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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by obsidian on July 23, 2009, at 21:34:00
each other, or some person considered expert in something? or maybe they'd really hate that?
what do you think?
Posted by Phillipa on July 23, 2009, at 23:42:12
In reply to you think pdocs like to do consultations with...., posted by obsidian on July 23, 2009, at 21:34:00
I think it depends on the location, does the doc work in a large practice, hospital setting? A lone pdoc I think maybe not. Some have large egos and some are open to new ideas. Love Phillipa
Posted by yxibow on July 24, 2009, at 1:50:31
In reply to you think pdocs like to do consultations with...., posted by obsidian on July 23, 2009, at 21:34:00
> each other, or some person considered expert in something? or maybe they'd really hate that?
> what do you think?Some psychiatrists sometimes have peer groups that exchange ideas from their cases in an anonymous fashion.
Some probably have friend networks who will cover for them when they are on vacation and vice versa.
As for consultations.... I think you'd be getting a more unbiased opinion by having a second consult yourself with another doctor.
It is after all, something that should come from your viewpoint... yes, in teaching hospital situations, in a hospital setting, residents weigh in on a case, but we are talking about outpatient care here.
I don't think its a matter of whether one likes to do something or not (or it shouldn't), its something that is pro-active, something that you set up. You have the right to have other viewpoints.
A little information could be sent over from your previous doctor about your case but basically it would be up to you to discuss your situation and see if the other doctor has ideas / medications /etc that could be sent back to your primary psychiatrist.
Generally these consultations are not cheap... if you are already privately paying for a psychiatrist, it is probably a bit more expensive, and there may be a followup possibly.
That's my experience anyhow.-- Jay
Posted by Phil on July 24, 2009, at 5:58:07
In reply to you think pdocs like to do consultations with...., posted by obsidian on July 23, 2009, at 21:34:00
They all think they're smarter than their peers.
Example: After attempting suicide last month, I called my pdoc immediately. He said to go to a local psych / rehab hospital so they could get me balanced or something to that effect.
My psychiatrist at the hospital was a very cool lady(which was refreshing)
I had been on: 90 mg Cymbalta, 1200mg Lithium,
1.5mg Clonazepam, and 400mg Lamictal.She dropped the dose to 60mg Cymbalta and 600mg Lithium and left the others unchanged. She said sometimes less is more.
I see my regular pdoc shortly after getting out.
He ups the Lithium to 900mg and says Lithium cannot augment your AD below 900mg.
He upped the Cymbalta back to 90mg and said, you don't drop an AD dose on a severely depressed patient.I'm thinking, why the hell did I go to hospital(which I actually enjoyed)other than my safety?
Why couldn't my pdoc be more professional in how he handled it? Personally, I would have said, you know, I have a lot of respect for Dr. 'B' but I really feel we should do it my way.
Fine Dr. A but your way is what landed me in the hospital in the first GD place!
Assume they are self-absorbed educated idiots until proven otherwise.
Posted by obsidian on July 24, 2009, at 11:45:14
In reply to Re: you think pdocs like to do consultations with.... » obsidian, posted by yxibow on July 24, 2009, at 1:50:31
I know it won't be cheap. I just don't want to alienate my current pdoc. He's stuck with me for a long time, and I don't want to lose him.
However, I feel the need to find out about other possibilities. I've got a new medical issue to consider too, and while I'm less anxious than I have been in the past I still deal with a great deal of anxiety/fear.
We'll see how it works out.
Thanks,
sid
Posted by obsidian on July 24, 2009, at 11:50:57
In reply to Re: you think pdocs like to do consultations with.... » obsidian, posted by Phil on July 24, 2009, at 5:58:07
that's what I'm afraid of, although I'd like to think my pdoc is more interested in research and psychopharmacology than other stuff
so, now that you're out of the hospital, what's new with your meds? are you feeling alright today?
-sid
Posted by obsidian on July 24, 2009, at 11:51:33
In reply to Re: you think pdocs like to do consultations with.... » obsidian, posted by Phillipa on July 23, 2009, at 23:42:12
I hope mine is open to new ideas.
-sid
Posted by Phil on July 24, 2009, at 17:36:48
In reply to Re: you think pdocs like to do consultations with.... » Phil, posted by obsidian on July 24, 2009, at 11:50:57
Not OK, nope, uh uh, nyet. First mixed states episode this morning that frankly scared the sh*t out of me.
I was so wired with tears running down my face. I knew what was happening but felt I could get thru it. I ate, took my meds(includine Pristiq)which has knocked this disease into a whole new realm. I worked on my breathing and tried to relax. I'm not OK but better.
If this weekend continues to be bizarre, I'm telling the doc to get me off this crap now.
I've sent out word to friends to find me some pot now. I have extensive experience with it and I know it will help. No sativa's though, I need a mind numbing, I can't even walk to bed indica.
