![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 28 to 52 of 83. Go back in thread:
Posted by Phillipa on August 30, 2006, at 17:54:37
In reply to Re: Last Ditch Effort to Save My Life, posted by linkadge on August 30, 2006, at 17:28:26
Link was it math you were into? I feel strongly research is your passion. Love Phillipa
Posted by jealibeanz on August 30, 2006, at 18:26:17
In reply to Re: Last Ditch Effort to Save My Life, posted by exquilter on August 30, 2006, at 15:11:23
That would be a nice option, but unfortunately in my graduate program, it's not an option. Each class of 30 students starts and ends together. There's no room for failure, deviation, or breaks. It's 15 months of coursework.
Posted by jealibeanz on August 30, 2006, at 18:32:10
In reply to Re: Last Ditch Effort to Save My Life, posted by linkadge on August 30, 2006, at 17:28:26
Hmm... it does seem that we are almost complete opposites. I can do any type of school work basically in my sleep with little effort. It's not too difficult in that way.
My problems stem in just plain old unhappiness... I could be doing horribly difficult, challenging torturous tasks, yet be happy at times. While during other times, I could be in the most relaxed and ideal situation and completely miserable about everything without reason.
Posted by linkadge on August 30, 2006, at 21:30:33
In reply to Re: Last Ditch Effort to Save My Life, posted by jealibeanz on August 30, 2006, at 18:32:10
Well, I guess knowing yourself is the most important thing.
I regret having fooled myself for so long.
I wasn't doing what I wanted to do. I wasn't where I wanted to be. School imposed a great number of stressors that I wasn't emotionally prepared for.
Sure I was given stims, AD's, sedatives, anticonvulsants, antipsychotics, but in hindsight who wouldn't loose concentration at the volume of work assigned to me. Who wouldn't become depressed at the demands, and the lack of slack afforded.
I am doing fairly well, but the work is still too hard!!
Sorry for my mutterings :)
Linkadge
Posted by Ts6639 on August 31, 2006, at 5:56:04
In reply to Re: Last Ditch Effort to Save My Life, posted by linkadge on August 30, 2006, at 21:30:33
I had similar problems dealing with my mental illness, while completing my Masters, while running the gauntlet of medications. I did have the luxery of taking a medical leave for a semester to try and get my act together. I feel for your struggle. I am now applying for law school and hope I don't find myself in a similar situation. I hope by the time I begin that I will have found the magical cocktail. Let us know how you do. I appreciate your sharing your personal experience. Depression and anxiety is wrecking havoc with me know. Gritting my teeth to just get through the day.
Posted by bassman on August 31, 2006, at 10:36:10
In reply to Re: Last Ditch Effort to Save My Life, posted by Ts6639 on August 31, 2006, at 5:56:04
I dropped out of grad school for a year because the depression/anxiety was so bad I just didn't make the classes I needed to, plus my mental processor was mighty slow. I went back a year later and got my Ph.D. during a little rest from mental illness. I was lucky. Best of luck...
Posted by llrrrpp on August 31, 2006, at 10:59:13
In reply to Re: Last Ditch Effort to Save My Life, posted by bassman on August 31, 2006, at 10:36:10
Jeali,
I'm a student too, and it's so hard to try to maintain a high level of performance when those around you seem to have it much easier.Are you getting any kind of counseling/therapy to help you deal with the lifestyle/environmental issues that are getting you so down?
And, perhaps taking a semester leave of absence is not a bad plan, or take your classes pass/fail if that's an option. Take care of yourself, and your passions will return. you can do this.
Write a list, or an e-mail. Tell pdoc how miserable you are. Your pdoc sounds very sympathetic, and you guys have a good relationship. He will definitely try to help you.
In the meanwhile, figure out where you want to be when you are recovering. Do you want to be in a safe place, where you can take a walk in the afternoon and not worry about the homework that you are presently neglecting? Do you want to have a freezer stocked with healthy organic frozen entrees for you to pop in the microwave when you have no energy to cook? You can make these things happen for yourself. Cut down on some of your obligations, and spend an afternoon stocking your place so that you can feel at ease, comfortable and nurtured. Buy yourself some fresh flowers, and some bubble bath. Make your bed and put some light reading material nearby for when you just want to chill out.
Trust me, if you want to be taken care of, home is the best place to start. Make it your comfort pod.
