![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 12 to 36 of 46. Go back in thread:
Posted by PhoenixGirl on February 9, 2001, at 10:21:16
In reply to Re: solutions not cyberhugs, posted by TracyA on February 9, 2001, at 7:16:30
We're mostly adults here, I think we can handle the "f" word. If not, move to an Amish village.
Anyway Tracy, I understand your frustration since I have also been spending years trying to find an acceptable treatment. Like you, I'm able to sleep a lot (when I'm not taking something stimulating like Wellbutrin). My sleepiness problem has never been diagnosed as anything in particular, but it has plagued me for years. Looks like you have tried wellbutrin and it hasn't helped enough. Maybe modafinil? I wish I could make some good suggestions for you.
Do you think that anything traumatic happened to you that could be the source of your problems? Or something bad that is going on in your life. Maybe that's why the docs have not been able to give you a diagnosis, but sometimes these docs are just unhelpful idiots. Well I wish you luck Tracy.
> Alison,
>
> Leave me alone. You seem to be interested in only harassing me. Since you feel I have nothing of value to offer, and therefore, receive, go do some laundry. Don't post to my messages.
Posted by Noa on February 9, 2001, at 13:30:28
In reply to Come on people, she's just very frustrated, posted by PhoenixGirl on February 9, 2001, at 10:21:16
Have they ruled out any other endocrine disorders?
Sometimes with atypical depression it can be very hard to treat, and take a long time to find a good combo that works. You didn't mention (at least in this thread) what combos of meds you have tried (although you did mention that you did feel a good response to ritalin, at least in terms of concentration). Can they consider a different stimulant for you, maybe with a smoother delivery, so as to avoid sharp ups and downs (which I *think* could add to the risk for blood pressure probs)?
Posted by Noa on February 9, 2001, at 15:11:39
In reply to Re: I am fucking angry;give me solutions not cyberhugs, posted by shar on February 9, 2001, at 14:04:46
Sorry--just read Shar's post and I was wrong--you did say the meds you had tried.
But I do think Shar is giving good advice--there are other meds and med combos to try.
Posted by MarkinBoston on February 9, 2001, at 16:31:14
In reply to I am fucking angry;give me solutions not cyberhugs, posted by Tracy on February 8, 2001, at 17:00:41
Welcome to your thesis project. No one is going to hand you the answers and you can't buy this term paper over the internet. Most people here have come to accept no one is just going to give them the magic pill or answer. It sucks. Its frustrating. That's life. Sorry.
How about going past that and trying to make some progress?
Were you given Cytomel? How did you react? Or did the docs just look at your bloods and dismiss thyroid? You tried taking antidepressants not knowing if they would work or not, why not Cytomel?
In the sleep study, how was your architecture? Did you spend normal amounts of time in stages one through four and cycles of them?
Does a cold medicine like Benedryl make you more sleepy?
When did this all start? Did anything happen just prior or coincidently?
Posted by willow on February 9, 2001, at 18:24:23
In reply to OK, here » Tracy, posted by MarkinBoston on February 9, 2001, at 16:31:14
"Does a cold medicine like Benedryl make you more sleepy?"
Why this question? For myself drugs like this give me a buzz, kinda like an overdose on caffeine. I'm edgy but the energy sometimes gives me a boost in mood, since hypersomnia and fatigue have been my most prominient symptoms for almost the past five years.
Posted by willow on February 9, 2001, at 18:31:04
In reply to I am fucking angry;give me solutions not cyberhugs, posted by Tracy on February 8, 2001, at 17:00:41
How old are you? And how old were you when the problems started? How long were you on each of the meds?
Have you you recieved any counselling? I find that seeing a psychologist has helped me to deal with the angst of not feeling up to par. Just having someone, not to close to me emotionally, to rant at helps because they don't add fuel plus I know it will remain private.
Posted by Tracy on February 9, 2001, at 20:14:03
In reply to give me solutions not cyberhugs, posted by willow on February 9, 2001, at 18:31:04
It seems these doctors do not have the balls to stand up to each other.
