Psycho-Babble Medication Thread 81647

Shown: posts 1 to 15 of 15. This is the beginning of the thread.

 

bye, bye dysthymia

Posted by JohnX on October 19, 2001, at 0:54:16


Hi all,

Well, I've had another what I would call "an awakening".
It reminds me of the movie "Awakenings".
I feel like a hand from above has yanked me from point
A (crapper) to point B (where the rest fo the world
lived. I have had a breakout from dysthymia/anhedonia
that includes *recapturing my emtions*. I feel connected to
the world again! The last time this happened
was 2.5 years ago (on St. John's Wort) and it
lasted only 3 days.

After 2.5 years of struggling, and a huge list
of medications, misdiagnosis, therapy, etc. and severe
phsyical pain on top of the mood problems,
I seemed to have hit the jackpot. I really hope this
doesn't fade. My core diagnosis is ptsd with bpii.
Anyways, I have had spurts of manic europhoria during
this 2.5 year time span, but never had a feeling of
"well-being" and being connected to the world.

I hope this party lasts. I was about ready to give
up. I'm still pessimistic.

Anyways, here's what is working:

- Lamictal 150 mg/day
- Wellbutrin 300 mg/day
- Zyprexa 5 mg/day
- Klonopin 4 mg/day

Wish me luck; I hope this doesn't slip out
of my hands. Adding in the Wellbutrin kicked
things into action. Prior to this I had either
non-respnse to wellbutrin or short lived mania.
I tried adding it to the Lamictal alone (before
zyprexa) and it made my physical pain worse.
When I took Zyprexa, I found out that the Wellbutrin
no longer caused pain in my face, so I stayed
on it and WHAMO!

Anyways, thanks for everyone's support especially
AndrewB who took the time to personally communicate
with me in a compasionate way that helped me feel
much more optimistic and less misunderstood (not
to mention the wealth of information).

PS. AndrewB suggested Zyprexa 1st, but I went other routes.
Damn. He was right on the money. But he didn't think
Wellbutrin would ever work, which is at this very
mokent. ;)

Thanks for all the support and
good luck to everybody (including me)

-John


 

Re: bye, bye dysthymia

Posted by JohnL on October 19, 2001, at 3:55:48

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16

Very cool! Thanks for sharing.
John

>
> Hi all,
>
> Well, I've had another what I would call "an awakening".
> It reminds me of the movie "Awakenings".
> I feel like a hand from above has yanked me from point
> A (crapper) to point B (where the rest fo the world
> lived. I have had a breakout from dysthymia/anhedonia
> that includes *recapturing my emtions*. I feel connected to
> the world again! The last time this happened
> was 2.5 years ago (on St. John's Wort) and it
> lasted only 3 days.
>
> After 2.5 years of struggling, and a huge list
> of medications, misdiagnosis, therapy, etc. and severe
> phsyical pain on top of the mood problems,
> I seemed to have hit the jackpot. I really hope this
> doesn't fade. My core diagnosis is ptsd with bpii.
> Anyways, I have had spurts of manic europhoria during
> this 2.5 year time span, but never had a feeling of
> "well-being" and being connected to the world.
>
> I hope this party lasts. I was about ready to give
> up. I'm still pessimistic.
>
> Anyways, here's what is working:
>
> - Lamictal 150 mg/day
> - Wellbutrin 300 mg/day
> - Zyprexa 5 mg/day
> - Klonopin 4 mg/day
>
> Wish me luck; I hope this doesn't slip out
> of my hands. Adding in the Wellbutrin kicked
> things into action. Prior to this I had either
> non-respnse to wellbutrin or short lived mania.
> I tried adding it to the Lamictal alone (before
> zyprexa) and it made my physical pain worse.
> When I took Zyprexa, I found out that the Wellbutrin
> no longer caused pain in my face, so I stayed
> on it and WHAMO!
>
> Anyways, thanks for everyone's support especially
> AndrewB who took the time to personally communicate
> with me in a compasionate way that helped me feel
> much more optimistic and less misunderstood (not
> to mention the wealth of information).
>
> PS. AndrewB suggested Zyprexa 1st, but I went other routes.
> Damn. He was right on the money. But he didn't think
> Wellbutrin would ever work, which is at this very
> mokent. ;)
>
> Thanks for all the support and
> good luck to everybody (including me)
>
> -John

 

Re: bye, bye dysthymia JohnL

Posted by JohnX on October 19, 2001, at 11:51:49

In reply to Re: bye, bye dysthymia, posted by JohnL on October 19, 2001, at 3:55:48


Thanks, I really appreciate it.
I am starting to feel a bit drowsy,
reminds me of Serzone but with more
of the pluses than the minus.

