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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 22 of 22. This is the beginning of the thread.
Posted by Janice on March 16, 2000, at 23:56:15
Good day everyone,
Yesterday I upped my lithium from 600 mg to 1200 mg. I had a sleepless night last night because my body was not used to receiving lithium at night, and must have mistook this to mean it was morning again.
I have a terrible salty taste in my mouth. Will this last, or is there any way to get rid of it.
I had nausea both yesterday and today--although i am taking them with gingerroot, which has always worked in the past.
I drink ALOT of caffeine--which you are not supposed to do when you take lithium. I drink about 10 cups of tea (very strong tea from India). I drink very little other fluids. How dangerous is this?
When should I have my blood tested again? I just had it tested at 600 mg--which indicated that I need more lithium.
Finally, Tonight I am quite dizzy. Should this go away, or does it have anything to do with the caffeine.
I really don't like this pdoc I'm seeing:
**Everytime I see him, I am in the hotseat...and constantly have to defend myself.
**2 times he's made comments about my personality, that I am very dramatic. I didn't appreciate this at all.
**He has also criticized my psychiatrist from Toronto at least 2 times. I actually liked him.Does this sound like 'therapy' to any of you?
Posted by Mark H. on March 17, 2000, at 0:26:21
In reply to Info on Lithium... a pdoc I'm seeing, posted by Janice on March 16, 2000, at 23:56:15
Hi Janice,
Lithium is dangerous by any standard, since the therapeutic range is so narrowly close to the toxic range, and it's particularly hard on the kidneys. If your water intake additionally always contains caffeine, it makes it doubly hard on your poor kidneys. Why risk serious damage?
How about keeping a soft bottle of water near you all day, so you can suck down a fresh pint a couple of times an hour? Start a new habit of water-drinking. Have you figured out why you're taking in so much caffeine? I'd be a complete wreck!
Lithium management is tough -- but I'd sure like you to last a long, long time! Please take loving care of yourself.
Posted by michael on March 17, 2000, at 4:00:38
In reply to Info on Lithium... a pdoc I'm seeing, posted by Janice on March 16, 2000, at 23:56:15
> Good day everyone,
>
> Yesterday I upped my lithium from 600 mg to 1200 mg. I had a sleepless night last night because my body was not used to receiving lithium at night, and must have mistook this to mean it was morning again.
>
> I have a terrible salty taste in my mouth. Will this last, or is there any way to get rid of it.
>
> I had nausea both yesterday and today--although i am taking them with gingerroot, which has always worked in the past.
>
> I drink ALOT of caffeine--which you are not supposed to do when you take lithium. I drink about 10 cups of tea (very strong tea from India). I drink very little other fluids. How dangerous is this?
>
> When should I have my blood tested again? I just had it tested at 600 mg--which indicated that I need more lithium.
>
> Finally, Tonight I am quite dizzy. Should this go away, or does it have anything to do with the caffeine.
>
>
>
>
>
> I really don't like this pdoc I'm seeing:
>
> **Everytime I see him, I am in the hotseat...and constantly have to defend myself.
> **2 times he's made comments about my personality, that I am very dramatic. I didn't appreciate this at all.
> **He has also criticized my psychiatrist from Toronto at least 2 times. I actually liked him.
>
> Does this sound like 'therapy' to any of you?
I'd consider looking for another doc, or at least maybe a second opinion... either confirm your perception, or your doc's?I seem to have been saying this quite a bit lately, so take it for what it's worth. It just bugs me when anyone treats others in that manner, but especially someone who is supposed to be professional, is in the health "care" industry, and is being paid by you.
(Thought Mark might jump in on that one...?)
Posted by Noa on March 17, 2000, at 10:29:45
In reply to Re: Info on Lithium... a pdoc I'm seeing, posted by michael on March 17, 2000, at 4:00:38
I am a newcomer to lithium, but I think you should try to drink water more. Why are you needing so much tea/caffeine? Is it just the tea habit or do you need the stimulant?
Also, my doc has had me get my levels tested at one week after each increase. But I think there is a need to check after you have been at a dose for a while.
Can you check around about other docs that might be a better match?
Posted by judy on March 17, 2000, at 16:15:25
In reply to Info on Lithium... a pdoc I'm seeing, posted by Janice on March 16, 2000, at 23:56:15
Hi Janice,
How are you going to develop a therapeutic relationship with someone you don't like? I've learned the hard way to trust my instincts and get a different pdoc if I'm uncomfortable in any way- and you sound as if you are very uncomfortable with this pdoc. I agree with the others to have your levels checked as soon as possible- the tea is probably acting like a diuretic and lithium is nothing to mess around with. I hope you feel better soon. P.S.- I get the dramatic, "histrionic" bit too, big deal, it's who I am.
