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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 140 to 164 of 164. Go back in thread:
Posted by Elizabeth on February 8, 2002, at 23:52:42
In reply to Piracetam and Other Bits » Elizabeth, posted by IsoM on February 8, 2002, at 14:43:49
> I'm doing some reading on piracetam. Not enough solid information to make any decision right now.
I was interested because Keppra, an anticonvulsant labeled for adjunctive therapy (surprise) of partial seizures, is levetiracetam. I was thinking of asking for it when I see a neurologist.
> I may just let the adrafinil do what I want - enhanced memory - but I'd still like to learn more about piracetam, find if there's any interaction between it & adrafinil.
I don't know of any, but it's a good idea to check into that stuff.
> If I could get my memory working well, how knows what I may do? What an on-top-of-the-world feeling that would be!
Feeling grandiose today? :-)
> With the absessed tooth I had, I was taking lots of codeine painkillers & Ativan to dull it. I felt so thick - couldn't think, let alone remember.
Heh -- just shows how different we all are. Opioids (not just buprenorphine, but also morphine and hydrocodone, and presumably the rest too) help me think more clearly. And benzos at least don't make me tired at normal doses (even normal doses for me, which is already quite a bit higher than the usual normal doses).
Why were you taking Ativan for a tooth abscess, BTW??? Benzos don't generally help with pain, AFAIK.
[re taking Xanax before the driving test]
> So do you think it helped you with being more relaxed during the test?*shrug* It certainly didn't hurt.
> I found with myself, mistakes I made were due to "the evil one" watching every move I made to such an extent I felt so shakey. I wonder if they figure you can drive well under such adverse conditions, you can handle anything. :-)
No, I think Satan probably sent them up here for some other purpose. :-}
> Where you're living now (at family home, I think), can you still continue some sort of studies or such on-line?
You can't really do that with the stuff I need to learn -- virtual chemistry and biology labs just aren't the same as the real thing!
> Elizabeth, can you tell me if there's any practical applications of knot theory?
Sure there are, I think it has applications in chemistry, even.
> Also another question, if I wanted to learn more about fractal math (geometry), do you know what areas of math leads to it?
Actually understanding that sort of thing takes a lot of background. I'm not sure what it is ("fad math" never excited me < g >), but I think at the very least you'd need a good understanding of abstract algebra and real and complex analysis. Knots are more up my alley (I did a lot of topology and then branched out into differential geometry). But honestly, I haven't done much of this stuff in years. I sort of burned out when I tried to go to grad school. A life lesson: if you really love doing something, don't go to school in it. < g >
-elizabeth
Posted by IsoM on February 9, 2002, at 0:43:59
In reply to Re: Piracetam and Other Bits » IsoM, posted by Elizabeth on February 8, 2002, at 23:52:42
> >"...I was interested because Keppra, an anticonvulsant labeled for adjunctive therapy (surprise) of partial seizures, is levetiracetam. I was thinking of asking for it when I see a neurologist."
Let us know what happens. It does sound interesting alright. If I could get better info than just what 'smart drug' sites put out, I might put more credence in it.
> >"...Feeling grandiose today? :-)"
Sounds like it, huh? No, not grandiose but so good compared to my 2 1/2 weeks of pain & headaches.
> > "...Heh -- just shows how different we all are. Opioids (not just buprenorphine, but also morphine and hydrocodone, and presumably the rest too) help me think more clearly. And benzos at least don't make me tired at normal doses (even normal doses for me, which is already quite a bit higher than the usual normal doses).
>
> Why were you taking Ativan for a tooth abscess, BTW??? Benzos don't generally help with pain, AFAIK."Actually, if I have to take a painkiller (codeine) I generally feel clearer too, but I think it was the combination of infection, *severe* pain, & Ativan that made me dopey. Your're right benzos don't help pain but I didn't know what else to do to fight the pain. All my muscles were so tight & tense & I wanted to be numb temporarily. It helped a little, enough till the absess was drained. No way I'll go to the hospital for painkillers. I went once for a migraine & vowed to never go again unless I needed to seriously be admitted.
> > "...You can't really do that with the stuff I need to learn -- virtual chemistry and biology labs just aren't the same as the real thing!"
