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Re: self medicating: pdoc horror story pellmell

Posted by shelliR on September 30, 2001, at 14:09:31

In reply to Re: self medicating: pdoc horror story, posted by pellmell on September 29, 2001, at 20:29:12

> My pdoc poured a bucket of liquid nitrogen on my head tonight.
>
> Metaphorically, of course. Ok. I went to see him on Sept 14. Because of the awful things that happened just three days before, I felt petty talking about myself. Even for a 20 minute check-up session. So I told him the basics, and didn't protest when he decided I should stick with Effexor. I felt foolish telling him about my growing dissatisfaction with it. Maybe it's just me, but often when I describe how I think a drug is making me feel he gives me a really skeptical look. It makes me feel diminshed. And I don't say things like, "I seem to have more ingrown hairs on my ankles. I think it's the Effexor."
>
> Anyway, so I think I decided even before I left his office that I was going to try taking Wellbutrin as well (I had a month's supply left over from a failed trial with it alone). The next day I dropped down to 75mg of Effexor at night and took 150mg Wellbutrin SR in the afternoon. After a few days, I had more energy, could concentrate better, and was feeling more motivated. I was also feeling more *feelings*. I waited twelve days before I decided my improvement wasn't transient, and called my pdoc.
>
> I finally got his live voice on the other end of the line tonight. I explained to him what I'd done, that I was feeling better, and that I was probably one of his better educated (didn't say "most" or "best") patients on these matters because of the books I'd read and the time I spent on this board. And I was wondering...should I be taking two 100mg Wellbutrins through the day, instead of just one 150mg pill? And anyway, what did he think of all this?
>
> Oh boy. His response went something like, "It sounds like it would be a reasonable idea. If I came up with it. If you're going to 'self-medicate' like this, you're not my patient anymore. It's that simple. You're not a physician I'm not going to be responsible for people who self-medicate."
>
> I was shocked. I stammered something like, "Err...um...would you have been upset if I just went down on the Effexor?" Stuff like that. Then he said, "If you want me to continue to be your prescribing doctor, we should sit down and talk face-to-face." I'm going to call on Monday and try to get an appointment next week. The last thing I said was, "I didn't expect this to happen." He let out an incredulous chuckle and said, "Neither did I."
>
> I was reeling for about half an hour from this conversation.
>
> Is this a normal doctorly reaction? I've been reading this board at least three times a week and pretty thoroughly since May, and I haven't seen anyone talk about anything like this. A few doctors in Dr. Bob's Tips section talk about how their patients have tried things without their permission and come up with amazing results. I Did I really cross some line somewhere?
>
> It's not like I looked in my medicine cabinet and said, "Oooh, this pill looks pretty with this one! If I swallow them both it'll do wonders for the interior decorating in my stomach!" I researched thoroughly. I knew absolutely that I wasn't doing anything dangerous. I wanted to feel better. I was tired of feeling awful and anxious without drugs, and content and slothful on SRIs. I wanted to try something different. And I think it has worked, too.
>
> ..sigh.. So, ugh. I'd appreciate anyone's reaction to this story.
>
> Thanks,
>
> -pm

I don't really don't think that you handled things right. You say that your pdoc looks at you skeptically when you bring up things, and that diminishes you. I think that that's where you need to step up and keep your confidence, and say "I'll like to try adding Wellbutrin." If your doctor says, no without a good reason, then I think you need to find a doctor who is willing to accept your input and also to be more creative in his decisions. My pdoc hasn't always liked my choices, but we hash it out and he accepts them. That keeps him involved in my process. The last time I wanted to mix nardil and wellbutrin, my doctor was not enthusiastic, but he made sure that I would take my bp several times a day, etc. Then I felt that I would have the right to call him if I had a bad reaction. To decide not to tell your doctor, puts him in the uncomfortable position of perhaps picking up your pieces. In this case, that didn't happen, but I would be upset if I didn't know my patient was even taking a drug then they called me to ask when in the day I should take it. I see what you did as a slap in his face, even more so because then you called him *afterwards* and asked for his opinion. I think the collaboration should be both ways, and you both should be working for that. I mean if you are self-medicating, why even go to him?

Shelli


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poster:shelliR thread:79822
URL: http://www.dr-bob.org/babble/20010927/msgs/79945.html