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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Saragram on January 7, 2003, at 11:39:59
I went to a new GP yesterday, hoping to try Adderall or Ritalin for ADD that my therapist believes I have. Unfortunately, it seems that the new doc is anti benzos AND stims. She halved the number of Xanax tablets I can get at one time (says she's afraid I might get robbed by a coke addict if they found out I had them).
She also says she won't prescribe me a stim until I go to a psychiatrist for more formal testing. She thinks I'm simply a "disorganized procrastinator that just needs to exercise more self-discipline." That's what I've been hearing since first grade (52 years ago) and it's no help!
I just hope that testing will validate what I strongly feel is the case, that I DO have a neurotransmitter problem. I ran out of gas on the way to work today (probably the 6th time in the past year) right after stopping at the post office/gas station to get my mail. I had a bunch of other things on my mind and just didn't look at the gauge. These things happen to me all the time. I spent half the morning looking for a phone number and a package of vacuum cleaner bags that were in plain sight.
Posted by oracle on January 7, 2003, at 11:52:50
In reply to New doc is not only benzophobic but stimuphobic!, posted by Saragram on January 7, 2003, at 11:39:59
You need to see a psychiatrist, period.
Don't every expect a GP to give you schedule
II & III meds unlimited.
Posted by Ritch on January 7, 2003, at 12:38:26
In reply to New doc is not only benzophobic but stimuphobic!, posted by Saragram on January 7, 2003, at 11:39:59
> I went to a new GP yesterday, hoping to try Adderall or Ritalin for ADD that my therapist believes I have. Unfortunately, it seems that the new doc is anti benzos AND stims. She halved the number of Xanax tablets I can get at one time (says she's afraid I might get robbed by a coke addict if they found out I had them).
>
> She also says she won't prescribe me a stim until I go to a psychiatrist for more formal testing. She thinks I'm simply a "disorganized procrastinator that just needs to exercise more self-discipline." That's what I've been hearing since first grade (52 years ago) and it's no help!
>
> I just hope that testing will validate what I strongly feel is the case, that I DO have a neurotransmitter problem. I ran out of gas on the way to work today (probably the 6th time in the past year) right after stopping at the post office/gas station to get my mail. I had a bunch of other things on my mind and just didn't look at the gauge. These things happen to me all the time. I spent half the morning looking for a phone number and a package of vacuum cleaner bags that were in plain sight.Hi, can your therapist refer you to a psych? GP's are probably the least likely to prescribe stimulants to adults (kids-no problem). Have you tried L-tyrosine and/or fish oil supplementation? I've found it somewhat helpful for my attentiveness problems. That might get you by until you see a pdoc. I remember returning videos to the rental store and almost dropped them in a mailbox instead!
Posted by Saragram on January 7, 2003, at 13:14:39
In reply to Re: New doc is not only benzophobic but stimuphobic! » Saragram, posted by Ritch on January 7, 2003, at 12:38:26
That's funny about the videos. A couple of weeks ago I printed off a list of books about ADD to take to the library and request that my branch library order them for me. One of the books on the list was checked out -- to ME! I had forgotten I had it in a stack of new books and it had fallen behind the bed! At least I had't READ it and then forgotten -- then I'd think it was early onset Alzheimers!
Posted by Saragram on January 7, 2003, at 13:32:09
In reply to Re: New doc is not only benzophobic but stimuphobic!, posted by oracle on January 7, 2003, at 11:52:50
I've got no objections to seeing a psychiatrist, in fact I welcome it, but the one my therapist usually works with doesn't accept my insurance and the one my GP refers patients to has a LONG waiting list for appointments.
The last 2 GPs I have seen, and my Gyno, have never had any objection to giving me 60 Xanax refillable 3 times, which has always lasted me a year until my next blood pressure or gyno checkcup. They would write the prescription for one tablet twice a day as needed, and I never needed that many so I could make them last all year. I never got it from the GP AND the Gyno in the same time period -- I'm pretty sure that would raise a red flag with my insurance company.
My main objection to getting fewer pills at one time is that I have to make a co-payment at the pharmacy more often: I'm already paying $40 (nonformulary) for Lexapro, $20 (brand name) for Lotensin, and $10 each for generic xanax, estrogen, and diuretic which comes to $90 per month which is hard on my budget!
