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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 10 of 10. This is the beginning of the thread.
Posted by SusanG on May 16, 2002, at 17:19:35
This is part social, part med related so I decided to post this here. I could use advice on meds but mostly need to vent.
I had a conversation today with my pdoc that left me confused and frustrated. I had left a message for her saying, "Although I don't really want to, I need to go back on an AD. I have this prescription for Welbutrin but you mentioned a concern about seizures. I'm not sure if I really had febrile seizures as a child or if seizures are really only a concern at high doses. If I shouldn't take WB, what do you suggest, considering I have tried Paxil, Zoloft and Effexor and was unhappy with each, as we have discussed...."
Her response was (and I will summarize, but there was much repeating on both sides):
pdoc: Take WB at your own risk.
me: I am concerned about your concern about the seizure issue. Does what I described sound like seizures?
pdoc: If you've had seizures, you shouldn't take WB.
me: Yes, I understand and don't want to be foolish but I am hoping WB would work for me. I guess I need to find out if it is LIKELY that what I had were seizures, based on my account of what happened"
pdoc: No one can tell you that.
me: Aren't there typical symptoms?
pdoc: No, and no one would be able to say if you did or didn't have them...
me: Well, I think maybe I could do some research and find out what the risk is, etc. then decide. If not WB, what would you suggest I try?
pdoc: You need to decide about WB first.
me: Could you just tell me what you would recommend?
pdoc: AD's are all the same. They may target different parts of the brain but they all work the same. None is better than the others.
me: I understand it is somewhat individual. I didn't like Paxil, Zoloft, or Effexor for these reasons (blah, blah).
pdoc: Which of those do you want to try at a low dose?
me: None of them. I was unhappy with them. Since they are similar (I'm thinking SSRI's, etc.), shouldn't I try another type?
pdoc: They are all the same.
me: Uh....I thought there were different categories, SSRI's, etc....????
pdoc: No, no categories. They are all the same. So why don't you figure out which one you want and let me know.
me: I figured you are writing the prescription, maybe you would have a suggestion based on my having tried the others and having difficulty with weight gain and sexual side effects.
pdoc: There is no evidence that AD's cause weight gain. People gain weight for a lot of reasons.
me: Ok, well, what do you suggest I do?
pdoc: I feel you are resistant to taking medication.
me: I would prefer not to have to, but I called specifically because I think I need to get back on something.
pdoc: So, what one do you want?
me: Uh........(wishing my Babble friends were here beside me..) I understand this is a search process. Where do I start?
pdoc: Some people do well on Celexa.
me: ok........sigh
I know there is a ton of info here on meds but I get very lost when trying to read and understand all the different medications. I was hoping she would guide me. I have yet to get a "diagnosis" from this doctor; when pressed she said some depression, maybe some anxiety. Is it unreasonable for me to expect her to try to tailor this medication to my particular needs and my desire to avoid negative side effects (I know, I know, hard to do)? This is a somewhat small town and I don't have many options. She is also willing to discount her usual fee for me. Maybe you get what you pay for; maybe it is just me? Any thoughts?
Posted by Phil on May 16, 2002, at 18:17:51
In reply to Is it Pdoc or me?(long), posted by SusanG on May 16, 2002, at 17:19:35
That sounds like trying to order a cheeseburger and a Coke from John Belushi's character on SNL.
If the next pdoc is less than 150 miles, go. Just make sure they're not kin to each other.
I'd walk if I had to...8^DPhil
Posted by Dinah1 on May 16, 2002, at 18:24:11
In reply to Is it Pdoc or me?(long), posted by SusanG on May 16, 2002, at 17:19:35
That sounds like an unbelievably frustrating encounter. I know yours is a small town, but is there a larger one nearby? It's hard to find a good mental health professional, and it takes some time, so I wouldn't get rid of this one. But it wouldn't hurt to start looking around. It really does make a big difference.
She doesn't sound very focused or directive in helping you come up with a plan. She is supposed to be the professional!
Sorry to hear about your frustrating day.