Here is how things are progressing

Phase I: beat major depression and pain
Lamictal + Klonopin

Phase II: beat residual dysthymia.
Zyprexa + Wellbutrin.

onto phase III,IV

phase III: Klonopin detox.
phase IV: enjoy life, hopefully no med poop out.

So, when I woke up this morning an felt
a little edgy, taking Klonopin and a little
caffeine got me back to the happy land, but
I am feeling really drowsy (which is good, I'll
taper Klonopin without much withdrawl).

For some reason I got really bad diahhrea this morn
(I'm staying at home). I did't think Zyprexa would
do this. Maybe its just a concidence? The only
med that ever have me diahhrea was Zoloft.

Anyways, A Serzone trial detoxed me from klonopin fairly
readily over 3 weeks. But I had to discontinue
Serzone after a car accident. I hope Zyprexa will help me
with phase III. I specifically chose Zyprexa
over Geodon because I thought its drowsiness
would help offset Klonpin detox like Serzone.
I may need to swap out Zyprexa for something
else after the klonopin detox. I also thought
about adding a low dose of Zoloft, which was
the other anti-depressant that kinda worked
but really increased my energy. I'm actually
waking up earlier. my boss will be ecstatic.
My irregular sleep/work cycle has always been
an issue with him, even though I try to explain
to him why I have trouble setting my hours to
his (I'm a late person).

Thanks for your support,
John

> Very cool! Thanks for sharing.
> John
>
> >
> > Hi all,
> >
> > Well, I've had another what I would call "an awakening".
> > It reminds me of the movie "Awakenings".
> > I feel like a hand from above has yanked me from point
> > A (crapper) to point B (where the rest fo the world
> > lived. I have had a breakout from dysthymia/anhedonia
> > that includes *recapturing my emtions*. I feel connected to
> > the world again! The last time this happened
> > was 2.5 years ago (on St. John's Wort) and it
> > lasted only 3 days.
> >
> > After 2.5 years of struggling, and a huge list
> > of medications, misdiagnosis, therapy, etc. and severe
> > phsyical pain on top of the mood problems,
> > I seemed to have hit the jackpot. I really hope this
> > doesn't fade. My core diagnosis is ptsd with bpii.
> > Anyways, I have had spurts of manic europhoria during
> > this 2.5 year time span, but never had a feeling of
> > "well-being" and being connected to the world.
> >
> > I hope this party lasts. I was about ready to give
> > up. I'm still pessimistic.
> >
> > Anyways, here's what is working:
> >
> > - Lamictal 150 mg/day
> > - Wellbutrin 300 mg/day
> > - Zyprexa 5 mg/day
> > - Klonopin 4 mg/day
> >
> > Wish me luck; I hope this doesn't slip out
> > of my hands. Adding in the Wellbutrin kicked
> > things into action. Prior to this I had either
> > non-respnse to wellbutrin or short lived mania.
> > I tried adding it to the Lamictal alone (before
> > zyprexa) and it made my physical pain worse.
> > When I took Zyprexa, I found out that the Wellbutrin
> > no longer caused pain in my face, so I stayed
> > on it and WHAMO!
> >
> > Anyways, thanks for everyone's support especially
> > AndrewB who took the time to personally communicate
> > with me in a compasionate way that helped me feel
> > much more optimistic and less misunderstood (not
> > to mention the wealth of information).
> >
> > PS. AndrewB suggested Zyprexa 1st, but I went other routes.
> > Damn. He was right on the money. But he didn't think
> > Wellbutrin would ever work, which is at this very
> > mokent. ;)
> >
> > Thanks for all the support and
> > good luck to everybody (including me)
> >
> > -John


 

Fantastic (nm) JohnX

Posted by kid47 on October 19, 2001, at 12:07:15

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16

 

Best of Luck! (nm) JohnX

Posted by Neal on October 19, 2001, at 18:36:02

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16

(nm)

 

Very glad you made it

Posted by Anna Laura on October 20, 2001, at 1:44:13

In reply to Best of Luck! (nm) JohnX, posted by Neal on October 19, 2001, at 18:36:02

Please keep on posting and let us now are you doing: you've been a ray of hope.

