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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by Berberis on January 7, 2006, at 21:51:53
I have a long history of noncompliance with meds my pdoc prescribes. By noncompliance I don't mean I don't take the drugs; I stop them and restart them or change the doseage without consulting him. I don't tell him I'm messing with the meds because I don't want to *bother* him. Even when I feel I'm not doing well and may need a med tweaking, I think I can't possibly be bad enough to warrant a call to him. Usually when I make changes on my own, I regret it. I don't get why I don't learn from these mistakes. The latest go round is I stopped one drug and cut another in half. I see pdoc the week after next and worry about whether to tell him or not. I know how stupid this is but I can't seem to stop this behavior. I don't know what to do. Anyone in the same boat?
Posted by zeugma on January 7, 2006, at 22:08:19
In reply to Noncompliance, posted by Berberis on January 7, 2006, at 21:51:53
Why would you think it would bother him?
There is no set level of badness that you need to meet in order to call him.
Do you feel that your pdoc is doing a good job in terms of the meds he prescribes?
-z
Posted by Phillipa on January 7, 2006, at 22:09:47
In reply to Noncompliance, posted by Berberis on January 7, 2006, at 21:51:53
Of course and I think we know our own bodies better than a pdoc does. They are not the ones experiencing what we are. Many times I have taken a little more or less of a med as I know I should. Nothing major. Fondly, Phillipa
Posted by Dinah on January 7, 2006, at 22:14:37
In reply to Noncompliance, posted by Berberis on January 7, 2006, at 21:51:53
All the time. My pdoc is pretty understanding of it. Or at least if he minds, he doesn't say so.
I've just now decided to try to take medications at a steady dose without trying to do without them.
I'd tell him about it. Some doctors get pretty upset about it (my old pdoc did), but if you're going to do it it's best to find a pdoc you can be honest with about it.
Posted by wildcard on January 7, 2006, at 23:08:49
In reply to Noncompliance, posted by Berberis on January 7, 2006, at 21:51:53
yeah, i've always done that and been okay but some people aren't which is the concern. if you don't feel you can talk openly w/ your doc, if it's an option, can you find a different one you can talk too? i know that where i live and the doc i see (partial state funded), unless it's a life/death emergency your usually brushed to the side. i hope you have better options. just be careful...
Posted by Berberis on January 8, 2006, at 7:47:12
In reply to Re: Noncompliance » Berberis, posted by zeugma on January 7, 2006, at 22:08:19
> Why would you think it would bother him?
I'm not sure. I think I don't want to appear to be a whiner.
>
> Do you feel that your pdoc is doing a good job in terms of the meds he prescribes?Yes, I do. He's a good guy and very understanding. I don't want to be a difficult patient.
>
> -z
Posted by Berberis on January 8, 2006, at 7:53:08
In reply to Re: Noncompliance » Berberis, posted by Phillipa on January 7, 2006, at 22:09:47
> Of course and I think we know our own bodies better than a pdoc does. They are not the ones experiencing what we are.
I think this is true and works for many people, but I don't think it always works for me. Often the meds seem to be working at the dose he prescribes and I'm stable, then I change everything and get unstable. I'm sabotaging myself. He knows it and I know it. We both know I've been doing this for a long time. He must be fed up with me.
Posted by Berberis on January 8, 2006, at 7:55:02
In reply to Re: Noncompliance » Berberis, posted by Dinah on January 7, 2006, at 22:14:37
> I'd tell him about it. Some doctors get pretty upset about it (my old pdoc did), but if you're going to do it it's best to find a pdoc you can be honest with about it.
Yeah, you're right. I'm going to tell him and hope I don't see the eye roll. I don't have any intention of leaving this pdoc.
Posted by fairywings on January 8, 2006, at 19:54:53
In reply to Noncompliance, posted by Berberis on January 7, 2006, at 21:51:53
My pdoc is good about listening to how I feel on a drug and adjusting based on how I feel. I tell him when I've increased or decreased betw. appts, and he's been fine with that, but I do see him every mo., and I'd never tweak very much. I've only done it with one med, and we've tried diff. dosages at diff. times. I guess some docs are more comfortable with it, and I guess some of it depends on what you're on, and if there are several meds involved. Maybe at your appts. discuss with him how he feels about your tweaking a bit up or down, and how much tweaking is okay, or if you should call b4 tweaking. If you're not having good results though maybe stick with what's rx'd and make an appt. to discuss it with him.
fw
Posted by fairywings on January 8, 2006, at 19:57:55
In reply to Re: Noncompliance, posted by Berberis on January 8, 2006, at 7:53:08
opps, didn't read that. if you're sabotaging, then you better stick with what he is rxing. I don't mean to be critical, that's not my intention, but is it possible it's attention seeking? It happens to the best of us. I'm sure your pdoc has heard it all, seen it all. I'm sure you're not the only one who's self sabotaging.
fw
Posted by Berberis on January 8, 2006, at 20:37:48
In reply to Re: Noncompliance » Berberis, posted by fairywings on January 8, 2006, at 19:57:55
>is it possible it's attention seeking? It happens to the best of us. I'm sure your pdoc has heard it all, seen it all. I'm sure you're not the only one who's self sabotaging.