Your psychosomatic spa.Best of luck to you- sending you some healing vibes~~~~~~~~~~~~~~~~~~~~~~<><><><><><><
-ll
Posted by jealibeanz on August 31, 2006, at 11:35:52
In reply to Re: Last Ditch Effort to Save My Life, posted by llrrrpp on August 31, 2006, at 10:59:13
This is my situation in terms of school... I either go non-stop, for 15 months with a predetermined curriculum, maintaining an 80% in every class, or I'm out. There's no way to stop or take a shorter load.
I have a couple days to think about it. I was questioning whether I should tell my doctor about my decision to leave school, but I think I should. It's important piece of information.
I appreciate the comments on making time for myself. That's very kind and helpful.
Posted by llrrrpp on August 31, 2006, at 12:00:46
In reply to Re: Last Ditch Effort to Save My Life, posted by jealibeanz on August 31, 2006, at 11:35:52
Jeali,
Have you looked into the possibility of a medical leave of absence? Do you have an advisor, or a dean, or a counsellor that can help you make this decision? I just would hate for you to make a hasty decision because your mind is not in the right place to consider all the possibilities. At the very least, speak with your pdoc. He (she?) might be able to contact someone in the administration of your program, or perhaps he can help you figure out what is best for you right now and for your future.(((((Jealibeanz)))))
I hope your appt. goes well. I'll be thinking of you
-ll
Posted by jealibeanz on August 31, 2006, at 14:09:09
In reply to Re: Last Ditch Effort to Save My Life » jealibeanz, posted by llrrrpp on August 31, 2006, at 12:00:46
At this point, I'd have to drop out and reapply. It's very tough to get into any school and the admissions process is terribly intricate and time consuming when dealing with multiple schools. So, this would mean changing directions, career wise. I don't know, maybe it wasn't meant to be.
Posted by llrrrpp on August 31, 2006, at 14:27:34
In reply to Re: Last Ditch Effort to Save My Life, posted by jealibeanz on August 31, 2006, at 14:09:09
Jealibeanz,
this sounds like the beast of depression is talking for you. It's cruel. It saps your dreams and passions, and makes you wonder if you ever had any. I think you DID have this dream, but the beast of depression is not letting you access your dream.((((((((Jeali)))))))))
Don't give up on yourself yet. Please wait to see what pdoc says. You've made it so far, and you are smart and capable enough to do the work, if you can convince the beast to let you free. Hoping that a medicine tweak will do the trick for you, and that a conversation with pdoc, who cares what happens to you, will momentarily distract the beast, allowing you the freedom to realize your real future.
-ll
Posted by jealibeanz on August 31, 2006, at 16:49:40
In reply to Re: Last Ditch Effort to Save My Life » jealibeanz, posted by llrrrpp on August 31, 2006, at 14:27:34
Thanks... yeah, it is the depression making me feel this way. My doctor (actually not a pdoc, a DO) would recognize this based on the enthusiastic conversations we've had together aboutour mutual interest and passion. Me claiming to have no desire to continue would evoke a double-take, no doubt.
I know most people here praise pdocs, especially over GP's, but I'm not so comfortable with the idea. This is partly based one bad experience with a pdoc, and actually bad experiences with other GP's, so I guess I biased just because I prefer my own doctor on a personal level.
Anyway, I like that he can treat my body, not just the emotional aspect of the disease. He can do physical exams. He can run tests. I actually should have another thyroid test done. I don't care that I've had it done twice before in my life. If I'm anywhere near the low end up normal, I bed it wouldn't hurt to try some augmentation, especially considering my fatigue even while rested. He's probably more capable of prescribing medications to counter physical side effects than a pdoc.
Posted by Phillipa on August 31, 2006, at 18:42:57
In reply to Re: Last Ditch Effort to Save My Life, posted by jealibeanz on August 31, 2006, at 16:49:40
True but I have low thyroid and the numbers for normal have changed . Now between l-3 is normal. And the docs like them low. Love Phillipa
Posted by jealibeanz on August 31, 2006, at 19:54:48
In reply to Re: Last Ditch Effort to Save My Life » jealibeanz, posted by Phillipa on August 31, 2006, at 18:42:57
Yeah, I am aware that normals have changed, and also that many haven't completely adapted their practice to new standards. Plus, what's optimal for an individual may not actually be within the normal range, so it's difficult to correctly diagnose and treat thyroid disorders.
Posted by bassman on August 31, 2006, at 20:16:03
In reply to Re: Last Ditch Effort to Save My Life, posted by jealibeanz on August 31, 2006, at 16:49:40
I've had MUCH better experience in terms of being effectively treated by my personal internists through the years as opposed to pdocs, so I couldn't agree more. All the pdocs I've gone to were crazier than I am.