Thanks for sharing


Anna Laura

 

Re: bye, bye dysthymia, follow up

Posted by JohnX on October 20, 2001, at 11:38:51

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16


Follow up....

Well, the total remission lasted for 2-3 days
which is pretty good actually if you have follow
any of my previous posts. Then I started to get
a little emotional numbing (poop-out) and pain in
my face consistent with my prior responses to
Wellbutrin (and Zoloft).

So, I dropped the Wellbutrin dose to a less
than therapeutic range (to continue to help with
drowsiness without interefering with the facial
pain and numbing).

The Zyprexa is helping, I haven't had any negative
thoughts for 1 week, which is really good, and
without the Wellbutrin or the lower dose of it.
The Zyprexa is ridding me of my pain syndrome
and relieving anxiety, and is helping with my
motivation (or maybe that is the now tolerable
low dose wellbutrin).

My doctor wants me to stay on the Zyprexa even
though I am a bit drowsy and focus on tapering
off the Klonopin (which may help improve my mood
too). He poo-pooed at the idea of adding a low
dose of Zoloft instead of Wellbutrin (which
I will admit I added on the sly). I wanted to
ask about adding some Adderall, but he seems
to be anti-adderall for any bipolar.
Anyways he wants me to focus on the klonopin
tapering 1st, which I agree is a good idea given
that I can.

So, its getting better. I'll remain optimistic.
I have found a consistent trend of meds that
help/worsen my pain and depression, and will
hang in there.

Interestingly the Zyprexa helps with the pain
similar to the Serzone, and it makes me a bit
drowsy. But it doesn't have the cognitive dulling
effect of Serzone. For example, I may feel drowsy
like I had a long day of work on Zyprexa, but
on Serzone I always felt like I had a
long day of work and 3 happy hour beers. ;)

Hanging in there.

Thanks for all your kind words.
I'll keep you posted.

Regards,
-john


>
> Hi all,
>
> Well, I've had another what I would call "an awakening".
> It reminds me of the movie "Awakenings".
> I feel like a hand from above has yanked me from point
> A (crapper) to point B (where the rest fo the world
> lived. I have had a breakout from dysthymia/anhedonia
> that includes *recapturing my emtions*. I feel connected to
> the world again! The last time this happened
> was 2.5 years ago (on St. John's Wort) and it
> lasted only 3 days.
>
> After 2.5 years of struggling, and a huge list
> of medications, misdiagnosis, therapy, etc. and severe
> phsyical pain on top of the mood problems,
> I seemed to have hit the jackpot. I really hope this
> doesn't fade. My core diagnosis is ptsd with bpii.
> Anyways, I have had spurts of manic europhoria during
> this 2.5 year time span, but never had a feeling of
> "well-being" and being connected to the world.
>
> I hope this party lasts. I was about ready to give
> up. I'm still pessimistic.
>
> Anyways, here's what is working:
>
> - Lamictal 150 mg/day
> - Wellbutrin 300 mg/day
> - Zyprexa 5 mg/day
> - Klonopin 4 mg/day
>
> Wish me luck; I hope this doesn't slip out
> of my hands. Adding in the Wellbutrin kicked
> things into action. Prior to this I had either
> non-respnse to wellbutrin or short lived mania.
> I tried adding it to the Lamictal alone (before
> zyprexa) and it made my physical pain worse.
> When I took Zyprexa, I found out that the Wellbutrin
> no longer caused pain in my face, so I stayed
> on it and WHAMO!
>
> Anyways, thanks for everyone's support especially
> AndrewB who took the time to personally communicate
> with me in a compasionate way that helped me feel
> much more optimistic and less misunderstood (not
> to mention the wealth of information).
>
> PS. AndrewB suggested Zyprexa 1st, but I went other routes.
> Damn. He was right on the money. But he didn't think
> Wellbutrin would ever work, which is at this very
> mokent. ;)
>
> Thanks for all the support and
> good luck to everybody (including me)
>
> -John

 

Re: thanks johnx again!! JohnX

Posted by kregpark@yahoo.com on October 20, 2001, at 16:35:25

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16

Hi JohnX,

I replied to another of your posts just about 15 minutes ago.

