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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by willyee on March 1, 2006, at 23:37:22
Well today i seen my Doc,and normaly ive had rough visits,as she is a tough little lady,but usualy all is ok by the time i leave.
Well i had to go in today with the displeasuring task of telling her,on my own fault for the first time i was short on meds,i recently had a trip to NY and i consumed more benzos then i relaised,this is not an excuse just my fyi it was my fault,i thought i was more ready for a trip as such and i apppearently was not.
So many things went wrong in this 20 min appt its unbelivable.First we addressed running short on klonopin,never in 5 years had i usualy cause i cut them and in ny i couldent cut them on the move as well.Anyway she was furious,and finaly gave me a re-script after near choking me.Then i had to tell her,unlike the OLD parnate program i was in,this new coverage where she writes scripts monthly shes not giving me enough.I told her its a fact 90 mg is a standred high dose but she said 60 and she was going over that,i told her id bring in a copy of a most recent data sheet showing 90 mg to be a max dose.Anyway she gave me my next script at that but assured me she would not go a single mg higher.
Then she went back to what she has been saying,that she wants me on lexapro and she really wants me off parnate.Im not stable now how can she think of having me two weeks off a med unstable to go on a med that LIKLY will not work,this could be the end for me.I failed on every ssris there is every one.So she gave me her plan of action and them.......
****THE KICKER,after being the one to iniatly inform her of the patch,from the get go,letting her know it was something i had hopes in,i mentioned,"well we still have the patch" she then turned to me and said,I WAS NOT A CANDIDTAITE for it,she said she did some reading,and that since the dose of the patch is so low,she dident see how it would make sense to work when im already on such a HIGH maoi dose now of parnate.
But what about the fact its a patch,a new method of medication firstly?What about the fact being on parnate so long COULD BE THE ACTUAL DISADVANTAGE" and not a matter of dosage just tolerance,and i might respond to the patch.
What about the fact that its a different med period and a option.I could not believe my ears,after all we talked about she shot it down that quickly.
Then the final sword to the gut was she informed me she is leaving the state and moving in a few months.And that is why she wanted me on lexapro.I asked her if i should wait to check on a few docs and she said wait till she leaves,WELL no way,i am going to see a doc or two i know well this week to explain my situation and ill have 3 months to work on having this med prescribed.
The entire day went horrid like this,my stomach is in a knot,good thing i dident mention i was also out of the xanax,lol ill just wait for the refill date is all.
Its just a giant mess,im going no where,and hell dont even know if the patch would work.Im just gonna make all of this a serious thing till its sstraight,fixing all the details ,taking my meds more correctly,all of it will be my job now,no more games i dont wana end up on a bad road which is where i am heading.I have some hope if i do take things serious i can get these problems fixed,im just glad i have a decent amount of time.
Thankd for the air,all in my prayers tonight,
Posted by snapper on March 2, 2006, at 0:07:50
In reply to Worst visit ever.........., posted by willyee on March 1, 2006, at 23:37:22
Hey my friend, I read your post and I feel for you. I would do :what ever" is neccessary for you to keep on a med that YOU know is right for you. I am very sick of the dr's. out there who are being duped into the idea the SSRI's are the best since bread kind of thing. Insist on the best. We are all here behind you! Good Luck
Posted by alohashirt on March 2, 2006, at 0:23:32
In reply to Worst visit ever.........., posted by willyee on March 1, 2006, at 23:37:22
If you regularly visit NY may be worth looking for a NY pdoc - thre are so many to choose from!
Posted by linkadge on March 2, 2006, at 14:12:00
In reply to Re: Worst visit ever.........., posted by alohashirt on March 2, 2006, at 0:23:32
Yeah, it seems that your doctor is making some abrupt decisions probably related to the fact that she is moving.
I would think that lexapro would definately be a negative move for you. I would find a new doctor.
Could you imagine a doctor saying, you're not a candadate for Nardil because you failed Parnate? Of course not. You are right, the two drugs are completely different.
