![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 51 to 75 of 76. Go back in thread:
Posted by jealibeanz on April 9, 2007, at 11:03:48
In reply to I should hit myself., posted by jealibeanz on April 2, 2007, at 16:03:14
So, I finally called my doctor's office and spoke to a nurse. I asked for:
1. A refill on Ritalin LA
2. A refill on Lunesta
3. A refill on Provigil... and could he write it as a 30 day supply, b/c he's accidentally writing it as a 15 day.
4. Xanax XR... I'm due for a refill, but it's not working. Could you ask if I could you back to regular Xanax?I got a call back 20 minutes later. Your prescriptions are all ready to pick up. You're going to stay on the Xanax XR. I'd suggest making an appointment next month if you still don't find that it's helping.
Ooooo... not happy with that one. Xanax XR isn't magically going to start working after 7 weeks. It's pretty safe to say that after a decent trial period, I'm not experiencing more anxiety due to outside circumstances, it's because I switch from Xanax IR to Xanax XR... and reduced the dosage from 4 mg to 3 mg.
I didn't expect this answer. I purposely waited and waited, trying to give the medication a chance. I wanted to let him know that I was willing to accept his new plan and explore new ideas. I didn't want to freak out just after a few days and call up asking for regular Xanax.
So, I made myself suffer through it, thinking that when I finally asked for help, I'd get it. I wouldn't have thought I would call up and say, "This medication is not working." and the response would be, "Keep taking it anyway."
It's pretty aparent now that my doctor is trying to get me off altogether. I wish he'd at least tell me. It's odd. This happened out of nowhere. And it's not like I walked in to his office one day and said, "I feel great! No anxiety whatsoever!"
He knows that's not true and this is not the ideal time in my life to stop anxiety medication. I'd be willing to try to go down to 3 mg of Xanax IR, just to please him, not because I think it will increase my quality of life. It won't. It will decrease.
Hmm... disappointed.
Posted by KayeBaby on April 9, 2007, at 13:18:08
In reply to Update!, posted by jealibeanz on April 9, 2007, at 11:03:48
Hi JB,
He has no idea how unhappy you have been with the xr. You may need to go ahead and make appt.I'm sure he probably would rather you be on the xr so he turned down what might seem to be a casual request. If he knew that you have been toughing it out the way you have and it just not working he may not mind. Perhaps you could ask that he change it back for the time being and you could pick a better time to explore a substitiute.
Timing is everything.
Try not to read a lot into it. You cannot know his mind till you talk to him face to face.
Take Care,
Kaye
Posted by jealibeanz on April 9, 2007, at 13:40:28
In reply to Re: Update!, posted by KayeBaby on April 9, 2007, at 13:18:08
> Hi JB,
> He has no idea how unhappy you have been with the xr. You may need to go ahead and make appt.
>
> I'm sure he probably would rather you be on the xr so he turned down what might seem to be a casual request. If he knew that you have been toughing it out the way you have and it just not working he may not mind. Perhaps you could ask that he change it back for the time being and you could pick a better time to explore a substitiute.
>
> Timing is everything.
>
> Try not to read a lot into it. You cannot know his mind till you talk to him face to face.
>
> Take Care,
> KayeI did talk to him face to face after 2 weeks of the generic. I was super casual at that time though. There was still some hope that I'd do much better on the brand name, plus I still had been supplementing with leftover Xanax IR. I told him it did absolutely nothing, but did so with no distress whatsoever.
If I went in there right now I'd tell him it does nothing and that I'd rather actually take nothing than continue with the XR. Taking it and having NO anxiety relief makes me feel like there's something wrong with me, since medication (3mg of alprazolam should have an effect!), can't even help.
It's really personal for some reason. I don't think I could say that without tears in my eyes. He's never actually seen me upset. He can imagine, but doesn't see it, which is very obvious, because I'm always in my "it's polite and professional to be pleasant, happy, and smiley" mode. He has to rely on me helping him adjust things, because his observations would be incredibly inaccurate.
This is pretty upsetting. I feel like I lost the doctor who's always been on my side.
It's not like I can go "doctor shopping" in order to find someone who will prescribe daily Xanax. That's not going to happen. It only happened with this doctor after being his patient for a few years, having documented anxiety, and failed trials of other drugs.
