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A Combination Cardiology and Psychology Doctor?

Posted by Messy on May 12, 1999, at 14:50:02

A 71-year-old male I know had heart surgery
(a balloon angioplasty and stent). Afterwards,
he changed his diet and increased his exercise,
and now does the equivalent of climbing stairs of
10 or 20 story buildings, although his aorta is
still enlarged and there is still a small block
somewhere. After the heart surgery, he was put
on some drug to lower cholesterol, which worked,
and on atenolol, a beta blocker. He was also
taking Wellbutrin (not SR) for depression, without
reported side-effects, since well before the heart
surgery. Other members of same family have also
been diagnosed with depression and have responded
well to medication.

Some of us who read drbob's web-site know beta
blockers can cause depression for those with a
history. Patient is pessimistic and tired.
Patient also suffers from interrupted sleep
apparently due to repeated need to use the
bathroom at night. Told this is normal aging.

He is also dealing with situational issues on
what to do with his time if he retires, and
that the job is no longer fun. He feels his
emotions are situational rather than the results
of internal chemistry, but according to the
personal story on drbob's one cannot always tell
from inside. Also, according to the discussion
on drbob's, atenolol is one of the less
bad beta blockers for causing depression,
which implies that the patient may well be correct
in his belief.

Both psychologist and cardiologist have been asked
about the situation. The cardiologist seems to view
that emotional health is not his department, and
that the state of the cardiac system suggests beta
blockers still advisable. The psychologist seems
to view that the cardiac medications are not his
department but that one could increase the dosage
of Wellbutrin. (This psychologist does not trust
Wellbutrin SR.)

How would one go about finding an M.D. in the
Northeastern U.S., with expertise BOTH in cardiology
and in depression? Are there any groups of doctors
that work together on this combination? Would an
external (more integrated) opinion on this
case be useful? How would one find it?





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