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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by getinwl72 on October 25, 2006, at 7:59:39
Hi there.
I wanted to share with you my experience with my Doctor visit yesterday. I have a wornderful Doctor. I have been seeing him about 3 years. I decided to switch to Kaiser 1/1/2006 to save money and knew that would mean a new doctor but since I was stable I thought it would be an easy transfer. Well, it was anything but. Kaiser and many other HMO's have practicing guidelines that they follow and will prescribe by the book, not the patient. I went completely off kilter within a month when he refused to give me the meds I had been on stating that I was at risk of seratonin overdose because of the 90 mg of Cymbalta I was on. He would only prescribe 30mg. He kept prescribing me things that I did not want. Finally, I could not take it and went back to my old doctor and pay 75.00 to see him although I could pay 15.00 to see a Kaiser doctor. I have to wait 2 hours everytime I go to see him because his practice is overloaded and a 1 hour drive, but once I am in his office I realize why. He is the head of one a Behavioral Hospital in my city.
I had written down my concerns about being on Stimulants and Xanax. I felt like perhaps I was becoming a drug addict or something. See, I have MS, Panic Disorder, Depression and Fibromyalgia. I am taking
100 mg Topamax pm
60 mg Cymbalta pm
20 mg adderall (not XR)3 times day, sometimes just two
.5 mg Xanax afetrnoon and 1 mg Xanax PM
I asked him if I was just getting myself high during the day and then taking a downer at night.
I felt uncomfortable knowing that this cocktial is one that finally gives me the best relief.
He said , You have to function. You have several medical issues at hand, you are not alone, many people need these to function and perform.
I said but why are so many doctors reluctant to prescribe Benzo's? He said because they are small minded and not looking at the big picture. You have to treat your patient as an individual. I can write you this prescription and know it will last all month. There are some people of whom I know if I write the script they will take it all in one week. You have to treat people as people Michelle. He said as for the stimulants that I will always need one and I will have to change them up every so often and to be prepared for that, but it's not to worry. He makes me feel OK about the meds I take and that is so important. The Kaiser doctor actually told me that he was running out of options. A stimulant was never one of them.
Bottom line, I think I was feeling guilty about the medication I was taking because stimulants and Benzo's get a bad rap. I am kind of a controlling person and don't ever want to feel like I could become an addict. Fact is, I am sick and I need these to be on a level playing field. If you truly feel that your doctor is not listening to you and answering your questions and doesn't trust you, you need to find a new one. Because I figure for most of us, we have a lifelong battle ahead of us and we better find someone that we can trust and who believes in us.Thanks for listening and I hope that this encouranges someone to change their doctor who is not listening to them and prescribing medication from a book and not based on you!
Posted by Phillipa on October 25, 2006, at 13:13:19
In reply to Why your doctor can make or break you, posted by getinwl72 on October 25, 2006, at 7:59:39
What a wonderful and caring doctor you have. Consider yourself lucky as you found out most are not like that. And trust is so important. Love Phillipa keep waiting to see this one it's worth it as I'm sure you know
Posted by getinwl72 on October 25, 2006, at 19:39:55
In reply to Re: Why your doctor can make or break you » getinwl72, posted by Phillipa on October 25, 2006, at 13:13:19
> What a wonderful and caring doctor you have. Consider yourself lucky as you found out most are not like that. And trust is so important. Love Phillipa keep waiting to see this one it's worth it as I'm sure you know
Hey Phillipa, You post to like every message, do u mind if I ask if you work? You are so sweet and open minded. You always have such encouraging words for people and dont let the naysayers get others down. U just seem to be fair minded. I appreciate your points of view. Can you tell me a little bit about why you are so responsive to most Threads? Do you have a support system in the non pysco babble world? Why are you so drawn to this board so often? I obviously am drawn myself, but surious as to why you have become kind of the resident spokesman in most threads , also someone named racer but Ihavent spoken to him yet. You are soo kind. and have responded to both my messages I have had on here. Thanks muchaloo!!