Posted by BrittPark on January 7, 2003, at 17:19:33
In reply to Re: New doc is not only benzophobic but stimuphobic! » oracle, posted by Saragram on January 7, 2003, at 13:32:09
One (time cosuming and frustrating) thing you can do is run through the list of psychiatrists who take your insurance and do a 5 minute phone interview with each of them. Ask them whether they treat ADHD, whether they every prescribe benzos, whether they ever prescribe stimulants and anything else that is important to you. Some doctors will take offense at being asked questions. Thank them politely and move on to the next. Some doctors will think that you're displaying "drug seeking behavior". Tell them to check with your therapist and doctors who have prescribed medication for you, but think twice about suspicious doctors. With luck you'll find a compatible psychiatrist.
That's how I found my very satisfactory psychiatrist. I used the yellow pages since my insurance didn't cover psychiatric illnesses, however.
Good Luck,
Britt
Posted by Ritch on January 8, 2003, at 0:44:21
In reply to Re: New doc is not only benzophobic but stimuphobic! » Ritch, posted by Saragram on January 7, 2003, at 13:14:39
> That's funny about the videos. A couple of weeks ago I printed off a list of books about ADD to take to the library and request that my branch library order them for me. One of the books on the list was checked out -- to ME! I had forgotten I had it in a stack of new books and it had fallen behind the bed! At least I had't READ it and then forgotten -- then I'd think it was early onset Alzheimers!
LOL! You just brought up a very interesting idea about checking out stuff at the library. The most overwhelming ADD experience must be going to a super-organized place like a library and trying to find ONE particular thing. I always HATED the library while I was in college. I liked putting together the fruits of the research in a paper, but just couldn't hack DOING the research at the library. I would waste endless hours trying to run down mag. articles, books, etc., and screw everything up. I dropped out of a research methods class (and had to change majors) because of this very problem. I am hoping to try to find a med that doesn't create excessive anxiety that will help with this. Thus far the only two that aren't AD's or pstims have been low-dose Neurontin and low-dose Trileptal. I want to try Straterra soon and see how that goes.
Posted by Saragram on January 8, 2003, at 8:36:26
In reply to Re: New doc is not only benzophobic but stimuphobi » Saragram, posted by BrittPark on January 7, 2003, at 17:19:33
> One (time cosuming and frustrating) thing you can do is run through the list of psychiatrists who take your insurance and do a 5 minute phone interview with each of them. Ask them whether they treat ADHD, whether they every prescribe benzos, whether they ever prescribe stimulants and anything else that is important to you. Some doctors will take offense at being asked questions. Thank them politely and move on to the next. Some doctors will think that you're displaying "drug seeking behavior". Tell them to check with your therapist and doctors who have prescribed medication for you, but think twice about suspicious doctors. With luck you'll find a compatible psychiatrist.
>
> That's how I found my very satisfactory psychiatrist. I used the yellow pages since my insurance didn't cover psychiatric illnesses, however.
>
> Good Luck,
>
> Britt
>Thanks -- I think I'm going to ask my therapist to recommend someone off the list from my insurance. I think my new doctor thinks I was displaying "drug seeking behavior" about the stims but not the benzos, since I have a long history with benzos without ever escalating doses.
When I mentioned my ability to hyperfocus, and said that I had recently read a book cover to cover between 8 p.m. and 5 a.m., she said that sounded manic to her instead of ADD so I think she thinks I'm a bit bipolar and seeking additional stimulation for thrills. This is definitely not the case, as I am a bit phobic about stims because of bad experiences with stuff as minor as caffeine in pain meds: When I was a freshman in college I had a botany exam on a day my period was starting with very bad cramps, and since the prof was a VERY unsympathetic type I took about a triple dose of Midol instead of asking to take the exam later. I had serious shakiness and a near panic attack during the exam -- I didn't know Midol contained caffeine!
Posted by joy on January 8, 2003, at 8:44:18
In reply to New doc is not only benzophobic but stimuphobic!, posted by Saragram on January 7, 2003, at 11:39:59
I think going to a Psychiatrist who treats anxiety, etc. is the best way to go. The first Psych I went to was anti-benzo. I had never taken a benzo before, a friend gave me a couple, and it helped [Xanax]. I promptly found another Psychiatrist on my HMO list, and have been on low dose Xanax [alaprozam] ever since. I see him every 3 months and I have never raised my Xanax dose. In fact, I asked him for a higher dose just so I could always have extras in case of any emergency. Going to a general practioner does not cut it; they are mostly anti-benzo and not familiar enough with real/severe anxiety problems.
Good luck.