Posted by Janice on March 18, 2000, at 11:46:47
In reply to Re: Info on Lithium... a pdoc I'm seeing, posted by judy on March 17, 2000, at 16:15:25
and I stopped dancing.
which means the lithium is working--sadly enough.hypomania is the hardest disorder for any patient to treat.
Thanks for your responses Mark H., michael, Noa & Judy
I'll take all your suggestions into considerations. Actually, after reading them I started exchanging my caffeinated tea for herbal tea--and managed to drink about 5 water.Mostly, it's about bad habits.
Secondly, I am addicted (probably BADLY) to caffeine. I'm pretty certain I have ADHD that am undergoing psycholgical testing for right now.Which brings me to that studid pdoc I'm seeing. I would have switched him long before but I'm not certain how long I will be living here.
I know I am not going to test positive (for his test anyway) for the ADHD because I believe there is still alot of prejudice surrounding who gets diagnosed with ADHD.
*aggressive little boys & girls (or people who were once this)
*bad studentsI wasa 'gifted' student. Which for me doesn't disclude ADHD.
My equation for what often makes a gifted students are ADHD + no learning disabilities + ADHD with the ability to hyperconcentrate + relatively bright anyway + loves to learn.I'll just wait for science to catch up with me on that one.
I will make an appointment with my gp to get another psychiatrist, and ask her for a blood test. thank you again, Janice
Posted by judy on March 18, 2000, at 17:59:59
In reply to Today, the music died... , posted by Janice on March 18, 2000, at 11:46:47
Bummer on the hypomania ending- I totally relate. Just a comment on the ADHD, I was seeing my pdoc last week and may have been a little "high"- he said manic- anyway I was rocking in the chair (it wasn't a rocking chair) and he said sometimes he has kids that actually fall out of it and he labels them ADHD. For some reason that just cracked me up and I fell out- I guess a low budget test for ADHD. Take care and let us know how your testing went.
Posted by Noa on March 19, 2000, at 13:02:25
In reply to Re: Today, the music died... , posted by judy on March 18, 2000, at 17:59:59
Judy, LOL. Pretty soon, we'll see that chair being marketed by these medical/psychological supply companies for some outrageous price--"guaranteed to identify ADHD in children and adults, with 97.8% reliability. An efficient, simple diagnostic tool that provides fast, easily interpretable data--right in your consulting room. Comes in black, ivory, or teal brushed cotton. Ottoman extra."
Posted by Janice on March 19, 2000, at 16:00:57
In reply to Re: Today, the music died... , posted by Noa on March 19, 2000, at 13:02:25
the chair method would be cheaper and faster...and, I'd guess, as effective as the psychological testing I'm undergoing.
I feel more unstable since starting the lithium. I keep thinking how I wish I was dead--no suicidal intentions.
Today, I am extremely ANGRY. I am also experimenting without taking the Dexedrine because I believe I may have to get used to this. I am hiding from everyone. And worried about irrational things, which seem so real right now.
My blood is quick to boil...and I feel like smashing things. I doubt this is stability.
Does anyone know what stability feels like? Will I recognize it when I feel it?
Janice
Posted by judy on March 19, 2000, at 19:15:39
In reply to Re: Today, the music died... , posted by Noa on March 19, 2000, at 13:02:25
Noa- you've got to be in advertising- with that kind of marketing I think we may have a million dollar seller here. Janice for sure you're not stable- not that I'm any expert on stability, I think it was 1996 or 7 that I last heard a pdoc say euthymia in the same sentence as my name. Did your pdoc tell you to stop dexedrine and not taper? Or did you just do it on your own? Maybe you're having withdrawal- I know whenever I just stop a drug there is always some kind of mood change and you sound kind of mixed with the rage and depression. Call your pdoc- I always call on Sundays when I'm pissed, or better yet in the middle of the night. Hope you feel better.
Posted by JanetR on March 19, 2000, at 20:58:06
In reply to Noa and Janice, posted by judy on March 19, 2000, at 19:15:39
> Noa- you've got to be in advertising- with that kind of marketing I think we may have a million dollar seller here. Janice for sure you're not stable- not that I'm any expert on stability, I think it was 1996 or 7 that I last heard a pdoc say euthymia in the same sentence as my name. Did your pdoc tell you to stop dexedrine and not taper? Or did you just do it on your own? Maybe you're having withdrawal- I know whenever I just stop a drug there is always some kind of mood change and you sound kind of mixed with the rage and depression. Call your pdoc- I always call on Sundays when I'm pissed, or better yet in the middle of the night. Hope you feel better.
