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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by pretty_paints on January 13, 2005, at 11:25:54
Hello!
This post doesn't really tie in very well with the last post I just posted. I wrote it a few days ago but didn't really get many replies as it somehow got deleted. Even though things have changed now, I thought I'd re-post it to see if anyone had any thoughts, they would still be valuable.
Anyway, onto today. I have just been in to see the consultant pdoc with my dad and she was BRILLIANT. She asked me about everything really clearly, starting with the antidepressants (venla, mirt). Side effects, how they made me feel, etc etc.
Then went onto the AP Quetiapine, and went through all that really quickly.
She went into detail about exactly what we were dealing with, explained that the reason I didn't have a diagnosis wasn't because they were bad doctors but was because it is always difficult to tell with mental health problems.
For me, the diagnosis is between psychotic depression and a schizophrenia-based disorder. So whether I got depressed and then psychotic, or whether the psychotic symptoms have been building up to the point where they got me depressed. She was the first one who's actually EXPLAINED PROPERLY what she thought. Everyone else has basically decided to dance around the issue, leaving me in limbo as to what's going on. She said she is on the side of schizophrenia-based illness, because my psychotic symptoms are "bizarre" and not "mood congruent". Mood congruent, ever heard of that? I hadn't until today. Basically my psychotic symptoms do not really tie in with the depression. Some do, I hear voices in my head telling me I'm stupid a lot of the time (my voice though). But a lot of my thoughts are not of a depressed tone.
She explained what can cause psychosis (the first pdoc to really do this). We sorted out which of my thoughts is the "marker thought", one which we can use to determine whether or not a drug is helping. She was just very clear, very sorted, very positive about it all. I cannot sing her praises highly enough! She knew all about cambridge, explained that lots of students experience things like this. She explained a lot to my dad so that he understood everything that was going on.
Anyway, it has been decided to change to aripiprazole (Abilify). Mainly because, yes all the big-time psychotic thoughts have gone, but apparently paranoia and some risidual thoughts are still there. PLUS I sleep till the afternoon EVERY DAY on these ridiculously sedating Quetiapine tablets. So that is not really on. She is also gonna send me some information sheets through on Abilify!
So, all is well I hope. I am still feeling very on the edge as I have been having things with Ally (a guy in my life who is kind of tied up with my bad thoughts) going on. But I just set up a new thing with blockbuster, a free trial where I get to rent as many dvds as I want in a month! And I can get 3 at a time, order them online and then they plop through my letterbox! Yay! I ordered Silence of the Lambs, Hannibal - and the finale of Dawson's Creek!! Woooh. So that has cheered me up. Don't know what the Silence of the Lambs will be like, supposed to be scary :oO But I've heard that it's brilliant too, so hmm. We shall see. xxxx
PS: Some bad news though. I found out that my normal pdoc has been diagnosed with Multiple Schlerosis (sp!) and will be off to the end of Feb. I can't believe it, I feel so bad for her. She has 4 children. And she's so lovely. Grrrrrrrrrrr. Things arn't fair.
Posted by ed_uk on January 13, 2005, at 11:42:51
In reply to SUPER CONSULTANT PSYCHIATRIST!!, posted by pretty_paints on January 13, 2005, at 11:25:54
Hello!
It's so cool that your doctor is good! You sound really happy about your appointment :-)
I don't know what the American name for a consultant is, is it an 'attending'?
I think it is a good idea to try Abilify, if you don't like it you could try Solian (amisulpride).
Like Risperdal, Abilify sometimes causes akathisia (restlessness) so it would be useful to have a few procyclidine tablets available.
Ed xxx
Posted by pretty_paints on January 13, 2005, at 11:56:43
In reply to Re: SUPER CONSULTANT PSYCHIATRIST!! » pretty_paints, posted by ed_uk on January 13, 2005, at 11:42:51
Argh, really?
Rispiridone was a complete nightmare for that reason. Is Abilify thought to be worse than Zyprexa and Seroquel?
:o(
Posted by ed_uk on January 13, 2005, at 12:05:46
In reply to Re: SUPER CONSULTANT PSYCHIATRIST!!, posted by pretty_paints on January 13, 2005, at 11:56:43
Hi!
I would say that Abilify is more likely to cause akathisia than quetiapine. It's too new to accurately compare the risk of akathsia with Zyprexa. You'll probably be fine, just make sure you've got some procyclidine or diazepam to calm you down if you get akathisia. If you don't have any at home you could always get a few tablets from your GP. I'm sure s/he'd be willing to prescribe something once you've described your experience with Risperdal and akathisia.
Ed xx
Ed xx
Posted by Iansf on January 14, 2005, at 0:45:30
In reply to Re: SUPER CONSULTANT PSYCHIATRIST!! » pretty_paints, posted by ed_uk on January 13, 2005, at 11:42:51
> I don't know what the American name for a consultant is, is it an 'attending'?
>
Do you mean you don't know what the American "definition" is for consultant? Because it's definitely a term we use in the U.S. If you are asking what the definition is, in terms of medicine it's a doctor who doesn't have a regular roster of patients but rather sees patients being treated by other physicians. Other physicians send a patient to the consultant to help figure out a problem the regular physician can't solve. Once the consultant has provided input, the patient returns to his or her regular physician to continue treatment.
Posted by ed_uk on January 14, 2005, at 12:34:58
In reply to Re: SUPER CONSULTANT PSYCHIATRIST!! » ed_uk, posted by Iansf on January 14, 2005, at 0:45:30
>Do you mean you don't know what the American "definition" is for consultant?
No, I meant that I don't know what the American equivalent of our consultant is called.
I was under the impression that what we call a consultant physician you would call an attending physician.
Our grades of hospital physician/surgeon....
Highest.... consultant, associate specialist, specialist registrar, staff grade, senior house officer (SHO), house officer (PRHO)....... Lowest.
Ed.
Posted by Iansf on January 18, 2005, at 0:20:24
In reply to Re: SUPER CONSULTANT PSYCHIATRIST!! » Iansf, posted by ed_uk on January 14, 2005, at 12:34:58
> Our grades of hospital physician/surgeon....
>
> Highest.... consultant, associate specialist, specialist registrar, staff grade, senior house officer (SHO), house officer (PRHO)....... Lowest.
>
>
> Ed.I've never heard anyone refer to grades of physician here. We have interns, who are still in medical school but receiving on-the-job training; residents, who have completed medical school and are now learning a specialty; and supervising physicians, who oversee the residents. The residents oversee the interns. Generally, the attending physician is either your own doctor or a specialist your physician has sent you to; if you don't have your own doctor, then a resident will be assigned as your attending physician. Any other gradations have to do with hospital administration -- chief of staff, head of radiology, etc. -- and are not, strictly speaking, medical titles.
John
Posted by ed_uk on January 19, 2005, at 5:26:32
In reply to Re: SUPER CONSULTANT PSYCHIATRIST!!, posted by Iansf on January 18, 2005, at 0:20:24
Hi John,
Thank you for the summary :-)
>Generally, the attending physician is either your own doctor or a specialist your physician has sent you to.
That sounds basically like what we would call a consultant.
Regards,
Ed.
This is the end of the thread.
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