Posted by jealibeanz on August 31, 2006, at 20:37:27
In reply to Re: Last Ditch Effort to Save My Life, posted by bassman on August 31, 2006, at 20:16:03
Yeah, GP's tend to have very good people skills. They interact with all kinds of patients with differing ailments, so they have to be very flexible and open minded, and various colleagues. A lot of mental health practitioners just seem to isolated and narrow minded. It's an entirely different method of practice. Their approach, in general, just seems so cold and accusatory to me. I'd rather go to a caring and inviting doctor any day, over an unapproachable pdoc with vast knowledge of psych meds. The attitude is more important to me and my progress.
Posted by Phillipa on August 31, 2006, at 20:57:08
In reply to Re: Last Ditch Effort to Save My Life, posted by jealibeanz on August 31, 2006, at 20:37:27
Very good point. And they say pdocs choose that specialty to solve their own problems. Love phillipa
Posted by nickguy on August 31, 2006, at 21:35:30
In reply to Re: Last Ditch Effort to Save My Life » jealibeanz, posted by Phillipa on August 31, 2006, at 20:57:08
> Very good point. And they say pdocs choose that specialty to solve their own problems. Love phillipa
It took me a while to find a good Pdoc and now I have the most laid back, caring, smiley-type guy who wants to try all kinds of treatments to do whatever gets me feeling better. I had 2 HORRIBLE pdocs before this, so don't give up on them even after 2 or 3 bad ones. The advantage is that they do have a much wider knowledge of the meds, and experience with using them on different types of people.
Posted by jealibeanz on August 31, 2006, at 23:27:56
In reply to Re: Last Ditch Effort to Save My Life, posted by nickguy on August 31, 2006, at 21:35:30
I'm trying to write up a script/list of issues I want to bring up. If anyone want to hear or critquw just babble mail me!
Posted by llrrrpp on September 1, 2006, at 7:35:27
In reply to Re: Last Ditch Effort to Save My Life, posted by nickguy on August 31, 2006, at 21:35:30
Yes, and two further advantages of pdocs is that 1)They often have more experience dealing with people in acute psychological distress. So, they often have the ability to do some talk therapy too, just to make sure that you are getting to the bottom of the issues, rather than treating some biochemical consequence of one's lifestyle.
2)The drugs in their toolbax don't come with very good instructions, so experience is SO important- so that they can tell you whether your side effect is typical, or troublesome, and give you good advice on withdrawal effects, augmentation strategies, and side effects with one's lifestyle (e.g. alcohol abuse...)BUT
I'm often frustrated that my pdoc doesn't treat my whole body- no monitoring of my b.p. or blood sugar or any of that stuff. So, I have to get that done on my own. Not a big deal, because I'm basically healthy- but what if I had complications from some other condition? I'd want my mind and body treated as one, not as two separate systems!
-ll
good luck today jeali. If you want to post your script, go for it. Psychology board is a good place too, for practicing how you're going to tell your doctor about your suffering. Nice people over there.
Posted by jealibeanz on September 1, 2006, at 8:03:13
In reply to Re: Last Ditch Effort to Save My Life » nickguy, posted by llrrrpp on September 1, 2006, at 7:35:27
OK, here's my attempt at an outline for tomorrow. I'll try to make this as brief as possible.
1. Reason for Appointment: Insomnia
It's been 3 weeks since my last appointment. During that time I basically slept about 18 hours a day. I was sleeping a little more through the night, but constantly fatigued and felt the need to sleep nonstop.
Once I started classes, I was back to only sleeping 2 hours at night. In effort to sleep throughout the night I've taken 8 mg one night, 3 mg Lunesta and Tylenol Sinus PM a couple of others, Ambien CR 12.5 mg and Tylenol Sinus. The 8mg Lunesta helped, but I had difficulty waking the next day. Ambien makes me feel dizzy, drunk, gives me nightmares and I sleepwalk.
I'd like to try another medication to help me sleep...
I need to mention that until the past year, I never had insomnia. In fact, I used to sleep alot. The fact the I've been sleeping 18 hours on non-class days concerned me. I've been through an entire year like that in the past.
If he asks how I got through that year: I had a script for Provigil (and a little Xanax), but only took it for about a month. It helped. I moved to transfer schools and had no doctor. I just continued to sleep as much as possible in effort to have the energy to go to school, but it was basically all I did for a year... take multiple naps and go to classes. I was alllways tired and sleeping never truely helped me feel better.