Posted by Phillipa on April 9, 2007, at 19:50:27
In reply to Re: Update! » KayeBaby, posted by jealibeanz on April 9, 2007, at 13:40:28
Jelly know what you mean as it didn't work for me either but the short acting does. So what will you do now? Love Phillipa
Posted by jealibeanz on April 9, 2007, at 20:06:30
In reply to Re: Update! » jealibeanz, posted by Phillipa on April 9, 2007, at 19:50:27
> Jelly know what you mean as it didn't work for me either but the short acting does. So what will you do now? Love Phillipa
I have no idea. Just continue with the ineffective Xanax XR for the time being, at least a month. That's in accordance to what I was told by the nurse.I don't even know if my doctor was really told or understood. Maybe he was, maybe he wasn't.
When I first called to leave the message, the LPN acted as if she was "placing the order". I can't even explain why I felt that was, I just did. I've called countless times for refills. This time seemed odd.
Plus, they are all controlled drugs! It's not something they handle lightly. Obviously an LPN doesn't have prescriptive authority, but maybe they are allowed to fax the electronic refill scripts. I'm not sure.
When she called back, it was clear that it was her suggestion to me to make an appointment next month if I haven't improved.
This doesn't seem like the actions or words of a doctor. In fact, they weren't. She wasn't even pretending to relay a message from him. She just informed me that things were staying as they were and the scripts could be picked up shortly.
I don't even want to make an appointment. I'm surprised that wasn't ordered, rather than an off-the-cuff suggestion.
I don't want to go in and ask for Xanax, because apparently I'm now being thought of as a drug-seeking addict. No thanks.
I've made the decision to drop all meds (there's a lot, for many conditions), because I don't feel like I have a doctor anymore.
Posted by Phillipa on April 9, 2007, at 21:14:16
In reply to Re: Update! » Phillipa, posted by jealibeanz on April 9, 2007, at 20:06:30
Jelly first she couldn't call the meds in without talking to the doc. When working as an RN we called in all the scripts that's the way it works. I would call and ask to directly speak to the doc. Let him return your phone call as you can't stop all meds and I think you know that. Would hate to see you on the withdrawal board for a misunderstanding. Love Phillipa
Posted by jealibeanz on April 9, 2007, at 21:23:06
In reply to Re: Update! » jealibeanz, posted by Phillipa on April 9, 2007, at 21:14:16
> Jelly first she couldn't call the meds in without talking to the doc. When working as an RN we called in all the scripts that's the way it works. I would call and ask to directly speak to the doc. Let him return your phone call as you can't stop all meds and I think you know that. Would hate to see you on the withdrawal board for a misunderstanding. Love Phillipa
Well, she must have had a doctor authorize the scripts. Controlled drugs cannot be faxed and must be signed by a physician w/DEA license.There's not a whole lot to call and talk about right now. I explained my situation and no change was made. I cannot force or guilt my doctor into doing something he does not want to do.
Posted by Phillipa on April 9, 2007, at 21:57:40
In reply to Re: Update!, posted by jealibeanz on April 9, 2007, at 21:23:06
No you can't I guess. Love Phillipa
Posted by elanor roosevelt on April 9, 2007, at 22:44:01
In reply to Re: Update!, posted by jealibeanz on April 9, 2007, at 21:23:06
it's a controlled substance. Can't be alled or faed.
have you considered printing articles about the bad reaction consumers are having to the xanaxXR?
I have been try to work with my doctor in this way (with a bit of success)When you say you are always keeping it together in front of your doctor it mad me sad. I get myself in trouble over that one. The doctor thinks I seem good enough when that isn't the case. For now on I think I will try to see my pdoc at my worst time of the day.
Good luck.
Posted by jealibeanz on April 10, 2007, at 3:01:53
In reply to Re: Update!, posted by elanor roosevelt on April 9, 2007, at 22:44:01
> it's a controlled substance. Can't be alled or faed.
> have you considered printing articles about the bad reaction consumers are having to the xanaxXR?
> I have been try to work with my doctor in this way (with a bit of success)
>
> When you say you are always keeping it together in front of your doctor it mad me sad. I get myself in trouble over that one. The doctor thinks I seem good enough when that isn't the case. For now on I think I will try to see my pdoc at my worst time of the day.