>
You ask a very good question, which I've asked myself. I don't think it's attention seeking. I think what I keep doing is: get stable...take it for granted...start focusing on undesirable side effects of drugs...start messing with them thinking I can feel better if I do so. I also think a big component of all this is I WORRY about being on the drugs and their long-term effects. I also often convince myself I don't need any meds to feel okay.
Posted by wildcard on January 8, 2006, at 22:07:01
In reply to Re: Noncompliance, posted by Berberis on January 8, 2006, at 20:37:48
Been there many many times. Feel better, stop meds, then crash. (sigh) I know how you feel...
Posted by Berberis on January 9, 2006, at 9:33:23
In reply to Re: Noncompliance » Berberis, posted by wildcard on January 8, 2006, at 22:07:01
> Been there many many times. Feel better, stop meds, then crash. (sigh) I know how you feel...
Why do we do this? It may be that I can't accept that there's really anything wrong with me. The bipolar diagnosis is also a hard pill to swallow, so to speak.
Posted by wildcard on January 9, 2006, at 9:37:26
In reply to Re: Noncompliance » wildcard, posted by Berberis on January 9, 2006, at 9:33:23
That's the reason for me. EXACTLY! I cannot 'accept' that I have an illness that requires medication to help so once I begin to feel better I decide to try mind over matter again and it is very frustrating, especially when people you know do not believe your illness is real. I tell them to walk in my shoes for one day!
Posted by yxibow on January 9, 2006, at 12:32:15
In reply to Noncompliance, posted by Berberis on January 7, 2006, at 21:51:53
> I have a long history of noncompliance with meds my pdoc prescribes. By noncompliance I don't mean I don't take the drugs;
That's exactly what noncompliance means...
>I stop them and restart them or change the doseage without consulting him.
That can be dangerous with medications that one can get habituated to. Cold turkey is really not a fun thing.
>I don't tell him I'm messing with the meds because I don't want to *bother* him.
If a doctor doesn't have an emergency number, a page, or an answering service, they're doing their patients a disservice not to mention putting them in harm.
>Even when I feel I'm not doing well and may need a med tweaking, I think I can't possibly be bad enough to warrant a call to him.
I understand this, I've done this on a few occasions, but when I reveal this he may or may not be the most pleased. Suppose you took a major dose of a benzodiazepine or a barbiturate. What would the autopsy say ? How much would his malpractice insurance go up? And who would this decision be attributed to ? I may be exagerating but it happens, and that's the usual response I get, especially when I decide to pop a small dose of some expired thing we had tried before. Sure, it's a collaborative effort -- the doctor is driving the bus and you're looking at the road to see that he's in the right lane, but that's how it is.
>Usually when I make changes on my own, I regret it. I don't get why I don't learn from these mistakes. The latest go round is I stopped one drug and cut another in half.
One might want to reflect, and I am not trying to be in an accusative case, whether its somewhat self-destructive behaviour. I mean that in the best of terms I can say it.
>I see pdoc the week after next and worry about whether to tell him or not.
You might as well, because whether they will lecture you or not, suppose they prescribe something that then mixes wrongly with what he or she thought was actually going on with you? Egads!
>I know how stupid this is but I can't seem to stop this behavior. I don't know what to do.
Just tell the doctor what is going on, and figure from then why you're doing it, what medications really set you off and if the doctor has any compassion which they ought to, maybe both of you will delve into something else that will make you feel better instead of a Didnt-Attend-Medical-School-Dr. You and Dr. Them decision strategy. I think that would be far better. And if your doctor is really not listening to what pains you and what really works for you, maybe its time for a new doctor.
I hope that helps.
Cheers.
- J
Posted by Racer on January 9, 2006, at 17:03:29
In reply to Re: Noncompliance, posted by Berberis on January 8, 2006, at 7:53:08
>
> I think this is true and works for many people, but I don't think it always works for me. Often the meds seem to be working at the dose he prescribes and I'm stable, then I change everything and get unstable. I'm sabotaging myself. He knows it and I know it. We both know I've been doing this for a long time. He must be fed up with me.
