11:52:27
In reply to Re: Buprenorphine-- bee happy, posted by androog on February 18, 2003, at 23:02:04
Hi androog.
> stories like yours are really inspirational, since you're still putting up a good fight after all these years. you make me realize i should stop whining so much -- that others have it even worse than i do.
For any given person suffering depression, their's is the worst - and that's certainly bad enough.
Thanks for the caring sentiments. They couldn't have come at a better time.
(It's my birthday).
Take care and be well.
- Scott
Posted by ShelliR on February 19, 2003, at 12:13:12
In reply to Re: Buprenorphine-- bee happy » androog, posted by SLS on February 19, 2003, at 11:52:27
Posted by Jack Smith on February 19, 2003, at 13:05:25
In reply to Re: Buprenorphine-- bee happy » bee happy, posted by SLS on February 18, 2003, at 21:16:16
Scott,
I was just wondering if you have ever been off medication altogether at any period in the last 20 years. Perhaps a break for a couple of months could stimulate your system in some way. Of course that is easy to say but doing it would be much harder.
Also, I assume you have tried ECT. Did it not work for you?
Do you have a family history of mental illness.
Jack
Posted by bee happy on February 19, 2003, at 15:35:11
In reply to Bee and Bupe, posted by kara lynne on February 18, 2003, at 21:12:13
> My doctor said there is a delay in the release of subutex in the US; suboxone has made its debut. Is it legal where you are?
Hi Kara...I get my prescription in California. It's made up for me in lozenge form. Most major cities have at least one pharmacy capable of making compounds. Look in the phone book....this is such a terse answer...I'm on my way out the door. Any other questions...Will be glad to answer later on tonight.Bee
Posted by kara lynne on February 19, 2003, at 20:06:11
In reply to Re: Bee and Bupe, posted by bee happy on February 19, 2003, at 15:35:11
Since it is illegal in California, how do you get it made up for you? My doctor would prescribe it if it were legal. He thought both Subutex and Suboxone were going to be released, but alas only Suboxone is presently available because of "potential for abuse" with Subutex. When it does become available it will therefore be harder to obtain and more expensive, due to the kind hearted and intelligent folks in charge. In any event, is your doctor willing to prescribing it illegally then? It's so frustrating.
Posted by androog on February 19, 2003, at 22:16:12
In reply to Re: Bee and Bupe, posted by kara lynne on February 19, 2003, at 20:06:11
hi folks,
i did a quick search on the internet for subutex and suboxone and the first hit was from the almighty FDA itself. according to them (and they should know) both drugs are legal and available at the pharmacy, but the doc needs to have DEA credentials, which probably involve a secret handshake and a decoder ring ;>)kara lynne, i think maybe your doc needs to see the FDA link below.
http://www.fda.gov/cder/drug/infopage/subutex_suboxone/subutex-qa.htm
Posted by bee happy on February 19, 2003, at 22:35:36
In reply to Re: Bee and Bupe, posted by kara lynne on February 19, 2003, at 20:06:11
Hi again Kara. Buprenorphine is not illegal in the U.S. It has been available for several years for pain. It was recectly approved for opiate addiction treatment and maintenance. But doctors may prescribe a drug for other than it's originally intended use. My doctor heard about the Harvard study using buprenorphine for depression, and used that as his basis for trying it with me for depression. The oxone in suboxone is added to prevent maintenance patients from abusing it (injecting or snorting) or selling it on the street to other addicts.I would imagine that someone taking it as prescribed for depression would not be affected by the additional ingredient,but I don't know that for sure.As I said, there are pharmacies where they can make a sublingual lozenge without the 'oxone' if it turns out that you are sensitive to that ingredient. If you want more information about the Harvard study at McClean hospital, let me know and I'll find the web address for you. You might also look back through the postings here on the board from about jan 25th-feb 14th or so....laura777 and I had an onging dialog during which I gave her alot of that information along with a brief explanation of my experience.Agian, if you can't find it, let me know and I'll look it up for you. The good news is that this drug is a schedule III and because of it's agonist-antangonist properties has less potential for abuse. Am curious, what other medications have you tried...and why do you think this might work for you? Any addiction history? Ever felt more 'normal' when taking pain medication such as codeine or vicodin? Hope this helps. Bee
Posted by bee happy on February 19, 2003, at 22:48:33
In reply to Re: Bee and Bupe, posted by androog on February 19, 2003, at 22:16:12
Androog and Kara..The new fda regs require the registration if the doctor is treating drug dependence.Any family practice doctor can take an 8 hour course and get the certificate. My doctor is treating depression. It was only after trying many antidepressants that he looked into the use of Buprenorphine for depression.
Posted by bee happy on February 19, 2003, at 22:53:56
In reply to Re: Buprenorphine-- bee happy » bee happy, posted by SLS on February 18, 2003, at 21:16:16
Oh Scott. Happy Birthday indeed. I don't know what all those medical names mean but they sound serious. I wish you verrrry well. Bee
Posted by bee happy on February 19, 2003, at 23:28:54
In reply to Re: Bee and Bupe, posted by kara lynne on February 19, 2003, at 20:06:11
http://balder.prohosting.com/~adhpage/bupe.html oops...hope this works...am a bit computer challenged....I think this is the address for the Harvard study....right down to individual patient profiles. Show your Doctor. If he is apposed to trying it because it isn't officially approved for depression, this might help sway him to at least try it.
Posted by kara lynne on February 20, 2003, at 0:13:10
In reply to Re: Bee and Bupe Kara, posted by bee happy on February 19, 2003, at 23:28:54
Hi Bee, androog,
I actually spoke to the manufacturers of subutex and suboxone today, and they said that subutex is *not* available in the US or in pharmacies, which my doctor said yesterday. It was supposed to be, and may be someday, but it isn't now. I don't know how current what you read from the FDA is. My doctor is pretty well informed, and not opposed to using bupe for depression, but is waiting for subutex to be released....bee, I will go back and read your post again about the legality issues because I guess I don't (and maybe my doc either) understand it all. Any way I could email you personally? Thanks
Posted by kara lynne on February 20, 2003, at 0:28:00
In reply to Re: Bee and Bupe Kara, posted by kara lynne on February 20, 2003, at 0:13:10
...oh, and, my doctor was actually the one to suggest buprenorphine to *me*, over a year ago, after endless failed med trials. He was advised however, not to because of legal issues. I guess he has used it with his addiction patients (he's also an addictionologist), but for some reason learned it was illegal to use for anything else. I know he's not trying to mess with me, but he's concerned about the legal stuff and hasn't had much experience with this in particular. I don't want to make him sound like a dolt, because he's not-- maybe we're just missing some info. Bee, you sound like you have a great doctor!
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