I talked with the Dir. of the Psych clinic today, and he told me I had
to change my lifestyle -- AKA continue to go to bed at 8 pm at night,
and leave school -- he claims it is stress and my body is responding
this way because I can't handle it. I tried to explain that all of my
health insurance, income, and purpose in life is tied up in going to law
school. I am on assistantship which pays my health insurance, tuition,
and a stipend. He didn't get it. I told him it wasn't his duty or right
to tell me to change my life path, but instead help me come up with a
way to live my life as it is. He felt the conversation was unproductive
and ended the conversation, telling me that my regular shrink would be
calling me on Monday. The one I haven't seen in a month because he keeps canceling on me.
The sleep doc referred me back to my primary care doc; refusing to
prescribe the provigil himself, wanting her to do it-- she had scheduled
an appointment with me for WEDNESDAY -- then I get a call this afternoon
telling me that she has to cancel. I called the doctor's office and had
a HAIRY FIT. They are suppose to get me in for Monday at 12.However, I still have no diagnosis -- and that wrecks any possibility of
me getting these grades thrown out and taking my exams over.I absolutely hate doctors. They are playing hot potato with me, and it
disgusts me.
As far as the Benadryl -- never take it -- no reason to. And why is this important?I started with the depression at 24, at least that's when I was diagnosed. But remember, people, I was tested, and that the test came out negative for depression and anxiety (wouldn't know it by the way I feel right now) -- and I was taken off all medications because it was believed that a) I didn't need them and b) they weren't doing anything.
If I have to suffer this way for much longer I am not sure i want to go on -- no one believes me; or their theories are ridiculous and won't give me any relief. Like psychotherapy alone is going to solve my problems. I feel like a fking failure. Everyone around me is functioning just fine. I know I am not stupid -- I just can't think straight right now. No one understands.
This asshole shrink really got my ire today. He clearly didn't have a good grasp of how I would respond -- if he thinks insulting me, by telling me my priorities aren't in order because I am unwilling to cut classes to meet with my doctor, or because I am unwilling to leave school and go to bed everynight at 8pm, is going to cause me to respond favorably he clearly doesn't understand me. If nothing else that type of behavior will only get me pissed off and angry.
Posted by Rzip on February 9, 2001, at 22:36:38
In reply to Re: give me solutions not cyberhugs, posted by Tracy on February 9, 2001, at 20:14:03
Hi Tracy,
Something very much like what you are going through happened to me last semester. Here is what I did, I stopped all forms of extracurricular communications. I focused my energy on my schoolwork and ONE therapist (and I stopped posting here for a while). It sounds to me like you have a lot of excess therapy stuff going on right now. I am sure they are interfering with your work. I mean if your shrink do not understand you, then forget about him. Cut off the contact (in a civil way, of course). Focus your concentration and energy on what will help you through the rest of this current semester of Law School. Don't drill yourself on the past test scores right now, take care of the present agenda.
The above mindset worked for me when I was in a state of confusion, depression, and instability last school semester. Hopefully, you can find the suggestions to be of some usage to your situation.
- Rzip
Posted by Tracy on February 9, 2001, at 22:50:07
In reply to Re: give me solutions not cyberhugs, posted by Tracy on February 9, 2001, at 20:14:03
This is the email message I shot off to the psych clinic director. I thought you might be interested in reading it.
...
Prior to my conversation with you today, 2/9/01, I had a great sense of hope
that maybe we could get to the bottom of this problem, whatever it may be.
