![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 23 of 23. This is the beginning of the thread.
Posted by Racer on June 12, 2004, at 14:33:53
Sorry, I know that this is something I will have to cover with my therapist and I will, but I have a little bit of a time constraint that makes it a bit of a priority for me this weekend. My next appointment with my brand new still shiny T is Thursday, and my next appointment with Dr EyeCandy is Tuesday, and this relates to Dr EyeCandy and impairs my ability to function effectively with him. That's why I'm trying to get a little bit of a jump on working on this -- even if it's working on my own, with or without assistance from others who might have similar experiences.
Those of you who "know" me from what I've written here already know that I'm pretty gunshy at this point to begin with, and that I'm pretty desperate for some relief, but being so scared off already, I'm pretty avoidant right now. Makes getting that relief pretty damned hard, huh? And, trying to get relief from a place and a person who has been such a nightmare for so long is even harder. (At this point, the thought of seeing any pdoc for any drug is overwhelming for me. I am not sure I'd be able to see another doctor at this point, without being shackled to get me in the door.) That's the basic background. Now for the specific issue I want to try to get under control before Tuesday, so that I can be as close to effective in his office as I am currently capable of being.
I can't ever remember feeling better. I can remember taking drugs and having a "good response" to them in the past, but I don't remember what that really meant, I don't remember feeling better. What I do remember, quite vividly, was being fat, lethargic, constipated, and anorgasmic. I remember the utter despair of starving myself, exercising compulsively, and still watching the numbers on the scale rise dramatically, no matter what I did, how little I ate, how much time I spent on the cardio machines. I remember splitting my skirts because I couldn't afford new clothes. I remember just giving the hell up over it. I remember giving up in the middle of an exercise routine because I was too lethargic, there was too much pressure in my gut, and it didn't matter anyway. Those are the things I remember. And I really cannot see how that would be a net improvement in my life.
Yeah, I know that I could do things while I was taking those drugs that I couldn't do before, and can't do now. But all I really remember is how hard I worked, and how little it got me -- even in the short term, especially when you factor in the weight gain. (And the Effexor experience is both the most recent and the worst for scaring me off -- by the end of about 18 months, I was unable to get out of bed for days on end, and couldn't stop crying. I'd cry until I was sick. Then, as if that wasn't enough, it took eight solid months, with plenty of misery involved the whole time, to taper down and off of it. Can't imagine how remembering that nightmare would make me even more resistant to the idea of taking another drug, can you?)
Can anyone offer anything to help me get at least through the door to Dr EyeCandy's office? Preferably some suggestions of things I can do that might help me actually try to talk to him? A big part of what I perceive to be the problem is that he won't listen to any of this stuff -- he just gets that exasperated tone and orders a new drug. If there's any problem, he just says, "stop taking it."
I know. That isn't a possibility right now. In January, I'll be able to get a new pdoc, and I've even gotten a solid referral to one I am looking forward to working with. Between now and January, though, I have access to Dr EyeCandy. Period. No other options.
And beyond Tuesday, Dr EyeCandy and our marriage counselor (who, you'll remember, supervises my new therapist) spoke yesterday. She got him to agree to try to coordinate efforts for my care. So, at some point, I will probably ask my new therapist to call him and express some of this to him as something that he could really help me just by taking seriously. Because you know what? I do think that, if he would just take my concerns seriously, rather than dismissing them as totally irrelevant, it would help me. Even if he had to say that there was nothing to be done about it, just taking it seriously would help me adjust to being fat as a damned house.
Sorry. Today is a very, very bad day for me.
