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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 24 to 48 of 97. Go back in thread:
Posted by JaclinHyde on April 9, 2006, at 13:32:58
In reply to Re: I get frightened when I read this sort of thing » Racer, posted by TylerJ on April 9, 2006, at 10:56:27
The problem is too when one hand doesn't talk to the other. Bringing up Tyler (hope you don't mind Ty) for instance he has high blood pressure and was prescribed his med for that from one doctorr while another gave him Parnate. They don't interact per se but they do affect each other. I think doctors you treat you should work like a team to help you get the best quality of life that you can.
JH
Posted by Squiggles on April 9, 2006, at 14:01:49
In reply to Please be civil » Squiggles, posted by gardenergirl on April 9, 2006, at 13:25:20
> > but the fact that he is ... and possibly a net KOOK
>
> Please don't post anything that could lead others to feel accused or put down. If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
> http://www.dr-bob.org/babble/faq.html#civil
>
> Follow-ups regarding these issues, as well as replies to the above post, should be directed to Admin and should of course themselves be civil.
>
> Regards,
> gg acting as deputy for Dr. Bob
>I only said that because Dr. Bob
kept kicking him out when he posted
racist remarks here. Rather consistent
i should think;Squiggles
Posted by Squiggles on April 9, 2006, at 14:14:12
In reply to Re: Blind Faith In A P Doc » Phillipa, posted by gardenergirl on April 9, 2006, at 13:14:03
> > Seems after MRI's ordered by the neurologist that my cervial spine is narrowed and can create paralysis if in a car wreck. but when i told the pdoc about my sytoms he wasn't interested and said that's not my specialty it must be anxiety.
>
> Um, Phillipa. Maybe I'm misunderstanding what you told your pdoc. But cervical narrowing would not be related at all to a pdoc's speciality, so I think his response makes sense.
>
> > Hence I do not have respect for the ones I now know. And the last study I read said psychiatrists have the highest rate of suicide among doctors. So is it because they do or do not take meds?
>
> I don't think that it's quite that simple, but that's for another discussion.
>
> About your original post, though. You asked why do people come here if they are going to listen to their pdocs. Well, I come here as well as use other resources in order to be an informed consumer of health care services. I think it's the patient's responsibility to the best of their ability to have some knowledge about treatment in order to make an informed decision.
>
> And as others have said, physicians do indeed know a heck of a lot more about how the body works and how medications can interact with the body and other substances than I certainly do. I don't expect my doctors to know everything about everything off the top of their heads, but I do expect them to consult references and to be thoughtful about treatment decisions.
>
> I would not take it upon myself to know that taking Drug A might increase Drug B's blood levels, and thus might mean I need to lower drug B. I would expect my doctor to work with me on this based on my report of what I know...how I feel, and his/her knowledge of medicine.
>
> It's a team effort, not a competition of who knows more or who knows best.
>
> ggI think it's a team effort too, given that
a team is available, in these hard times.Squiggles
Posted by linkadge on April 9, 2006, at 14:23:06
In reply to Re: Blind Faith In A P Doc » Phillipa, posted by gardenergirl on April 9, 2006, at 13:14:03
>And the last study I read said psychiatrists >have the highest rate of suicide among doctors. >So is it because they do or do not take meds?
Perhaps they don't believe in the medications. Perhaps they believe (/know) that most of the responce is a placebo effect, (and just knowing that would make it very difficult to respond).
Linkadge
Posted by linkadge on April 9, 2006, at 14:27:03
In reply to Re: Blind Faith In A P Doc, posted by Anna5 on April 9, 2006, at 13:30:17
Even if a doctor didn't believe that medications were safe, they wouldn't really have the option to tell that to the patient would they? They are expected to hand out pills. Patients want pills.
I remember reading that an extrodinarily disproportionatly few number of Eli Lilly workers actually took prozac. They still have to push it even if they don't believe in it. Same thing goes for the doctors. They probably think that if they try enough pills maybe the patient will eventually stop whining.
Linkadge
Posted by linkadge on April 9, 2006, at 14:28:01
In reply to Team work, posted by JaclinHyde on April 9, 2006, at 13:32:58
To work as a team with your doctor, generally you need more than 5 minautes every 2 months.
Linkadge
Posted by Squiggles on April 9, 2006, at 14:30:00
In reply to Re: Team work » JaclinHyde, posted by linkadge on April 9, 2006, at 14:28:01
> To work as a team with your doctor, generally you need more than 5 minautes every 2 months.
>
> LinkadgeAnd more than one doctor - no offense gg;
Squiggles
Posted by gardenergirl on April 9, 2006, at 14:32:22
In reply to Re: Blind Faith In A P Doc, posted by linkadge on April 9, 2006, at 14:27:03
> > I remember reading that an extrodinarily disproportionatly few number of Eli Lilly workers actually took prozac.