Thank you very much for this!!
I am printing out your post.

My severe SP is treatable (and treated).
My main issue is some dysthmia I think. More interested in various things.
I know that more DA/NE will help me there.

I had a week off from work so for first time in a year or 2 have thought about things more.

Your meds are very similar to ones I do well on.
Once I added 2.5 Zyprexa (skeptically) and immediately got sedatied as I expected.
I then took 150mg Wellbutrin.
I went to the gym and was talking to anyone (but not like an idiot - appropriately).
All of those little things I remember - but implemeting an almost limitless combination of meds is impossible.
So I just have the note for the day on the calender and the memory.

Over 2 years I have gaining interest in:
1) Wellbutrin SR
2) lamictal
.. well especially those.

Anyway - just wanted to say thanks and I can assure you I really appreciate the info, I printed the post, only the 2nd, and it may be the only one I keep after reading.
Thanks again and I am with you!!! I hope it keeps working good!!!

kregpark@yahoo.com
http://www.socialfear.com/

> Hi all,
>
> Well, I've had another what I would call "an awakening".
> It reminds me of the movie "Awakenings".
> I feel like a hand from above has yanked me from point
> A (crapper) to point B (where the rest fo the world
> lived. I have had a breakout from dysthymia/anhedonia
> that includes *recapturing my emtions*. I feel connected to
> the world again! The last time this happened
> was 2.5 years ago (on St. John's Wort) and it
> lasted only 3 days.
>
> After 2.5 years of struggling, and a huge list
> of medications, misdiagnosis, therapy, etc. and severe
> phsyical pain on top of the mood problems,
> I seemed to have hit the jackpot. I really hope this
> doesn't fade. My core diagnosis is ptsd with bpii.
> Anyways, I have had spurts of manic europhoria during
> this 2.5 year time span, but never had a feeling of
> "well-being" and being connected to the world.
>
> I hope this party lasts. I was about ready to give
> up. I'm still pessimistic.
>
> Anyways, here's what is working:
>
> - Lamictal 150 mg/day
> - Wellbutrin 300 mg/day
> - Zyprexa 5 mg/day
> - Klonopin 4 mg/day
>
> Wish me luck; I hope this doesn't slip out
> of my hands. Adding in the Wellbutrin kicked
> things into action. Prior to this I had either
> non-respnse to wellbutrin or short lived mania.
> I tried adding it to the Lamictal alone (before
> zyprexa) and it made my physical pain worse.
> When I took Zyprexa, I found out that the Wellbutrin
> no longer caused pain in my face, so I stayed
> on it and WHAMO!
>
> Anyways, thanks for everyone's support especially
> AndrewB who took the time to personally communicate
> with me in a compasionate way that helped me feel
> much more optimistic and less misunderstood (not
> to mention the wealth of information).
>
> PS. AndrewB suggested Zyprexa 1st, but I went other routes.
> Damn. He was right on the money. But he didn't think
> Wellbutrin would ever work, which is at this very
> mokent. ;)
>
> Thanks for all the support and
> good luck to everybody (including me)
>
> -John

 

Re: bye, bye dysthymia, follow up JohnX

Posted by kregpark@yahoo.com on October 20, 2001, at 16:43:48

In reply to Re: bye, bye dysthymia, follow up, posted by JohnX on October 20, 2001, at 11:38:51

Thank John for the update!