Dinah
Posted by Alii on May 16, 2002, at 19:09:37
In reply to Re: It's your pdoc. » SusanG, posted by Dinah1 on May 16, 2002, at 18:24:11
Posted by rainbowlight on May 17, 2002, at 1:41:40
In reply to Is it Pdoc or me?(long), posted by SusanG on May 16, 2002, at 17:19:35
I have to agree, find a new pdoc. You deserve to be treated with respect and care. I have had my fair share of doctors ask me which med I would like to try, and than write me a prescription for it. A good doctor wouldn't do that. And a good doctor should be concerned whether or not you will have seizures. And all SSRI's aren't the same, they all act differently. Some are activating/energizing while others cause sedation. If they were all the same, why would there be so many different types? And wouldn't we all have the same reaction from them? Sorry, your post touched a nerve with me, lol! I can't stand doctors like that, I figure I am paying good money to see you, and you have been through medical school, don't you have SOME knowledge of these meds and my condition? Okay, my vent is over. I would definately look into finding a new doctor. The good thing is there are many other SSRI's that you can try. It's basically trial and error to a point, but a good doctor should be able to make a proper recommendation. Good luck to you!
Posted by IsoM on May 17, 2002, at 2:37:44
In reply to Is it Pdoc or me?(long), posted by SusanG on May 16, 2002, at 17:19:35
Susan, I find it remarkable that those sort of comments come from a psychiatrist's mouth. A regular GP who might not have had much experience or knowledge of ADs, I could understand but not someone who's supposed to be a specialist in that field!?!
The comments from others are placing the fault with her too, not you, & I agree. Would your family doctor be willing to suggest something? My regular doctor handles my psych problems for me & many others. It's only in stubborn, hard-to-treat cases, or those that need additional therapy, that my regular doctor (plus other GPs like him) will refer someone to a psychiatrist.
Posted by mair on May 17, 2002, at 7:34:10
In reply to Your Pdoc » SusanG, posted by IsoM on May 17, 2002, at 2:37:44
I had an experience with an ex-pdoc when I was trying to decide on an augmentation drug. He gave me about 7 articles from a scientitfic jounal to read. I don't have a background in science and I found it very difficult to understand what I was reading. I ended up feeling pretty overwelmed and angry. I think some doctors are into the notion that patients have to make their own decisions and of course they're concerned with informed consent. But you have to give your patient the tools to make those decisions and that may not mean giving them overly technical info and it certainly doesn't mean just throwing the decision back in their lap. This woman doesn't listen and seemed to have no regard for your concerns. Unless you've had some very positive experiences with her in the past and it's clear she was just having a bad day, I agree with Phil that you need to find another doctor no matter how inconvenient. If you have had some real positive experiences with her, then you have to thrash this out with her before you commit to staying.
Mair
Posted by SusanG on May 17, 2002, at 9:46:24
In reply to Is it Pdoc or me?(long), posted by SusanG on May 16, 2002, at 17:19:35
Thanks for your responses. I am still shaking my head over this. I have only met with this woman twice. She seemed like a nice person but scattered and not particularly helpful. I know two sessions is not enough so I was planning to give her another shot but after my conversation with her I'm not sure why, other than she is affordable. It took a while for me to convince myself to even see someone so now to have to start over....I don't know, I feel like just forgetting the whole thing. I am doing a bit better today so I may just think about this later ("tomorrow is another day"). Thanks again and thanks to those of you who helped with my little meltdown in chat last night. I appreciate you all.
Posted by KB on May 17, 2002, at 11:56:14
In reply to Thanks everyone, posted by SusanG on May 17, 2002, at 9:46:24
I had a similar situation with rheumatologists - by the time I had seen a couple of bozos I wanted to completely forget it and just stay home with my Lupus. Luckily, the third one turned out to be a really good guy and I feel a lot better now, physically and mentally. I guess the lesson is, keep looking until you find what you want.
Posted by Zo on May 18, 2002, at 5:22:21
In reply to Is it Pdoc or me?(long), posted by SusanG on May 16, 2002, at 17:19:35
This is the end of the thread.
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