How many Eli Lilly workers are depressed?
gg
Posted by Squiggles on April 9, 2006, at 14:48:06
In reply to Re: Blind Faith In A P Doc » linkadge, posted by gardenergirl on April 9, 2006, at 14:32:22
> > > I remember reading that an extrodinarily disproportionatly few number of Eli Lilly workers actually took prozac.
>
> How many Eli Lilly workers are depressed?
>
> ggThat's hard to answer. How many extraordinarily
disproportionately few numbers are left over
an extraordinarily disproportionately few?My math has always been poor - but i think
it would be 0.Squiggles
Posted by linkadge on April 9, 2006, at 14:54:18
In reply to Re: Blind Faith In A P Doc » linkadge, posted by gardenergirl on April 9, 2006, at 14:32:22
With such a large population sample, (i.e. in Lilly), one would expect to see the same proportion of depressed people as one would in the general population. (Unless working for Lilly was a significanly less depressing job than the average american job :) )
Linkadge
Posted by linkadge on April 9, 2006, at 14:58:36
In reply to Re: Blind Faith In A P Doc » gardenergirl, posted by Squiggles on April 9, 2006, at 14:48:06
What I mean is this. Suppose 10% of the American population is on SSRI's. Then in a company the size of Lilly, you would expect to see approximately the same proportion of people taking SSRI's. This is not the case.
If forget the exact percentage, but it was very disproportionate to the to the population at large.
Linkadge
Posted by Squiggles on April 9, 2006, at 15:03:08
In reply to Re: Blind Faith In A P Doc » Squiggles, posted by linkadge on April 9, 2006, at 14:58:36
> What I mean is this. Suppose 10% of the American population is on SSRI's. Then in a company the size of Lilly, you would expect to see approximately the same proportion of people taking SSRI's. This is not the case.
>
> If forget the exact percentage, but it was very disproportionate to the to the population at large.
>
> LinkadgeIs it possible they screen people for mental
illness? I know my friend lost a high-paying
corporate job because of the physical test -
showing psychiatric drugs. They were at first
very impressed with an exceptional record and
very high IQ and almost showed him the office,
but after the test, he did not
get the job. Hmmm.Squiggles
Posted by Caedmon on April 9, 2006, at 15:43:28
In reply to Re: Blind Faith In A P Doc » linkadge, posted by Squiggles on April 9, 2006, at 15:03:08
I've always had good luck with pdocs, they generally go along with my ideas, unless they are too far in left field.
The only time I've really been 'put in my place' re: meds, and complied despite my own inclinations, was in taking Risperdal for an acute mixed mania episode. Which, thinking back, I'm glad I did. That was a time when he was right to tell me what's what, and I was smart to go along.
I've known of some pdocs who are very liberal with their Rx pad and will write just about whatever someone asks, so long as it's not a controlled substance. "Doc I'd like Cymbalta and Remeron and Geodon and Neurontin and a touch of Wellbutrin" winds up being okay. Go figure.
In general I think that the better self-educated you are wrt psych meds, the better you'll be able to help your pdoc make decisions. Unfortunatley as some have mentioned, getting only 5 minutes of consult every 2 months often means you had better just have a good game plan and execute quickly.
Wish everyone could have a pdoc who was inexpensive and gave them at least an hour every two weeks, if they wanted it. That would be great. It's sad, but very often my favorite days, the days I look forward to the most, are days when I get to see my shrink.
- C
Posted by Squiggles on April 9, 2006, at 15:53:06
In reply to Re: Blind Faith In A P Doc, posted by Caedmon on April 9, 2006, at 15:43:28
Yeah, you're right. Pdoc is an American
category of doctor i think; Well, things
could be much worse. I read at WHO of
a village that has one psychiatrist dealing
with 400 people, and they have gone through
traumatic experiences that are only the
worse nightmares in this country.I use the net a lot for extra help - i
probably use it *too* much.Squiggles
Posted by john berk on April 9, 2006, at 16:11:05
In reply to Re: Blind Faith In A P Doc » Caedmon, posted by Squiggles on April 9, 2006, at 15:53:06
I have a good friend whose mother is a respected psychologist who has had major depression for 20 years and refuses to take medication, [my friend says she has her reasons] i often wonder what she knows that i am not privy to, or maybe she is just stubborn, but it does worry me at times...john
Posted by Caedmon on April 9, 2006, at 16:17:33
In reply to Re: Blind Faith In A P Doc, posted by john berk on April 9, 2006, at 16:11:05
> I have a good friend whose mother is a respected psychologist who has had major depression for 20 years and refuses to take medication, [my friend says she has her reasons] i often wonder what she knows that i am not privy to, or maybe she is just stubborn, but it does worry me at times...john
Perhaps she is able to cope with psychological techniques? In which case, good on her.
Or it could be that classic antagonism sometimes existing between therapists and doctors for psych problems. I suppose that if you're a psychotherapist, you are so because you believe that you can help people with interpersonal and behavioral things.