I am following this. BTW, I respond similarly to Serzone, like beer. I generally don't care for beer (even before meds) - but I have found that taking Wellbutrin first allows me enjoy beer! Kind of trivial and off topic but just wanted to throw that in... :)

Anyway, good luck guy!

kregpark


> Follow up....
>
> Well, the total remission lasted for 2-3 days
> which is pretty good actually if you have follow
> any of my previous posts. Then I started to get
> a little emotional numbing (poop-out) and pain in
> my face consistent with my prior responses to
> Wellbutrin (and Zoloft).
>
> So, I dropped the Wellbutrin dose to a less
> than therapeutic range (to continue to help with
> drowsiness without interefering with the facial
> pain and numbing).
>
> The Zyprexa is helping, I haven't had any negative
> thoughts for 1 week, which is really good, and
> without the Wellbutrin or the lower dose of it.
> The Zyprexa is ridding me of my pain syndrome
> and relieving anxiety, and is helping with my
> motivation (or maybe that is the now tolerable
> low dose wellbutrin).
>
> My doctor wants me to stay on the Zyprexa even
> though I am a bit drowsy and focus on tapering
> off the Klonopin (which may help improve my mood
> too). He poo-pooed at the idea of adding a low
> dose of Zoloft instead of Wellbutrin (which
> I will admit I added on the sly). I wanted to
> ask about adding some Adderall, but he seems
> to be anti-adderall for any bipolar.
> Anyways he wants me to focus on the klonopin
> tapering 1st, which I agree is a good idea given
> that I can.
>
> So, its getting better. I'll remain optimistic.
> I have found a consistent trend of meds that
> help/worsen my pain and depression, and will
> hang in there.
>
> Interestingly the Zyprexa helps with the pain
> similar to the Serzone, and it makes me a bit
> drowsy. But it doesn't have the cognitive dulling
> effect of Serzone. For example, I may feel drowsy
> like I had a long day of work on Zyprexa, but
> on Serzone I always felt like I had a
> long day of work and 3 happy hour beers. ;)
>
> Hanging in there.
>
> Thanks for all your kind words.
> I'll keep you posted.
>
> Regards,
> -john
>
>
>
>
> >
> > Hi all,
> >
> > Well, I've had another what I would call "an awakening".
> > It reminds me of the movie "Awakenings".
> > I feel like a hand from above has yanked me from point
> > A (crapper) to point B (where the rest fo the world
> > lived. I have had a breakout from dysthymia/anhedonia
> > that includes *recapturing my emtions*. I feel connected to
> > the world again! The last time this happened
> > was 2.5 years ago (on St. John's Wort) and it
> > lasted only 3 days.
> >
> > After 2.5 years of struggling, and a huge list
> > of medications, misdiagnosis, therapy, etc. and severe
> > phsyical pain on top of the mood problems,
> > I seemed to have hit the jackpot. I really hope this
> > doesn't fade. My core diagnosis is ptsd with bpii.
> > Anyways, I have had spurts of manic europhoria during
> > this 2.5 year time span, but never had a feeling of
> > "well-being" and being connected to the world.
> >
> > I hope this party lasts. I was about ready to give
> > up. I'm still pessimistic.
> >
> > Anyways, here's what is working:
> >
> > - Lamictal 150 mg/day
> > - Wellbutrin 300 mg/day
> > - Zyprexa 5 mg/day
> > - Klonopin 4 mg/day
> >
> > Wish me luck; I hope this doesn't slip out
> > of my hands. Adding in the Wellbutrin kicked
> > things into action. Prior to this I had either
> > non-respnse to wellbutrin or short lived mania.
> > I tried adding it to the Lamictal alone (before
> > zyprexa) and it made my physical pain worse.
> > When I took Zyprexa, I found out that the Wellbutrin
> > no longer caused pain in my face, so I stayed
> > on it and WHAMO!
> >
> > Anyways, thanks for everyone's support especially
> > AndrewB who took the time to personally communicate
> > with me in a compasionate way that helped me feel
> > much more optimistic and less misunderstood (not
> > to mention the wealth of information).
> >
> > PS. AndrewB suggested Zyprexa 1st, but I went other routes.
> > Damn. He was right on the money. But he didn't think
> > Wellbutrin would ever work, which is at this very
> > mokent. ;)
> >
> > Thanks for all the support and
> > good luck to everybody (including me)
> >
> > -John

 

Re: bye, bye dysthymia, follow up JohnX

Posted by ChrisK on October 21, 2001, at 3:46:48

In reply to Re: bye, bye dysthymia, follow up, posted by JohnX on October 20, 2001, at 11:38:51

John X,

Have you considered trying Mirapex when you get off of the Klonopin? I am diagnosed as recurrent major depression (which to me basically means that it never goes away). I tried Mirapex and it worked wonders for the ongoing anhedonia/apathy that always seemed to linger. I would think that it would also help with dysthmia. I take it along with Nortriptyline and Zyprexa without any side effects at all. Some peolpe get naseau on it but that didn't affect me.