Posted by Pfinstegg on June 12, 2004, at 16:10:05
In reply to Any amateur therps wanna take this on?, posted by Racer on June 12, 2004, at 14:33:53
I understand how bad the side effects of those drugs can be. Since you are in an interim situation with Dr. EyeCandy, what about taking very low doses (even levels considered sub-therapeutic) of Lexapro and Wellbutrin. It's possible to take 10 or even 5 mg. of Lexapro, and 75, or 37.5 mg. of the old-fashioned non sustained release form of Wellbutrin. These might help a bit to take the edge off while you are developing an alliance with your new therapist. By taking those two at such low levels,it's similiar to taking an MAOI at low doses- i,e,. it will raise serotonin, epinephrine and even dopamine a bit, but you shouldn't be bothered by weight gain, anhedonia or major difficulties with orgasm- you might have a little, but the Wellbutrin usually helps a lot with that.
Posted by Racer on June 12, 2004, at 16:45:15
In reply to Re: Any amateur therps wanna take this on? » Racer, posted by Pfinstegg on June 12, 2004, at 16:10:05
Sorry, I know that sounds like "Yes, but..." and it really and truly isn't:
Lexapro was a nightmare for me, even at half the lowest dosage tablet. And it's what I used when I tried to kill myself last year, so Dr EyeCandy would know something was really wrong if I asked for it. (I got almost catatonic on it, even at that low a dose.)
Wellbutrin is right out -- I've even asked him about it, because that's what they put me on in the hospital and I thought it was starting to kick in. I have a history of head injuries, including a fractured skull, which raises the risk of seizure. (But my history doesn't include any eating disorders, because my periods never stopped.) I have asked if we could try it anyway, and he says no way, no how, no chance.
The other problem is that I can't ask him to treat me as an 'interim' sort of thing. If the clinic found out that I could have gotten into the HMO -- regardless of why I didn't -- they'd drop me and I'd be totally without any safety net at all. I have to approach him as if he's The One. (Yeah, *I* know that I'll have the insurance coming, so it does take some pressure off of me, which is good. But I can't say, "Listen, Dr EyeCandy, you only have to tide me over for another six months, so let's try something, no matter what to get me through it, 'K?")
I really hate to sound like "yes, but..." over this, because I really appreciate the fact that you do care. It feels good that people who understand because they've been through it care enough about me to respond to my questions. Thank you.
Another part of the problem, though, is that I can't just say that I'll take something for six months and if I get fat, it's only for six months. That's the real issue I'm trying to realign in myself right now. Getting fat would be worse than death to me, you know? That's the real base of my resistance, getting fat would be worse than death, it would be worse than feeling the way I feel now, I would much rather just die now than to get fat from the drugs again. (The anorgasmia would only matter if I had a sex life, right?) I know -- I really and truly do know -- that that is ridiculous, and I truly hate myself for feeling that way. I'm also so ashamed of it -- after all, it's just as bad for anyone else, why should I expect to be any different? Why should it matter so much more to me than to everyone else? lol Guess anyone who's suffered from depression knows the whole self-loathing litany involved in that sort of thing, right?
Thanks, pfin. By the way, what does your name signify?
Posted by Racer on June 12, 2004, at 16:50:49
In reply to Re: Any amateur therps wanna take this on? » Racer, posted by Pfinstegg on June 12, 2004, at 16:10:05
You know, this is a real problem for me, no matter how ridiculous it is from any rational point of view. I guess I'm totally irrational at this point. I cannot get myself the idea of trying "anything, no matter what, just to get me through this" right now. That makes it really overwhelming, just totally impossible when I think about trying to do it.
Yeah, I know there's this theory that rational people are willing to put up with a little discomfort in order to treat a disease state, and that in the whole scheme of the world, weight gain really isn't life threatening, it really isn't that big a deal when you consider the alternative, but that's what I can't get inside myself. All I can see is that I'd rather hide at home, miserable, unable to function -- but Not Fat -- than take the drugs and have to leave the house when I Am Fat.
And every time I start trying to think my way around all this, I spiral straight back to the whole "the only possible solution is death" conclusion.