Linkadge
Posted by willyee on March 2, 2006, at 14:12:27
In reply to Re: Worst visit ever.........., posted by alohashirt on March 2, 2006, at 0:23:32
Unfortunatly im living in VABEACH and im close to house bound now,immense fear feels like it rpelaced all my blood i already made a call to a new doctor i just dont know what to do at this point my meds are just not working i dont know if i should up my parnate or up my klonopin but i have to do something.
Posted by Maxime on March 2, 2006, at 15:13:47
In reply to Worst visit ever.........., posted by willyee on March 1, 2006, at 23:37:22
I swear, lexapro is the drug of the month!
Hope you stay on the parnate.Maxime
Posted by Maxime on March 2, 2006, at 15:16:24
In reply to Re: Worst visit ever.........., posted by willyee on March 2, 2006, at 14:12:27
Don't take this the wrong way, but it's comforting to know that Parnate pooped out on someone else (again, I am sorry about that). When I finally got Parnate, I thought I would be able to stay on it forever. I've never heard of it pooping out on anyone before.
Hang in there.
Maxime
> Unfortunatly im living in VABEACH and im close to house bound now,immense fear feels like it rpelaced all my blood i already made a call to a new doctor i just dont know what to do at this point my meds are just not working i dont know if i should up my parnate or up my klonopin but i have to do something.
Posted by TylerJ on March 2, 2006, at 15:28:59
In reply to Re: Worst visit ever.........., posted by willyee on March 2, 2006, at 14:12:27
Yea, you definitely need a new pdoc Willyee. She sounds like a real Bitc* ! It's like she's trying to punish you or something..i don't get that b.s. at all. You're not a candidate for Emsam? What the hell's up with that? I say get a new doc who is MAOI oriented and get on the "Patch" asap. Don't mean to be negative but Lexapro? I wouldn't do it. I tried it about 5 yrs. ago and it didn't work for ME at all. Take care Willyee, things will get better...hopefully soon!
Tyler
Posted by forgetful mary on March 2, 2006, at 16:32:48
In reply to Re: Worst visit ever.......... » willyee, posted by TylerJ on March 2, 2006, at 15:28:59
Get thee to a new Pdoc.....It's bad enough to deal with depression , never mind an intolerant, egotistical pdoc who knows less than their patients!!!....Get a load of this pdoc in the news today:
"Santa Ana - A renowned psychiatrist lost up to $3m over 10 years to a Nigerian internet scam, his son alleges in a lawsuit.
Dr Louis A Gottschalk, an 89-year-old neuroscientist who works at the University of California, Irvine medical plaza that bears his name, acknowledged losing $900 000 to "some bad investments," according to court papers.
Guy Gottschalk filed a lawsuit last month asking a judge to remove his father as administrator of the family's $8m partnership. He alleges his father destroyed bank records to cover up his losses. "and I ask you,
Who is running the asylum???
(Nothing personal Dr Bob!!!)
Posted by willyee on March 2, 2006, at 17:02:54
In reply to Re: Worst visit ever.........., posted by forgetful mary on March 2, 2006, at 16:32:48
Thanks for the messages,im trying to make my mom understand this,im glad she started going with me to visits so she knew i was being honest at how horrid the sessions are,i mean she cuts me off,she dominants the conversation,shes always late,and she gets me so nervous i forget what to say.
Her words were she said if i coninued to fail on parnate before she left she was taking me off cause she said no other doc would presccribe it,also she said she personaly wanted me on lexapro.
Im unstable now and going two weeks off parnate will kill the little lifei hae left,i hope this new doc im seeing listens.
Im also shocked cause she knew nothing of the patch,I TOLD HER about,on and on for months,and she anchwledged my desire for it,then she read on it,prob a paragraph and told me TWICE no and its not even out yet.She also said maois are not gonna be used a lot reffering to the patch,meanwhile the whole idea of the patch is to make it a mainstream drug.
Im really scrwed now not sure what to expect .