> Good luck.Yeah I know controlled substances can't just be printed out and signed by anyone. The doc's are the ones who give the commands on their laptops for the machine to print. I'm sure they are password protected.
I haven't printed out any articles about Xanax XR. I've never found any studies.
I'd rather my doctor go by my reactions and input, rather than by the book. If I were a textbook case it would be much simpler and he wouldn't have had to to half the things we've tried. But obviously that won't work with all patients or docs. I don't even know ahat will help me now.
You're on Xanax XR right now? Trying to get off? Or did you just mean to find articles whenever you want to bring up a point to your doctor?
Posted by jealibeanz on April 10, 2007, at 4:33:46
In reply to Re: Update!, posted by elanor roosevelt on April 9, 2007, at 22:44:01
> it's a controlled substance. Can't be alled or faed.
> have you considered printing articles about the bad reaction consumers are having to the xanaxXR?
> I have been try to work with my doctor in this way (with a bit of success)
>
> When you say you are always keeping it together in front of your doctor it mad me sad. I get myself in trouble over that one. The doctor thinks I seem good enough when that isn't the case. For now on I think I will try to see my pdoc at my worst time of the day.
> Good luck.
Yeah, I knowwww "keeping it together" hurts me. I just can't change that.I don't lie about symptoms or when asked questions. I'm honest.
But I don't exactly look or act overly anxious when I'm in the office. I'm not. I'm there quite a bit. I'm used to my doctor. He makes me comfortable, which is very good, except when he needs to observe the anxiety that he's helping to diminish by his demeanor.
It's a controlled setting. I can't worry too much because it's like I'm being taken out of my real world, and placed in a little box. My only duty when I'm there is to sit in a chair and talk to a few people. I can't do much else and don't have a lot of time to think about anything other than health-related matters.
Plus, I've trained myself. I know how to act in public in order to appear to have as little anxiety as possible. It's the way to function and prosper in the real world, it's just not beneficial when I'm seeing my doctor.
So, I'm not putting up a false front for my doctor. I just don't walk around in a public setting with my feelings written all over my face. I'm not stoic by any means, but I can and do act much happier and relaxed than I am. That's not going to change, and I don't really want it to, since this is to my own benefit in terms of my future advancements in the workplace, just not terribly helpful when seeking medical care.
To further this a little, I did a college internship at that office a year and a half ago. So yes, I'm very used to putting on my happy face and professional act there. It's hard to take that away. I have to remind myself sometimes that I am the patient when I'm there now, not a the future employee, and must act accordingly... but I don't.
Posted by Phillipa on April 10, 2007, at 18:38:29
In reply to Re: Update! » elanor roosevelt, posted by jealibeanz on April 10, 2007, at 4:33:46
Jelly I do the same. Why I wonder? Love Phillipa
Posted by jealibeanz on April 10, 2007, at 18:50:40
In reply to Re: Update! » jealibeanz, posted by Phillipa on April 10, 2007, at 18:38:29
> Jelly I do the same. Why I wonder? Love Phillipa
Just trying to adapt and function in our environment.
Uhh... I'm pretty sad and distressed right now. I don't have any other doctors who I can go to. I've tried others in the area. This was the only one who ever took me seriously.
Oh well. I'm proud of myself for asking for what I needed. I'm proud of myself for admitting weaknesses and seeking help over the last few years. It's hard to get the guts to do that. I don't have a treatment team on my side right now, but that's OK. I've always pushed myself to be the best I can be and never gave up without a fight.
For now I'll just go back to living with anxiety. I feel like I've exhausted my options at the moment. Maybe I'll change my mind and seek treatment again after a couple of years going med-free.
Posted by Phillipa on April 10, 2007, at 21:03:29
In reply to Re: Update! » Phillipa, posted by jealibeanz on April 10, 2007, at 18:50:40
Jelly are you med free now? How did you do it? Oh I remember when I was young and could do it too. Love Phillipa
Posted by jealibeanz on April 11, 2007, at 4:11:15
In reply to Re: Update! » jealibeanz, posted by Phillipa on April 10, 2007, at 21:03:29
> Jelly are you med free now? How did you do it? Oh I remember when I was young and could do it too. Love Phillipa
No, I did reluctantly pick up the new prescriptions that were written (Ritalin LA, Provigil, Lunesta, Xanax XR). I considered not picking them up, since I've basically decided I no longer have a physician, but decided I needed the first 2 in order to stay awake and do my coursework.