I see myself falling into that pattern again. It's not a normal type of fatigue, due to lack of sleep. It's am overwhelming feeling, like my body is heavy and I can't get up...
Posted by jealibeanz on September 1, 2006, at 8:26:27
In reply to Tomorrow Part 1, posted by jealibeanz on September 1, 2006, at 8:03:13
I don't plan on going back to school. I can't get through it if I feel like this. Plus, I'm not sure it's what I truely want anymore.
I'm hoping HE makes my life a little easier and follows up on my complaint of depression from our last appointment, and the obvious indication from how I've described the last few weeks.
So, right, I'm not happier. It's not just since the Straterra experiments, I've been struggling with little ups and downs for the past year. The only things that help are exercise to some extent (but I'm just too tired to be consistent right now. Also, I've grown to hate working out, which is soo abnormal for me), and coffee to a larger extent. It's a major mood booster for me, but still I don't drink much because I'd have to drink coffee non-stop to be helped.
The Effexor did help, but I hated the extreme apathy. I didn't want to take it anymore because I felt that I'd rather feel horrible than feel nothing at all. Funny, it's easy to say that at the time when you aren't feeling anything.
I haven't the general feeling that I just don't like any reuptake inhibitor. While the meds I've taken are all very different (Paxil, Wellbutrin, Effexor), they all caused the apathy and weight gain which I don't want to go through again... So, I really don't think I want an SSRI.
At this point I could:
1. Ask if there's been any new antidepressants released.
2. Tell him I'd heard about EMSAM in class and ask him what he thinks about it.
3. Tell him I've read about EMSAM in my texts.
4. Agree that I hate AD's (in most GP's mind, that only includes SSRI/SNRI's) and don't want one. Pretend that I'm OK with the way things are going, dropping out of school, waiting things out. Hopefully walking out with a script for a sleeping med and nothing else. This really is the most likely one because I'm feeling tired and wimpy right now.
Ahh... I'm afraid I'll just get upset and cry and forget everything. The intelligent and informed part of me could get a lot out of this appointment tomorrow. The emotional part just might breakdown and be helpless.
Posted by llrrrpp on September 1, 2006, at 10:23:00
In reply to Re: Tomorrow Part 1, posted by jealibeanz on September 1, 2006, at 8:26:27
> I don't plan on going back to school. I can't get through it if I feel like this. Plus, I'm not sure it's what I truely want anymore.
>
> I'm hoping HE makes my life a little easier and follows up on my complaint of depression from our last appointment, and the obvious indication from how I've described the last few weeks.
>
> So, right, I'm not happier. It's not just since the Straterra experiments, I've been struggling with little ups and downs for the past year. The only things that help are exercise to some extent (but I'm just too tired to be consistent right now. Also, I've grown to hate working out, which is soo abnormal for me), and coffee to a larger extent. It's a major mood booster for me, but still I don't drink much because I'd have to drink coffee non-stop to be helped.
>
> The Effexor did help, but I hated the extreme apathy. I didn't want to take it anymore because I felt that I'd rather feel horrible than feel nothing at all. Funny, it's easy to say that at the time when you aren't feeling anything.
>
> I haven't the general feeling that I just don't like any reuptake inhibitor. While the meds I've taken are all very different (Paxil, Wellbutrin, Effexor), they all caused the apathy and weight gain which I don't want to go through again... So, I really don't think I want an SSRI.
>
> At this point I could:
>
> 1. Ask if there's been any new antidepressants released.
>
> 2. Tell him I'd heard about EMSAM in class and ask him what he thinks about it.
>
> 3. Tell him I've read about EMSAM in my texts.
>
> 4. Agree that I hate AD's (in most GP's mind, that only includes SSRI/SNRI's) and don't want one. Pretend that I'm OK with the way things are going, dropping out of school, waiting things out. Hopefully walking out with a script for a sleeping med and nothing else. This really is the most likely one because I'm feeling tired and wimpy right now.
>
> Ahh... I'm afraid I'll just get upset and cry and forget everything. The intelligent and informed part of me could get a lot out of this appointment tomorrow. The emotional part just might breakdown and be helpless.
>(((((Jealibeanz)))))
It's okay to break down and be helpless. Sometimes we need to just let it out, and have a witness. Sometimes it's okay to say- I need help. I'm a mess. Don't be scared to be honest with your feelings. You sound like you have depression, and it's time to find something that will give you some relief. If you had a broken leg and went to a doctor and pretended to walk on it like it was just fine- well, you'd be nuts! If you have depression, it's okay to let the symptoms show. That's the best way to treat you. And if you have a policy of trying to be too good, and too strong, (like me) then you may find yourself in a bad place. Emotions are there for a reason. Feel them. Let them run their course. It's okay. Really. Even when it's embarrassing. Your doctor sounds so kind. He will take care of you, and if you cry in the office, maybe it will help you cope better in the outside world.Good luck Jeali!