lol
Posted by Phillipa on October 25, 2006, at 20:18:32
In reply to Re: Why your doctor can make or break you » Phillipa, posted by getinwl72 on October 25, 2006, at 19:39:55
Sure and it's simple I am not working at the moment but was a nurse for l5 years. I was a charge nurse in psych the last I worked. I love to give support if that's all the knowledge I have. I am not as educated on meds as a lot of the other posters but I almost feel like I'm back at work when on this board . And I'm constantly learning. So if I improve enough and can go back to nursing I will be more knowledgeable and able to understand what others are going through. You know what they say about walking the path too. I love people. Love Phillipa
Posted by getinwl72 on October 26, 2006, at 7:16:52
In reply to Re: Why your doctor can make or break you » getinwl72, posted by Phillipa on October 25, 2006, at 20:18:32
Thanks Phillipa- I was just curious about you. I think that when you deal with people you have feel good about you and "ready for the world" so not working right now is in my opinion the responsible thing to do. I am a systems analyst and I work from home. I get anxiety and used to swing up and down in my moods, blurt out inappropriately in meetings, cut people off alot, react to people in a negative way too often, etc. I am much more able to control myself at home. I am a very productive person and have low tolerance for others I work with who have what I call a substandard work ethic. My co-workers write it off to me being a New Yorker. I live in the South now. More Likely:-) I am just anti social and focused on producing work and less interested in being socially correct with others. When I am stable on my meds I am more productive than most which is why I think they have bothered to keep me.I need to work in a quiet setting with minimal disturbances. When I was working on the office I had to take 2 leaves of absence because of my illness(Breakdowns, Rapid Cycling at work). Many people at work know about my depresson and anxiety. Since working from home 95% of the time I have not had the need to do so. I love your contributions to the site. By your name I was assuming you were a male, but I think I may be wrong. Are you a female Phillipa? Sorry , I hope I did not offend.
Posted by iforgotmypassword on October 26, 2006, at 12:11:39
In reply to Re: Why your doctor can make or break you » Phillipa, posted by getinwl72 on October 26, 2006, at 7:16:52
please be careful with your bluntness. this message is quite a bit better. but still, i feel a bit guarded around certain personalities that go a certain way.
i find that enough 'driven' and ambitious bipolars have a propensity to just be plain dickheads (NOT you specifically) regularly whenever they get impatient with how 'unimpressive' they think someone is. this general attitude ironically seems to impress high functionning M.D.s. they seem to be at least a part of who make up the "hyperthymic" personality type seemingly and documentedly common in enough bipolars. i am not saying you are being a dickhead. but please, as you kind of recognize the propensity in yourself, watch sometimes where your attitudes lead towards people and watch what you can say. watch questions you just bluntly ask. you are on a support forum and you have to be pretty sensitive that certain people are vulnerable to certain things being asked about them.
i am just saying that if you ever see your personality going this way, if it ever does, it can be pretty harmful to vulnerable people you may come across whenever a mental patient, and some people can take a while to heal.
Posted by Phillipa on October 26, 2006, at 12:29:28
In reply to Re: Why your doctor can make or break you » Phillipa, posted by getinwl72 on October 26, 2006, at 7:16:52
Female. Love Phillipa
Posted by Bonnie_CA on October 26, 2006, at 14:41:56
In reply to Why your doctor can make or break you, posted by getinwl72 on October 25, 2006, at 7:59:39
Ugh... see, I'm switching FROM Kaiser starting 1/1/07, because of problems with their psychiatric department. Oh yes, super cheap to get prescriptions and see the doctor, but if you have a serious problem it's hard to get any help. My doctor wasn't very helpful, it was impossible to get in to see him, the nurses always told me "give it more time" and all the while, my life is wasting away because I can't go anywhere or do anything, but they don't care, just give it more time. The doctor actually said "Oh I could flip a coin, they all do the same thing". Yeah... so I'm leaving Kaiser. And I can hardly wait. Yeah, it's sad how they do everything by the book. My medical doctor is the one prescribing me Xanax. I'm not even sure my pdoc would prescribe them. It was just a mess. And GAWD the staff was always short and borderline rude. I have never been anywhere like that before. I was with them for two years, and it wasn't good enough to justify the money we're saving.