Praise the lawd
Posted by obsidian on July 24, 2009, at 17:57:36
In reply to Re: you think pdocs like to do consultations with.... » obsidian, posted by Phil on July 24, 2009, at 17:36:48
I hope this gets better soon
I am a big fan of pot, too much of one in factbe well,
sid
Posted by floatingbridge on July 24, 2009, at 22:12:59
In reply to Re: you think pdocs like to do consultations with.... » obsidian, posted by Phil on July 24, 2009, at 17:36:48
Phil,
I'm so sorry to hear that this is happening to you. Is this your first mixed state episode, or your first on pristiq? I really don't know my meds--have you brainstormed w/ any of the experienced babblers here? Can you temporarily increase your klonopin around the clock to give you some relief from what sounds like terrible anxiety? Sometimes, one must muscle through, as we all know. But the benefits of comfort and finding immediate relief in a storm should not be diminished.
please keep us posted if you will,
fb
Posted by floatingbridge on July 24, 2009, at 22:24:20
In reply to you think pdocs like to do consultations with...., posted by obsidian on July 23, 2009, at 21:34:00
Hi Obsidian,
My pdoc seems quite engaged in continuing education and updating his knowledge. I know he also talks w/ people in adjunct fields like endocrinology and other MD's. He has his favored views and personal interests w/in his field--you know, his 'take' on things. However, he's also open to new ideas and this seems like as it should be....however, he is the first shrink I have seen that seems to relish acquiring knowledge. Others have been open to consultation to varying degrees. (And a few just don't seem to give a sh*t.... I mean, it's just a job to them. Oh, and I suppose some could be vindictive or vain if they felt 'threatened' but that's not right, is it?)
I don't know your shrink--what do you think of him/her?
good luck
fb
Posted by Phil on July 25, 2009, at 1:02:22
In reply to Re: you think pdocs like to do consultations with. » Phil, posted by floatingbridge on July 24, 2009, at 22:12:59
First mixed state episode. I've bounced ideas off experienced babblers here but I've been here since almost day one so this ain't my first rodeo.
Just my most bizarre.I'm eating clonazepan like jelly beans right now.
thanks
Posted by yxibow on July 25, 2009, at 20:53:00
In reply to Re: you think pdocs like to do consultations with.... » obsidian, posted by Phil on July 24, 2009, at 5:58:07
> They all think they're smarter than their peers.
That's a bit of high generalization don't you think ?
I'm sure you know your psychiatrist but I happen to know that both ethically and just by personality, my doctor is not opposed to consultations by various other doctors, even other (related) fields.
I admit there are "Dr. God" types of doctors but if you're paying for one and seeing one and you get that impression a lot, why continue?
(This is not a "dump your doctor" statement -- I don't really approve of that sort of line)
> Example: After attempting suicide last month, I called my pdoc immediately. He said to go to a local psych / rehab hospital so they could get me balanced or something to that effect.
Well, I'm not sure what country you're in, but in the US in general, or at least in this part, you're bound as a doctor to report only a few things: imminent danger of harm to self or others, potential danger of child abuse, and potential danger of elder abuse. And possibly DMV related things only if they get to a certain level. But there are few things that go outside the doctor-patient relationship.So if you reported a suicide (attempt), why wouldn't you be in a hospital ?
> My psychiatrist at the hospital was a very cool lady(which was refreshing)
>
> I had been on: 90 mg Cymbalta, 1200mg Lithium,
> 1.5mg Clonazepam, and 400mg Lamictal.
>
> She dropped the dose to 60mg Cymbalta and 600mg Lithium and left the others unchanged. She said sometimes less is more.This is one view of medicine, that the fewer agents the better, the fewer side effects, and simplification.
> I see my regular pdoc shortly after getting out.
> He ups the Lithium to 900mg and says Lithium cannot augment your AD below 900mg.
> He upped the Cymbalta back to 90mg and said, you don't drop an AD dose on a severely depressed patient.Hmm.... Actually its never been proven that beyond 60mg is any better than 60mg itself; although I went up to 80, 90 and 120 when I was on it.
> I'm thinking, why the hell did I go to hospital(which I actually enjoyed)other than my safety?I do see the argument here.... (enjoying a hospital is not something I've ever felt, but....)
I would say safety.... and yes, hospitals have been known as a place if you -really- need to adjust your medications, which I can see was changed again.... not sure what to say there..
> Why couldn't my pdoc be more professional in how he handled it? Personally, I would have said, you know, I have a lot of respect for Dr. 'B' but I really feel we should do it my way.
>
> Fine Dr. A but your way is what landed me in the hospital in the first GD place!Well.... suicide attempts do go there... But please don't take that as any character assassination or implication that that feeling or urge is your fault.
> Assume they are self-absorbed educated idiots until proven otherwise.
I think you should have a discussion with your doctor and be open about just how you really feel. I think of doctor relationships as a give and take relationship and not something where you sit down and no part is taken in things.
So I can see at least -part- of your argument here.
-- Jay
Posted by obsidian on July 25, 2009, at 23:19:15
In reply to Re: you think pdocs like to do consultations with.... » Phil, posted by yxibow on July 25, 2009, at 20:53:00
I really hope my pdoc thinks that consultations are a good thing.