Posted by Poet on June 12, 2004, at 18:00:42
In reply to Any amateur therps wanna take this on?, posted by Racer on June 12, 2004, at 14:33:53
Hi Racer,
Write it all down and read it or hand it to Dr. Eye Candy. That's what my T told me to do with Dr. All State (looks like an insurance agent.) Somehow I mustered the courage to just tell him stuff, but that note was in my pocket if I needed it.
I wish I could offer meds advice, but I'm freshly off Paxil withdrawl and in week three of Effexor. I hope that didn't give you flashbacks of your horrid experience.
Dr. Eye Candy needs his eyes opened that your concerns about meds not working and that no weight gain is mandatory. If he doesn't take you seriously this time, absolutely have your new T talk to him. Have the marriage counselor talk to him again, too.As an ex bulimic, weight gain is something I fear. I fully get where you are coming from and I hope Dr. Eye Candy finally catches on.
Write it down, if anything it'll put it fresh in your mind if you read it before your go in on Tuesday.
Hope I helped, sometimes I don't know if the chemicals in my brain really are functioning enough to be of any use.
Poet
Posted by gardenergirl on June 12, 2004, at 19:59:48
In reply to Re: Any amateur therps wanna take this on? » Racer, posted by Poet on June 12, 2004, at 18:00:42
Racer,
I like Poet's advice. I was also thinking that maybe some kind of contract between you and Dr. Eye Candy might be worth considering. You could make it for six months :) with an option to renew. The contract might contain stuff about how he will allow for check in calls, will respond by a certain length of time, etc. The question is, what will you do on your end? What are you willing to do to get him to listen and respond for six months? You don't have to tell him why six months, of course, but that's a convenient time frame. You could even make it shorter and re-eval. it after say, two or three months.Just a thought. But this might give you a stronger sense of control with everything spelled out.
Take care and hoping things go well.
gg
Posted by Pfinstegg on June 12, 2004, at 22:44:09
In reply to Good advice, but not possible » Pfinstegg, posted by Racer on June 12, 2004, at 16:45:15
I'm so sorry thse two drugs are out for you. The reason I mentioned them is that they are the best combination I have ever been on. The doses are so low that I can't say they ever had a full antidepressant effect, but now that I have been going to a psychoanalyst for 15 months, my depression has really lifted- before it was very severe. I gained 50 lbs. taking various combinations of prozac, paxil and zyprexa- I'm just like you- it made me feel so terrible about myself that any real AD effect was nullified by huge amounts of self-hate, especially when i looked in the mirror or saw photos of myself.. However, on 5 mg Lexapro and 37.5 of Wellbutrin, I have lost 40 of those pounds, really without trying very hard. I really like to keep all these medications as low as I possibly can, so I don't really know what to suggest next. Do you have anything in mind which seems fairly reasonable?
My posting name sounds very strange, I know! It's the place-name of a favorite hiking destination in Switzerland.
Posted by Racer on June 13, 2004, at 14:02:48
In reply to Re: Good advice, but not possible » Racer, posted by Pfinstegg on June 12, 2004, at 22:44:09
I wanna go hiking with you. Next time you go, will you bring me back some sock yarn? Germany makes the best sock yarn, you know. (As well as the best of most other things, like FOOD, but I won't ask you to bring me back anything to eat. Just a couple of pounds of sock yarn.)
Listen, I really appreciate the thought behind the suggestion. And I really appreciate that you took the time to answer me. Must be because you like to hike in Switzerland. (I'm guessing it's a German speaking region, rather than French or Italian, based on the name. If I'm wrong, forget the sock yarn.)