The odd thing I noticed is that the Provigil was written without refills. So, that would mean me calling again next month (since he doesn't realize I've decided not to be his patient anymore). Usually they only leave no refills if there is a recheck scheduled. It seems to me like something has gone wrong in my process.
My biggest concern with not having a doctor is that I can't breath/function without Flonase. I could buy OTC Claritin instead of the Clarinex I'm prescribed (none of the newer antihistamines help anyway, I'm allergic to life). I could buy OTC acne medication instead of the antibiotic ointment, prescription pads and cream I'm prescribed. I could buy any OTC sleeping med. I could down caffeinated drinks like crazy instead of Ritalin and Provigil (but I already do, so I'd have to drink the really potent ones, which make me sick).
I'm supposed to have a physical for college too. I'll figure that one out later.
Posted by KayeBaby on April 11, 2007, at 11:44:05
In reply to Re: Update!, posted by jealibeanz on April 11, 2007, at 4:11:15
JB,
I understand how you feel. I really do.
So, I will give you the same advice a really brillaint friend gave me in the same sort of situation.This doesn't have to be an all or nothing deal, you know. Do the best you can with what you have got.
I felt crushed when I have been in similar situations.
It seems like every time I tentively reach out for help (hard for me) someone just slaps my hand.Im so afraid to ask, to reveal myself or to put myself in someone eles hands that I am highly sensitive to the smallest faltering of that person. I take it very personally.
I am independant by nature. My motto is never allow yourself to need something that you cannot provide for yourself. You can only rely on yourself.
All well and good except for the fact that I was handicapped by this mindset. Humans are interdependant, social creatures. I need too many things that I cannot provide for myself. AND I have cut my nose off to spite my face so many times I can hardly breath.
Your Dr. is not perfect but he has been caring with you. Work with what you got for YOU. He will believe as he will. So what.
Get what necessary meds you can from him. If you cannot get something from him that you need get it elswhere.
Don't make your life any harder than it has to be, sweetie. You are working your tail off as it is. You are smart, you care about your life and you are in control. Don't doubt yourself. ok?
I am feeling for you.
Peace,
Kaye
Posted by jealibeanz on April 11, 2007, at 12:42:56
In reply to Re: Update! » jealibeanz, posted by KayeBaby on April 11, 2007, at 11:44:05
Thanks for the advice. It helps to know that others have gone through the same thing.
Revealing myself is hard. The first time I sought treatment was when I was 19, but I've been under the care of my PA or doc now for 1.5 years continuously, monthly. It's especially hard when I can't even find a stable plan. I just feel defective.
I know doctors are real people. Going through my own medical education has really shown me that. Doctors are not gods. They have thoughts, feelings, and flaws. During lecture they joke, complain, talk about their fears and feelings, and are noooowhere near perfect.
I've learned this also over the last year and a half, with my doctor and PA. The more I see them, the more of the real person they let me see. I was really honored when I realized that I was beginning to be treated slightly like a peer, not just a person off the street in the officee.
Plus, the more I see them, the more I see their mistakes or shortcoming. I've asked questions or presented a problem with a medication before, and gotten a very honest answer of, "I don't know."
My doctor isn't the best practitioner in the world. He misses things, lots of things, with me and my family. Or, he doesn't always pick up on the severity of something I'm conveying to him.
I've stuck with him because he's so incredibly nice and caring with me. When I'm in his office, he listens to every word I say and he makes me feel like I'm his #1 concern right then and there, which really is how it should be. There's also the added benefit that's I've pretty much always gotten everything I ask for. But still, it was him I was sticking with, not the drugs.
I realize that the use of Xanax on a daily basis is not considered ideal and is controversial. I completely accept that.
I'm a very idealistic person, but also very realistic. I see absolutely no point in a person having to live with the anxiety that I have when not properly treated. Why? So I can say I'm drug free.
I think my doctor was under the impression that I was unusually anxious last year because I was moving away to a new school, and that after a while I'd easily drop the Xanax. Nope, I always have anxiety.