Joy
Posted by Saragram on January 8, 2003, at 8:47:52
In reply to Re: New doc is not only benzophobic but stimuphobic! » Saragram, posted by Ritch on January 8, 2003, at 0:44:21
Ritch wrote: "LOL! You just brought up a very interesting idea about checking out stuff at the library. The most overwhelming ADD experience must be going to a super-organized place like a library and trying to find ONE particular thing. I always HATED the library while I was in college. I liked putting together the fruits of the research in a paper, but just couldn't hack DOING the research at the library. I would waste endless hours trying to run down mag. articles, books, etc., and screw everything up. I dropped out of a research methods class (and had to change majors) because of this very problem. I am hoping to try to find a med that doesn't create excessive anxiety that will help with this. Thus far the only two that aren't AD's or pstims have been low-dose Neurontin and low-dose Trileptal. I want to try Straterra soon and see how that goes."
Ritch,
I don't have that problem with libraries, but I do with grocery stores, complicated by the fact that I wear bifocals and have to constantly adjust for them while scanning up and down the shelves looking for a particular thing.
I think what helps me in research situations is the same thing that masked my ADD so much in school and my work life: I have an unusual ability with verbal stuff: Even though I was a B- student, I scored in the high 90s percentiles on the verbal portion standardized tests. I always LOVED taking standardized tests as opposed to tests you were supposed to study for. My memory seems to store things I've read and heard very well, but in a random sort of way. You wouldn't want to play Trivial Pursuit or Jeapardy with me, but I'm a total loss at learning card games.
Posted by Ritch on January 8, 2003, at 9:53:01
In reply to Re: Ritch's problem with libraries, posted by Saragram on January 8, 2003, at 8:47:52
> I don't have that problem with libraries, but I do with grocery stores, complicated by the fact that I wear bifocals and have to constantly adjust for them while scanning up and down the shelves looking for a particular thing.
>
> I think what helps me in research situations is the same thing that masked my ADD so much in school and my work life: I have an unusual ability with verbal stuff: Even though I was a B- student, I scored in the high 90s percentiles on the verbal portion standardized tests. I always LOVED taking standardized tests as opposed to tests you were supposed to study for. My memory seems to store things I've read and heard very well, but in a random sort of way. You wouldn't want to play Trivial Pursuit or Jeapardy with me, but I'm a total loss at learning card games.This is very interesting. I have trouble with stores as well (especially unfamiliar ones). Also, better bring a list or forget about coming out with what you intended to go there for! I did the best at Math in school, but when it comes to card games I am at sea as well. When I was first prescribed Adderall (just 5mg) combined with Neurontin it was amazing how I could sit at a table of people and listen to the rules and remember them, and most importantly follow through and keep up with everybody else. Otherwise it would be like walking up and sitting down and taking over someone else's hand and make a play and then go back to another room in the house and then come back and sit down again (with no knowledge of what went on since you played last).
Posted by Saragram on January 8, 2003, at 10:27:30
In reply to Adderall and card games, posted by Ritch on January 8, 2003, at 9:53:01
Rich wrote: This is very interesting. I have trouble with stores as well (especially unfamiliar ones). Also, better bring a list or forget about coming out with what you intended to go there for! I did the best at Math in school, but when it comes to card games I am at sea as well. When I was first prescribed Adderall (just 5mg) combined with Neurontin it was amazing how I could sit at a table of people and listen to the rules and remember them, and most importantly follow through and keep up with everybody else. Otherwise it would be like walking up and sitting down and taking over someone else's hand and make a play and then go back to another room in the house and then come back and sit down again (with no knowledge of what went on since you played last).
Sara replies: Ritch, it looks like our brains are wired similarly except that yours is math-oriented and mine is verbal. I score OK on the math side of standardized tests (100 points lower than my verbal on the SAT, 200 points lower on the GRE 17 years later) but ran into a brick wall math-wise during second semester college chemistry. I can't balance a checkbook and both the only jobs I have ever had that I was outright awful at were as a check proof operator at a bank in my 20s and as an accounts payable clerk 35 years later. If there's an error or discrepancy I CANNOT find it or reason out where it could be.
Posted by utopizen on January 8, 2003, at 21:14:11
In reply to New doc is not only benzophobic but stimuphobic!, posted by Saragram on January 7, 2003, at 11:39:59
>
She halved the number of Xanax tablets I can get at one time (says she's afraid I might get robbed by a coke addict if they found out I had them).
>My p-doc's benzophobic too, but at least he gives solid excused based on actual experience he's witnessed, not paranoid obsessions like this. Your doctor needs help, and I'm not being sarcastic. That's just NOT a rational statement for a doctor to make, and I'm not just saying that because I'm pro-benzo. I actually respect my doctor's reasons for not prescribing me Klonopin, but your doctor's reasons rest on undocumented, unverifiable paranoia.
Switch doctors, and not just so you can get benzos- what other thoughts are going through this guy's head? Do you really want to trust your life to a person who bases his prescribing habits on absurd hypotheticals?
