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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 27. Go back in thread:
Posted by Phillipa on April 23, 2014, at 17:58:04
In reply to Re: ...i need to have ECT done, posted by linkadge on April 23, 2014, at 17:50:18
Poser you pick blue Value on Obama care? It is the worst one. Seriously. Not many people knew this. One of the two hospitals here will no longer take patients who have it. You need to get a better plan.
Posted by Phillipa on April 23, 2014, at 18:00:50
In reply to Re: ...i need to have ECT done, posted by Phillipa on April 23, 2014, at 17:58:04
Poser they have to have a hospital and doc in the network that accepts the insurance. Find out who they are. Phillipa
Posted by baseball55 on April 23, 2014, at 19:30:23
In reply to ...i need to have ECT done, posted by poser938 on April 23, 2014, at 15:49:15
The problem with getting yourself committed (if you can even do this), is that ECT needs more time than the commitment period. So say they commit you due to suicidality for a week and start you on ECT on an emergency basis, without insurance paying. What do you do at the end of the week? ECT is usually a several week course of treatment. You can't expect much improvement until session 8 or so.
Posted by Christ_empowered on April 24, 2014, at 12:18:57
In reply to ...i need to have ECT done, posted by poser938 on April 23, 2014, at 15:49:15
I wouldn't get myself committed. I've had heavy, involuntary ECT before, at age 23...
...they went hardcore, because I had a breakdown at college, like "Franny and Zooey" or something....
...took a long time to recover. You don't want that kind of old school, balls-to-the-wall treatment.
Posted by poser938 on April 24, 2014, at 18:22:09
In reply to Re: ...i need to have ECT done, posted by Christ_empowered on April 24, 2014, at 12:18:57
I've already tried Ketamine with no benefit.
And yeah, the insurance plan I got, I got it off the "health insurance marketplace". I called BCBS yesterday, and the lady I talked to said the insurance I got is part of a new subcategory that had gone into effect when the Affordable Care Act had gone into effect. And many doctors/hospitals just haven't started accepting it yet. I had also dislocated my shoulder last week, went to the ER at like 11 at night intense pain, they told me they accept every plan that BCBS has, except mine.
BCBS hasnt even sent me a book listing all the doctors and hospitals that accept my insurance. In America, the patient is the last in line to benefit from the healthcare system....anyway, I'm not sure what I'm going to do yet about having ECT done. I suppose I just need to find a hospital that will accept my insurance. Or just pay out of pocket. I'm just sick of effing waiting.
Posted by poser938 on April 24, 2014, at 19:03:01
In reply to Re: ...i need to have ECT done, posted by Christ_empowered on April 24, 2014, at 12:18:57
> I wouldn't get myself committed. I've had heavy, involuntary ECT before, at age 23...
>
> ...they went hardcore, because I had a breakdown at college, like "Franny and Zooey" or something....
>
> ...took a long time to recover. You don't want that kind of old school, balls-to-the-wall treatment.Did ECT end up benefitting you, though?
Posted by Christ_empowered on April 25, 2014, at 2:34:35
In reply to Re: ...i need to have ECT done, posted by poser938 on April 24, 2014, at 19:03:01
hey. sorry to be so down on ECT :-(
Get ready for religious talk...seriously...God saved me. ECT wiped the slate clean, though. Lots of pre-zap memories are still gone, even though some come back now and then. They've lost their hold over my life and personality, which is good.
If you don't need memory loss, heavy ect probably isn't for you. Maybe voluntary, modern ECT does something else (?) . I dunno. I'm just a sample of n=1, right?
Posted by kirkglen on April 25, 2014, at 11:13:35
In reply to Re: ...i need to have ECT done, posted by Christ_empowered on April 25, 2014, at 2:34:35
Poser
I've known @ 5 people in my life that had ECT. If I tell you it helped I'd be wrong. They all came out of the hospital on heavy meds. They were miserable people to be around.
If you've tried numerous AD's have you tried Nardil?
Many people feel Nardil is the Gold Standard, others believe ECT is. I use Nardil.Their is a new method of a ECT that you do as an outpatient. You'd have to search the internet. You can even buy the unit and do at home therapy.
My insurance actually cover it if my doc prescribed. Their are reviews posted on TMS as I don't have knowledge. I've seen several posts on TMS on this site.On a cost basis Nardil or TMS would be inexpensive enough to try out of pocket where ECT 6-8 wks. hospital would be difficult.
Many yrs. ago I used benzos to maintain my depression while trying different AD.s Once I found Nardil I weaned myself off the benzos.
I'll assure you I was in the deepest black hole one could go. I'd tried every known AD with no success. When people came to the house I'd hide under the bed until they left. ( Sometimes for hours ). I cried enough to feel an ocean. I never reached suicide but I'll assure I wanted to go to
sleep and never waken. The only way I could work was keeping several bottles of Nyquil in my desk.
Then I started Nardil, I woke up one morning and "my God" I was alive. I woke my wife and told after several years it was over. Then Pfizer had to change the formula. It's not near as effective as it was but I keep trying to do things with it.My point is I know where you're at and I also know we aren't good decision makers when in that state.