So, I could walk in there and tell him I can taper off. I will have a lot of anxiety because I have a lot right now and have always lived with a lot. I'm tough. I can do it. I always used to accept that I'd have a very difficult and unhappy life because of it. I'll just go back to that mindset. I'm pretty used to it now. I was able to have almost a year with some relief, but I can go back to the way I was living before. I'd done it for quite some time.
Posted by elanor roosevelt on April 11, 2007, at 22:30:31
In reply to Re: Update! » elanor roosevelt, posted by jealibeanz on April 10, 2007, at 3:01:53
i print articles for my pdoc often
often the purpose is to show him that side effects i am experiencing are real
there is so much out there about the disappointment people have with xanax XR
Posted by jealibeanz on April 12, 2007, at 0:08:48
In reply to Re: Update!, posted by elanor roosevelt on April 11, 2007, at 22:30:31
Yeah, this may be true, but I feel like I'm stepping on toes by doing that. Plus, he now seems to have taken the mindset that benzo's in general, and particularly short acting ones cause dependence. So he'd like me on a lower and lower dose of a long acting until I'm down to nothing.
That's what I've concluded, which is not based on any words spoken to me, just the fact that he's refusing to go back to IR of increase back to 4 mg on the XR.
I can't believe I've chosen this career when I'm so upset with my treatment and care by all involved. And I'm not one to blame docs or nurses. I defend them when the public rants. But right now I'm disappointed and care too much about health and medicine to go into something that's getting away from a patient centered practice.
Posted by jealibeanz on April 15, 2007, at 6:54:53
In reply to Re: Update! » elanor roosevelt, posted by jealibeanz on April 12, 2007, at 0:08:48
I don't know what I'll end up doing. It probably is a better decision to go back to see my doctor, if only for one last time. At least that would bring a little closure to my medical merry-go-round, instead of giving up by myself.
Of course I will once again tell him that my medication is not helping, but from there I don't know what I will do.
I could ask for my old regime back... which would come with a sense of desperation, distress, pain, and sadness... while questioning his authority and decisions by clearly requesting something that has been turned down twice.
I could ask to go off the medication, without going on another, because it isn't helping. There's no need to prolong this ineffective treatment. It's almost demeaning for me to continue with it.
I guess it's nice that I had quite a few months when my anxiety was be fairly effectively treated. That's only a few months out of my whole life, but at least I experienced it. I'll go back to my old ways.
I do hope this doesn't leave me with panic attacks. I've never had a full-blown one and the thought scares me.
Posted by KayeBaby on April 15, 2007, at 19:41:04
In reply to I'm torn., posted by jealibeanz on April 15, 2007, at 6:54:53
JB,
I would go in and see him again and tell exactly what you just wrote in this post. It is respectful of him and sums up your attitude (which is one of a person who is not an abuser, who is sufferring, and is sufferring more than is probably necessary) Really, this post makes the issue crystal clear. Give this info to the DR. and you will know exactly where you stand with him and then you can know how best to proceed.You need some anxiety relief and I sense that more than being attached to specific drug you would like to know that he truly understands your situation and has some compassion for it.
I am not sure that he is fully aware of your predicament.
To be fair to him you need tell him exactly how you feel, your fears etc. and give him the opportunity to help you better. IMO this is the right thing to do and what he does with this info is his business.
I know this is easier said than done. Just do what you think is right, JB. That way it will be alright either way.
I am rooting for you!
Peace,
Kaye
> I don't know what I'll end up doing. It probably is a better decision to go back to see my doctor, if only for one last time. At least that would bring a little closure to my medical merry-go-round, instead of giving up by myself.
>
> Of course I will once again tell him that my medication is not helping, but from there I don't know what I will do.
>
> I could ask for my old regime back... which would come with a sense of desperation, distress, pain, and sadness... while questioning his authority and decisions by clearly requesting something that has been turned down twice.
>
> I could ask to go off the medication, without going on another, because it isn't helping. There's no need to prolong this ineffective treatment. It's almost demeaning for me to continue with it.
>
> I guess it's nice that I had quite a few months when my anxiety was be fairly effectively treated. That's only a few months out of my whole life, but at least I experienced it. I'll go back to my old ways.
>
> I do hope this doesn't leave me with panic attacks. I've never had a full-blown one and the thought scares me.