Posted by utopizen on January 8, 2003, at 21:19:07
In reply to Re: New doc is not only benzophobic but stimuphobi » Saragram, posted by BrittPark on January 7, 2003, at 17:19:33
> Ask them whether they treat ADHD, whether they every prescribe benzos, whether they ever prescribe stimulants and anything else that is important to you. Some doctors will take offense at being asked questions. Thank them politely and move on to the next. Some doctors will think that you're displaying "drug seeking behavior".
>>"Some doctors"? Um, probably all doctors, even the ones who are rather generous with the benzos. And even if you do get these doctors, they'll never trust you because you asked a question like this off the bat. Don't follow this advice.
Posted by Ritch on January 8, 2003, at 23:57:38
In reply to Re: Adderall and card games, posted by Saragram on January 8, 2003, at 10:27:30
> Rich wrote: This is very interesting. I have trouble with stores as well (especially unfamiliar ones). Also, better bring a list or forget about coming out with what you intended to go there for! I did the best at Math in school, but when it comes to card games I am at sea as well. When I was first prescribed Adderall (just 5mg) combined with Neurontin it was amazing how I could sit at a table of people and listen to the rules and remember them, and most importantly follow through and keep up with everybody else. Otherwise it would be like walking up and sitting down and taking over someone else's hand and make a play and then go back to another room in the house and then come back and sit down again (with no knowledge of what went on since you played last).
>
> Sara replies: Ritch, it looks like our brains are wired similarly except that yours is math-oriented and mine is verbal. I score OK on the math side of standardized tests (100 points lower than my verbal on the SAT, 200 points lower on the GRE 17 years later) but ran into a brick wall math-wise during second semester college chemistry. I can't balance a checkbook and both the only jobs I have ever had that I was outright awful at were as a check proof operator at a bank in my 20s and as an accounts payable clerk 35 years later. If there's an error or discrepancy I CANNOT find it or reason out where it could be.
>
>I got stuck when it came to taking Calculus in college. The instructor was talking about derivatives and it seemed the stuff he was writing on the chalkboard looked a lot like "Pascal's triangle" which I had checked out in a previous class. It also seemed to have something to do with a logic class I was taking at the same time (meta-statements). I was trying to put these together somehow and was fascinated with them to the point that I could't follow the mechanics of constructing the proofs the teacher wanted. That's where the bipolar part of my troubles probably has more to do with the attention troubles than anything else. It "creates" more things to put on my "plate", than I need to solve the problem or task in front of me.
Posted by viridis on January 9, 2003, at 2:58:22
In reply to Re: New doc is not only benzophobic but stimuphobi, posted by utopizen on January 8, 2003, at 21:19:07
I agree that calling up doctors and asking for benzos and pstims directly could be risky, but a slightly different approach -- describing what's worked for you (and what hasn't) and asking if they feel this is reasonable -- might provide some useful insights.
I just lucked into my pdoc by picking nearby psychiatrists who are on my insurance plan. I originally had appointments with a few others, but he got me in first (it took a month or so). I saw him, we clicked, and I just cancelled with the others. So, one strategy could be to make appointments with several, and see them in the order that they're available. If one seems especially good, cancel with the others. They're used to it -- my pdoc says that psychiatrists probably have more cancellations than any other doctors. Once I started seeing him, he told me that if ever had a crisis he could always find a way to see me within a day or two, because he has so many last-minute cancellations.
Luckily though, I've had no real crises since getting on the right meds, and now I just go in every three months or so. It's a big change, since my life used to be one (perceived) crisis after another.
Posted by Saragram on January 9, 2003, at 7:49:41
In reply to Re: New doc is not only benzophobic but stimuphobic!, posted by utopizen on January 8, 2003, at 21:14:11
> >
> She halved the number of Xanax tablets I can get at one time (says she's afraid I might get robbed by a coke addict if they found out I had them).
> >
>
> My p-doc's benzophobic too, but at least he gives solid excused based on actual experience he's witnessed, not paranoid obsessions like this. Your doctor needs help, and I'm not being sarcastic. That's just NOT a rational statement for a doctor to make, and I'm not just saying that because I'm pro-benzo. I actually respect my doctor's reasons for not prescribing me Klonopin, but your doctor's reasons rest on undocumented, unverifiable paranoia.