-Bonnie
> Hi there.
> I wanted to share with you my experience with my Doctor visit yesterday. I have a wornderful Doctor. I have been seeing him about 3 years. I decided to switch to Kaiser 1/1/2006 to save money and knew that would mean a new doctor but since I was stable I thought it would be an easy transfer. Well, it was anything but. Kaiser and many other HMO's have practicing guidelines that they follow and will prescribe by the book, not the patient. I went completely off kilter within a month when he refused to give me the meds I had been on stating that I was at risk of seratonin overdose because of the 90 mg of Cymbalta I was on. He would only prescribe 30mg. He kept prescribing me things that I did not want. Finally, I could not take it and went back to my old doctor and pay 75.00 to see him although I could pay 15.00 to see a Kaiser doctor. I have to wait 2 hours everytime I go to see him because his practice is overloaded and a 1 hour drive, but once I am in his office I realize why. He is the head of one a Behavioral Hospital in my city.
> I had written down my concerns about being on Stimulants and Xanax. I felt like perhaps I was becoming a drug addict or something. See, I have MS, Panic Disorder, Depression and Fibromyalgia. I am taking
> 100 mg Topamax pm
> 60 mg Cymbalta pm
> 20 mg adderall (not XR)3 times day, sometimes just two
> .5 mg Xanax afetrnoon and 1 mg Xanax PM
> I asked him if I was just getting myself high during the day and then taking a downer at night.
> I felt uncomfortable knowing that this cocktial is one that finally gives me the best relief.
> He said , You have to function. You have several medical issues at hand, you are not alone, many people need these to function and perform.
> I said but why are so many doctors reluctant to prescribe Benzo's? He said because they are small minded and not looking at the big picture. You have to treat your patient as an individual. I can write you this prescription and know it will last all month. There are some people of whom I know if I write the script they will take it all in one week. You have to treat people as people Michelle. He said as for the stimulants that I will always need one and I will have to change them up every so often and to be prepared for that, but it's not to worry. He makes me feel OK about the meds I take and that is so important. The Kaiser doctor actually told me that he was running out of options. A stimulant was never one of them.
> Bottom line, I think I was feeling guilty about the medication I was taking because stimulants and Benzo's get a bad rap. I am kind of a controlling person and don't ever want to feel like I could become an addict. Fact is, I am sick and I need these to be on a level playing field. If you truly feel that your doctor is not listening to you and answering your questions and doesn't trust you, you need to find a new one. Because I figure for most of us, we have a lifelong battle ahead of us and we better find someone that we can trust and who believes in us.
>
> Thanks for listening and I hope that this encouranges someone to change their doctor who is not listening to them and prescribing medication from a book and not based on you!
Posted by deniseuk190466 on October 26, 2006, at 15:26:34
In reply to Why your doctor can make or break you, posted by getinwl72 on October 25, 2006, at 7:59:39
I just had to respond to this post because sometime I feel like my current psychiatrist is grinding me down.
I'm in the UK, unfortunately last July I got made redundant (due to my depression I'm convinced although I never took any time off sick with it). Anyway, I lost my private medical insurance and had to go and see one on the NHS in January.
This one seemed (and is) very kind and sweet by he is so f*cking rigid he makes me want to throttle him (excuse my language. Admittedly I have presented him with a difficult challenge, which is "get me better but without the use of antipscyhotics" and let me try "what I want to try within reason".