Every doctor involved in this situation, or with whom I have consulted
(XXXX, XXXX, XXXXX, XXXXX) seemed to know who you were. However,
after our conversation today I was filled with ire, and at the same time
hopelessness. While, now, I personally do not care what you think about me,
my choices, or my situation, I realize that you have undue influence over my
doctor. And, in order for him to treat me, since you will be speaking to
him, I want you to have a clear understanding of how I feel and what my
goals for treatment are with your clinic, in case I did not make myself
clear on the phone (I feel as though I was not given that opportunity).First, I do not care for your approach, as I perceived it, of "my way or the
highway." I have absolutely no intention of leaving school, stopping work,
or any combination thereof. My understanding of medicine in the 21st
century is that doctors are suppose to work with patients to achieve their
[the patient's] goals. And, that treatment decisions are to be made in
consultation with the patient. I was very offended by your repeated
suggestions that I seek treatment elsewhere, or that my priorities are out
of order. It is not your position to unilaterally decide my lifepath,
particularly since you know nothing about me except what is subjectively
written in some little blue binder; rather, I see the position of
psychiatrist as one who works __with__the patient to learn to deal with
their lives as they __are__at the time. If your interest is in seeing me
out of treatment then you can continue to try to suggest leaving school;
leaving school would necessitate me leaving my job, which would cause me to
lose my stipend and full tuition scholarship, for now and in the future, as
well as my health insurance, and force me to move back to NH, to a home
where they don't believe in psychiatric treatment, nor is a place I want to
be. In addition, claims that my priorities are out of order because I have
stated I can't cut classes to make appointments with my doctors, are
particularly offensive. Missing class and not understanding the material
will only increase my anxiety. Furthermore, if you think suggestions like
these are going to make me receptive to any treatment, you are wrong; in
fact they infuriate me; they make me very defensive; and put me in an
adversarial position. I am sure you can agree that that mind frame is not
one that is conducive to any medical treatment, never mind psychological.Second, to be abundantly clear, since during our conversation I felt as if
you were interested in trapping me into saying things that would support
your theory of "stress", my symptoms include: extreme fatigue, as well as
excessive daytime sleepiness; feeling too cold or too hot, sometimes coming
in waves; lack of concentration; my mind feeling foggy and slow; inability
to speak coherently (stumbling over my words) or remember what I am saying
(forgetting or becoming confused mid sentence); becoming easily distracted;
high levels of anxiety (associated with environmental factors, as well as
generally); binge eating (which has increased to nightly); and tearfulness
(mostly due to the sense of frustration with the medical profession, and
their attempts at playing hot potato with me).Finally, as far as goals are concerned, I want to not be tired; I want to
feel well, physically as well as mentally; I want to be able to function at
the levels expected in school (to be able to concentrate on exams and in
class, to be able to speak without sounding incoherent, and forgetting what
I am saying; to be able to complete assignments without massive errors and
omissions; and to be able to study at all so that I can be prepared in class
the next day), and to not feel the incredible anxiety I feel all the time
(partially caused by my inability to perform to the levels expected in
school), as well as to not cry at the drop of a hat.My hope is that Dr. XXXX is willing to take an aggressive approach to this
situation.Additionally, I realize that much of this letter is inflamatory, however I
feel you were not interested in listening to me and how I felt on the phone.
Hopefully, you can move beyond the inflamatory nature of this message, and
recognize that I need some help, and advise accordingly, while at the same
time, respecting my wishes.
Posted by Rzip on February 9, 2001, at 23:42:25
In reply to RE: letter to the clinic that treated me like crap, posted by Tracy on February 9, 2001, at 22:50:07
Tracy,
My therapist used to remind me to stop and smell the roses. You will always have your undergraduate degree. You are in Law School, and furthermore you have a full scholarship and stipend to go with it. Stop a minute and appreciate the roses.
Now, go back to your work. You have written the letter. I hope it makes you feel stronger, more in control. Now, pick a therapist (perhaps not one from the clinic) for the next couple of weeks till the end of the semester. Right now, forget the people who are no use to you and focus on your agenda. Therapists are only as good as long as they are useful and helpful to you. Otherwise, forget them. Only you can turn around your work situation. You have to reach within yourself to redefine the inner strength to pull through till the end of this week, this month, and finally this semester. Only you are going to be graded on your exams.
My suggestion is to pick a therapist and stick to him/her till the end of the semester in a stable manner (i.e. weekly session). You only have to commit to this till the end of the semester (one step at a time). What you need most of all, in my biased opinion, is stability. With stability, comes the ability on your part to concentrate and turn around the choas and confusion that is surrounding your personal and professional situations.