Posted by tessellated on March 2, 2006, at 17:57:12
In reply to Re: Worst visit ever.........., posted by willyee on March 2, 2006, at 17:02:54
W,
THERE IS LIFE AFTER PARNATE.
-crap i use to snort that stuff, gives you red boogas, eaccchkkk.nevertheless I love bitching about psychiatry so freak her.
you need to move on regardless, and she's prob not the one to ask for referrals, as she's just going to turn into a flippin answering service. i cannot stand that aspect. i think they do this particularly if they deal w/addiction. its the most passive pavlovian way they assert themselves.
i just signed up with a new pdoc based almost entirely upon his voice mail system....
ps: don't take the red boogies as medical advice in fact i strongly recommend against it.
Posted by linkadge on March 2, 2006, at 19:03:06
In reply to Re: Worst visit ever.........., posted by willyee on March 2, 2006, at 17:02:32
Thats absolute B.S. that a doctor would not prescribe it. Doctors are hesitant to start parnate in sombody who's never taken it before, but for somebody like you, who has taken it so long, and knows the diet etc. most doctors would not have a problem continuing with what has been working for you.
Linkadge
Posted by Phillipa on March 2, 2006, at 20:26:51
In reply to Re: Worst visit ever.......... » willyee, posted by linkadge on March 2, 2006, at 19:03:06
Willyee I know one pdoc that still has one patient on an MAOI in Greenville NC. Fondly, Phillipa E-mail me I'll give your her name.Old too but good.
Posted by linkadge on March 3, 2006, at 9:36:50
In reply to Re: Worst visit ever.........., posted by Phillipa on March 2, 2006, at 20:26:51
MAOI prescrption varies from doctor to doctor. Some believe in them and will try them very quickly.
The doctor who prescribed parnate to me, did so on the first visit.
Linkadge
Posted by TylerJ on March 3, 2006, at 10:03:48
In reply to Re: Worst visit ever.........., posted by tessellated on March 2, 2006, at 17:57:12
> W,
> THERE IS LIFE AFTER PARNATE.
> -crap i use to snort that stuff, gives you red boogas, eaccchkkk.
>
> nevertheless I love bitching about psychiatry so freak her.
>
> you need to move on regardless, and she's prob not the one to ask for referrals, as she's just going to turn into a flippin answering service. i cannot stand that aspect. i think they do this particularly if they deal w/addiction. its the most passive pavlovian way they assert themselves.
>
> i just signed up with a new pdoc based almost entirely upon his voice mail system....
>
> ps: don't take the red boogies as medical advice in fact i strongly recommend against it.You really snorted Parnate? LOL
How did it make you feel. Excuse me, but I have a sudden urge to blow my nose! Take care.Tyler :)
Posted by Racer on March 3, 2006, at 12:52:18
In reply to Re: Worst visit ever.........., posted by willyee on March 2, 2006, at 17:02:32
>
> Her words were she said if i coninued to fail on parnate before she left she was taking me off cause she said no other doc would presccribe it,also she said she personaly wanted me on lexapro.
>I agree with what others have said, and what you already know: this is not the pdoc for you.
>
>
>
> Im also shocked cause she knew nothing of the patch,I TOLD HER about,on and on for months,and she anchwledged my desire for it,then she read on it,prob a paragraph and told me TWICE no and its not even out yet.
>(Disclaimer: please read this next part with an open mind. It's not meant as criticism, just as an alternate view of the interactions.)
You say that you're the one who told her about the patch, and that you told her about it "on and on for months," and that you were explaining it to her. Do you think that she might have been reacting to that? A lot of doctors do, in a knee jerk sort of a way, "I'm the one who went to Med School here -- stop trying to tell me how to do my job."
In one sense, they're right. They've been through med school, and passed enough tests to prove that they've learned something -- and the important thing that sets that apart is that they have the structure and context for the information we can read on the net. We may be more informed than many people out there, but for most of us it's not in a complete matrix of information. It's rather isolated bits, hanging around out of context. (And even if it's not, the doctors rarely know that. I've got friends with doctorates in sciences who get the same treatment from doctors.)