- C
Posted by john berk on April 9, 2006, at 16:27:23
In reply to Re: Blind Faith In A P Doc » john berk, posted by Caedmon on April 9, 2006, at 16:17:33
that's a good point "c", i worried that her family may say her symptoms more obectively and wondered if she had some "insiders" info on meds, but i think there definetly is antagonism between therapists and psych docs on the healing process.that is maybe until therapists get prescribing privleges, [i here that is in the works] then we may see less antagonism, lol. but she may have good coping mechanisms, your right, therapy is much underrated these days..john
Posted by ed_uk on April 9, 2006, at 17:38:15
In reply to Re: Blind Faith In A P Doc » Phillipa, posted by linkadge on April 9, 2006, at 11:38:11
>Doctors often just say things becuase they think that (in the medical community) this is what is acceptable, and expected of them.
A wise statement Link. Doctors also like to prescribe whatever med is currently considered to be most 'acceptable', regardless of whether it is actually the most appropriate choice eg. starting a depressed patient on Celexa after all the other SSRIs have failed, rather that trying a different type of antidepressant eg. nortriptyline.
Ed
Posted by Phillipa on April 9, 2006, at 17:41:38
In reply to Re: Blind Faith In A P Doc » Phillipa, posted by gardenergirl on April 9, 2006, at 13:14:03
GG that's one of the problems he won't listen. Only his nurse talks to the patients. A month after his own pscy testing he didn't even know the results and that was two docs in his own office so where is the team? Obviously not there. Love Phillipa ps you're lucky you have a good pdoc with the communication you do.
Posted by ed_uk on April 9, 2006, at 17:45:02
In reply to Re: Blind Faith In A P Doc, posted by linkadge on April 9, 2006, at 14:27:03
>Even if a doctor didn't believe that medications were safe, they wouldn't really have the option to tell that to the patient would they? They are expected to hand out pills.
I work in a pharmacy Link. I am *expected* to 'reassure' patients that their symptoms are not side effects and that they should continue taking their medication as prescribed. This is what is expected of me. I am not expected to warm patients of side effects, since this may reduce 'compliance'. Under NO circumstances am I expected to challenge a doctor's prescribing or advice.
Eddy
Posted by Phillipa on April 9, 2006, at 17:56:00
In reply to Re: Blind Faith In A P Doc » linkadge, posted by ed_uk on April 9, 2006, at 17:45:02
Another scenario. When I met my husband his Mother had shorness of breath and weakness . She saw a pdoc and he said the reason was anxiety and depression. He prescribed paxil which she couldn't take due to the side effect. Two weeks later they had a consult at Duke University Hospital and it was not anxiety or depression it was Lou Gerhigs Disease. She went into respiratory depression declined a ventilator and died a week later. Misdiagnosed. She knew something was wrong with her but the pdoc wouldn't listen but there was no internet then. So she died. Love Phillipa
Posted by linkadge on April 9, 2006, at 18:07:34
In reply to Re: Blind Faith In A P Doc » linkadge, posted by Squiggles on April 9, 2006, at 15:03:08
Lilly..screen for SSRI's ?!!
Well then that too would say something! "Here at Lilly, we stand behind our product, as being safe and effective, our only policy is that if you work for us you cannot actually consume our product, and our reasoning behind that is confidential. Any questions ?"
Linkadge
Posted by Squiggles on April 9, 2006, at 18:11:45
In reply to Re: Blind Faith In A P Doc » Squiggles, posted by linkadge on April 9, 2006, at 18:07:34
> Lilly..screen for SSRI's ?!!
>
> Well then that too would say something! "Here at Lilly, we stand behind our product, as being safe and effective, our only policy is that if you work for us you cannot actually consume our product, and our reasoning behind that is confidential. Any questions ?"
>
> Linkadge
Heh :-) Funny - hope this is not against
the posting rules; frankly i don't know
about Lilly, but the incident with the
Big Corp is authentic - again they may have
just changed their mind in not hiring the
whiz kid.Squiggles
Posted by linkadge on April 9, 2006, at 18:21:40
In reply to Re: Blind Faith In A P Doc » linkadge, posted by ed_uk on April 9, 2006, at 17:45:02
>I am not expected to warm patients of side >effects, since this may reduce 'compliance'. >Under NO circumstances am I expected to >challenge a doctor's prescribing or advice.
The funny thing was that (on my own) I added some lithium to an MAOI one time, (now I know some people have got away with it), but it was BAD news, I felt like I was going to have a seizure.
I've also had serotonin syndrome on an SSRI + lithium, which a doctor said was not possible, but I didn't care at this point for his opinion, he told me it was just my nerves.
Its not that I don't think the doctors are smart, as they are, but I do think I know my own body better.
Linkadge
Posted by linkadge on April 9, 2006, at 18:23:58
In reply to Re: Blind Faith In A P Doc, posted by Phillipa on April 9, 2006, at 17:56:00
Thats a very good example. Doctors don't know everything. They will try to chalk everything up to your nerves.
Linkadge
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Dr. Bob is Robert Hsiung, MD,
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