- Rzip
Posted by Pandora on February 10, 2001, at 0:17:57
In reply to Good. Now focus on your work, and stop and smell » Tracy, posted by Rzip on February 9, 2001, at 23:42:25
Tracy,
I don't know if this will help, but it's worth a try. You say a major stumbling block is not being able to get your school to recognize your situation without a diagnosis. I have worked in the mental health arena in Texas for several years, most recently with a state and county funded agency. Almost EVERY person who was assessed by us was given a diagnosis. Granted, there were some who really didn't have a psychiatric disorder (I worked with kids and sometimes the school refered them or their parents brought them in for minimal difficulties or learning disorders, etc. - in the mental health part of the agency we only dealt with axis I disorders and no v-codes). Anyway, my suggestion is to find a similar agency and go for an assessment there. Chances are you will have to pay out-of-pocket for the service (ours is ~$120) since they probably are geared toward those who have no insurance or are below poverty level. However, if they are run at all like our agency, you would be given a Dx and could have a therapist or psychiatrist fill out the proper forms to allow you help at school. I would never presume to diagnose anyone over the internet, but from what you've already written, I can almost guarentee if we sat down and I conducted an assessment, you would have SOMETHING to take away with you.A second though -which I'm sure you've already explored - is to use the school's counseling center for an assessment.
I realize that effective treatment is what you need most and that my suggestions don't really address that, but I hope this has been of some help. Good luck, and hang in there! (Oops, that was almost a c-hug... sorry!) : )
Posted by willow on February 10, 2001, at 0:19:53
In reply to RE: letter to the clinic that treated me like crap, posted by Tracy on February 9, 2001, at 22:50:07
Tracey
BRAVO! I wrote a similar but shorter letter to my previous family doctor, though I didn't send it! I applaud you for having the balls to send yours!!
"your theory of "stress", my symptoms include: extreme fatigue, as well as
excessive daytime sleepiness; feeling too cold or too hot, sometimes coming
in waves; lack of concentration; my mind feeling foggy and slow; inability
to speak coherently (stumbling over my words) or remember what I am saying
(forgetting or becoming confused mid sentence); becoming easily distracted;"Your symptoms are all similar to mine (I have muscle pain.) I'm starting to have some success with Effexor, but unfortunately this is at at "non-stress" level. I'm not able to work or function normally at home.
In my opinion you should change to a doctor who does believe in involving the patient. I found a new doctor (first practice) who doesn't have a problem with this. My anxiety level has decreased significantly. I agree with RZip in that you should find one good care-provider. For myself this involved seeing a psychologist, I'm from a one shrink town and he's the "crazy" one, and my family doctor.
PS I didn't see a great improvement on the effexor until about four months, though I immediately had some response. I know this doesn't help when you want an immediate cure, but honestly I don't think you'll find one. Get your family doctor to write you a health dismissal for the time you had your exams, he doesn't need to clarify why! This will probably help with some of the anxiety. Talk to a school official concerning your future concerns. You probably have laws that will protect you and someone at the school schould be able to direct you.
If you do a quick search on the internet you may be able to find these yourself.BEST WISHES
Posted by allisonm on February 10, 2001, at 8:47:04
In reply to solutions not cyberhugs » Tracy, posted by allisonm on February 8, 2001, at 20:16:44
Tracy,
I will reiterate what I said in my first post:
> > Maybe it would help to get out of that psych clinic, if you can afford it, and find an experienced pdoc with 10 or more years under his belt, who knows his stuff and isn't practicing on you. < <
Sounds like you need someone with more experience in clinical psychiatry. Sorry, but a resident doesn't have that. Also, psychiatrists who have practices in town are much less likely to move away, as your other resident pdoc did.
Since you do have insurance, it might be worth your while to look outside. Syracuse is a big enough city and should have a large enough pool of psychiatrists. You might have to interview a few before you find the right one for you, but with patience and perseverance you will. And if it does cost more, isn't your physical and mental health worth it? I think your school work will be much more of an uphill battle, if not impossible, without it.
I also wonder whether there are some grains of truth in what your recent doctors recommended. Sometimes it isn't possible to keep on the path you are on no matter how much you want to or think that the doctors should help you in this goal. I have learned this lesson several times. Whether you want to accept this or not is your decision of course, but if they're right, the current situation may well bring you to your knees at some point in the future, if it hasn't already. Will it be worth it?
If the stress of school is a major cause of your distress, and if stopping school isn't an option even for a short time, perhaps there is a middle ground. Can you take a lighter course load for awhile? Can you take a semester off? If not, if this work is doing this to you and this scholarship is putting the pressure on you to do this work at this pace, is there an alternative to this scholarship that will allow you to continue your schoolwork at a pace that works better for you? Many people get their degrees with student loans.