I'm driving myself crazy about the whole pdoc thing, you know. For one thing, my experiences with that agency have been such a nightmare, and they do that whole "treatment team" model which has been a big part of the problem for me. Everyone else on the treatment team have lectured or scolded me about things he's said -- as in, "Dr EyeCandy says that you..." -- and I'm convinced that the process works in reverse, too. That he's heard the whole damn thing from them about how really rotten I am, how it's my fault and that nothing will help me because I refuse to cooperate at all. What's so really devastating about it is that I've been trying to say all along that a lot of what they were trying to force down my throat was inappropriate for me and that they'd see that if they'd step back and try to identify my own personal issues. The response was always some version of, "You're just in denial, the [insert name of inappropriate therapy model here] really is what's best for you because it's best for everyone, so your failure to face that is a further sign of your psychopathology." Can you imagine being trapped in that? It's like being stuck in a revolving door, knowing you'll never be able to get anywhere at all, but not able to stop it from moving.
There's another key piece to all this, but I'm not ready to post it -- because I'm so afraid that no one would believe me if I do! LOL Ain't it great when a well-meaning therapist has you running so scared that you can't tell the whole story to anyone? I could probably post this part and have a lot of people say, "Wow, no wonder you're having problems with this! What a lousy attitude that shows on his part." Someone might even be able to say, "Here's a way to say it that might get past that attitude, you could try saying, [x]" That would be great. But I'm so afraid of having someone come back with, "He's absolutely right, you just can't see that it's all your own fault and you should consider yourself lucky he even shows up for your appointments" that I just can't post it. You know?
Anyway, tell us about your hiking, 'K?
Posted by lonelygirl on June 13, 2004, at 16:30:05
In reply to Good advice, but not possible » Pfinstegg, posted by Racer on June 12, 2004, at 16:45:15
> Getting fat would be worse than death to me, you know?
Uh huh.
Posted by Pfinstegg on June 13, 2004, at 20:00:04
In reply to Re: Good advice, but not possible » Pfinstegg, posted by Racer on June 13, 2004, at 14:02:48
We go hiking (and flower and bird-watching) a lot, but our favorite place is the Bernese Oberland in Switzerland. It is very beautiful there, especially early in the season, and there are wonderful walks, ranging from easy ones, aided by chairlifts, to very challenging ones, involving 3000-4000 vertical feet of climbing to a mountain hut. Those are the best, but require us getting into shape for at least a week. You are absolutely right- it's in the German-speaking part of Switzerland- in Grindelwald and surrounding villages. Come with us sometime!
In thinking about these difficult conditions you are facing with Dr. Eyecandy and other members of that team, it seems to me like you have been *scapegoated*. It is just not acceptable for those health-care providers to make you feel like everything is your fault- whether it is because you have some well-founded doubts about whether a particular medication is right for you, or whether you have come to distrust their recommendations. Under good circumstances, you naturally don't want to distrust them. They, ideally, should be respecting all of your doubts, fears and concerns, and not blaming you for not falling right into agreement with their recommendations. You obviously have excellent reasons for being worried and uneasy about medication recommendations. Maybe what would work the best is for you to study up, yourself, about what medications (and dosages) seem best to you, and then go in to your appointment with your own ideas of what would be best for you. I've found the medication board to be immensely valuable in helping me begin to make wiser (and lower dose) recommendations for my own medications. I also had to change pdocs, as the first one blamed me for the side effects I experienced, and also for my unwillingness to go along with his recommendations, which was always for huge doses of things like Effexor, MAOI's and various mood-stabilizers. Luckily, I now have a much more flexible pdoc- and I feel we are working together. That helps so much.
I think we have one other thing in common- riding. I know you have been a riding teacher. I'm not that skilled, but do have a lovely dressage horse, with whom I do (low level) musical freestyle. It's been such a help with the depression- it just gives you a lift to have your horse lie down and, after a big sigh, put his head in your lap!
Posted by Racer on June 14, 2004, at 18:33:46
In reply to Re: Good advice, but not possible » Racer, posted by Pfinstegg on June 13, 2004, at 20:00:04
So, now that I know where you hike, do you live Over There? Or are you in the US?
Thank you for pointing out our common ground, too. I knew there had to be a reason I liked you.
Posted by Dr. Bob on June 14, 2004, at 20:44:10
In reply to Pfin?, posted by Racer on June 14, 2004, at 18:33:46
> So, now that I know where you hike...