He first of all added small dose of tegretol, then tried buspar which just made me more tired and then after trying thyroid hormone (at my suggestion and after a long hard fight)he tried my on Cymbalta. The cymbalta made me extremely anxious and so I went back to see him hoping he would try adding something else to the Seroxat to get it to work, hoping that he might have another idea. This was back in June and he more or less threw his hands up in the air and said that I wasn't getting any better (like it was my fault, not that I'm saying it's his) and that in order for him to try me on anything else I'd have to go in either as a day patient or as an inpatient. I told him I wanted to try and carry on working and he sort of insinuated that by saying I wouldn't go into the day care centre I was not helping myself! I thought the idea was to keep people in work.
I wouldn't have minded going into hopsital if he intended trying out a radical treatment but his only plan was to put me on escitalopram!
I really feel like I'm at loggerheads with this psychiatrist. I'm actually going to go to the Daycare centre now for three weeks (so three weeks without work) just to get to try escitalopram.
Admittedly, I know I am not entirely blameless in this, if I wanted to I could just take the zyprexa regularly like he wants me to (but for some reason, don't ask me why, I can't bring myself to take it daily). I guess I just would feel happier if I was just feeling well on an antidepressant on it's own. I'd feel a bit safer for some reason, a bit closer to being normal I suppose.
Anyway, the long and short of this is that I don't have much faith or belief in my current psychiatrist but unfortunately I'm stuck with him, he refuses to refer me to anyone else as HE doesn't feel it would be necessary. And YET he feels its necessary for me to go into a hospital as an inpatient! He never gives me any encouragement, I can't communicate with him, I don't understand his reasoning half the time. He never gives me a good explanation for not trying something new. I just don't have much belief in him and I think you need to have some faith in your psychiatrist.
The first psychiatrist I saw that was any good was a private one, admittedly he never got me better but he was the one who gave me zyprexa 10mg to take as and when needed, he radiated passion in what he did and he never doubted what I told him. He always encouraged me to keep working and he made me believe that one day I would get better. My latest psychiatrist just makes me feel more confused and disheartened each time I go to see him.
Denise
Posted by getinwl72 on October 26, 2006, at 18:33:41
In reply to Re: Why your doctor can make or break you, posted by deniseuk190466 on October 26, 2006, at 15:26:34
> I just had to respond to this post because sometime I feel like my current psychiatrist is grinding me down.
>
> I'm in the UK, unfortunately last July I got made redundant (due to my depression I'm convinced although I never took any time off sick with it). Anyway, I lost my private medical insurance and had to go and see one on the NHS in January.
>
> This one seemed (and is) very kind and sweet by he is so f*cking rigid he makes me want to throttle him (excuse my language. Admittedly I have presented him with a difficult challenge, which is "get me better but without the use of antipscyhotics" and let me try "what I want to try within reason".
>
> He first of all added small dose of tegretol, then tried buspar which just made me more tired and then after trying thyroid hormone (at my suggestion and after a long hard fight)he tried my on Cymbalta. The cymbalta made me extremely anxious and so I went back to see him hoping he would try adding something else to the Seroxat to get it to work, hoping that he might have another idea. This was back in June and he more or less threw his hands up in the air and said that I wasn't getting any better (like it was my fault, not that I'm saying it's his) and that in order for him to try me on anything else I'd have to go in either as a day patient or as an inpatient. I told him I wanted to try and carry on working and he sort of insinuated that by saying I wouldn't go into the day care centre I was not helping myself! I thought the idea was to keep people in work.
>
> I wouldn't have minded going into hopsital if he intended trying out a radical treatment but his only plan was to put me on escitalopram!
>
> I really feel like I'm at loggerheads with this psychiatrist. I'm actually going to go to the Daycare centre now for three weeks (so three weeks without work) just to get to try escitalopram.