Posted by europerep on April 25, 2014, at 16:25:37
In reply to Re: ...i need to have ECT done, posted by poser938 on April 24, 2014, at 19:03:01
Hey there..
Have you had a trial of buprenorphine, or of another opioid that is sometimes used for treatment-resistant depression (such as tramadol)?
I would definitely give that a try before venturing into ECT. Of course, in some cases this may not be a viable option, for example if you have a history of opioid abuse or addiction.
I do hesitate to recommend this because taking an opioid for depression is a somewhat risky endeavor. However, unsuccessful treatment of TRD is very dangerous as well, so at some point one may have to weigh those options against each other.
ER
Posted by poser938 on April 25, 2014, at 19:20:34
In reply to Re: ...i need to have ECT done » poser938, posted by europerep on April 25, 2014, at 16:25:37
What my problem is, is that psychiatric meds were never meant for me. I started my first round of medications in 2005. At first they had a dramatic beneficial effect on my mood. Especially adderall.
But before long, it all went down hill. I believe they had the same basic effect as when someone takes hormones, such as testosterone, and after using it chronically, the body decreases
or stops producing its own testosterone. My brain/emotions basically feel shut down. And there have been many meds I've tried that I just do not respond to. Adderall, SSRI's, SNRI's, tricyclics, the effects of alcohol on my mood are basically nonexistent. It just makes me feel awkward. I tried marijuana for the 1st time 2 weeks ago, and all I got was dry mouth. Ketamine only made me dizzy when I tried it.I'm just not responding to anything. The only success I had was about 4 years ago with Cyproheptadine. I believe its 5ht2c antagonism just kinda took the brakes off dopamine release, and I slowly but surely got more able to feel pleasure, joy, interests and just everything good about life again. But each dose would stop working after just like 3 days. And then I'd have to raise the dose until I got to a sky high dose and had to stop taking it. Since then I've slowly sunk back to my pre-cyproheptafine state.
I've considered going far out in left field and asking my psychiatrist if I could try the 5ht2c agonist Belviq (weight loss med) to see if a 5ht2c agonist would reverse my tolerance to Cyproheptadine, and hopefully make Cyproheptadine work once again... though I've tried a few SSRI'S and it seems they would have accomplished this if my idea to work.
Anyway, idk of all this sounds kinda odd. But I believe the reason for me reacting so horribly to psychiatric meds is the Encephalitis I had in 2001 that resulted in a coma.
Before I got into the antidepressant game, my mood problems were a world different from what they became a few months into starting meds. I responded well to talk therapy in the beginning as well. But once these meds had their way with me, i stopped responding to talk therapy. I stopped responding to pretty much anything good in life. These meds have ruined me. A few months after starting them, I became my emotional state became nearly unrecognizable to my normal self.
Yup.
Posted by poser938 on April 25, 2014, at 19:29:52
In reply to Re: ...i need to have ECT done » poser938, posted by europerep on April 25, 2014, at 16:25:37
And I have tried rTMS with zero benefit. Zero effect from atypical AP's as well.
I've just stopped responding to treatments.
Posted by poser938 on April 25, 2014, at 19:49:15
In reply to Re: ...i need to have ECT done » poser938, posted by europerep on April 25, 2014, at 16:25:37
And I had the opiate hydrocodone prescribed last week when I dislocated my shoulder. It has zero effect on my mood.
Posted by Phillipa on April 25, 2014, at 19:57:41
In reply to Re: ...i need to have ECT done, posted by poser938 on April 25, 2014, at 19:20:34
Poser wait---- encephalitis started all this is it possible that an antibiotic could be needed now. Can you get a spinal tap? See if all the bugs are gone. Physical problems sometimes are the reason. Can you see a neurologist? Phillipa
Posted by poser938 on April 25, 2014, at 20:45:03
In reply to Re: ...i need to have ECT done » poser938, posted by Phillipa on April 25, 2014, at 19:57:41
> Poser wait---- encephalitis started all this is it possible that an antibiotic could be needed now. Can you get a spinal tap? See if all the bugs are gone. Physical problems sometimes are the reason. Can you see a neurologist? Phillipa
Phillipa, you really think there could be something like a slight lingering infection?I was 13 when I had the encephalitis, was in a coma 5 days, and was in the hospital about 2 and a half weeks in all. I was told they did a spinal tap when I first arrived at the hospital (I don't remember it, or anything else around the time I first went into the coma. But I don't remember if they did another spinal tap to see if it had all cleared up. I'll ask my family and see if they remember.
But in 2010 I went to a family doc and they did some blood tests, a sleep test and an MRI. They found nothing abnormal with those tests.
But it would be incredible if I were to have a spinal tap and they found a lingering infection. Is that even possible? Other than a little bit of a cough and a runny nose, I haven't exactly been sick since then. I figured the encephalitis had strengthened my
immune system. So I haven't taken any antibiotics since then.Hmm... I wonder if anybody else has anything to add to this? Like I said, it would just be incredible if they did a spinal tap and found a problem.