No, they certainly aren't! I was somehow thinking on-line math.
> > "...Actually understanding that sort of thing takes a lot of background. I'm not sure what it is ("fad math" never excited me < g >), but I think at the very least you'd need a good understanding of abstract algebra and real and complex analysis. Knots are more up my alley (I did a lot of topology and then branched out into differential geometry). But honestly, I haven't done much of this stuff in years. I sort of burned out when I tried to go to grad school. A life lesson: if you really love doing something, don't go to school in it. < g >"
I don't pretend I'd understand fractals but they've interested me for almost 2 decades now but I never had much chance to learn about it before. It's the relationship fractals have with biology & nature that I love so much.
I agree about not going to school for what you really love. Plants & nature is my big, BIG love & I can't get enough of it.
Posted by Elizabeth on February 10, 2002, at 11:53:53
In reply to Other Bits » Elizabeth, posted by IsoM on February 9, 2002, at 0:43:59
> Let us know what happens. It does sound interesting alright. If I could get better info than just what 'smart drug' sites put out, I might put more credence in it.
It's going to be a while until I see a neurologist -- I have to see a GP and then get a referral and who knows how long I'll wait after that and then they might not want to add anything to the Trileptal. I know what you mean about the credibility problems with smart drug websites (or any websites, for that matter).
> Your're right benzos don't help pain but I didn't know what else to do to fight the pain. All my muscles were so tight & tense & I wanted to be numb temporarily.
That's a good point: benzos can help with muscle tension, which often results from pain even if the pain isn't musculoskeletal. They're also sedating, which is always rather helpful if you're in pain.
> No way I'll go to the hospital for painkillers. I went once for a migraine & vowed to never go again unless I needed to seriously be admitted.
Oh jeez -- I bet they gave you a hard time when you went for the migraine. Can I ask what happened? (I'll understand if you don't want to discuss it!)
> No, they certainly aren't! I was somehow thinking on-line math.
I haven't investigated it, but I don't think there are any online math courses at the level that I'd need. Anyway, I'm not studying math anymore.
> I agree about not going to school for what you really love. Plants & nature is my big, BIG love & I can't get enough of it.
For some reason I want to go to med school anyway, though! I should probably practice what I preach. :-}
-e
Posted by IsoM on February 10, 2002, at 13:40:36
In reply to Re: Other Bits » IsoM, posted by Elizabeth on February 10, 2002, at 11:53:53
> > "...Oh jeez -- I bet they gave you a hard time when you went for the migraine. Can I ask what happened? (I'll understand if you don't want to discuss it!)"
I've no problem saying why. Emergency rooms are generally the worse spot to be in anyway - with a migraine, the noise & lights make it much worse. Plus the whining patients get treated first around here, regardless of how serious it is. I'm not a noisy whining type. I laid on the bed for a couple of hours before I was even looked at. They were so afraid of even giving me anything. I got a Gravol shot for the nausea by insisting they treat that too. The final thing they gave me was Demerol which I didn't particularily want. Fine, if you don't move but when I was driven home after the farce, I fought not to vomit in my friend's car. As soon as I got home, I threw up repeatedly & the pain wasn't even diminished. It lasted another 3 days! As you can understand I'd rather treat pain (unless broken limbs) at home. I can do better myself.
Talk to you later - I've a number of things to do today.
Posted by Elizabeth on February 13, 2002, at 17:16:15
In reply to Hospital Emergency Rooms » Elizabeth, posted by IsoM on February 10, 2002, at 13:40:36
> I've no problem saying why. Emergency rooms are generally the worse spot to be in anyway - with a migraine, the noise & lights make it much worse.
I don't get migraines, but I'm generally sensitive to noise, light, and cold. ERs can be pretty unpleasant places. Plus they're full of people who are mostly in a bad mood for one reason or another.
> Plus the whining patients get treated first around here, regardless of how serious it is.
I'm not sure if that's true here. It is true that (here at least) if you're a psychiatric patient and you whine too much (or otherwise piss off the doctor/nurse/psychologist/whatever), you risk being pathologized for your whining ("hysterical," "hypochondriac," etc.).