I've got some real real concerns right now, a few of them.
Posted by floatingbridge on July 26, 2009, at 0:18:11
In reply to Re: you think pdocs like to do consultations with.... » yxibow, posted by obsidian on July 25, 2009, at 23:19:15
> I really hope my pdoc thinks that consultations are a good thing.
> I've got some real real concerns right now, a few of them.
>Sid, when are you seeing your pdoc again? I hope your s/he is able to give you the support you need. If you feel it might be helpful, maybe you could get some feedback on some of your concerns here at babble before you go. Or babble mail some people here who you think might be helpful.
fb
Posted by Phil on July 26, 2009, at 8:52:38
In reply to Re: you think pdocs like to do consultations with.... » Phil, posted by yxibow on July 25, 2009, at 20:53:00
I'm 56, I've seen shrinks for 25 years. I have no idea how old you are or what your experience has been.
Pristiq was making me very aggressive and angry and frustrated, even posting here. So I apologize for that.
I'm no dumbass and know how to talk to doctors. I don't sit there like a bump on a log and say. OK, if you believe this heroin will work, give me some.
My doctor told me, in effect, that Pristiq passes straight thru your liver so side effects should be few. Yeah? For me, it's the most dangerous med I've ever taken.
I'm in the US, Austin to be exact. My pdocs have their degrees from some of the most pristigeous schools in the country.
That goes to show how hard bipolar is to treat and why it carries the highest suicide rate of any MI.
Thanks for your input and again I apologize for overly generalized aggresive posts.
But, like I've said before, this ain't my first rodeo.
Phil
Posted by obsidian on July 27, 2009, at 16:31:23
In reply to you think pdocs like to do consultations with...., posted by obsidian on July 23, 2009, at 21:34:00
so, I'm just going to taper myself off my meds over time to try going med free for a while
am I acting out? probably
do I care? not really, it might be the best thing anyway.I am not a fan of psychiatry at the moment. In fact I don't feel good about anything right now.
medication can't be my solution.
it'll be rough for a while, but I know I'll be ok.thanks folks,
sid
Posted by yxibow on July 28, 2009, at 14:54:24
In reply to the discussion didn't go well...., posted by obsidian on July 27, 2009, at 16:31:23
> so, I'm just going to taper myself off my meds over time to try going med free for a while
I wouldn't do that but its up to you. Whatever benefit, small or big, side effect or not, you will NOT have if you aren't taking your medications.
> am I acting out? probablyAre you? I can't answer that and I won't try to insult you but think about this wisely before you do it, because I think you're also (below) asking for help in this way.
> do I care? not really, it might be the best thing anyway.
I think you do because you wouldn't be posting otherwise. You want some reassurance and I can't reassure dumping all medications, even through the crap you've been with doctors.
We argue with doctors at times. I argue too. Sometimes its constructive and sometimes not.
> I am not a fan of psychiatry at the moment. In fact I don't feel good about anything right now.I can understand that, really. Its not a panacea, and it is still a branch of medicine that is in its middle ages of what we know.
> medication can't be my solution.
It can't be the ONLY solution for anyone... doing some sort of therapy or even reading self-help books adds to things... its not as simple as just downing pills.
> it'll be rough for a while, but I know I'll be ok.
It -could- be quite rough depending on the medications you're on. I don't know what you're on... there was an example someone was adjusting SNRI doses. If you're on one of those, e.g. Effexor, etc.... it will be HARD to get off of it alone.
>
> thanks folks,
Good luck, I think it is a heated reaction but I wasn't there and if you decide to go AMA on your regimen, you should give it a week or a few days at least to really think about before you do it.
Because if you interpreted your doctor's discussion as "not well" and I wasn't there.... it sure won't be well when you go off your medications.
Unless you're determined to also cancel your doctor because of his opinion -- I'd really have one picked on board to replace before you decide to do this and -not- try to start removing medications when you're just about out of them, but when you have a full refill.
Also your doctor has his ethical obligations too and he should point you in any direction other than himself for a place to go. You don't drop psychotropics like a lead brick. Believe me.-- Jay
Posted by obsidian on July 29, 2009, at 20:38:40
In reply to Re: the discussion didn't go well.... » obsidian, posted by yxibow on July 28, 2009, at 14:54:24
I know, I don't think I was thinking clearly, I was so upset
I've been slowly letting go of that notion...I've been thinking to myself..
"I do have to somehow function at work, would I get depressed and anxious? and even if these effects were transitory, could I really ride it out without losing time at work?"I'm going to see a consultant in a couple of weeks, I don't see regular pdoc for a month anyway. I'm open to what might be said about me...I don't understand a lot of things about me.
thank you yxibow
Posted by obsidian on July 29, 2009, at 21:33:19
In reply to Re: the discussion didn't go well.... » obsidian, posted by yxibow on July 28, 2009, at 14:54:24
I also happen to take effexor, which by all accounts, is hard to withdraw from.... I don't want to deal with the backlash.
This is the end of the thread.
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