Noa How areyou feeling these days? Better I hope. Janice I am always stably depressed, that doesn't feel too good either. I hope you feel better soon .Jan
Posted by Brenda on March 19, 2000, at 22:14:36
In reply to Anyone know what STABILITY feels like? [help], posted by Janice on March 19, 2000, at 16:02:08
> the chair method would be cheaper and faster...and, I'd guess, as effective as the psychological testing I'm undergoing.
>
> I feel more unstable since starting the lithium. I keep thinking how I wish I was dead--no suicidal intentions.
>
> Today, I am extremely ANGRY. I am also experimenting without taking the Dexedrine because I believe I may have to get used to this. I am hiding from everyone. And worried about irrational things, which seem so real right now.
>
> My blood is quick to boil...and I feel like smashing things. I doubt this is stability.
>
> Does anyone know what stability feels like? Will I recognize it when I feel it?
>
> JaniceJanice - This may be oversimplified, but I feel (for me) stability most resembles contentment. Please be well. B.
Posted by ChrisK on March 20, 2000, at 5:07:20
In reply to Re: Anyone know what STABILITY feels like? [help], posted by Brenda on March 19, 2000, at 22:14:36
Janice,
I finally felt like I was stable when I noticed one day that I was not self absorbed thinking about what kind of mood I was in. I didn't have to analyze whether I was depressed or anxious or whatever else would go through my mind. I just started living without obsessing on my mental state. It's not a bad feeling.
Chris
Posted by Noa on March 20, 2000, at 8:15:51
In reply to Re: Anyone know what STABILITY feels like? [help], posted by ChrisK on March 20, 2000, at 5:07:20
Been a long while since I felt stable.
Janice, I agree about the sudden discontinuation of the dexedrine. I get a wicked rebound depression if I stop my ritalin suddenly.
I feel like I have been less stable since starting lithium, too, because it has whacked out my thyroid system. I just made an appointment with another pdoc for a consult, and over the phone he said the lithium might have also messed up my calcium levels which can cause some of the symptoms I have been having.
I think the additional thyroid meds have helped some, but I still feel like cold mollases (ie slow).
Posted by Janice on March 20, 2000, at 23:23:57
In reply to Re: Anyone know what STABILITY feels like? [help], posted by Noa on March 20, 2000, at 8:15:51
Judy, JanetR, Brenda, ChrisK & Noa,
This is good for my ego to see your responses, especially since no one in my real life is especially pleased with me the past couple of days.
The Dexedrine withdrawal is my idea. On a conscious level because I'm afraid this doctor isn't going to give me any on a regular basis. And maybe on an unconsciuos level, because I am worried about being flat and depressed. I was like this for a bit on Saturday and never before that. Before whenever I was depressed...I got fed-up, pissed-off, wound-up and then I went to bed--sometimes for 2 days. I'd rather be asleep than depressed, although sleeping makes depression worse in the long (and short) run.
Today I was an irrational monster again and feel guilty as hell. I've made an appointment with my p(doc) to ask him whether or not he ever plans to prescribe Dexedrine for me on a regular basis.
And Noa, I made an appointment with my GP for a thyroid test (sometimes I think I have the hyper??? one because all pills seem to make me lose weight). Thyroid problems are common with rapid cyclers and my mother has this problem--the woman who's fault I am. In my immature moments [when the active thinking part of my brain is busy elsewhere and me, the irrational mess is left] I blame her, in anger, for my life.
Thank you for your responses. Excellent description of stability Chris K. The absence of what most people would call 'self-obsession'. Depression has to be biology...screaming at us to take a look at ourselves, that something is drastically wrong.
peace to all of you, Janice
Posted by Janice on March 22, 2000, at 1:01:21
In reply to Definately not stable yet...thanks everyone..., posted by Janice on March 20, 2000, at 23:23:57
Hello,
so today, I had an appointment with my Pdoc and directly confronted him about whether or not he ever plans to prescribe me Dexedrine.
He fudged around alot, and when I outright asked him if he ever prescribed a stimulant to anyone--He said, NO. so I flipped out, not because I was unstable, but because he deserved it.