Also, perhaps there are alternative ways to obtain health insurance. At the university where I work, I believe it's possible for students to get health insurance policies through the university if they can't be covered on their parents' policies.
I wish luck in your struggle and peace on your journey.
Allison
Posted by PhoenixGirl on February 10, 2001, at 10:33:31
In reply to RE: letter ** BRAVO Tracey, posted by willow on February 10, 2001, at 0:19:53
I dispise doctors also. I'd be interested in learning how the director responds to your letter.
Posted by Noa on February 10, 2001, at 14:10:00
In reply to I am fucking angry;give me solutions not cyberhugs, posted by Tracy on February 8, 2001, at 17:00:41
Tracy,
I am not sure what tests you took to determine if you are anxious or depressed, but I would trust what you say you feel over a test.
Also, have you ever tried a mood stabilizer either alone or together with an antidepressant?
Posted by shar on February 10, 2001, at 16:38:25
In reply to OK, here » Tracy, posted by MarkinBoston on February 9, 2001, at 16:31:14
My post disappeared, and it was a pretty good one, too, if I do say so myself.....8-)
What's the deal? It was number 53607.
Censorship (gasp) ?!
Shar
Posted by shar on February 10, 2001, at 16:46:07
In reply to Good. Now focus on your work, and stop and smell » Tracy, posted by Rzip on February 9, 2001, at 23:42:25
I would like to echo Rzip's suggestions to you, and also encourage you to not give up on ADs or docs altogether. It can be a long row to hoe, but you are in good company here!
S
> Tracy,
>
> My therapist used to remind me to stop and smell the roses. You will always have your undergraduate degree. You are in Law School, and furthermore you have a full scholarship and stipend to go with it. Stop a minute and appreciate the roses.
>
> Now, go back to your work. You have written the letter. I hope it makes you feel stronger, more in control. Now, pick a therapist (perhaps not one from the clinic) for the next couple of weeks till the end of the semester. Right now, forget the people who are no use to you and focus on your agenda. Therapists are only as good as long as they are useful and helpful to you. Otherwise, forget them. Only you can turn around your work situation. You have to reach within yourself to redefine the inner strength to pull through till the end of this week, this month, and finally this semester. Only you are going to be graded on your exams.
>
> My suggestion is to pick a therapist and stick to him/her till the end of the semester in a stable manner (i.e. weekly session). You only have to commit to this till the end of the semester (one step at a time). What you need most of all, in my biased opinion, is stability. With stability, comes the ability on your part to concentrate and turn around the choas and confusion that is surrounding your personal and professional situations.
>
> - Rzip
Posted by Rzip on February 10, 2001, at 17:33:10
In reply to Hey!! What happened to my post????, posted by shar on February 10, 2001, at 16:38:25
Shar,
Are you sure you posted it? Maybe some computer glitch.
I think the only time Dr. Bob pulls a post without comment is when the content is revoltingly inappropriate. Since you do not do that, I suspect perhaps you forgot to push the submit button. Perhaps you can write another post?
Thanks for your support on P-Social-B and PB-Admin.
I think Tracy has been blocked, but I hope she finds comfort and guidance in our continuing suggestions.
- Rzip
Posted by MarkinBoston on February 10, 2001, at 20:09:53
In reply to Re: give me solutions not cyberhugs, posted by Tracy on February 9, 2001, at 20:14:03
Some of your symptoms sound viral like Chronic Fatigue Syndrome, Epstein-Barr, Hepatitis, ???, mono. The others sound stress related. The stress of being sick and not diagnosed and having to deal with the medical system.
My first stress reduction measure would be to stop seeing that therapist who just wastes your time and pisses you off. No amount of talking will kill off a virus.
I had an appointment with a new doctor and she cancelled it because the type of hormone therapy I want (Arimidex, that she used in research) is not shandard practice (yet, but someday I hope) and the AMA says testosterone should not be used for weight loss after telling her I was quite pleased losing 30 lbs in two months on testosterone. It used to be that the AMA claimed anabolic steroids (testosterone is only one) didn't improve lean/fat ratios. As if Arnold Schwartzineger got that big from a balanced diet and regular exercise. Now the AMA has conceeded that they work, but have few uses. This doc is going to be a good girl, follow the party line and persue a lucrative practice of helping monied career women get pregnant in their late 30's and 40's. I won't die tomorrow without Arimidex and these women can adopt. My want is less Politically Correct than their want, so I lose.