Posted by jealibeanz on April 15, 2007, at 21:17:51
In reply to Re: I'm torn. » jealibeanz, posted by KayeBaby on April 15, 2007, at 19:41:04
> JB,
> I would go in and see him again and tell exactly what you just wrote in this post. It is respectful of him and sums up your attitude (which is one of a person who is not an abuser, who is sufferring, and is sufferring more than is probably necessary) Really, this post makes the issue crystal clear. Give this info to the DR. and you will know exactly where you stand with him and then you can know how best to proceed.
>
> You need some anxiety relief and I sense that more than being attached to specific drug you would like to know that he truly understands your situation and has some compassion for it.
>
> I am not sure that he is fully aware of your predicament.
>
> To be fair to him you need tell him exactly how you feel, your fears etc. and give him the opportunity to help you better. IMO this is the right thing to do and what he does with this info is his business.
>
> I know this is easier said than done. Just do what you think is right, JB. That way it will be alright either way.
>
> I am rooting for you!
>
> Peace,
> Kaye
>
>
> > I don't know what I'll end up doing. It probably is a better decision to go back to see my doctor, if only for one last time. At least that would bring a little closure to my medical merry-go-round, instead of giving up by myself.
> >
> > Of course I will once again tell him that my medication is not helping, but from there I don't know what I will do.
> >
> > I could ask for my old regime back... which would come with a sense of desperation, distress, pain, and sadness... while questioning his authority and decisions by clearly requesting something that has been turned down twice.
> >
> > I could ask to go off the medication, without going on another, because it isn't helping. There's no need to prolong this ineffective treatment. It's almost demeaning for me to continue with it.
> >
> > I guess it's nice that I had quite a few months when my anxiety was be fairly effectively treated. That's only a few months out of my whole life, but at least I experienced it. I'll go back to my old ways.
> >
> > I do hope this doesn't leave me with panic attacks. I've never had a full-blown one and the thought scares me.
>
>Haha, I could schedule an appt. for next month and go in with the bold intention of lying everything I'm thinking, feelings, and wondering right out in front of him.
Yet, I know better. It won't happen. We'll probably chat about nothing related to my medications, then he'll ask me right as he walks out the door if I need any refills.
Sometimes it's not quite so drastic if I make it reallllly clear to the nurse who rooms me that I'm having major horrible problems with a medication. I have to make it seem very dramatic for the doctor to even bother glancing at their notes.
The doctors will always take their own history anyway, plus patients don't always bother to tell the nurse anything. I sometimes don't, just because it's pointless to go in to detail with the LPN and hard not to when discussing the matter. So, I'll just say I'm here for a recheck, I'm fine, let's speed up this process a little.
On occasion he'll pop in a decide to focus on my health. I think that's when he's quite pressed for time.
I could just be really quiet with the smalltalk, but that almost never happens. We honestly enjoy our visits together. He tries to relate by thinking about things that went on when he was in med school, sometimes giving my suggestions. I like going because he and his PA who I see really enjoy there jobs, and makes me more passionate about the field, especially when I'm up to my eyeballs in textbooks and notes. (I've slept with books or binders on half my bed nearly every night for the past year... weird? ... no, just insane... at least they keep me company:)
Yeah, so problem #1 is that we often have little time to discuss my medical concerns in detail.
Problem #2 is that I appear far too happy, normal, successful and functional to need high levels of medication and constant monitoring because I am super-sensitive.
Problem #3 is that we talk about drugs. We don't talk a whole lot about symptoms. I'm willing to, even though it's mildly awkward, it wouldn't be if it felt like commonplace when I was there. I think he doesn't probe into dept, or even shallowly, regarding psych problems because he doesn't want to embarass me. I'd be OK with it though.(comorbidities... ADHD, fatigue, anxiety, insomnia, ummm depression that I hide... maybe it's easier for him not to have to ask. Too much!).
Posted by KayeBaby on April 15, 2007, at 22:25:02
In reply to Re: I'm torn., posted by jealibeanz on April 15, 2007, at 21:17:51
>
> Haha, I could schedule an appt. for next month and go in with the bold intention of lying everything I'm thinking, feelings, and wondering right out in front of him.
>
> Yet, I know better. It won't happen. We'll probably chat about nothing related to my medications, then he'll ask me right as he walks out the door if I need any refills.
