Posted by Janet on July 6, 1999, at 22:15:19
In reply to Re: Please, Doctors, Urgent Help Needed, posted by JohnL on July 6, 1999, at 20:49:30
John makes sense. Here's my opinion also, even though I doubt if you want to hear it:
Let's just say ,oh for the heck of it, you had this really bad disease that left you incapcitated, confused, even suicidal, wouldn't you do all you could to survive? People come down with cancer and can't give up hope just because they don't have a few hundred thousand dollars for chemo. Sell the horse, that could give you a couple visits with a private psychiatrist to get you started on the meds. Forget the county for now, they are no help. Sell your computer if you have to. Contact every church in town for $10 for meds. Beg some money from your relatives. Come on here, we're talking life and death here.If you are suicidal, no hospital can legally turn you away ,I don't think. I went to Belmont Hills south of South San Fransisco and got excellent care. There was a patient in there that had no insurance and they took her and set up a payment plan and was helping her to get the meds. she needed. I was diagnosed on my first interview there after spending a week of MANIA at a psychologist's house.He was a friend of mine. He didn't know what was going on. He had the book learning but hadn't seen it in an all blown bipolar episode. We all learned a lot that week.This is all I'm saying, I'm on your side. Don't let the system beat you. Go around it. Go to another general practioner until you find one that has a lot of experience in depression and mental illnesses. They'll tell you on the phone if they really do, quiz the nurse first to eliminate a lot.
There is probably a support group in your area that can give suggestions about doctors in your area. Remember, the doctor doesn't have to be THE ONE forever, just until you can get your head about you. AND DON'T WORRY ABOUT THE MONEY .
> >
> > I've been transferred to the general practice physician for the county now. I spoke with her, and she's not comfortable with treating me, but will if she can't find a way to get me back into the mental health system. She says that she knows something about anti-depressants, but not much.
> >
> > I also called the patient's rights advocate, who is also working on my behalf to get me in to see a psychiatrist. He says that he doesn't think it'll help, though.
> >
> > Anyway, since I apparently won't be able to see a doctor who knows much about anti-depressants, I wonder if anyone here would be willing to recommend a next step drug? I will tell you anything, either on this board or via email, about my responses to prior meds, and my fears currently about meds, and give you any information I can. I don't know what else to do. I need help, but can't seem to get it through the county health system. I can't afford to see a private doctor, and anyway can't afford to pay for the medications if I could find one, so I may be stuck with this doctor. Maybe if I could have someone with experience in these drugs making suggestions, that might help.
> >
> > Anyone willing to try? Or anyone willing to offer any other suggestions? Please, I'm so desperate! I don't necessarily want to die, but I can't take this sort of despair much longer. I'm just drained.
>
> So the new doc isn't an expert on ADs. That pretty much rules out combinations. You will most likely have to choose one of the more common choices of SSRIs, Wellbutrin, or TCAs, Serzone, or Remeron as monotherapy. Often simpler is better. There are some powerful experienced minds at this site. I bet if you laid out your history of drugs (what, dose, how long, why quit) and side effects you can and cannot tolerate, folks here could put two and two together and give logical suggestions to discuss with the doc. Would advice making your case as clear, concise, and to-the-point as possible (that will also be important when facing the doc). Right off the bat I like Remeron because you have insomnia real bad, and I think you mentioned somewhere you are skinny (?) so gaining a few pounds shouldn't be a huge concern. Without knowing more, that makes sense to me. But with more info, you can probably get great insight from folks here.
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> First things first though. The whole lousy situation has been based on SUBJECTIVE opinions. As soon as you sit down in the office request to take the Becks Depression Inventory Test, or some similar multiple choice questionnaire designed to determine OBJECTIVELY degree and type of depression. Maybe call ahead to make sure they have a depression screening test on hand. In my opinion it is crucial at this point to start a clean slate and get something objective in your records. If you take the test and your score shows you are moderately or severely depressed, then there is no way in hell any doctor can say you are doing OK. The doc should be quite willing and capable of giving this test, it only takes a couple minutes. But if there is any resistance at all, remind them that you need your test score reflecting how you feel right now today so we can measure progress in the future. Can't sail the seas with opinions can you? Nope, need a compass. Insist on it. We've been lost at sea too long already. JohnL.
poster:Janet
thread:8346
URL: http://www.dr-bob.org/babble/19990628/msgs/8362.html