I think its kind of ironic, this being a mental health board and the AMA, US government and so many institutions are out of touch with reality.
I asked about the cold medicine because histamine blockers like Benedryl and especially Remeron knock me out.
Posted by willow on February 10, 2001, at 21:03:31
In reply to Virus? Some doctors Really suck, posted by MarkinBoston on February 10, 2001, at 20:09:53
CFS is what I've been diagnosed with, but honestly I think it's a "I don't know" diagnosis. Tracey symptoms sound so similar to myself. I do feel for her emotional pain. She's still so young.
Markin are you not in Ontario?
The reason I was wondering is because I'm looking for something safe to help me fall asleep since the effexor has kicked in. And I don't know if the remeron is available up north?
Posted by Dr. Bob on February 10, 2001, at 23:43:16
In reply to Hey!! What happened to my post????, posted by shar on February 10, 2001, at 16:38:25
> My post disappeared, and it was a pretty good one, too, if I do say so myself.....8-)
>
> What's the deal? It was number 53607.
>
> Censorship (gasp) ?!Sorry, but you let that naughty word slip through...
Bob
Posted by Dr. Bob on February 10, 2001, at 23:59:28
In reply to Re: Virus? Some doctors Really suck, posted by TAB on February 10, 2001, at 22:51:15
> Yeah I was blocked -- I don't understand why, either.
I ended up sending my post to the admin board:
http://www.dr-bob.org/babble/admin/20001124/msgs/616.html
Which is where I asked discussion of this to take place, which is why I've deleted this post that I'm replying to. Besides, you're supposed to be blocked! Please feel free to email me, though, if you want to discuss this further.
Bob
Posted by MarkinBoston on February 11, 2001, at 13:03:37
In reply to Re: Virus? Some doctors Really suck, posted by willow on February 10, 2001, at 21:03:31
> Markin are you not in Ontario?
No, but we're sending our govenor to Ottawa! I've been to Toronto and Missasauga numerous times on business and like every Canadian place I've visited.
> The reason I was wondering is because I'm looking for something safe to help me fall asleep since the effexor has kicked in. And I don't know if the remeron is available up north?
My solution was going from Effexor XL - > Effexor instead of taking another drug. The only withdrawl symptom I get is a little headache reminding me to take my afternoon 75mg. My one experience of taking 15mg of Remeron on a friday night and being sleepy all weekend really put me off. I wasn't safe to drive and spent most of the weekend in bed. Taking a drug on a friday night, becoming unsafe to drive, and spending the weekend in bed is supposed to be done with a new friend and little sleep!
Posted by willow on February 11, 2001, at 14:27:29
In reply to Ontario? No. Take our Govenor, please! » willow, posted by MarkinBoston on February 11, 2001, at 13:03:37
"My solution was going from Effexor XL - > Effexor instead of taking another drug. The only withdrawl symptom I get is a little headache reminding me to take my afternoon 75mg."
You had mentioned this before, at the time I had hesitated because I had had to split my XR dose into two to avoid the headache. Finally that is starting to go away, and now sometimes I forget the afternoon dose. So your suggestion is probably the best option for me now, I'll suggest it the doc on Tuesday when I get my refill.
"My one experience of taking 15mg of Remeron on a friday night and being sleepy all weekend really put me off."
Thanks for the warning! I'm a sleep addict and if I spent the weekend in bed it would probably turn into a week long marathon.
PS I'll nab your govenor if he's not racist, if you take our premier! - Mike Harris - I think he would really enjoy the states.
Posted by allisonm on February 11, 2001, at 17:57:24
In reply to Ontario? No. Take our Govenor, please! » willow, posted by MarkinBoston on February 11, 2001, at 13:03:37
The thing about Remeron, though, is that it will knock you out for a couple of days, so it is wise to start taking it on a weekend. However, that side effect goes away quickly, I found.
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