How about seroquel? My pdoc uses it to help me with the insomnia. It took a week of experimenting with the doses. I know that it I have to be super functional at 8 am to take 12.5 mg. If I'm in need of sound sleep for 9 hours, i take 50 mg, and for most nights I take 25 mg to help me sleep from 11pm-7am, with some yawning and stuff before the day begins.
In addition to being a sedative, seroquel is a mood stabilizer, and I believe that it has subtle AD and anxiolytic effects too. My most profound observation is that the bad thoughts that woke me up nightly at 3am have totally stopped. even if I wake up by accident at 3am (stupid car alarms), i feel tired and sleepy, not panicked and anxious.
Best of luck Jealibeanz (((((hugs)))))
-ll
Posted by jealibeanz on September 1, 2006, at 12:24:54
In reply to Re: Tomorrow Part 1 » jealibeanz, posted by llrrrpp on September 1, 2006, at 10:23:00
Thanks for the encouragement. Yeah... I am a mess! I am an extremely emotional and sensitive person. Sometimes that's a good thing, sometimes that's a bad thing. I'm almost too sensitive to my emotions and body... so if things aren't going well, I'm verrry aware of it. However, I think my input could be very helpful in my treatment since I have such acurate sensitivity and intuition about myself.
My PA knew I was a mess! He basically told me so, but not in an unkind manner. It was just his way of saying... wowwww... you've gotten completely out of wack within the few months that I've known you. (I was interning/shadowing there for a while, so he saw the bright, ambitious, confident side of me... then... my complete crash. I stopped doing my internship there once I needed to go back as a patient. It was a big conflict of interest in my opinion.) We need to fix this! I actually think his ability to see this is partially due to the fact that he's not thaaat much older than me, maybe about 29 or so.
He's the one I began treatment with this year when my doc was on break for a week. It was first for insomnia, then anxiety, then depression, then my own unexplained illness where I was freaking out and thought I was dying... Haha, I had been sick with a bad cold for two months, which I thought was soo not normal since I'm never even get sick with a cold for a few days (it most likely because I had wayyy overworked myself with school, work, interning, and the never ending task of applying and interviewing for pharmacy and PA schools).
I'm very healthy. So, he checked lymph nodes and decided to run some blood tests and check my thyroid to rule out an underlying disease.
Then at a Lunesta checkup I decided I needed to be put on medication for my ADHD since I hadn't ever been consistently treated with medication and suddenly was having major issues concentrating. His thought was that it was the anxiety. My thought was that since my ADHD had been out of control, it caused major anxiety because I couldn't get myself to concentrate long enough to do school work, simple household tasks, and was becoming verrry forgetful and scatterbrainws. This all caused more anxiety.
We were both partially correct in my opinion. But when he was saying that my anxiety needed to be under control, I just was afraid of what his approach would be. I didn't want an SSRI. I don't think cognitive therapy has ever been helpful, if anything, just caused more hyperawareness and stress.
I had had a bad reaction to Klonopin earlier and knew he wasn't keen on benzos anyway. He's not technically allowed to write his own script for them, so he's definitely not comfortable messing around with something he couldn't authorize, didn't have great confidence in, and had given me past problems. That could get him into trouble. So he gave in and gave me Straterra. Haha, he was just trying to please me with a med he considered to be very safe.
He had to turn me over to my actual physician anyway because PA's need to have supervisors check in on their patients every so often. So my doc hasn't actually been through the recent turmoil with me directly. My PA might be a little more in tune with my distress since he saw me when I fell to a huuuuge low point last fall. However, he's not really comfortable being super aggressive and risky.
My doctor has the potential to be. He just hasn't experienced my distress first hand and long enough to truely recognize the need forit himself without me being very blunt. Until recently he just thought I was a cool little chick who could possibly come back and work with his practice in a few years!
Posted by llrrrpp on September 1, 2006, at 12:47:13
In reply to Re: Tomorrow Part 1, posted by jealibeanz on September 1, 2006, at 12:24:54
You are still a cool little chick who can come back and work in his office in a few years. I bet in that environment you'd do really well. I hope that you get stabilized soon so that you can get on with the rest of your life. In the meanwhile, just take it easy.
best,
-ll
Go forward in thread:
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.