> They were so afraid of even giving me anything.
Why?
> I got a Gravol shot for the nausea by insisting they treat that too.
Gravol? Isn't that just diphenhydramine (or something similar)? Promethazine or prochlorperazine would be my drug of choice for nausea.
> The final thing they gave me was Demerol which I didn't particularily want.
What did you want -- one of the *tripans? (It's cool that there's actually a specific tx for migraine, even if no one knows why it works. < g > Most people with chronic or recurring pain syndromes have to beg for medication.)
> As you can understand I'd rather treat pain (unless broken limbs) at home. I can do better myself.
In general, if I have pain that I can treat myself with OTC meds, then it's not bad enough that I would bother taking any medication for it. I only get headaches *very* rarely, I use a prescription NSAID for menstrual cramps, and the buprenorphine has virtually eliminated the chronic (musculoskeletal) back-neck-shoulder pain that I've been suffering for the last 6+ years. (Not the reason I wanted to try it in the first place, but certainly a nice benefit.)
-elizabeth
Posted by IsoM on February 13, 2002, at 19:45:06
In reply to Re: Hospital Emergency Rooms » IsoM, posted by Elizabeth on February 13, 2002, at 17:16:15
> I don't get migraines, but I'm generally sensitive to noise, light, and cold. ERs can be pretty unpleasant places. Plus they're full of people who are mostly in a bad mood for one reason or another.
There was one woman who whined. I heard the nurses muttering about her under their breath because the doctor on duty was picking the noisiest patients to treat first. There was also a 13 yr old girl who'd cry every time someone came near her but was giggling when nurses & the doctor was engaged elsewhere. It made my "someone needs a damn good slap" mode start up. One nurse came to me & apologised.
> I'm not sure if that's true here. It is true that (here at least) if you're a psychiatric patient and you whine too much (or otherwise piss off the doctor/nurse/psychologist/whatever), you risk being pathologized for your whining ("hysterical," "hypochondriac," etc.).
As I said, it was more due to that doctor on call, I think, than other reasons.
> > They were so afraid of even giving me anything.
I have no idea. While I've had tests at the hospital's lab before, I've never been a patient there. There's no reason & I felt too sick to argue.
> Gravol? Isn't that just diphenhydramine (or something similar)? Promethazine or prochlorperazine would be my drug of choice for nausea.
Seems like they don't dish meds out easily there. I know from previous experience that Gravol (yes, it's what you think it is) works fairly well for the nausea if given intramuscularly & they were willing to give me that. It helps with a touch of sedation too. Hardly noticable, but anything would help.
> What did you want -- one of the *tripans? (It's cool that there's actually a specific tx for migraine, even if no one knows why it works. < g > Most people with chronic or recurring pain syndromes have to beg for medication.)
Yeah, I was hoping for one of the new drugs specifically for migraines. But they told me they won't give it out unless their doctor says too. What crap! They're just to cheap to pay for it as it's expensive.
> In general, if I have pain that I can treat myself with OTC meds, then it's not bad enough that I would bother taking any medication for it. I only get headaches *very* rarely, I use a prescription NSAID for menstrual cramps, and the buprenorphine has virtually eliminated the chronic (musculoskeletal) back-neck-shoulder pain that I've been suffering for the last 6+ years. (Not the reason I wanted to try it in the first place, but certainly a nice benefit.)
Demerol isn't a good med to give for headaches as it doesn't work that well for whatever reason. This was one migraine that had me lying on the floor, I was so sick. Someone was concerned about me & took me to the hospital for help. They thought it was a good idea & I didn't know better at the time. Nothing I had done for it diminished it & the pain & nausea was getting worse.
Glad to hear your combo works good for you. I'm not even a wuss but long bouts of pain really saps so much from a person. I honestly don't know how some people manage, like those with cancer (esp bone cancer).
Posted by kpo2002 on May 29, 2002, at 10:04:25
In reply to Re: chronic pain » BarbaraCat, posted by Elizabeth on January 30, 2002, at 6:37:35
I have many other detailed informative postings about my experiences with severe chronic neuropathic pain. They can be found at:
www.dr-bob.org/babble/20020402/msgs/101474.html
www.dr-bob.org/babble/20020517/msgs/106848.html
www.dr-bob.org/babble/20020525/msgs/107931.html
www.dr-bob.org/babble/20020510/msgs/106225.html
and a few others.