>First of all, treating YOUR mental illness doesn't really concern whether or not he's fed up with you. It's not about him, it's about you.
Then again, it does sound as though YOU'RE rather fed up with yourself...
You're probably right that you're sabotaging yourself, and that you need to stop. The best advice I can offer is to see a therapist about just this issue. Of course, most of us can do better with a combination of therapy and meds, than either alone, so maybe a therapist is a good idea anyway? Regardless, do see someone to figure out why you do this, and how to stop.
Which brings me to:
If you know that you're doing well on a particular dose of a particular med, what is it that makes you change it? Do you get antsy because you're not having enough drama? Or are you having trouble with side effects that bother you? Or do you not think that you need the meds? What starts you off on changing things? Once you figure that part out, it'll be much easier to stop doing it.
Good luck.
Posted by Berberis on January 10, 2006, at 7:04:40
In reply to Re: Noncompliance » Berberis, posted by yxibow on January 9, 2006, at 12:32:15
> One might want to reflect, and I am not trying to be in an accusative case, whether its somewhat self-destructive behaviour.
>
Very possibly. I don't like myself much.Thanks for taking the time to give me your thoughts and suggestions.
Posted by Berberis on January 10, 2006, at 7:16:58
In reply to Re: Noncompliance » Berberis, posted by Racer on January 9, 2006, at 17:03:29
> First of all, treating YOUR mental illness doesn't really concern whether or not he's fed up with you. It's not about him, it's about you.
>
> Then again, it does sound as though YOU'RE rather fed up with yourself...EXTREMELY fed up with myself.
>
> You're probably right that you're sabotaging yourself, and that you need to stop. The best advice I can offer is to see a therapist about just this issue. Of course, most of us can do better with a combination of therapy and meds, than either alone, so maybe a therapist is a good idea anyway? Regardless, do see someone to figure out why you do this, and how to stop.
>
Been in therapy for a few years now. This topic has never been discussed, probably because I'm embarrassed to admit I'm purposely making things worse for myself constantly. I truly DO NOT want to be miserable! I see my T next week; will print out this thread and discuss with her.> If you know that you're doing well on a particular dose of a particular med, what is it that makes you change it? Do you get antsy because you're not having enough drama?
That thought has crossed my mind, but I don't like to consider it too seriously.
> Or are you having trouble with side effects that bother you?
Yes, almost always.
> Or do you not think that you need the meds?
I often believe I don't really need the meds because I'm not mentally ill.
> What starts you off on changing things?
I either feel fine and tell myself I don't need to take medication or I feel lousy and accuse the meds of not helping.
Thanks for making me think more about why I'm doing this, Racer.
Posted by Racer on January 10, 2006, at 12:03:37
In reply to Re: Noncompliance » Racer, posted by Berberis on January 10, 2006, at 7:16:58
> >
> Been in therapy for a few years now. This topic has never been discussed, probably because I'm embarrassed to admit I'm purposely making things worse for myself constantly. I truly DO NOT want to be miserable! I see my T next week; will print out this thread and discuss with her.Good for you. That takes a heck of a lot of courage, and it's great that you can do that. Good luck to you, and all the support you need.
>
> > Or are you having trouble with side effects that bother you?
>
> Yes, almost always.Can you talk to your doctor about them? That is, do you trust that your doctor takes your reports seriously? (If you don't trust your doctor, can you fire him and find another?) Many side effects can be mitigated, if your doctor is willing to work with you. Obviously, though, if your doctor just says, "Yeah, and?" that's not going to help you. But most side effects can be addressed, one way or another. Find a doctor who will work with you on this, and ask your T to help you figure out how to address it with your doctor.
What are you taking, and what side effects do you have? Knowing that may help folks here suggest ways to counter those side effects.
>
> > Or do you not think that you need the meds?
>
> I often believe I don't really need the meds because I'm not mentally ill.Very common. Here's a question, which you don't have to answer: if you're not mentally ill, why are you in treatment? Keep in mind that depression is a serious mental illness. How many people out there are suffering depression? ALL of them are mentally ill. Mental illness ain't such a shameful thing, if so many people experience it. Sure, you may have a dx that sounds more frightening to other people, but what does their opinon really matter? The bottom line is that it takes a lot of courage to get treatment, and it reflects well on you that you continue to pursue it.
>
>
>
> Thanks for making me think more about why I'm doing this, Racer.No problem. Good luck with it.
This is the end of the thread.
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