Just a thought to keep in mind,
Chris

 

Re: bye, bye dysthymia, follow up ChrisK

Posted by JohnX on October 21, 2001, at 13:39:13

In reply to Re: bye, bye dysthymia, follow up JohnX, posted by ChrisK on October 21, 2001, at 3:46:48

Hi Chris,

Thanks for your interest and suggestion.

I did try Mirapex twice and the nausea/flu like
sypmtoms were just too much to deal with.

Since the Lamictal has gotton me past the major
depression, I am primarily targeting the dysthymia,
and at this point how I weigh qualitity of life with
respects to dealing with med side effects is
a different scenario. If I was still having major
depressive symptoms, I would give Mirapex a longer
trial. BTW, I wish Mirapex was cheaper for those
of you using it sucessfully.

Thanks
-john

> John X,
>
> Have you considered trying Mirapex when you get off of the Klonopin? I am diagnosed as recurrent major depression (which to me basically means that it never goes away). I tried Mirapex and it worked wonders for the ongoing anhedonia/apathy that always seemed to linger. I would think that it would also help with dysthmia. I take it along with Nortriptyline and Zyprexa without any side effects at all. Some peolpe get naseau on it but that didn't affect me.
>
> Just a thought to keep in mind,
> Chris

 

Re: bye, bye dysthymia, follow up

Posted by noa on October 22, 2001, at 18:00:47

In reply to Re: bye, bye dysthymia, follow up ChrisK, posted by JohnX on October 21, 2001, at 13:39:13

Hey, John. Hope you continue to feel better, with tweaking the combo some more. Interesting about the zyprexa helping with the facial pain. Was the pain due to your antidepressants?

 

Re: bye, bye dysthymia, follow up noa

Posted by JohnX on October 22, 2001, at 23:12:19

In reply to Re: bye, bye dysthymia, follow up, posted by noa on October 22, 2001, at 18:00:47


I always had a problem with nightime bruxism
(teeth grinding). The pain became more severe
and during the day while taking SSRI's.
This is a known potential side-effect of SSRI's.
I actually was off of meds for a while and was
taking large doses of flax-seed oil, which had
a very strong effect on me. It surprisingly
gave me symtoms similar to the SSRI's (anti-anxiety,
really intense dreams). After about a month I
woke up one day with this permanent pain in my
head and or jaw, even without meds.

It turns out that medications that work well
to treat SSRI side effects, specifically meds
that block serotonin 5ht-2a receptors (the ones that cause
sexual dysfunction, and other problems with SSRIS)
are usefull for SSRI induced bruxism. For me
this has included Serzone & Zyprexa.
Klonopin and Adderall also alleviate the pain,
but I believe through a different mechanism.

Anyways the pain sucks, and I'm glad to find
a non-habit forming med besides Klonopin
that is bearable and helping.

Thanks for your support and kind words. I'll
continue to keep people posted of any of my
findings.

regards,
john


> Hey, John. Hope you continue to feel better, with tweaking the combo some more. Interesting about the zyprexa helping with the facial pain. Was the pain due to your antidepressants?

 

ReCongrats!!! (nm) JohnX

Posted by Lorraine on October 25, 2001, at 12:15:45

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16

 

Re: bye, bye dysthymia JohnX

Posted by musico on November 13, 2005, at 10:47:33

In reply to bye, bye dysthymia, posted by JohnX on October 19, 2001, at 0:54:16

Hi I am looking for any research pointed to a problem with Zyprexa and Wellbutrin together. I'm having the dreaded anorgasmia using Zoloft with Zyprexa (I'm Bipolar)and have used Wellbutrin alone in the past and it was an aphrodisiac! My pdoc does not recommend Wellbutrin with Zyprexa - said they don't interact well. Anyone seen any studies on this? I am researching but have found nothing negative in this sense. Any help would be deeply appreciated.


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[dr. bob] Dr. Bob is Robert Hsiung, MD, bob@dr-bob.org

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