>
> Switch doctors, and not just so you can get benzos- what other thoughts are going through this guy's head? Do you really want to trust your life to a person who bases his prescribing habits on absurd hypotheticals?Utopizen,
I agree with you, but the problem is that I switched GPs because the previous one wouldn't listen to me -- he was generous with benzos, but for 6 years pooh-poohed my complaint that I had leg cramps at night if I took my diuretic as directed, and the straw that broke the camel's back was when I went to him last year for a persistent sore throat, told the nurse that was why I was there, told the doctor that was why I was there, and was back in my car in the parking lot with a year's worth of blood pressure prescriptions before I realized he had never addressed the issue of my sore throat! He just ran through a list of blood-pressure related questions, entered stuff in his computer, and hustled me out of the office! I hate to switch again after waiting 4 months for an appointment with the benzo/stimuphobic one who was recommended by my gyno.
I'd also like to make her eat her words by coming back from the psychiatrist with a clear-cut diagnosis of ADD, which I am SURE I have. I'm not denying that I might be a bit bipolar, too, but she seemed so sure that I would have a much worse history of failures in life if I really had ADD -- she doesn't know what it's like to, every day, face a series of competing tasks and messes and NEVER have a clue as to where to start or how to climb out of the chaos!
Posted by utopizen on January 9, 2003, at 8:39:01
In reply to Re: New doc is not only benzophobic but stimuphobic!, posted by Saragram on January 9, 2003, at 7:49:41
It sounds like you have an HMO. I don't, so maybe I'm wrong, but don't they require a referral from everyone? Anyway, just say you want a second opinion from a psychiatrist. For a GP to be asked that is extremely reasonable-- I mean, I'm about to mention that to my p-doc so I may see a psychophamacologist (theory is that they're less uptight over benzos).
Your GP isn't a psychiatrist, so asking him for a second opinion is something he'll understand, even if he doesn't agree with your ADD concerns.
Posted by Saragram on January 9, 2003, at 10:28:15
In reply to Re: New doc is not only benzophobic but stimuphobic!, posted by utopizen on January 9, 2003, at 8:39:01
> It sounds like you have an HMO. I don't, so maybe I'm wrong, but don't they require a referral from everyone? Anyway, just say you want a second opinion from a psychiatrist. For a GP to be asked that is extremely reasonable-- I mean, I'm about to mention that to my p-doc so I may see a psychophamacologist (theory is that they're less uptight over benzos).
>
> Your GP isn't a psychiatrist, so asking him for a second opinion is something he'll understand, even if he doesn't agree with your ADD concerns.Thanks, Utopizen -- It's a PPO, not HMO, but I don't think any of the psychiatrists in my town are taking new patients without referrals from another doctor. The receptionist is supposed to set me up with a psychiatrist but I haven't heard back from them.
On another website (addconsults.com) I found a link to a local ADD support group and e-mailed their volunteer coordinator for a recommendation of a local psychiatrist who is ADD-adult friendly.
Posted by BrittPark on January 11, 2003, at 15:06:32
In reply to Re: New doc is not only benzophobic but stimuphobi, posted by utopizen on January 8, 2003, at 21:19:07
> > Ask them whether they treat ADHD, whether they every prescribe benzos, whether they ever prescribe stimulants and anything else that is important to you. Some doctors will take offense at being asked questions. Thank them politely and move on to the next. Some doctors will think that you're displaying "drug seeking behavior".
> >>
>
> "Some doctors"? Um, probably all doctors, even the ones who are rather generous with the benzos. And even if you do get these doctors, they'll never trust you because you asked a question like this off the bat. Don't follow this advice.Perhaps you're right and I've just been lucky. Phone screening is how I found my fantastic psychiatrist, however.
I had been a graduate student and had my meds monitored by a psychiatrist on staff at student health services (He, btw, never thought twice about prescribing benzos, since I had told him that they had been helpful in acute phases of depression). I then went into the working world and gradually tapered off (a bad mistake) the imipramine I had been taking. About a year and a half after my drug discontinuation I had an acute depressive episode. I called my insurance company to be referred to a psychiatrist. He turned out to be a quasi-Jungian who would not prescribe benzos as a matter of principle. (I don't mean to put down Jungians; they are just not a good match for me.) At that point I realized that it was no use painfully going through the insurance company's list of psychiatrists. So my wife and I grabbed the yellow pages and started calling. The basic questions we asked were "do you take into consideration patients past medication experiences?" and "Are you flexible and agressive about medication as a treatment for depression?" As I stated in my original post, some doctors acted insulted, some were perfectly polite but didn't fit my bill, a few seemed positively pleased to be asked questions. Among the last group I found the doctor who was the best fit for me.Now, we never asked about specific medications so that may have been why we didn't get the "drug seeking behavior" reaction. So perhaps I should amend my recommendation to say that asking about specific medications is probably a bad idea.
Britt
This is the end of the thread.
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