Posted by reese1 on October 23, 2002, at 14:17:59
hello everyone or anyone,
this is reese, i've written before about my situation, and i finally have gotten in contact with Dr. Stoll. I have an appointment with him on the first of november.
i was told he will work with opiates. my problem is i have a high tolerance for opiates and everything else. be it regular medication , to mood stabalizer, add meds, whatever
my concern then is how do i explain this to him so i don't wast months trying opiate oriented medication of a low level. if i were to try oxycontin it would be ridulous if i was to stary at 10mg. i would have to start higher probably at 20mg. doess this sound like a bad situation? or do you think he will understand and not have to much of a problem with it?
thank you everyone, anyone, elizabeth ,
reeese
Posted by reese1 on October 23, 2002, at 15:37:18
In reply to doctors » reese scott, posted by Elizabeth on January 18, 2002, at 10:08:12
> Reese,
>
> Dr. Stoll has used opioids to treat depression, although I'm not sure if he's used bupe. He has used full agonists like oxycodone (he wrote a letter to the American Journal of Psychiatry reporting on some cases where he did this successfully), so he would probably not have a problem with bupe. I'm not sure if he's still seeing patients, though (he's very into his research on omega-3 fatty acids), and he's pretty hard to reach.
>
> Best of luck to you! You seem very persistent so I think that you will find a way to get the help you need.I have an appointment with Dr. Stoll this Nov 1 what doses does he prescribe for oxycontin. how flexible is he. i ask this because i have always had a high tolerance for all meds including opiate oriented meds. would he be willing to prescribe 20mg 3x a day or more as time went on or start at a much smaller dose which i know i will have no response to
thanks
>
> -elizabeth
Posted by BrittPark on October 23, 2002, at 16:53:36
In reply to i have an appt w/ Dr. Stoll please help anyone, posted by reese1 on October 23, 2002, at 14:17:59
Just tell Dr. Stoll that in the past you have usually required larger doses of medication than average. It's quite probable that you're a hyper-metabolizer. I am. I need to take 300mg imipramine a day to get a blood level in the middle of the therapeutic range.
Now, Dr. Stoll may still wish to start you on a low dose but if he's really used to working with opiates he'll be willing to increase dosages as needed.
If you get a chance ask him if he's heard of the combination of an opioid agonist, like oxycontin, in combination with a super low dose of naltrexone (perhaps 100 micrograms). There has been research done that shows that such a combination potentiates the action of the opioid and inhibits the development of tolerance which is of course the chief difficulty with opioid therapy. There's a company called Pain Therapeutics which is developing just such combination drugs. I think they are in stage III trials.
I think opioids are the great undiscovered country for the treatment of depression.
My apologies for ranting.
The most important thing is that you get effective treatment. Best of luck, though you shouldn't need it because you will find something that works.
Feel Better,
Britt
Posted by reese1 on October 23, 2002, at 17:07:33
In reply to Re: i have an appt w/ Dr. Stoll please help anyone » reese1, posted by BrittPark on October 23, 2002, at 16:53:36
thank you so fucking much for writing back so fast. i'm starting to feel really nervous about the whole thing.
in your expierence what are the average doses given out for oxycontin? 10mg 3x a day or is it unheard of to recieve 20mg 3x a day it i have a strange tolerance to all drugs.
i just don't want to sit around running around in my mind 24 hours a day without finding a place to sit still
it's so hard and it's been going on for over ten years
so the appt with dr. stoll is pretty important
thre's also the concern that he resides in boston and i reside in new york and i don't know how that would work for getting prescription.
what other information you have about what the typical dose is for starting someone out on oxycontin
to me starting out at 10mg seems okay. 20 would be most apporpriate.
i have taken adderall for years and i have never abused it one bit. i know how much i can take and usually i don't take my whole dose unless i feel it necessary. i am very responsible with my meedication.
thanks again
reese (doug)
Posted by Dr. Bob on October 23, 2002, at 18:18:20
In reply to Re: i have an appt w/ Dr. Stoll please help anyone » BrittPark, posted by reese1 on October 23, 2002, at 17:07:33
> thank you so f***ing much
I understand that you were just being grateful, but please don't use language that could offend others, thanks.