Sorry to interrupt, but I'd like to redirect follow-ups not about psychology and psychotherapy to Psycho-Social-Babble. Here's a link:
http://www.dr-bob.org/babble/social/20040611/msgs/356744.html
Thanks,
Bob
Posted by Racer on June 16, 2004, at 12:49:35
In reply to Any amateur therps wanna take this on?, posted by Racer on June 12, 2004, at 14:33:53
Well, when I got to the clinic yesterday, the gal at the front desk told me that the doctor had called to say that, when I showed up, I was to be told to come back next month.
So, it really didn't matter much what I could have or would have said, after all.
Since the county hospital -- aside from being notoriously monstrous -- would not provide anything beyond meds -- if they provided meds at all, since a doctor contracted through the county is already prescribing for me -- if they even admitted me in the first place, since I'm still at the "I'm trying to find alternatives to suicide" stage rather than actively suicidal. I can't see much point in going there at all right now, you know?
The worst of it right now is that I've just started working with a new therapist. I do have more trust in her than in any of the therapists at the same agency with this doctor, but the way I've been feeling since being turned away yesterday is pretty much a "why bother talking" reaction. It doesn't seem worth telling her about how I feel, since there's nothing she can do about it, and I'm still afraid that no one will believe me. I'm afraid that there's no point in therapy until I can get the worst of the painful misery over with and can then be able to express my feelings. I don't want to burden the new therapist with how miserable I feel, especially since she really can't arrange to have me hospitalized.
Oh, our marriage counselor spoke with the doctor last week. She asked what they needed to do to have me hospitalized. He said to call someone else in his agency. What the marriage counselor doesn't know that I do know, and she won't believe unless she hears it for herself, is that he's not talking about a hospital, he's talking about the 'residential crisis unit' run by his agency. After all that I've experienced with this agency so far, can anyone tell me WHY I would trust them to do anything positive for me in a situation where they had absolute control over me twenty four hours per day?
Now, I'm terrified that this is all just total distortion on my part -- because every time I tried to say any of what I was feeling to any of the therapists there that's what they told me, as did the administrator I spoke with trying to get reassigned to a new case manager -- and that maybe I really do need them to totally realign my entire personality and thinking patterns. You wanna know how totally f****d up I am though? I don't think that would be an improvement for me. I really do think that *they're* the problem. That's obviously pretty psychotic of me, don't you think?
I feel trapped. I know that help exists. That part isn't distorted. I know that help exists, elements that would help me, personally. That, in theory, is hope. I know that I don't have any alternative for access to this theoretical help. That's not distortion, either, because both my husband and I have looked for it. I even called the county, to ask what I would have to do in order to get out of this agency and into some other treatment program they contract with. The answer? This agency has to call the county and say that they are unable to provide appropriate services for me. (Another example of my severe cognitive impairment caused by psychopathology: that sounds to me like hiring a hungry fox as head of security for a henhouse.) So, help exists, I just can't have it. And I feel trapped.
I told my husband last night that I wish they had just let me die last year, rather than forcing me into this sort of torture for so long. I do. It is a betrayal: they promised to provide treatment that would help me.
Right now, on my mood scale, I'm slipping down from my "recognize that I don't actually want to die, but unable to continue suffering so much pain." I'm not at the next step yet, but I know that it's too close for comfort. Please, everyone, let's pick a time for us all to put our good thoughts and intentions together and send them out to the universe in hopes of something changing to bring that little feather of hope back to me.
Thank you for reading, and caring.
Posted by DaisyM on June 16, 2004, at 18:46:25
In reply to Update for the amateur Ts, posted by Racer on June 16, 2004, at 12:49:35
RACER -- YOU MUST HANG IN THERE!!
You can not let some snot nose MD push you over the edge. He's an idiot. You are totally right in your thinking about where the blame lies. If all else fails - Go to the county hospital ER. They HAVE to treat you.