I guess what I'm trying to get across is that you may have inadvertantly triggered some of her own ego issues, by "telling" her about things, rather than asking. That's happened to me, and it's not fun. Doctors will get into power struggles with patients, and while it's supposed to be their responsibility to avoid it, sometimes it ends up being up to us to get out of it. What I've done that has worked well for me is to say something more like, "I've read about this new drug, it's this sort of medication, and I wondered if you thought, since I'd responded well to a similar sort of med, that it might be helpful for me?" That's worked a whole lot better than the alternative...
Hope that helps, and good luck with your new pdoc, whoever it is.
Posted by Chairman_MAO on March 3, 2006, at 13:47:08
In reply to Re: Worst visit ever.........., posted by willyee on March 2, 2006, at 14:12:27
I feel for you. I really do. What you described is a travesty and I really do not know what to say except that I am in a similar situation myself.
The maximum safe dosage of tranylcypromine is actually _180-200mg/day_. Most psychiatrists are utterly incompetent and have less knowledge of pharmacology than a first-year pharmacy student, it seems.
I have a feeling you are looking for something that no dose of parnate is going to provide. The good effect will last longer at 200mg/day, but you will eventually crash at some point. Please try Nardil 1mg/kg if at all you can. Forget the side effects right now. I have learned that the hard way.
Posted by forgetful mary on March 3, 2006, at 17:35:14
In reply to Re: Worst visit ever.......... » willyee, posted by Chairman_MAO on March 3, 2006, at 13:47:08
There are a lot of BAD Pdocs out there, sad but true One has to keep looking til they find a good one. The best one I ever had admitted that it was a crap shoot as to which med would work or not. Most won't admit that they know less than anyone as to how you will react to it. And I think oftentimes those suffering DO know more than the supposed experts. Who is more expert?, one who has to live and deal with the illness and thus has more at stake or one who merely cares for those suffering. Keep looking and don't let the turkeys get you down. I'm reminded of the pdoc years ago who was treating a student , she was a Harvard Doc and became her male patient's "surrogate mother" through therapy. Talk about a Loony Tune!! She was sued by his family after he committed suicide and they got millions. BUT she was allowed to continue practicing as a therapist although not as a Pdoc. Scary that docs like her are out there!!! Trust your own instincts about this doc and CAN HER !!!
Posted by tessellated on March 3, 2006, at 17:51:27
In reply to Re: Worst visit ever.......... » willyee, posted by Chairman_MAO on March 3, 2006, at 13:47:08
i'm not one for conservative approaches, but i can mention that i had one of the more unfortunate, though totally fascinating, and expensive side effects from high dose (self prescribed) parnate: PSYCHOSIS. I believe that at high doses over 100mg, it does begin to function quite like amphetamines, triggering the dopamine receptors quite heavily and causing a supersensitivity. i think they can begin almost to self stimulate creating a dream/awake stake.
i don't know if the psychotic break was from stopping parnate, or upping it. this is common with ampetamines (and used to induce models of schizo in rats in order to develop antiPsychotics). Aside from being locked up and force administered seroquel, i would not persononally take that road again.
psychosis is not like simply hallucinating off a typtamine, fungi, or cacti, etc...it's like being those dudes in the middle of traffic talking to invisible people, tweakers as they say.
i have no idea what dose i was up to, no how long i went without sleep, though i would expect around 150mg/day. now we all have dif physiology, but there is a rule: you have to pay to play.
with this med as with others it does require respect, as it is a valuable agent. i myself would not want the task to oversee someone at the 150mg level unless they were in patient-
think about the worries, the possibilities, the random unknowns...ideally meds are a stop gap. get you to the next pay check. etc. to look at them as being necessary for years should not be a default decision rather only pure serious desperation.
The mind is a truly wonderous and resilliant organ with amazing self healing capacity if given the chance.
Give it that.
> I feel for you. I really do. What you described is a travesty and I really do not know what to say except that I am in a similar situation myself.