Bob
PS: Follow-ups regarding posting policies, and complaints about posts, should be redirected to Psycho-Babble Administration.
Posted by IsoM on October 23, 2002, at 18:36:24
In reply to i have an appt w/ Dr. Stoll please help anyone, posted by reese1 on October 23, 2002, at 14:17:59
Reese, Brittpark mentioned being a fast metabolizer before I did so that's good. I don't know enough about this doctor, but would it help to have some info about fast metabolizers printed out to show him in case he's skeptical?
It might also help to have a list of the previous meds you've been on with the dosages of each of them for him to understand and/or believe you too. If there's any past evidence or info that would affirm this idea, bring it in to him too.
Posted by reese1 on October 24, 2002, at 11:50:18
In reply to Re: doctor Dr. Stoll » Elizabeth, posted by reese1 on October 23, 2002, at 15:37:18
> > Reese,
> >
> > Dr. Stoll has used opioids to treat depression, although I'm not sure if he's used bupe. He has used full agonists like oxycodone (he wrote a letter to the American Journal of Psychiatry reporting on some cases where he did this successfully), so he would probably not have a problem with bupe. I'm not sure if he's still seeing patients, though (he's very into his research on omega-3 fatty acids), and he's pretty hard to reach.
> >
> > Best of luck to you! You seem very persistent so I think that you will find a way to get the help you need.
>
> I have an appointment with Dr. Stoll this Nov 1 what doses does he prescribe for oxycontin. how flexible is he. i ask this because i have always had a high tolerance for all meds including opiate oriented meds. would he be willing to prescribe 20mg 3x a day or more as time went on or start at a much smaller dose which i know i will have no response to
>
> thanks
> >
> > -elizabeth
>
dear elizabeth,i am concerned at what amount he will start me out on oxycontin. i know for a fact that 10mg 3xa day will be of no avail. how should i go about telling him this. i have always needed a very high dose of any medication and it will be the same with this one. should i just be honest and tell him i need to start at 20mg and will eventually maybe need to go higher.
thank you
doug
Posted by reese1 on October 24, 2002, at 16:11:45
In reply to Re: doctor Dr. Stoll » reese1, posted by reese1 on October 24, 2002, at 11:50:18
elizabeth,
for some reason i remember reading you had taken
oxycontin. how much did you get up to taking
and what did you start at?i'm very nervous about this appt. i am so in need.
just spent weeks three, with no success at NYU. after a month of searching for doctors my mother got in contact with dr. stollwhat should i expect?
how honest can i be about my past expierence. in the past i have used street drugs when i was suicidal because it was the only thing to keep me from seriously killing myslef.
thank you so much
doug
Posted by reese1 on October 24, 2002, at 16:14:03
In reply to Re: doctor Dr. Stoll » reese1, posted by reese1 on October 24, 2002, at 16:11:45
ABOVE MESSAGE IS FOR ELIZABETH OR ANYONE WHO WOULD LIKE TO REPLY
Posted by reese1 on October 24, 2002, at 16:18:13
In reply to Re: i have an appt w/ Dr. Stoll please help anyone » reese1, posted by IsoM on October 23, 2002, at 18:36:24
if anyone knows anything about the amount of dosage for oxycontin
my biggest fear is that i have a huge dosage capacity for meds. all of them.
i am scared i will have to start on such a low dosage that it will take months to take effect
how honest can i be
does anyone know what amounts of oxycontin are usualy given out from the lowest to the highest with treatment resistent depression
or anything else that has to do with oxycontin use
Posted by reese1 on October 24, 2002, at 18:02:42
In reply to Re: doctor Dr. Stoll » reese1, posted by reese1 on October 24, 2002, at 16:11:45
i'm getting confused writing on psycobable so i'm writing the same thing over and overa gain
what can i expect from dr.stolli will need to take at least 20 to 40 mg daily for oxycontin to have any effect.
should i explain this to him
i thought you mentioned that you had take oxycontin?
what did you start on
what did you get up toand how honest were you about where you wanted to start at etc
rreese
Posted by Dinah on October 24, 2002, at 18:08:15
In reply to for elizabeth, posted by reese1 on October 24, 2002, at 18:02:42
Hi Reese,
I just wanted to let you know that I haven't seen Elizabeth posting for a while. I'm not sure she still reads the boards.