•••So do you think he has behaved unethically?•••
He knew that I tried ADs for 5 years (many types, many combos and no luck). He knew the only medication that helps me other than lithium is Dexedrine.
So for the past 3 and 1/2 months, he's been stringing me along (with psychological testing for ADHD), but basically, he's been wasting my time. He's had a private agenda that he wasn't telling me about.
So when I got home, I called the College of Physicians and Surgeons, and they suggested I put in a complaint about him for misleading me, which I think I will do.
Janice.
What do you think?
Posted by bob on March 22, 2000, at 18:24:47
In reply to Do you think this pdoc behaved unethically? , posted by Janice on March 22, 2000, at 1:01:21
> ... He fudged around alot, and when I outright asked him if he ever prescribed a stimulant to anyone--He said, NO. so I flipped out, not because I was unstable, but because he deserved it.
Well, at THAT point in the story, I was thinking "No, not really." If he has some sort of professional qualms abotu prescribing stims, he's got his right not to, and you've got your right to walk.
Then I read the rest of your message.
If he has been stringing you along, with some hidden agenda about getting you to decide you really don't need dexedrine or something along those lines, then he's been a baaaaaad, baaaaad boy. I mean, he's getting paid to make diagnoses and decisions based upon those. If he couldn't tell you flat out from the start that stims are a path he wouldn't go down, you deserved to know then and there.
I think we've all lost enough time to our disorders ... getting strung along like that sure would p*ss me off.
I'll loan you my steel-toed boots if you need'em,
bob
Posted by Cass on March 22, 2000, at 18:46:27
In reply to Re: Do you think this pdoc behaved unethically? , posted by bob on March 22, 2000, at 18:24:47
What were the results of the ADHD testing? If they indicated ADHD, you can go to another pdoc, and he will probably prescribe Dexedrine. I don't think your pdoc acted ethically either. He wasted your time, emotion and money. Sorry that happened to you. Good luck.
Posted by Elizabeth on March 26, 2000, at 0:39:52
In reply to Re: Do you think this pdoc behaved unethically? , posted by Cass on March 22, 2000, at 18:46:27
If he deliberately deceived you, then yes, that would be considered unethical. I'm curious whether you think that's what happened, and if so why you think so. I'm a little confused as to what motive he would have.
Posted by Janice on March 27, 2000, at 14:07:02
In reply to Re: Do you think this pdoc behaved unethically? , posted by Elizabeth on March 26, 2000, at 0:39:52
Hello everyone,
thanks for your responses. I believe he deceived me, and, at the same time, his intentions and motives were good. He probably believed that stimulants aren't good and are addictive. He then had me tested at a place that has never diagnosed anyone as ADHD.
He didn't seems to appreciate me knowing so much about my disorders, and, I believe, he would have preferred me to be like a passive, blank page blindly accepting his wisdom. This would entail me giving up 1 of the 2 medications that has ever helped me. He even criticized my last psychiatrist for having seen me for 5 years (he thought he could get me better in a much shorter period). As for the psychological testing I am undergoing (it's not finished yet), it seems, this far, I just have a 'very, very impulsive personality'--3 verys & you get the ADHD label.
I am going to fill out a report on him to the College of physicians and surgeons. When I asked them what would happen to this report, they said that he will have to respond to it. And I'm hoping that he will may pause for a few seconds before doing this again to someone else. Because it's only his job, but it's *my life*. As bob said, we've all wasted too much time to these disorders already. Thanks Janice.
Posted by Noa on March 27, 2000, at 17:09:54
In reply to Unethical Pdoc--bob, Cass, Elizabeth anyone else, posted by Janice on March 27, 2000, at 14:07:02
Janice, it seems like your vacation, and the view from afar, have given you a fresh perspective. Enjoy.
Posted by bob on March 29, 2000, at 21:39:56
In reply to Re: Unethical Pdoc--bob, Cass, Elizabeth anyone else, posted by Noa on March 27, 2000, at 17:09:54
> Janice, it seems like your vacation, and the view from afar, have given you a fresh perspective. Enjoy.
I second that.
I can also sympathize a bit now. My own pdoc didn't balk at prescribing a stimulant (ritalin) for me, but my visit last Monday was quite interesting. He seemed quite adamant about keeping any discussion of the ritalin **solely** on how it augments my nortriptyline. For me to suggest that I might be experiencing some sort of direct effect from the ritalin was quashed quite quickly, as if it were some taboo I was breaking.
good luck prying those eyelids open -- some folks just like to keep them clamped down as hard as possible,
bob
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