>
> The maximum safe dosage of tranylcypromine is actually _180-200mg/day_. Most psychiatrists are utterly incompetent and have less knowledge of pharmacology than a first-year pharmacy student, it seems.
>
> I have a feeling you are looking for something that no dose of parnate is going to provide. The good effect will last longer at 200mg/day, but you will eventually crash at some point. Please try Nardil 1mg/kg if at all you can. Forget the side effects right now. I have learned that the hard way.
Posted by tessellated on March 3, 2006, at 18:11:40
In reply to Re: Worst visit ever.......... » tessellated, posted by TylerJ on March 3, 2006, at 10:03:48
p.s: taking p up the nose is similar to snorting fruit punch koolaid. you cry, drip, RALPHHH...
never tried smoking it, nor as a suppository.
think its been proven pointless, though snorting deprenyl seemed curious. I suppose these approaches could work like a do it yourself emsam right? Avoid the stomach tyramine-and surrender your nose or *ss to science.
oh how about crunchin up what ever maoi and then sticking it it into a gummy worm, then using a cheese shredder nick off some skin, lick the worm, and stick it on the wound? repeat as necessary. the maoi leech system...
kidding peeps-hope i dont get banned...
this is all in the quest of being stupid.though i could come up with these all day.
Posted by greywolf on March 3, 2006, at 19:28:31
In reply to Re: Worst visit ever..high dose parnate, posted by tessellated on March 3, 2006, at 17:51:27
This will sound trite, but your doc probably just did you a favor. It takes time to even get in to consult with a new psydoc, and the way she treated you has given you motivation to get moving on the issue immediately. With any luck, you'll be ready to roll with a new and, hopefully, more understanding doc before she even leaves town.
Good luck.
Posted by cecilia on March 4, 2006, at 2:15:26
In reply to Re: Worst visit ever.......... » willyee, posted by Racer on March 3, 2006, at 12:52:18
You're right, the biggest part of dealing with doctors is making them think things are their idea. Nurses quickly learn to play the same game with doctors to get what they need for their patients. I just don't get why they have such huge egos, from reading Psycho-Babble, it's pretty obvious that for pdocs at least their success rate isn't that hot. ( And surgeons, of course are even worse.) Cecilia
Posted by willyee on March 4, 2006, at 6:43:27
In reply to Re: Worst visit ever..high dose parnate, posted by greywolf on March 3, 2006, at 19:28:31
You couldent more correct there,i remeber saying to her well my friend has seen your co-worker ann xxx and i actualy had a conversation with her outside for 30 min concerning the un conventional methods i use maois etc,and she did not seem shocked or anything,im sure on ur notes shed be more than willing to keep me where i am?
Should i even though still am seeing u get the ball rolling and make an appt to discuss things with her?
My doc then says....."no just hang on till im leaving" wt....... is she crazy,this isnt a game,i dont have weeks in fact depening on ones condition a day can be the differecne of endng up in a ward,which i dont wanna do.
So i of course made an appt with another doc,i just hope hes willing to work with me phillpa u ever seen dr shetty i remeber we spoke of him.
Posted by willyee on March 4, 2006, at 8:22:11
In reply to Re: Worst visit ever..high dose parnate, posted by tessellated on March 3, 2006, at 17:51:27
I agree,chairman might be an exception as others,but for the most part i did not like going above a 100,i do like however havign the option of going up and near 100,which would range from 8- to 100 mg max but never at a single dose,the most i dose at a single dose is 40 mg.
Posted by Phillipa on March 4, 2006, at 17:47:52
In reply to Re: Worst visit ever..high dose parnate, posted by willyee on March 4, 2006, at 8:22:11
Willyee I don't recall a Dr. Shetty. I remember Dr. Wallace now he is old and might still be praticing and be familiar with the MAOI's. Then Dominion Psych had a large practice and still exists off Laskin Rd. And King-Jones and your old friend. But that's all I remember Sheety doesn't ring a bell. Maybe look up the names and E-mail them to me. sorry willyee
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