And you HAVE to talk to your therapist about this. You aren't dumping on her, this is what they really do best. You are what they call an "interesting" case...(so am I, so I can say that). Give her the opportunity to help you. At this point could it really hurt??
I'd throw your own words back at you if I thought it would help. I may do that anyway via email. Besides, I thought we had a deal. I'm sending you my strength and wishes via the universe. I'll even let you borrow my therapist. He has come through for me this week in a way that makes me want to share. (I'll post about that later.)
Extra long, extra hard hugs.
Daisy
Posted by ghost on June 16, 2004, at 19:34:39
In reply to Update for the amateur Ts, posted by Racer on June 16, 2004, at 12:49:35
i just want to tell you to hang in there. things WILL change. they WILL. it's a blessing they didn't let you die before, and i'm happy you exist in the world. i'm happy you're on babble and you talk to us and just that you're here. so thanks. thanks for sticking around.
please, please, please continue to do so. the world is a better place with you in it.
ghost
Posted by Dinah on June 16, 2004, at 21:28:16
In reply to Update for the amateur Ts, posted by Racer on June 16, 2004, at 12:49:35
How long till that insurance kicks in? Use the countdown as a calming mantra.
In the meantime, please do tell your therapist, and vent to us as much as you wish.
(((Racer)))
Posted by Racer on June 16, 2004, at 21:54:21
In reply to Re: Update for the amateur Ts » Racer, posted by Dinah on June 16, 2004, at 21:28:16
Posted by Dinah on June 16, 2004, at 22:20:12
In reply to January is when it kicks in (nm) » Dinah, posted by Racer on June 16, 2004, at 21:54:21
Januuuuaaarrryyyy.
Breathe two three four.
Januuuuaaarrryyyy.
Breathe two three four.
Januuuuaaarrryyyy.
Posted by Racer on June 16, 2004, at 23:25:49
In reply to Re: January would make a lovely mantra., posted by Dinah on June 16, 2004, at 22:20:12
Thank you, Dinah. I can't last that long. The hell of it is that I could MAKE something good happen for someone else in this sort of situation. I am a good advocate, and don't take no for an answer until EVERY avenue has been explored. I'm very good at that. Right now, though, I don't have that in me, and especially since no one there will listen to me. My husband has called the head of medical services there. Maybe something good can come of that.
My husband, when he heard, says that this is not OK. He says that now he wants blood.
Posted by gardenergirl on June 17, 2004, at 23:24:48
In reply to I can't last that long » Dinah, posted by Racer on June 16, 2004, at 23:25:49
I'm starting to like you husband more and more. If he needs help in his pursuit of blood and answers, please let us know. We'll help here as much as we can.
gg
Posted by Poet on June 18, 2004, at 0:45:21
In reply to I can't last that long » Dinah, posted by Racer on June 16, 2004, at 23:25:49
Racer,
You deserve not only to be listened to, but to receive what you need to get you out of the crisis. Your husband is absolutely right, it's not okay. I hope that he can get through to someone who will listen and help.
I'm sending you positive energy.
Poet
Posted by antigua on June 18, 2004, at 10:55:39
In reply to Re: I can't last that long, posted by Poet on June 18, 2004, at 0:45:21
You can make it. You will find a better solution, or your husband will. Do not give up. You've given too much of yourself already and while it may seem like there is no hope, there is hope. I promise. You will find an answer that you can work with.
antigua
Posted by Dinah on June 19, 2004, at 14:04:41
In reply to I can't last that long » Dinah, posted by Racer on June 16, 2004, at 23:25:49
Well, what I meant was that things will prove considerably in January. I certainly hope that things will improve between now and then. You've got some good people on your side. Your husband, your marriage counselor, friends here at Babble.
I've been quite distressed with your experiences at the county, and am just looking forward to the time when you can have more choices.
This is the end of the thread.
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