I would hate to see you take it personally if she doesn't answer, or be overly disappointed.
Dinah
Posted by reese1 on October 24, 2002, at 18:19:08
what is the typical dosage a pdoc will give of oxycontin for severe problemactic depression
it has beeen fifteen years and nothing has belped. there is nothing left. i feel like the very end of the eraser on a bitten down pencil which can no longer write or erase.
ten hospitals. nothing. and i how i hate them.
in the past i've tried percocets nothing
vicoden nothing
oxycontin 20 or 40 mg made me for the first time in my life feel like myself again. i could go outside. use the telephone. go on the computer. look for a job. laugh. look at the sky. anything but what is normally considered normal.but that was short lived since i was given the meds because i had almost cut my thumb off through an accident
how do you go about explaining this to a doct who
works with opiates. i have an appt with a very
good doctor who works with opiates on nov 1. dr. stoll.i am so scared that i will get a prescription for 10mg 2x a day and have to make it through three more months till i reach some sense of safety.
now i wake up and cry and do for the rest of the day, terrified of sleep. and when i am not upset i walk from room to room, in circle to circle without gain or stop.
thank you everyone
reese
Posted by reese1 on October 24, 2002, at 19:09:13
In reply to Re: i have an appt w/ Dr. Stoll please help anyone » reese1, posted by IsoM on October 23, 2002, at 18:36:24
please if anyone knows what the typical amount of
dosage that is prescribed for oxycontin for treatment refractory depression is?my fear is that i have a high resistance to all drugs
and starting on 10mgs would do no good
does anyone know anything about this or hwo i should go about it
thank you
reese
Posted by BrittPark on October 24, 2002, at 19:57:37
In reply to Re: i have an appt w/ Dr. Stoll please help anyone, posted by reese1 on October 24, 2002, at 19:09:13
Someone with terminal cancer pain might be on a regiment of 30mg OxyContin t.i.d. or even q.i.d. There is no reason to believe that you'll need to take 90 to 120 mg of OxyContin to get relief from depression. Analgesia and AD effects don't necessarily go hand in hand. So, relax (I know that is not necessarily possible), and wait for your appointment, and when the time comes explain your concerns as calmly and dispassionately as possible. If Dr. Stoll is a good psychiatrist he'll listen.
Feel Better,
Britt
Posted by BrittPark on October 24, 2002, at 20:11:51
In reply to elizabeth about dosing on opiates/ anyone, posted by reese1 on October 24, 2002, at 18:19:08
Definitely tell Dr. Stoll what you've said here, particularly the fact that 30mg OxyContin was the only relief from depression that you've had. Do try to avoid the the hot button phrases like "I need OxyContin at 30mg t.i.d." Phrase it as "I found that so and so dose of OxyContin gave me great relief. I'd like to try it again."
Best of luck,
Britt
Posted by reese1 on October 25, 2002, at 16:06:05
In reply to Re: for elizabeth » reese1, posted by Dinah on October 24, 2002, at 18:08:15
dinah thank you for telling me that. do you know of any information that might help me for my meeting with dr. stoll.
i'm just terrified because of my high tolerance and how to go about explaining that to him
i don't want to stay on 10mg of oxy 2 x a day for a month because i will be in the same place i am now which is not worth writing words to describe
thank you for anyone who might have a word or more
for advice
Posted by oracle on October 25, 2002, at 16:32:36
In reply to Re: for elizabeth and dinah and everyone, posted by reese1 on October 25, 2002, at 16:06:05
There is no point in working yourself up about what "might" happen. Make your case but don't demand anything. If whatever med is not working, call the doc back to discuss, there is no reason to wait till next appt.
This is the end of the thread.
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