>
> Sometimes it's not quite so drastic if I make it reallllly clear to the nurse who rooms me that I'm having major horrible problems with a medication. I have to make it seem very dramatic for the doctor to even bother glancing at their notes.
>
> The doctors will always take their own history anyway, plus patients don't always bother to tell the nurse anything. I sometimes don't, just because it's pointless to go in to detail with the LPN and hard not to when discussing the matter. So, I'll just say I'm here for a recheck, I'm fine, let's speed up this process a little.
>
> On occasion he'll pop in a decide to focus on my health. I think that's when he's quite pressed for time.
>
> I could just be really quiet with the smalltalk, but that almost never happens. We honestly enjoy our visits together. He tries to relate by thinking about things that went on when he was in med school, sometimes giving my suggestions. I like going because he and his PA who I see really enjoy there jobs, and makes me more passionate about the field, especially when I'm up to my eyeballs in textbooks and notes. (I've slept with books or binders on half my bed nearly every night for the past year... weird? ... no, just insane... at least they keep me company:)
>
> Yeah, so problem #1 is that we often have little time to discuss my medical concerns in detail.
>
> Problem #2 is that I appear far too happy, normal, successful and functional to need high levels of medication and constant monitoring because I am super-sensitive.
>
> Problem #3 is that we talk about drugs. We don't talk a whole lot about symptoms. I'm willing to, even though it's mildly awkward, it wouldn't be if it felt like commonplace when I was there. I think he doesn't probe into dept, or even shallowly, regarding psych problems because he doesn't want to embarass me. I'd be OK with it though.(comorbidities... ADHD, fatigue, anxiety, insomnia, ummm depression that I hide... maybe it's easier for him not to have to ask. Too much!).
I have a similar relationship with my Dr. I have 15 minutes with him and we adore each other. He has ADD and I am so interested in neurology, pharmacology that we are just all over the place.I was depperate for help when I first went to him about 3 years ago. He was the 1st Doc I had seen that was willing to help me. The one I saw before him (only 1 appt)was just mean and ugly to me. My Dr. sees many ADD clients and is so happy to treat them because they respond well and quickly to the right med. it is gratifying for him to see such a positive turn around for them so fast as opposed to some of the other conditions.
I feel hesitant to ever let him down or make him doubt his diagnosis of adult ADD by admitting to any depression or what have you. I also don't want to ever seem to take advantage of his trust in me and the honor he bestows me by making me feel a friend rather than a 'case'
I have so much to say to you about this because of the similarities. Can you believe that I am agonizing over the same quandry that you are.
My Dr. is fearless when prescribing. He is no fool but will not be bullied by anyone and he prescribes for his patients as he sees fit. This is something he made clear on our first visit. The one med that works so well for me is a rarely prescribes class III stim that for some reason makes him more uncomfortable than any of the other well know ones such as Adderall, Dexedrine etc. I am trying to adapt to the meds he wants me to take but they just don't work as well. I have no idea why but I just am not quite well any of the others.
So, will be out of my preferred med in a few days and have enough of the other to last me about a month. I am going to give it all I got but this has not worked out for me in the past.
Forgive me if I am projecting too much on to you of my issues.
I just wanted you to know why I am so interested in your situation and have so much to say about it.
Feel free to send some advice my way, JB.
Peace,
Kaye
Posted by jealibeanz on April 16, 2007, at 6:01:30
In reply to Re: I'm torn. » jealibeanz, posted by KayeBaby on April 15, 2007, at 22:25:02
Kaye-
I can relate sooo much to what you just wrote.
I'm completely certain that my doctor, god love him, has untreated ADHD. The reason why I say this is because I shadowed him for several days during high school. The following year he switched practices, I switched practices, and we ended up together.
He was very relaxed, well spoken, organized, and thorough when I shadowed him. When I first saw him as a patient, I immediately thought that he has ADHD, and is not taking his meds! He's allll over the place now and is rather forgetful and frazzled. He's been this way for the past five years, although, he's working in a much more hectic and overscheduled environment, which doesn't help.
This is the first doctor to really care about me and bother to treat me, despite failures, and be persistent. All others have blown me off. I left him a year ago because I was mildly uncomfortable because I'd just completely a college internship there. (He had no idea. I had no records transferred and I did this in a matter of weeks in between appointments with him and his PA... They never missed me) I'd gone to 3 others, then came back to him.