Posted by poser938 on April 25, 2014, at 21:05:01
In reply to Re: ...i need to have ECT done, posted by poser938 on April 25, 2014, at 20:45:03
And I suppose an MRI wouldn't have had any capability to show any sign of an infection?
Posted by Phillipa on April 25, 2014, at 22:28:54
In reply to Re: ...i need to have ECT done, posted by poser938 on April 25, 2014, at 21:05:01
No but would rule out MS. I guess I always think of the lymes I still test positive for. All I know is something caused thyroid to go and from the minute on was a different person. And at same time the lymes blood test was positive. My spinal fluid was okay also. I did forget what you got the encephalitis from and know you told the story before. I wonder what long term effects of encephalitis are. I think will google that. Phillipa
Posted by Phillipa on April 25, 2014, at 22:36:05
In reply to Re: ...i need to have ECT done » poser938, posted by Phillipa on April 25, 2014, at 22:28:54
Worth a read if nothing else.
http://www.nytimes.com/health/guides/disease/encephalitis/print.html
Posted by LostBoyinNC45 on April 25, 2014, at 22:36:30
In reply to ...i need to have ECT done, posted by poser938 on April 23, 2014, at 15:49:15
??????????
What is your sleep like? You have restorative quality sleep? When you wake up in the morning, do you wake up feeling restored at all? Or non restorative sleep? Do you ever wake up feeling like you have a hangover sort of, even though you did not drink the night before?
Eric AKA "LostBoyinNC"
Posted by poser938 on April 25, 2014, at 23:15:00
In reply to Re: ..whats your sleep like? » poser938, posted by LostBoyinNC45 on April 25, 2014, at 22:36:30
> ??????????
>
> What is your sleep like? You have restorative quality sleep? When you wake up in the morning, do you wake up feeling restored at all? Or non restorative sleep? Do you ever wake up feeling like you have a hangover sort of, even though you did not drink the night before?
>
> Eric AKA "LostBoyinNC"My sleep is pretty good. I rarely wake up in the night, and though I always feel like I'm having to drag myself around all day, I end up having up the energy to do what I need to do.
As I mentioned, I did have a sleep test done, but it was done with an "at home" device that the doc had me use.
Nothing abnormal came back from it.
Posted by europerep on April 26, 2014, at 14:00:35
In reply to Re: ...i need to have ECT done, posted by poser938 on April 25, 2014, at 19:20:34
Have you been on an irreversible MAOI? Don't think they are just another "psychiatric med" that isn't worth exploring further.
Posted by poser938 on April 26, 2014, at 15:37:19
In reply to Re: ...i need to have ECT done » poser938, posted by europerep on April 26, 2014, at 14:00:35
Nope, no maoi's at all. I asked my current psychiatrist if I could try selegiline and she didn't want to take the risk with an maoi. I sure would have liked to have tried it. Perhaps with a dopamine precursor such as tyrosine. I'm considering asking the Ect doc that I have my consultation with Monday, if she would be willing to let me try selegiline. or another maoi's. I'm confident main problem is a low dopamine problem.
My psychiatrists nurse told me yesterday on the phone that my doctors next idea is brintellix. But I'm pretty sure that's going to be useless.
Posted by kirkglen on April 26, 2014, at 16:14:58
In reply to Re: ...i need to have ECT done, posted by poser938 on April 26, 2014, at 15:37:19
Poser
I would fire a doctor that wouldn't allow a patient to try Nardil or another MAOI.
That would tell me they are not in touch with patients and have a very poor knowledge of MAOI's.
Treating an atypical patient isn't the same.I would as her the success rate of ECT vs. Nardil. My guess is Nardil is more effective.
Posted by poser938 on April 26, 2014, at 16:23:22
In reply to Re: ...i need to have ECT done, posted by kirkglen on April 26, 2014, at 16:14:58
> Poser
>
> I would fire a doctor that wouldn't allow a patient to try Nardil or another MAOI.
>
> That would tell me they are not in touch with patients and have a very poor knowledge of MAOI's.
> Treating an atypical patient isn't the same.
>
> I would as her the success rate of ECT vs. Nardil. My guess is Nardil is more effective.Yeah, I should have insisted on it more. It does seem now like she would have eventually given in. But I've been through so many doctors over the years.
Posted by kirkglen on April 27, 2014, at 10:52:57
In reply to Re: ...i need to have ECT done, posted by poser938 on April 26, 2014, at 16:23:22
Poser
I had the same problem. I got on the internet to find an older PD. I found one 83 yrs. old. He's seen so many patients in his career and is open to trying anything on us hard to treat patients.
Posted by Beckett on April 28, 2014, at 14:35:58
In reply to Re: ...i need to have ECT done, posted by kirkglen on April 27, 2014, at 10:52:57
Hi poser,
Many doctors don't want to deal with MAOI's. They either were not taught to use them in med school or do not want to bother with them. My last doctor was such, and he suggested ECT and would not consider an MAOI. IMO, Emsam, the transdermal segeline is very low risk and easy enough to trial. ECT is invasive. I feel doctors should do the least harm possible to achieve potential results.
This is the end of the thread.
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