>
> Admittedly, I know I am not entirely blameless in this, if I wanted to I could just take the zyprexa regularly like he wants me to (but for some reason, don't ask me why, I can't bring myself to take it daily). I guess I just would feel happier if I was just feeling well on an antidepressant on it's own. I'd feel a bit safer for some reason, a bit closer to being normal I suppose.
>
> Anyway, the long and short of this is that I don't have much faith or belief in my current psychiatrist but unfortunately I'm stuck with him, he refuses to refer me to anyone else as HE doesn't feel it would be necessary. And YET he feels its necessary for me to go into a hospital as an inpatient! He never gives me any encouragement, I can't communicate with him, I don't understand his reasoning half the time. He never gives me a good explanation for not trying something new. I just don't have much belief in him and I think you need to have some faith in your psychiatrist.
>
> The first psychiatrist I saw that was any good was a private one, admittedly he never got me better but he was the one who gave me zyprexa 10mg to take as and when needed, he radiated passion in what he did and he never doubted what I told him. He always encouraged me to keep working and he made me believe that one day I would get better. My latest psychiatrist just makes me feel more confused and disheartened each time I go to see him.
>
>
>
> DeniseHi there- I don't really know how the Medical System is there but it sounds illegal almost. I cannot understand why you cannot switch your doctor if you have a mental illness and your doctor exacerbates that illness. Do you have some sort of appeals process? Unacceptable. He doesn't have to live your life, you do. So you should be actively particpating in your treatment. I refuse to take anything that will cause me significant weight gain. I have added a few pounds (10)with cymbalta and that is just what I had to do, but there are some others that I would flat out not even consider because of weight gain and my tendency to binge eat when I am depressed. I mean my doctor understands this and if I start gaining to much weight that in and of itself causes me extreme depression. So, for me that's one thing. Another is fatigue and apathy. What's your biggest concern? That's what you should explain to him and tell him that your goal is to get better and function with some level of peace in your mind, but that you have certain things that you cannot compromise on, so you and he have to find alternatives. That's that. Any good doctor would work with you on it.
I am so sorry to hear about this. I don't know what avenues you can take though to get a better doctor but I would spend my spare time looking into it if I were you. Best wishes...
Posted by yxibow on October 28, 2006, at 2:26:50
In reply to Re: Why your doctor can make or break you » getinwl72, posted by Phillipa on October 25, 2006, at 13:13:19
> What a wonderful and caring doctor you have. Consider yourself lucky as you found out most are not like that. And trust is so important. Love Phillipa keep waiting to see this one it's worth it as I'm sure you know
I agree, that trust is an important bond of the doctor-patient relationship.
Quite a while ago in my ongoing saga of a disorder we had said that it was sort of a two way street, an analogy that he is steering the bus and I'm in the seat, and I occasionally look over the window to see that we're not going off the road.
I am in a unique situation with a doctor that trusts me with medication as I have done few "experiments" outside of our prescribed regime and therefore he trusts me with a certain (not infinite) number of refills of X, Y, and Z (not to mention all the rest of the alphabet [humour], but he may give fewer refills for controlled (C-IV and above) medications than for uncategorized medications (e.g. Cymbalta.)
We agreed on a certain comfortable amount of refills because, while it may come from part of OCD worry, and my fear of death of myself or anyone (basically, the fear that if he goes off to a conference and the plane is lost over the ocean, I am s*** out of luck with my medication even if he has a covering doctor, I would not want to go to an ER and have to explain the reasons for certain doses of medications.).
I did have a doctor die on me, although that was shortly after I transitioned to my current one as a "better fit" (the other poor guy loved flying his own plane and would take a jet back to his home state on the weekend and take his own plane to his house and he died in a snowstorm although he was warned about the conditions... at any rate, lets not end on too dour of a note.)
-- tidingsJay
Posted by getinwl72 on October 28, 2006, at 8:48:42
In reply to philipa is a female name; fee-lee-pa, posted by iforgotmypassword on October 26, 2006, at 12:11:39
This is the end of the thread.
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