I know it would be foolish to try for another doctor, although I know he is not brilliant. I give off this aura of happiness and success, which throws people off, no matter what words are coming out of my mouth. At least this one treats me. The others have kicked me out the door, saying I'm perfect (but apparently likes making appts. for factitious conditions?!)
Yeah, I understand what you mean about not wanting to admit to depression because that could lead to an "undiagnosis" of your ADHD. My PA told me a year ago that he didn't think my ADHD was causing concentration problems, it was anxiety. I argued enough and told him that I thought not being able to concentrate and complete all my work at a normal pace causes a lottt of anxiety, so I needed to treat the ADHD. He gave in and prescribed Straterra.
I knew he was right, but I also knew I was too. Adult ADHD is really hard to diagnose confidently. They'd rather blame it on depression or anxiety, which is a valid conclusion, but they need to be able to consider all three... very difficult, I'm sure.
I definitely hesistate pushing my doctor too far with my own opinions and requests. It might cause him to pull back a little and change our relationship. I think this already has happened with my recent events. He's never been so firm. (I question whether or not I'm acting like a spoiled child right now in reaction to his decision. I've always gotten what I've asked for. Now I'm not. It's not that I care about getting my way, I just want to feel better!)
This bothers me. I don't need to be best friends with my doctor... and we're not. He could be my father. But I do appreciate the relationship we have, as odd as it might appear to anyone who'd sit in on all of our interactions. Most doctors want to keep more of a professional distance. Mine doesn't with me. He's pretty casual with most people. It's his style. You can tell he went in to the business because he's a people person, not because he wanted the prestigue or money.
He's respectful and doesn't talk down to me in any way (A good choice, because that would piss me off to no end and I'd never be back. I'm intelligent and want to be treated as a competent person).
He treats me like his daughter, his student, his apprentice, his (much younger and future) peer, and his patient all at the same time.
Haha.. a bit weird... but last time I went in there I was walking to one end of the hall with a nurse. He was at the other end with some colleagues. I saw him, but he didn't see me until I had my back turned and was quite far away. I heard him say my name. He wasn't talking about me or actually talking to the others, who don't know me from beans. It was like his reflexive reaction. It was such a strange tone though... like he had seen his long lost friend (not really... just little patient/child), and was happy and excited to see me, but sad. I think the sad part is because he knows I'm going through a rough time. Yeah, pointless story, and I got all of that from someone just saying my name.
He's more concerned with my life and family than he is my health... which is a good thing, because I'd rather have that than some amazing pharmacologist who treats me like a scientific experiment. It just adds to our relationship when he asks about how my siblings are, and really wants to know.
mmm... family practice... I want it! :)
He's like your doctor. It's so exciting and gratifying for him to even begin a treatment plan with a patient. If it helps, he loves it. But he gets a wiiiide variety in family practice.
What is a schedule III stimulant? Provigil? I probably should know because I taken it and other controls... but so many that I can't keep it straight. Plus, the numbering seems backward to me.
BTW, this is a famous medical quote, which I highly believe in:
"The art of medicine consists in amusing the patient while nature cures the disease."
-Voltaire
Posted by KayeBaby on April 16, 2007, at 13:24:00
In reply to Re: I'm torn. » KayeBaby, posted by jealibeanz on April 16, 2007, at 6:01:30
>I give off this aura of happiness and success, >which throws people off, no matter what words >are coming out of my mouth. At least this one >treats me. The others have kicked me out the >door, saying I'm perfect (but apparently likes >making appts. for factitious conditions?!)
Damn. This is exactly what happened to me with the last Dr. I saw before finding my present Dr. I mentioned that he was mean. I can't even talk about it. I was just crushed for some time after it and it was a while before I worked up the nerve to try again. If I am asking for help from someone-I gaurantee that I NEED it. I don't bother anyone for help almost as rule.
Well Ms. Beanz it seems that at least we are granted the comfort of not being lonely in our travels (or travails)
I am sure we will figure this out and grow from it. Maybe we just need solidification in our concepts of the healer/patient relationship. There seems to be a theme develping here. Personal and vocational.>"The art of medicine consists in amusing the >patient while nature cures the disease."
.-VoltaireOh, thank you for this quote! It is perfect!
Take Care,
Kaye
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